Psychoendocrinologic Studies in a Male with Cyclic Changes in Sexuality

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Abstract
A young man, aged 23, began therapy after experiencing cyclic alternation of feeling and acting "male" and "female" for 11 years. Cessation of this periodicity, soon after initial therapy, was accompanied by a striking increase in excretion of urinary 17-ketosteroids. The developmental and the endocrinological data aug-gest an association between a derangement in development of androgenic characteristics and the homosexual pattern of adolescence and homoerotic pattern of adult life. The deficiency of adequate levels of male hormones probably served to perpetuate and accentuate pre-existing effeminate childhood patterns. In early adulthood, 10 or 11 years after puberty, without medical intervention, a second puberty began. This was associated with an increased secretion of pituitary gonadotrophic hormones, a gradual increase in male hormone production with associated development of masculine physique, some decrease in feminizing characteristics and mannerisms, an awareness of his femininity, and a desire to correct this abnormality. These changes were probably enhanced by psychotherapy. The possible psychophysiological bases for this unusual disorder are discussed.

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