caa a22 4500 60623246X CHVBK 20210128101227.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s10508-014-0385-0 doi (NATIONALLICENCE)springer-10.1007/s10508-014-0385-0 Increased Cross-Gender Identification Independent of Gender Role Behavior in Girls with Congenital Adrenal Hyperplasia: Results from a Standardized Assessment of 4- to 11-Year-Old Children [Elektronische Daten] [Vickie Pasterski, Kenneth Zucker, Peter Hindmarsh, Ieuan Hughes, Carlo Acerini, Debra Spencer, Sharon Neufeld, Melissa Hines] While reports showing a link between prenatal androgen exposure and human gender role behavior are consistent and the effects are robust, associations to gender identity or cross-gender identification are less clear. The aim of the current study was to investigate potential cross-gender identification in girls exposed prenatally to high concentrations of androgens due to classical congenital adrenal hyperplasia (CAH). Assessment included two standardized measures and a short parent interview assessing frequency of behavioral features of cross-gender identification as conceptualized in Part A of the diagnostic criteria for gender identity disorder (GID) in the DSM-IV-TR. Next, because existing measures may have conflated gender role behavior with gender identity and because the distinction is potentially informative, we factor analyzed items from the measures which included both gender identity and gender role items to establish the independence of the two constructs. Participants were 43 girls and 38 boys with CAH and 41 unaffected female and 31 unaffected male relatives, aged 4- to 11-years. Girls with CAH had more cross-gender responses than female controls on all three measures of cross-gender identification as well as on a composite measure of gender identity independent of gender role behavior. Furthermore, parent report indicated that 5/39 (12.8%) of the girls with CAH exhibited cross-gender behavior in all five behavioral domains which comprise the cross-gender identification component of GID compared to 0/105 (0.0%) of the children in the other three groups combined. These data suggest that girls exposed to high concentrations of androgens prenatally are more likely to show cross-gender identification than girls without CAH or boys with and without CAH. Our findings suggest that prenatal androgen exposure could play a role in gender identity development in healthy children, and may be relevant to gender assignment in cases of prenatal hormone disruption, including, in particular, cases of severely virilized 46, XX CAH. Springer Science+Business Media New York, 2014 Androgens nationallicence Congenital adrenal hyperplasia (CAH) nationallicence Gender dysphoria nationallicence Gender identity nationallicence Pasterski Vickie Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut Zucker Kenneth Gender Identity Service, Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada aut Hindmarsh Peter Institute of Child Health, University College London, London, UK aut Hughes Ieuan Department of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK aut Acerini Carlo Department of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK aut Spencer Debra Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut Neufeld Sharon Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut Hines Melissa Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut Archives of Sexual Behavior Springer US; http://www.springer-ny.com 44/5(2015-07-01), 1363-1375 0004-0002 44:5<1363 2015 44 10508 https://doi.org/10.1007/s10508-014-0385-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10508-014-0385-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pasterski Vickie Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut NATIONALLICENCE 700 1- Zucker Kenneth Gender Identity Service, Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Hindmarsh Peter Institute of Child Health, University College London, London, UK aut NATIONALLICENCE 700 1- Hughes Ieuan Department of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK aut NATIONALLICENCE 700 1- Acerini Carlo Department of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK aut NATIONALLICENCE 700 1- Spencer Debra Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut NATIONALLICENCE 700 1- Neufeld Sharon Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut NATIONALLICENCE 700 1- Hines Melissa Department of Psychology, Free School Lane, University of Cambridge, CB2 3RQ, Cambridge, UK aut NATIONALLICENCE 773 0- Archives of Sexual Behavior Springer US; http://www.springer-ny.com 44/5(2015-07-01), 1363-1375 0004-0002 44:5<1363 2015 44 10508