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Sex and Gender: Biology, Culture, and the Expression of Gender 

Sex and Gender: Biology, Culture, and the Expression of Gender
Chapter:
Sex and Gender: Biology, Culture, and the Expression of Gender
Author(s):

Louise Newman

DOI:
10.1093/med/9780199213962.003.0034
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date: 14 October 2019

Louise Newman explores how psychiatry through classifications and treatments has regarded essentialist, fixed, conformist understandings of gender roles and heteronormative sexual preference as intrinsic to mental health: sexual minorities are therefore deemed to require treatment. Thus biology determines psychology and social gender roles, rather than culture and meaning having a role in shaping gender identity and sexual orientation. The chapter especially tracks psychiatry, the ‘natural gender’ account, and ‘Gender Identity Disorder’. While diverse non- Western cultures accept sex roles and fluid gender identity, Western culture tolerates sexual ambiguity less well. Where sex reassignment (only to the opposite sex) surgery is available, the applicant’s mental health and competency is assessed and the professional regulates treatment access. Individuals with gender dysphoria and their loved ones suffer considerable psychosocial and mental health consequences. Pressures to conform and treat intensely affect families, schools, and society, reassignment treatments are scarce, (mental) health professionals often are anxious and have negative attitudes, and services remain non-specific and culturally unaware. Persecution remains widespread internationally. Yet gender expression and sexuality are fundamental in international rights conventions. Newman promotes social reform encompassing increasing tolerance of gender diversity, culturally competent health services, and inclusive medicine that facilitates understanding and insight for self-determination.

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