GENDER-SOCIETY-Week-4.pdf

WEEK 4 G E E 1 - G E N D E R A N D S O C I E TY Instructor: MRS. IRINE VELARDE-QUITCO, LPT  WEEK 4 - Gender and Society Topic: MEDICAL AND SOCIAL CONSTRUCTS OF GENDER Expected Competencies: At the end of this session, the students will be able to:...

WEEK 4 G E E 1 - G E N D E R A N D S O C I E TY Instructor: MRS. IRINE VELARDE-QUITCO, LPT  WEEK 4 - Gender and Society Topic: MEDICAL AND SOCIAL CONSTRUCTS OF GENDER Expected Competencies: At the end of this session, the students will be able to: 1. make an artistic collage of their identity as influenced by their biology; 2. research on one certain case of abnormality on gender genetics.  WEEK 4 - Gender and Society 1. Gender identity is self-identified, as a result of a combination of inherent and extrinsic or environmental factors. 2. Gender role is manifested within society by observable factors such as behavior and appearance. 3. Development of Gender Identity - Usual Patterns a. Prenatal Influences A child’s gender development, meaning maturation of gender identity, clearly begins in the intrauterine stage.  WEEK 4 - Gender and Society b. Early Gender Development The environment in which a baby is reared with respect to gender begins to take shape prior to birth. Families who receive knowledge of the child’s biological sex often use this information to tailor parental planning and reactions. Gender constancy refers to the ability of a child to concretely differentiate between the genders, frequently occurring by age 2 years, at which time the first expressions of gender identity are commonly made.  WEEK 4 - Gender and Society c. Continuing Gender Development Throughout the rest of childhood and school years, a child’s gender identity is typically reinforced by gender role. A preference for same- sex playmates usually manifests by age 3-4 years, and the gender role is better defined by subsequent interactions. 4. Development of Gender Identity - Unusual Patterns Ø Genetic or Hormonal Influences a. Biology - the primary types of sex hormones are androgens (testosterone); and estrogens and progestins. These hormones are often classified as male and female sex hormones but are also found in both men and women, and the release within the body does not specifically determine maleness or femaleness.  WEEK 4 - Gender and Society b. The hypothalamus, which controls the main hormone distribution gland, the pituitary gland, is the main structure of the brain involved with sexual development and differentiation. c. The production of testosterone induces the masculinizing effects on the rest of the body. Ø Chromosomal Alterations In Turner syndrome, one sex chromosome is missing, causing a single X karyotype (a solo Y chromosome is not compatible with life). Many XO individuals have significant psychologic stress because of their infertility, their appearance, and the awareness of their genetic profile, which may make them feel inadequate or incomplete as females.  WEEK 4 - Gender and Society Klinefelter syndrome, occurs when the fetus possesses a sex karyotype of XXY. Because of the presence of the Y chromosome, fetal development is that of a normal male. Gender identity is affected by these factors. With the XYY individuals, the extra Y chromosome has been linked to aggressive or anti- social behavior. Mosaicism of sex chromosomes can also be present, including XX/XY persons who may present with the anatomic features of either sex or who may present as intersexed (with characteristics of both sexes). If those abnormal cells begin to outnumber the normal cells, it can lead to disease that can be traced from the cellular level to affected tissue, like skin, the brain, or other organs. Mosaicism is caused by an error in cell division very early in the development of the unborn baby. Examples of mosaicism include: Mosaic Down syndrome and Mosaic Klinefelter syndrome. WEEK 4 - Gender and Society WEEK 4 - Gender and Society  WEEK 4 - Gender and Society a. Hermaphroditism People with anatomically intersexed conditions are at times referred to hermaphrodites. The word was coined by John Money, and stems from the Greek god Hermes (Roman: Mercury) and goddess Aphrodite (Roman: Venus) and parallels the name of their son, Hermaphroditos. Some consider themselves both male and female. Others, believing hermaphrodeity, or hermaphroditism, to be a unique third gender, consider themselves to be neither male nor female. WEEK 4 - Gender and Society  WEEK 4 - Gender and Society b. Congenital Adrenal Hyperplasia In patients with CAH, the fetus is exposed to abnormally high levels of cortisol produced by its own adrenal gland. This leads to a greater amount of androgenic adrenal hormone production. For normal XX female fetuses, the prenatal exposure to androgens results in virilization of female genitalia, in what has been called female pseudohermaphroditism. In such cases, the genitalia are so masculine that male sex is mistakenly assigned to the newborn at birth. Soon, clinical findings reveal the defect in the adrenal gland and the true female genotype of the child. Genetic females with this condition have ovaries, so gonadal sex would be congruent with a female gender identity. The gender role can be more stereotypically masculine, with rougher play and a preference for male activities and dress.  WEEK 4 - Gender and Society Congenital adrenal hyperplasia (CAH) is a genetic defect in the adrenal glands. There is an enzyme block that usually leads to a deficiency in the production of two key hormones: cortisol and aldosterone. Cortisol and aldosterone are responsible for maintaining appropriate sugar levels, blood pressure levels, and salt balance. Living with CAH requires extra attention to common illnesses and stress (i.e. fever, injury, or surgery). During stress, extra cortisol is normally secreted to maintain normal function. Patients with CAH often need lifetime replacement of cortisol and aldosterone, as well as stress dosing of cortisol as needed. In addition, because there is a blockade in the enzyme pathway, there can be a build-up of male hormones (androgens). These androgens can lead to the masculinization of an infant girls’ genitalia, called ambiguous genitalia. https://rmpedendo.com/conditions-we-treat/congenital-adrenal-hyperplasia/ WEEK 4 - Gender and Society  WEEK 4 - Gender and Society c. Androgen Insensitivity Syndrome Genetically, normal XY males have female external genitalia and appear to be normal females at birth. The testes are undescended, although the vagina is blind-ending with no uterus or ovaries. The eventual appearance of these individuals is usually tall, devoid of body and facial hair, with a low percentage of body fat, thin hips, and fully developed breast tissue. The testes may be removed because of the risk for malignant conversion in undescended testicles.  WEEK 4 - Gender and Society Complete androgen insensitivity syndrome (CAIS) is a rare condition that occurs when the body cannot use androgens (male sex hormones) at all, thus affecting the sexual development before birth and during puberty. People with complete androgen insensitivity syndrome are genetically male (one X and one Y chromosome in each cell) but do not respond to male hormones at all. As a result, they generally have normal female external genitalia and female breasts. However, they do not have a uterus or cervix so are unable to menstruate or conceive a child (infertile). They are typically raised as females and have a female gender identity.  WEEK 4 - Gender and Society Affected individuals have male internal sex organs (testes) that are undescended, which means they are abnormally located in the pelvis or abdomen. Undescended testes have a small chance of becoming cancerous later in life if they are not surgically removed. People with complete androgen insensitivity syndrome also have sparse or absent hair in the pubic area and under the arms. Complete androgen insensitivity syndrome affects 2 to 5 per 100,000 people who are genetically male. Complete androgen insensitivity syndrome is one of the most common causes of disorders of sex development (DSD). Complete androgen insensitivity syndrome is caused by changes (mutations) in the androgen receptor (AR) gene and is inherited in an X-linked manner. Treatment and gender assignment can be a very complex issue, and must be individualized with each affected person. In general, surgery may be required to remove testes that are located in unusual places and estrogen replacement therapy can be prescribed after puberty. https://healthjade.net/complete-androgen-insensitivity-syndrome/ WEEK 4 - Gender and Society  WEEK 4 - Gender and Society d. Alpha-reductase Deficiency This is an enzyme defect with effects during prenatal development. The incidence in North America is roughly 1:40,000. The infant at birth appears female, although the external genitalia may be somewhat abnormal in size, shape, and color. When the testes produce a surge of testosterone at puberty, bodily changes occur. A full conversion to male appearance is noted, with growth of the phallus. Some of those who are raised as girls and who seemingly possess a female gender identity turn into males with puberty, converting to a male gender identity. WEEK 4 - Gender and Society WEEK 4 - Gender and Society  WEEK 4 - Gender and Society e. Genital Abnormalities and Related Phenomena of Gender Variance One such situation is micropenis, in which a normal male is born with extremely small genitals.  WEEK 4 - Gender and Society Cloacal exstrophy, in which intrauterine development of the urogenital structures is incomplete. Males with this condition are born without a phallus, although testes are present.  WEEK 4 - Gender and Society Cryptorchidism may play a part in gender development. Cases exist of patients with undescended testes whose gender identity was questioned and development did not follow the normative path until psychologic intervention in later years.  WEEK 4 - Gender and Society Female genital mutilation is a practice found in many parts of Africa and in other areas of the world, as well as in the United States in the past. Severe alterations to the female external genital tract are performed as part of ritual tradition.  WEEK 4 - Gender and Society The ‘hajra’ of India, who are eunuchs, males castrated during childhood and reared as neither male nor female. Lacking testes to induce pubertal development and through adherence to custom that effectively equals behavioral modification therapy, their gender role is mostly female. Castration is any action, surgical, chemical, or otherwise, by which a male loses use of the testicles: the male gonad. Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical castration uses pharmaceutical drugs to deactivate the testes.  WEEK 4 - Gender and Society Ø Gender Identity Disorders of Childhood Gender dysphoria or gender incongruence occurs in both children and adults; the term transsexualism has also been used for those whose sexual identity is altered to match the gender identity. Transgenderism is described to those who take on a gender role to match their gender identity, when it is at odds with their anatomic sex. Transgender also refers to the concept of being “between” genders, which may indicate either a pre-transitional phase in which gender incongruence persists or a phase in which gender congruence is achieved by remaining undefined or androgynous in terms of gender identity.  WEEK 4 - Gender and Society This desire is manifested in transsexual behavior, where an adolescent or adult pursues hormonal and surgical sex reassignment to achieve congruence with gender identity. Physicians should distinguish all aspects of gender dysphoria from transvestism or cross-dressing. The specific act of cross-dressing is classified as a fetish or simple gender- variant behavior and may have no particular associations other than increased family anxiety. It is quite common to see school-aged children or teenagers who engage in varying degrees of cross-dressing, sometimes in relation to peer group activity or for creative expression.  WEEK 4 - Gender and Society Therefore, while most children with gender dysphoria do in fact cross-dress, the act of cross-dressing alone does not qualify a patient as gender dysphoric or suggest a specific diagnosis of any kind. Because of current societal intolerance of cross-gender behavior in general, most children with gender incongruence experience severe levels of distress as they grow. Tomboyish behavior, or male stereotypical behavior in a girl, is often tolerated and even celebrated in some families. Boys who are inherently effeminate in appearance, behavior, or attitudes are often humiliated, teased, and hurt by peers and family members alike. Gender identity disorders of childhood or gender nonconformity of any type has been associated with increased risk for physical or sexual abuse, and post- traumatic stress in youth.  WEEK 4 - Gender and Society Many develop a gender identity consistent with their anatomic sex. Some become homosexual or bisexual, while others may not. Some psychologists offer behavioral treatment for cross-gendered children. Gender dysphoria remains profoundly stigmatizing. Many retreat into closeted lifestyles, and a significantly higher incidence of suicide has been linked with transsexualism. With greater awareness, tolerance, and acceptance of these individuals as part of society, some adolescents are able to take first steps into transgenderism, progressing to gender congruence either with or without surgical/medical interventions.  WEEK 4 - Gender and Society Summary of Gender Development in Children 1. Clinical evidence indicates that babies are indeed born with at least a basic underlying sense of gender identity. Early life provides cues and influences that may affirm or alter this brain bias. Gender-variant behavior occurs when gender identity manifests itself in later life and is at odds with the child’s sex. 2. The subject of gender assignment or the need for gender reassignment continues to cause debate among experts. Individualized personalized counseling for patients and families, must remain until a set of guidelines can be recommended. 3. As interest in gender identity grows and further research into genetic, hormonal, and environmental factors that affect gender identity is undertaken, a better definition of what exactly makes a person male or female (or both, or neither) will be found.  WEEK 4 - Gender and Society PROGRESS CHECK: 1. Using visual media (pen, watercolor, crayons, pastel, ballpen, pencil), make an artistic presentation of yourself as influenced by your chromosomes and genes. (Substance = 5pts; Artistry = 5pts; Total = 10pts) 2. Kindly research on the case of Elma Muros, a Filipino sprinter. Basing from the facts presented, do you agree with her assigned gender marker? Why? or why not? Support claim. (Arguments/Facts = 7pts; Organization/Technicality = 3pts; Total = 10pts)  WEEK 4 - Gender and Society RECAP: Please answer the following: 1. I learned: ____________________________________________________ 2. I agree with: __________________________________________________ 3. I want to learn more about: ______________________________________ 4. I disagree with: ________________________________________________ WEEK 4 G E E 1 - G E N D E R A N D S O C I E TY Instructor: MRS. IRINE VELARDE-QUITCO, LPT