Sexual incongruities and psychopathology: the evidence of human hermaphroditism
Money, J.; Hampson, J.G.; Hampson, J.L.
Bulletin of the Johns Hopkins Hospital 98(1): 43-57
1956
ISSN/ISBN: 0097-1383 PMID: 13276721 Document Number: 9896
Ninety-four hermaphroditic patients, representing eight varieties of hermaphroditism, have been under comprehensive psychologic and psychiatric study, and their psychologic healthiness has been appraised. On a four point rating scale, the 94 cases were distributed as follows: 63 healthy, 16 mildly nonhealthy, 14 moderately nonhealthy, 1 severely nonhealthy. The one severely nonhealthy patient was a congenital mental defective. Absence of psychosis, or rather lack of a high incidence of the so-called functional psychoses, is considered the most noteworthy finding of this study. There was a marked tendency for mild and moderate nonhealthiness to show up as an excess of inhibitory and control functions of the personality. The symptoms included, among others, retardation of psychologic growth and personality development relative to IQ and life age; depressive moody spells; sullen and anxious bashfulness and shyness; and extreme but circumscribed diffidence and guardedness pertaining to sexual and romantic situations. A rating of healthy was more common among infants and juveniles than among teenagers and adults, doubtless because the younger patients in our series had not experienced the impact of their hermaphroditic paradox with the same full force as the older patients had. A rating of healthy was also more common among patients whose body morphology, irrespective of gonads and chromosomes, was unambiguous looking than among those whose sexual appearance was equivocal. Patients whose sex of rearing was contradicted by chromosomal or gonadal sex were not necessarily destined to receive a nonhealthy rating. Reassignment of the sex of rearing after the early months of life was extremely conducive to subsequent psychologic nonhealthiness. Corrective surgical, hormonal or psychologic procedures were more beneficial if applied during infancy or childhood than later. Adaptation to a physiologic normalcy first induced during adulthood was seen to be a complex and difficult psychologic process, notably in adult hyperadrenocortical female pseudohermaphrodites feminized on cortisone therapy.
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