Explanations for Gender Incongruence (AQA A Level Psychology): Revision Note

What is gender incongruence?

• The ICD-11 (2022) defines gender incongruence as the feeling of a mismatch between one's assigned biological sex and one's experienced gender, which often leads to a strong desire to ‘transition,' i.e., to be a different gender than the assigned sex

  • E.g., a boy feels like he is a girl and wants to live as a girl, as he experiences distress at living within the assigned sex of male

    • They have a strong desire to change their primary and/or secondary sex characteristics to match the experienced gender

• For a diagnosis of gender incongruence, the incongruence must have persisted for about two years and cannot be assigned before the onset of puberty

  • Certain criteria must be met to ensure that the experience is consistent, persistent, and not temporary

Biological explanations for gender incongruence

• Biological explanations of gender incongruence focus on the influence of genetics, hormones and brain structure differences

Genetic explanation

• Heylens et al. (2012) examined 23 identical (Monozygotic, MZ) and 21 non-identical (Dizygotic, DZ) twin pairs in which one twin had gender incongruence. They saw concordance in 39% of the MZs but in none of the DZs

  • This suggests a genetic component to gender incongruence

• Hare et al. (2009) compared DNA from 112 transgender women with 258 cisgender men and found that the transgender group more often carried a variant of the androgen-receptor gene known to reduce the receptor’s sensitivity to testosterone

  • This suggests that reduced androgen signalling may contribute to gender incongruence

Hormonal explanation

• Berenbaum and Bailey (2003) reviewed cases of congenital adrenal hyperplasia (CAH), a genetic condition where the adrenal glands produce excess androgens in XX foetuses, which can lead to male external genitalia

  • The study found that around 5-10 % later reports significant gender incongruence, far higher than in the general female population.

• Hines (2004) found that XY individuals with complete androgen-insensitivity syndrome (CAIS) exposed to virtually no effective testosterone before birth almost invariably develop a female gender identity despite having XY chromosomes

  • This suggests that atypical levels of prenatal hormones contribute to gender incongruence

Brain structure explanation

• Brain-sex theory proposes that gender incongruence arises when certain sexually dimorphic brain regions develop with the template of the opposite sex

• One such region—the bed nucleus of the stria terminalis (BSTc), typically about 40 % larger in males than in females—illustrates this mismatch

• Postmortem research on six transgender women (male-to-female) showed that their BSTc was the same size as that generally seen in cisgender women (Zhou et al., 1995)

  • A later study confirmed that their BSTc contained an average neuron count within the normal female range (Kruijver et al., 2000)

Social/cultural explanations for gender incongruence

• Social explanations of gender incongruence explain it as a result of learned behaviour, with children gaining positive reinforcement from parents and/or peers for exhibiting behaviour usually associated with the opposite gender

• Thus, gender incongruence is explained as the result of socialisation; just as children are socialised into their usual gender roles, so they may be socialised into opposite gender roles 

• This could be the result of parents desiring a girl but instead having a baby boy and positively reinforcing feminine behaviours, either consciously or unconsciously.

Social psychological research which investigates gender incongruence

• Littman (2019) conducted interviews with parents of adolescents with gender incongruence and found that parents felt that this was a case of positive reinforcement from peers leading to these young people developing the disorder

Evaluation of the biological and social explanations of gender incongruence in A Level Psychology

Strengths

• Biological research can lead to successful hormone treatment for gender incongruence

• Research suggests that social explanations for gender incongruence have to be accepted when there are no physiological brain differences to be found between those with gender incongruence and those who do not experience it

Limitations

• There is a lack of empirical evidence for a social explanation – even Littman’s research (above) had to be withdrawn and revised substantially to show that this was just parental opinion

• Cause and effect cannot be established in biological explanations of gender incongruence, as it may be that brain changes happen after gender incongruence is present and could be a result of living as the opposite gender rather than before

Issues & Debates

• Biological accounts are biologically deterministic, implying individuals have little control over their experienced gender identity due to genetics, hormones or brain structure

  • However, the decision to transition and express gender identity suggests an element of free will and personal agency, especially within supportive cultural contexts

• Most research is Western-centric, which may overlook how different cultures experience or interpret gender

  • For example, third-gender roles (e.g., Hijra in India) suggest that gender diversity is not universally viewed as pathological

  • This highlights a cultural bias in Western diagnostic frameworks like the ICD