Psychosexual Outcome Among Iranian Individuals With 5α-Reductase Deficiency Type 2 and Its Relationship With Parental Sexism.
Few studies exist on the psychosexual outcome of homogeneous groups of individuals with 5α-reductase deficiency type 2 (5α-RD-2) and the relation between gender changes and parental hostile and benevolent sexism, which are two components of ambivalent sexism that assume a stereotypical approach toward women in an overtly negative way or a chivalrous, seemingly positive way.



To report on the psychosexual outcome of individuals with 5α-RD-2 and to investigate its relation to the level of parental sexism in a relatively large sample of Iranians with 5α-RD-2.



Twenty participants (mean age = 19.5 years, SD = 6.345) with a molecularly confirmed diagnosis of 5α-RD-2 who were assigned the female gender at birth and raised as female were included in the study. Participants and their parents were interviewed and their medical records were assessed. Parents also completed the Ambivalent Sexism Inventory (ASI), which includes hostile and benevolent sexism subscales.



Psychosexual outcome and parental hostile and benevolent sexism measurements.



Twelve of 20 participants (60%) were diagnosed with gender identity disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). Ten of these transitioned to the male gender. The other 10 participants (50%), including the two diagnosed with gender identity disorder not otherwise specified, continued living in a female gender role. When comparing the ASI subscale scores between families of participants who changed their gender and those who did not, no significant difference was found for ASI total and hostile sexism scores, but there was a difference for benevolent sexism (P = .049): those whose daughters had changed their gender had higher benevolent sexism scores.



The high prevalence of gender change and gender dysphoria reported in the literature was confirmed in this relatively large and homogeneous sample of Iranians with 5-α-RD-2 raised as female. Prenatal exposure to testosterone is hypothesized to play a role in the development of gender identity and sexual orientation, but parental attitudes also might be important. Although gender change in individuals with 5-α-RD-2 is often attributed to high levels of hostile sexism in some cultures, our findings show this to be associated with benevolent sexism.
Evolution and Human Behavior Group, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Behzad S
BS
Khorashad
Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran.
Zahra
Z
Aghili
Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands.
Baudewijntje P C
BP
Kreukels
Department of Pediatric Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mehran
M
Hiradfar
Evolution and Human Behavior Group, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Ghasem M
GM
Roshan
Endocrine Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mozhgan
M
Afkhamizadeh
Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Reza
MR
Abbaszadegan
Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Nosrat
N
Ghaemi
Evolution and Human Behavior Group, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: behnazkhazai@icloud.com.
Behnaz
B
Khazai
Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands.
P T
PT
Cohen-Kettenis
D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase / Q000172:deficiency*; D000293:Adolescent; D000328:Adult; D058490:Disorder of Sex Development, 46,XY / Q000523:psychology*; D005260:Female; D000068116:Gender Dysphoria / Q000523:psychology*; D005783:Gender Identity; D006791:Hostility; D006801:Humans; D007021:Hypospadias / Q000523:psychology*; D007492:Iran; D008297:Male; D010290:Parents / Q000523:psychology*; D012189:Retrospective Studies; D012727:Sex Characteristics; D063507:Sexism / Q000523:psychology*; D043202:Steroid Metabolism, Inborn Errors / Q000523:psychology*; D055815:Young Adult
D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase
5-α Reductase Deficiency Type 2; Ambivalent Sexism Inventory; Disorders/Differences of Sex Development; Intersex Conditions; Parental Sexism; Psychosexual Outcome