gender psychology case study

David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case

In the mid-1960s, psychologist John Money encouraged the gender reassignment of David Reimer, who was born a biological male but suffered irreparable damage to his penis as an infant. Born in 1965 as Bruce Reimer, his penis was irreparably damaged during infancy due to a failed circumcision. After encouragement from Money, Reimer’s parents decided to raise Reimer as a girl. Reimer underwent surgery as an infant to construct rudimentary female genitals, and was given female hormones during puberty. During childhood, Reimer was never told he was biologically male and regularly visited Money, who tracked the progress of his gender reassignment. Reimer unknowingly acted as an experimental subject in Money’s controversial investigation, which he called the John/Joan case. The case provided results that were used to justify thousands of sex reassignment surgeries for cases of children with reproductive abnormalities. Despite his upbringing, Reimer rejected the female identity as a young teenager and began living as a male. He suffered severe depression throughout his life, which culminated in his suicide at thirty-eight years old. Reimer, and his public statements about the trauma of his transition, brought attention to gender identity and called into question the sex reassignment of infants and children.

Bruce Peter Reimer was born on 22 August 1965 in Winnipeg, Ontario, to Janet and Ron Reimer. At six months of age, both Reimer and his identical twin, Brian, were diagnosed with phimosis, a condition in which the foreskin of the penis cannot retract, inhibiting regular urination. On 27 April 1966, Reimer underwent circumcision, a common procedure in which a physician surgically removes the foreskin of the penis. Usually, physicians performing circumcisions use a scalpel or other sharp instrument to remove foreskin. However, Reimer’s physician used the unconventional technique of cauterization, or burning to cause tissue death. Reimer’s circumcision failed. Reimer’s brother did not undergo circumcision and his phimosis healed naturally. While the true extent of Reimer’s penile damage was unclear, the overwhelming majority of biographers and journalists maintained that it was either totally severed or otherwise damaged beyond the possibility of function.

In 1967, Reimer’s parents sought the help of John Money, a psychologist and sexologist who worked at the Johns Hopkins Hospital in Baltimore, Maryland. In the mid twentieth century, Money helped establish the views on the psychology of gender identities and roles. In his academic work, Money argued in favor of the increasingly mainstream idea that gender was a societal construct, malleable from an early age. He stated that being raised as a female was in Reimer’s interest, and recommended sexual reassignment surgery. At the time, infants born with abnormal or intersex genitalia commonly received such interventions.

Following their consultation with Money, Reimer’s parents decided to raise Reimer as a girl. Physicians at the Johns Hopkins Hospital removed Reimer’s testes and damaged penis, and constructed a vestigial vulvae and a vaginal canal in their place. The physicians also opened a small hole in Reimer’s lower abdomen for urination. Following his gender reassignment surgery, Reimer was given the first name Brenda, and his parents raised him as a girl. He received estrogen during adolescence to promote the development of breasts. Throughout his childhood, Reimer was not informed about his male biology.

Throughout his childhood, Reimer received annual checkups from Money. His twin brother was also part of Money’s research on sexual development and gender in children. As identical twins growing up in the same family, the Reimer brothers were what Money considered ideal case subjects for a psychology study on gender. Reimer was the first documented case of sex reassignment of a child born developmentally normal, while Reimer’s brother was a control subject who shared Reimer’s genetic makeup, intrauterine space, and household.

During the twin’s psychiatric visits with Money, and as part of his research, Reimer and his twin brother were directed to inspect one another’s genitals and engage in behavior resembling sexual intercourse. Reimer claimed that much of Money’s treatment involved the forced reenactment of sexual positions and motions with his brother. In some exercises, the brothers rehearsed missionary positions with thrusting motions, which Money justified as the rehearsal of healthy childhood sexual exploration. In his Rolling Stone interview, Reimer recalled that at least once, Money photographed those exercises. Money also made the brothers inspect one another’s pubic areas. Reimer stated that Money observed those exercises both alone and with as many as six colleagues. Reimer recounted anger and verbal abuse from Money if he or his brother resisted orders, in contrast to the calm and scientific demeanor Money presented to their parents. Reimer and his brother underwent Money’s treatments at preschool and grade school age. Money described Reimer’s transition as successful, and claimed that Reimer’s girlish behavior stood in stark contrast to his brother’s boyishness. Money reported on Reimer’s case as the John/Joan case, leaving out Reimer’s real name. For over a decade, Reimer and his brother unknowingly provided data that, according to biographers and the Intersex Society of North America, was used to reinforce Money’s theories on gender fluidity and provided justification for thousands of sex reassignment surgeries for children with abnormal genitals.

Contrary to Money’s notes, Reimer reports that as a child he experienced severe gender dysphoria, a condition in which someone experiences distress as a result of their assigned gender. Reimer reported that he did not identify as a girl and resented Money’s visits for treatment. At the age of thirteen, Reimer threatened to commit suicide if his parents took him to Money on the next annual visit. Bullied by peers in school for his masculine traits, Reimer claimed that despite receiving female hormones, wearing dresses, and having his interests directed toward typically female norms, he always felt that he was a boy. In 1980, at the age of fifteen, Reimer’s father told him the truth about his birth and the subsequent procedures. Following that revelation, Reimer assumed a male identity, taking the first name David. By age twenty-one, Reimer had received testosterone therapy and surgeries to remove his breasts and reconstruct a penis. He married Jane Fontaine, a single mother of three, on 22 September 1990.

In adulthood, Reimer reported that he suffered psychological trauma due to Money’s experiments, which Money had used to justify sexual reassignment surgery for children with intersex or damaged genitals since the 1970s. In the mid-1990s, Reimer met Milton Diamond, a psychologist at the University of Hawaii, in Honolulu, Hawaii, and academic rival of Money. Reimer participated in a follow-up study conducted by Diamond, in which Diamond cataloged the failures of Reimer’s transition.

In 1997, Reimer began speaking publicly about his experiences, beginning with his participation in Diamond’s study. Reimer’s first interview appeared in the December 1997 issue of Rolling Stone magazine. In interviews, and a later book about his experience, Reimer described his interactions with Money as torturous and abusive. Accordingly, Reimer claimed he developed a lifelong distrust of hospitals and medical professionals.

With those reports, Reimer caused a multifaceted controversy over Money’s methods, honesty in data reporting, and the general ethics of sex reassignment surgeries on infants and children. Reimer’s description of his childhood conflicted with the scientific consensus about sex reassignment at the time. According to NOVA, Money led scientists to believe that the John/Joan case demonstrated an unreservedly successful sex transition. Reimer’s parents later blamed Money’s methods and alleged surreptitiousness for the psychological illnesses of their sons, although the notes of a former graduate student in Money’s lab indicated that Reimer’s parents dishonestly represented the transition’s success to Money and his coworkers. Reimer was further alleged by supporters of Money to have incorrectly recalled the details of his treatment. On Reimer’s case, Money publicly dismissed his criticism as antifeminist and anti-trans bias, but, according to his colleagues, was personally ashamed of the failure.

In his early twenties, Reimer attempted to commit suicide twice. According to Reimer, his adult family life was strained by marital problems and employment difficulty. Reimer’s brother, who suffered from depression and schizophrenia, died from an antidepressant drug overdose in July of 2002. On 2 May 2004, Reimer’s wife told him that she wanted a divorce. Two days later, at the age of thirty-eight, Reimer committed suicide by firearm.

Reimer, Money, and the case became subjects of numerous books and documentaries following the exposé. Reimer also became somewhat iconic in popular culture, being directly referenced or alluded to in the television shows Chicago Hope , Law & Order , and Mental . The BBC series Horizon covered his story in two episodes, “The Boy Who Was Turned into a Girl” (2000) and “Dr. Money and the Boy with No Penis” (2004). Canadian rock group The Weakerthans wrote “Hymn of the Medical Oddity” about Reimer, and the New York-based Ensemble Studio Theatre production Boy was based on Reimer’s life.

• Carey, Benedict. “John William Money, 84, Sexual Identity Researcher, Dies.” New York Times , 11 July 2016.
• Colapinto, John. "The True Story of John/Joan." Rolling Stone 11 (1997): 54–73.
• Colapinto, John. As Nature Made Him: The Boy who was Raised as a Girl . New York: HarperCollins Publishers, 2000.
• Colapinto, John. "Gender Gap—What were the Real Reasons behind David Reimer’s Suicide." Slate (2004).
• Dr. Money and the Boy with No Penis , documentary, written by Sanjida O’Connell (BBC, 2004), Film.
• The Boy Who Was Turned Into a Girl , documentary, directed by Andrew Cohen (BBC, 2000.), Film.
• “Who was David Reimer (also, sadly, known as John/Joan)?” Intersex Society of North America . http://www.isna.org/faq/reimer (Accessed October 31, 2017).

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“I Have Nowhere to Go”: A Multiple-Case Study of Transgender and Gender Diverse Youth, Their Families, and Healthcare Experiences

Megan s. paceley.

1 School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045, USA; ude.uk@adnanaj (J.A.); moc.liamg@8150sivadrt (T.D.M.)

Jennifer Ananda

Margaret m. c. thomas.

2 Luskin School of Public Affairs, University of California Los Angeles, 3250 Public Affairs Building, Los Angeles, CA 90095, USA; ude.alcu.niksul@samoht

Isaac Sanders

3 A Way Home Washington, 1200 12th Ave. S. Suite 710, Seattle, WA 98144, USA; gro.awemohyawa@srednasi

Delaney Hiegert

4 School of Law, University of Kansas, 1535 W 15th Street, Lawrence, KS 66045, USA; moc.liamg@tregeihcd

Taylor Davis Monley

Associated data.

Data are not made available to protect the privacy of participants.

Transgender and gender diverse (TGD) youth experience health disparities due to stigma and victimization. Gender-affirming healthcare mitigates these challenges; yet, we have limited understanding of TGD youth’s healthcare experiences in the U.S. Midwest and South. Using a multiple case study design, we aimed to develop an in-depth and cross-contextual understanding of TGD youth healthcare experiences in one Midwestern state. Families with a TGD child under 18 were recruited with the goal of cross-case diversity by child age, gender, race, and/or region of the state; we obtained diversity in child age and region only. Four white families with TGD boys or non-binary youth (4–16) in rural, suburban, and small towns participated in interviews and observations for one year; public data were collected from each family’s community. Thematic analysis was used within and across cases to develop both family-level understanding and identify themes across families. Findings include a summary of each family as it relates to their child’s TGD healthcare experiences as well as the themes identified across cases: accessibility and affirming care. Although limited by a small sample with lack of gender and race diversity, this study contributes to our understanding of TGD youth healthcare in understudied regions.

1. Introduction

Transgender and gender diverse (TGD) youth experience stigma and victimization in their homes, schools, and communities [ 1 ]; these experiences are associated with increased health concerns, including depression, suicidality, substance abuse, eating disorders, and stress [ 2 , 3 , 4 , 5 ]. These health concerns can be mitigated or alleviated by supportive individuals and communities. When TGD youth report having at least one supportive adult in their lives, their risk of suicidality decreases by 40% [ 6 ]. Additionally, TGD youth report decreased depression and suicidality when people in their lives use their chosen names [ 7 ]. Communities can also reduce risk for TGD youth via TGD-inclusive non-discrimination policies, presence and visibility of other TGD people, and access to affirming resources [ 8 ].

An important resource for TGD youth is access to physical and mental healthcare that is affirming of their gender identities and expressions [ 8 ]. At the broadest level, having affirming healthcare means access to providers who use a patient’s chosen name and pronouns and affirms their gender. More specifically, gender-affirming healthcare for youth includes access to puberty blockers (to safely delay puberty associated with sex assigned at birth), use of hormones consistent with their gender, and medications to promote physical development [ 9 ]. Gender-affirming healthcare is recognized by major pediatric medical organizations as evidence-based practice for TGD youth [ 10 , 11 ] and is associated with reduced health disparities [ 12 ] including risk of suicide [ 13 ].

Even with this professional recognition, gender-affirming care is facing significant social and political backlash. In early 2021, in the U.S. more than 20 bills were proposed that aim to restrict gender-affirming healthcare for TGD children and adolescents [ 9 , 14 ]. These bills include provisions making it a criminal act to provide gender-affirming care (for medical professionals and/or parents), opening medical professionals up to civil liabilities for providing gender-affirming care to youth, and/or restricting insurance coverage for gender-affirming care for people under 18 [ 9 ]. If passed, these bans could restrict access to gender-affirming care for as many as 45,000 TGD youth in the U.S. [ 9 ], primarily in Midwestern and Southern states.

Access to affirming physical and mental healthcare is a critical component of reducing health disparities for TGD youth, yet we lack research on the healthcare experiences of TGD youth in the U.S. Midwest and South, precisely those areas where TGD youth face heightened risks for health disparities. Simultaneously, legislation in these regions is targeting TGD youth via restrictive and discriminatory policies and rhetoric. To redress this critical gap in the literature, this study centers the lived experiences of TGD youth and their families in one Midwestern state with the goal of understanding their healthcare experiences broadly and related to gender-affirming care specifically.

1.1. TGD Youth in the Midwest

The Midwest is characterized as having low tolerance for sexual minorities [ 15 ]. TGD youth in the Midwest and South report higher rates of anti-TGD victimization compared with TGD youth in other regions of the country [ 16 , 17 ]. Few studies have centered an understanding of the Midwest context on the experiences and well-being of TGD and sexual minority youth. One study explored the community context of TGD youth living in rural communities in a Midwestern state [ 18 ]. They found that community climate (e.g., the level of support for TGD people in a community) was a better predictor of supportive resources than was community size. This finding suggests that it is critical to identify strategies to increase support for TGD people within their communities. Another study examined the community factors relevant to how TGD youth perceive support in rural and small towns in the Midwest [ 8 ]. Youth described a lack of TGD-affirming resources, including healthcare options that affirmed and supported their identities.

1.2. TGD Youth Healthcare

Access to supportive and competent healthcare can reduce health concerns and promote well-being for TGD youth [ 19 ], yet TGD youth face barriers to accessing both general and gender-affirming healthcare. Specifically, barriers to healthcare for TGD youth include fears of mistreatment based on gender [ 20 , 21 ] and providers using youth’s incorrect names/pronouns [ 20 , 22 ]. Additionally, TGD youth face barriers to gender-affirming care such as lack of competent providers [ 21 , 22 , 23 ], lack of access to puberty blockers or hormones [ 20 , 22 ], and insurance and financial issues [ 21 , 22 ]. Alternatively, affirmation of TGD youth’s gender is associated with reduced barriers to affirming care for TGD youth of color [ 24 , 25 ].

Importantly, access to supportive and affirming healthcare extends beyond provider competency and accessibility. For TGD youth under the age of 18, parental consent and support is often a prerequisite to care [ 26 ]. Very few studies have examined the healthcare experiences of TGD youth from the perspective of both youth and parents. A qualitative study of TGD youth and parents in Newfoundland found that while both youth and parents identified the barriers described above, parents also discussed concerns about their child’s mental health, wait times for access to care, and a lack of information on providers and gender-affirming care [ 23 ]. Additionally, youth specifically worried about parental acceptance, safety, and feelings of dysphoria.

These studies provide an important understanding of the healthcare experiences of TGD youth, and yet there remain key gaps in the literature. Given the important role of parents in the provision of healthcare for TGD youth, we need more studies including both youth and parent perspectives. Additionally, healthcare access and affirmation may be different in regions and communities with less supportive attitudes and resources, such as the U.S. Midwest and South. Finally, existing studies have primarily used cross-sectional surveys or interviews, providing important details at a point in time. We lack studies exploring the lived experiences of TGD youth and their families over time. Therefore, the purpose of this study was to center the lived experiences of TGD youth and their families in one Midwestern state over the course of a year with the goal of learning about their experiences with healthcare.

2. Materials and Methods

We used a multiple case study design to explore the healthcare experiences of TGD youth and their families in one Midwestern state. Multiple case study designs allow for in-depth exploration of a phenomenon across varying contexts or situations [ 27 ]. Four families in one Midwestern state participated in the study over the course of twelve months (July 2019–June 2020). All procedures were approved by the University of Kansas ethics review board.

2.1. Positionality

As scholars engaged in research-advocacy with TGD youth, it is essential that we identify our positionalities within the study. Author one (she/they) is a queer, white, genderqueer woman with professional, educational, and class privilege. They have over a decade of practice experience working with TGD youth. They led the study, engaged in all data collection and analysis, and were the primary contact for all families. Author two (she/her) is a white, queer, cisgender woman with professional, educational, and class privilege. She engaged in data analysis and dissemination. Author three (she/her) is a white, lesbian, cisgender woman, with class, educational, and professional privilege. She joined the study during the dissemination phase as a policy expert. Author four (they/them) is a Black, two spirit, queer person with professional and educational privilege. They joined the study during the dissemination phase as a TGD practice expert. Author five (they/them) is a white, queer, transmasculine nonbinary person with professional, educational, and class privilege. They engaged in data analysis and dissemination. Author six (she/her) is a white, queer, cisgender woman. She was involved in the study from the start and engaged in data collection, analysis, and dissemination.

2.2. Recruitment and Sampling

A multiple case study design requires the selection of cases (i.e., families) who have a similar connection to a phenomenon (i.e., TGD healthcare) but with different contexts or situations [ 27 ]. We aimed to recruit and retain four families who lived in the sampled state and had at least one child under the age of 18 who identified as transgender, non-binary, or gender diverse. We also aimed to include varying contexts to explore diversity across cases; specifically, we hoped to include children of varying age, race/ethnicity, and gender identities or expressions, as well as families in multiple regions of the state.

Families were recruited via advertisements on social media, emails from LGBTQ+ organizations, and professional connections throughout the state. Interested parents or children were asked to email or call the first author to establish eligibility and consent. For each family, the parent was the initial contact. A total of five families consented to participate. One family withdrew after data collection began, and their data are not included. Although we attempted to recruit a diverse sample in terms of race/ethnicity and gender, the final set of families included only age and regional diversity. Table 1 describes the characteristics of each family. Notably, all families were white and three youth participants were trans boys.

Family Case Characteristics.

Note. Pseudonyms are used to protect family anonymity.

2.3. Data Collection

Data collection included three or four in-depth interviews with parent and child participants, observations of each family, public document review, and member checking/data review by each family. Data collection occurred between July 2019 and June 2020. Due to the onset of COVID-19 in early 2020, all data collection after March 2020 was conducted online.

2.3.1. Interviews

Multiple interviews were conducted with each family to understand their individual contexts and experiences, attending to changes over time. After receiving initial agreement to participate in the study by parents and children, we set up a time to meet the families in person. The first and last author traveled to meet the families in their homes. At the first meeting, we brought food, snacks, and/or things to play with (for the family with younger children) to establish rapport and get to know the family before starting data collection. Consent documents were shared and parents provided signed consent for themselves and their child. Children received an assent form and provided verbal agreement to participate. Families participated in three to four interviews over the course of twelve months, spaced about three to four months apart. Parents and children received a USD 20 gift card for each data collection visit for a total of up to USD 160 per family.

An interview guide was used to facilitate each interview. The first interview guide was developed to establish an understanding of the child, family, school, community, and healthcare contexts. Initial interviews with parents and children were conducted separately to provide privacy and confidentiality for all families except one (due to age of the child). The parent interview guide included questions related to their interest in the study, family background, their TGD child, their child’s physical and mental healthcare experiences, and needs of the family. The child interview guide was adapted based on the age of the child and included questions related to their family, gender, healthcare experiences, and any need for support they had. Subsequent interview guides were developed for each family based on their individual contexts and after preliminary analyses of their previous interview(s). Subsequent interviews focused on changes since previous meetings, past and upcoming healthcare appointments, shifts related to gender identity or expression, and ongoing or new needs for support. Two families elected to conduct these subsequent interviews as a family, rather than individually (both were the two families with younger children). All interviews were audio recorded and transcribed by a professional transcription service.

2.3.2. Observations

Participant observations were used to document and explore family dynamics and contexts. At each family meeting, we engaged with the parent(s) and child together before and after interviews. Following each meeting, we individually documented our observations of the family, family dynamics, and possible topics for further exploration. Observations included memos from the interviews. Observation memos were written within 48 h of each meeting, and we also discussed our reactions and thoughts as a group.

2.3.3. Public Document Review

Public documents in each family’s community were collected to understand the healthcare and community context for each family. Public data included the presence or absence of TGD-affirming healthcare services, non-discrimination policies inclusive of gender identity, and any other relevant public documents, such as lists of TGD-affirming healthcare providers.

2.3.4. Member Checking/Data Review

At the end of the data collection period (Summer, 2020), each family was provided with a two-to-three-page summary description of their family contexts and TGD healthcare experiences. They were asked to read and review it for accuracy and anonymity, allowing them the opportunity to change details or obscure facts that might make them easy to identify. No families asked to change any information. They were asked to answer a few questions via email in their response, including whether there had been any changes or updates since their last interview, feedback they hoped healthcare providers would take from this study, and ideas for training healthcare professionals. All families responded to the questions, and these responses were incorporated into the analyses.

2.4. Data Analysis

Data for this study included interview transcripts, observation notes, public documents, and member checking reviews. Given the multiple case study design, it was essential to analyze these documents within cases (e.g., each family) and across cases (e.g., the entire data set). This allowed for an in-depth understanding of each family’s contexts and experiences and for the comparison of data across cases. This is an essential step in a multiple case study with the goal of understanding each individual case and identifying similarities and differences across cases [ 27 ].

The first and last authors began analyzing data within families at the start of data collection to develop a thematic understanding of each family prior to the subsequent interview/meeting. Interview transcripts and observation notes were read by each author who each took notes about emerging ideas and codes to attend to in subsequent rounds of analysis. These notes were used to create interview guides for subsequent meetings with families, including follow-up questions from within-case analysis (e.g., “Tell me more about what happened when the doctor….”) and across cases (e.g., “Some families are reporting [a specific experience]. Has that been true for you).

When data collection ended, the first and final two authors engaged in the thematic analysis procedures outlined by Braun and Clark [ 28 ]. Each author read all data materials to establish familiarity within each family and then across cases. Next, codes were generated within data related to healthcare experiences, needs, and concerns. We developed themes and then reviewed them to ensure accuracy and that no other codes or themes were missing. One author then wrote family summaries using these themes and sent them to the families for review. Families were able to make corrections or omissions and answered a few final questions; these answers were used in the final round of analyses. Themes were then compared across cases by coding excerpts for similarities and differences and compiling them into a set of themes that described the findings across all four cases.

With the goal of providing a rich description of each case, as well as sharing insights across cases, the findings from this study are presented in two parts. First, we provide a brief but in-depth description of each family and their healthcare experiences. Second, we share the findings from the across-case analyses demonstrating two broad themes of TGD healthcare experiences: accessibility and affirming care.

3.1. Family Descriptions

3.1.1. family 1.

Travis was 16 years old at the start of the study, the middle child of three siblings, living with his mom and dad in a rural town. Although adjacent to an urban county, the community had a small town feel with neighbors waving at cars as they drove by and a small, walkable downtown in which we picked up lunch for the family on our first visit. There were no TGD-affirming providers within the county, and the county had no legal protections for TGD people. An urban city is about an hour away, providing access to resources, but only if one were able to make the drive. Throughout the course of the study, Travis’ family had access to medical care and private insurance. Travis and his mom, Carrie, were open, loving toward each other, and friendly. Travis shared his love of music, art, and writing.

Travis explored his gender on his own for years prior to telling his parents he is trans at the age of 13. They were supportive of him, using his correct name and pronouns, finding TGD-affirming providers, and advocating for him. Travis indicated his school was mostly supportive, but he described instances where, in an attempt to be supportive, the school would do things like ask what group he preferred when events were separated by gender, which he felt like they should know, given he is a boy. Although he was generally reserved, he had gotten involved in advocacy efforts with his school’s gender and sexuality alliance (GSA). Travis attended an LGBTQ+ organization in the neighboring city, providing him with social support and resources.

Travis sought both TGD-related medical and mental healthcare. He described his therapist as helpful and affirming. He first saw his family doctor for gender-related care; however, the doctor was uncomfortable with this and provided no referrals. Carrie explored other options and eventually found a transgender-friendly clinic, referred by friends from the LGBTQ+ center. Travis receives hormones and ongoing care from the clinic, which has been affirming and competent; physicians and nurses use proper language, understand how to work with TGD youth, and ensure TGD people feel comfortable. However, the clinic is an hour away, and there have been logistical challenges with scheduling and physician turnover. Carrie described several examples of times in which their insurance initially would not cover visits to the clinic due to coding issues or confusion about Travis’ gender. After phone calls to the insurance, these issues were resolved; however, it required time and emotional labor on Carrie’s behalf. She described their healthcare hurdles to be finding and accessing TGD-affirming healthcare and navigating insurance challenges, such as improperly coding TGD-related healthcare as not covered.

3.1.2. Family 2

Aiden was 15 years old, the youngest of two, living with his mom and dad in a suburban community. The town had a long-standing non-discrimination ordinance that included gender identity, as well as numerous therapists skilled at working with TGD youth. There were a few medical providers affirming of TGD people; however, there were no TGD-specific providers or centers. The city is about an hour from an urban community that had numerous TGD-affirming providers, including a gender clinic for children, if families could make the drive. Aiden and his family had lived in this community for a couple of years, having moved from another state due to transphobia. They had access to private insurance and means to travel and pay for medical care. Aiden shared enjoying physical activity and playing video games. Throughout the study, Aiden and his mom, Vanessa, as well as other family members who stopped in to say hi, were friendly and welcoming. Aiden and Vanessa appeared to have a strong, trusting relationship.

Aiden knew at five that his gender was not what people expected of him, but he did not have the words for it at such a young age. Vanessa described wondering if her child might be transgender and meeting with a mental health professional to ensure they were providing Aiden with the right types of support. At 10, he met with a gender-affirming therapist and then came out as transgender, changing his name and pronouns and starting hormone blockers to delay puberty. His family has been incredibly supportive, advocating for him when his school denied him use of facilities consistent with his gender (e.g., boys’ bathrooms), and eventually moving to provide him with a more accepting community and resources.

Aiden’s experiences with healthcare have been mixed. He described his previous doctor as “scared” of him, as he refused to prescribe hormones even after a therapist said Aiden was ready. He switched doctors and found a general practitioner who was TGD-affirming. He also visited the gender clinic in the neighboring urban city every four weeks. He sees a local therapist who is skilled at working with TGD youth. Aiden and Vanessa described generally positive experiences with healthcare but indicated that barriers existed with physician training and education on how to work with TGD people.

3.1.3. Family 3

Blake was 11 years old, the middle child of three kids living with their mom, Faith; Blake’s dad lived in another state. Although they lived within an urban city, their home was situated on the outskirts of town, just off a major interstate, giving it a more rural feel. Despite that, the city is one of the largest in the state and has several LGBTQ+ organizations and TGD-affirming healthcare providers. At the time of this study, the city did not have any policies protecting TGD people from discrimination. Blake shared his joy of cats, art, and rock collecting, as well as experimenting with make-up and fancy clothes. During our meetings, the family often had spirited conversations, sometimes openly disagreeing with each other’s take on situations, but also demonstrating closeness and care.

Blake had been exploring his gender and sexuality for a few years. He reported feeling both like a boy and non-binary, as well as bisexual, but expressed no desire to change his name or pronouns from those assigned at birth. He described liking make-up, high heels, and dresses. At times, Faith questioned this and Blake would respond adamantly that liking these things did not make him a girl. He was allowed to start wearing make-up in public, including at school, when he started the 6th grade, the same as his older sister had been.

Blake was in both family and individual therapy. Faith shared that Blake started individual therapy at a local clinic for multiple reasons, of which gender and sexuality were a part, but that his therapists would only discuss gender and sexuality if he brought it up. Faith expressed concern that this was about their discomfort with TGD issues. Blake shrugged, indicating he had no concerns about his gender or sexuality. Blake had not told his primary doctor about his gender or sexuality, but Faith reported feeling as if they would be competent. Blake indicated no desire for any medical transition or gender-related care at this time. Faith shared that the biggest hurdle she witnessed regarding TGD-affirming care was in education for mental health providers. As a clinician herself, she shared that psychologists and social workers needed better and more ongoing continuing education on working with LGBTQ+ youth.

3.1.4. Family 4

Ethan was four years old, living with his twin sister, mom, and dad in a small town. Situated in a more conservative and less densely populated area of the state, the town was unique in having a county-wide non-discrimination ordinance that included gender identity. There are no gender clinics or specific TGD-affirming providers in the community; however, there is a human rights organization providing training and resources to physicians providing care for all genders. Additionally, a more urban area, about an hour’s drive away, hosts additional resources for access to care. Ethan, his mom, Natalie, and their family were well-established in the community and the family had insurance through Natalie’s job. Ethan loved coloring, playing with toys, and laughing with his sister. During our visits, the family was loving toward each other and reported intentional efforts at building family cohesion and community.

Ethan began talking about his gender as a boy at 2 ½ years old. He regularly said he was a boy, would wear boy clothes, and questioned his own body. When we first met with Ethan and his family, he was using his name provided at birth and she/her pronouns. He appeared shy and reserved, though warmed up quickly and wanted to play with us. When we visited the second time, his demeanor had changed completely. He was using the name Ethan and he/him pronouns, had cut his hair, and was expressing his gender as a boy full-time. Natalie informed his preschool teacher, sharing that she “didn’t give them a choice” about whether to accept him or not. She said his Kindergarten the next year had a gender-inclusive policy, and she was not worried.

Natalie shared that Ethan’s general practitioner was open and supportive of Ethan and the family, noting no potential concerns. She shared that she sought out the expertise of a child therapist to identify how best to support Ethan, but the therapist shared harmful rhetoric surrounding a gender binary as opposed to being helpful. Although Ethan was too young for any TGD-specific medical care, Natalie shared concerns about being able to access that type of care in their town as Ethan got older. She indicated a barrier to effective care for Ethan is in the lack of education and training of medical and mental health providers.

These family descriptions illustrate how families navigated TGD youth healthcare, broadly and related to gender. Importantly, all the youth in the study had supportive parents willing to advocate for them to access affirming care. Most had the financial resources, insurance, and/or ability to travel to access care. This is clearly not the situation for many TGD youth; however, the themes that emerged across the families revealed important implications for access to TGD healthcare, likely relevant for TGD young people across contexts.

3.2. TGD Healthcare

Thematic analysis across data sources and families resulted in two themes related to healthcare: accessibility and affirming care.

3.2.1. Accessibility

Youth and their parents described accessible healthcare as access to TGD healthcare information, having TGD-competent providers, and safe physical resources that were obtainable given their financial and geographical location. Each family shared stories about accessibility, recognizing their own privilege of access due to supportive parents with stable incomes and access to transportation. Even so, each family shared accessibility challenges including a lack of TGD healthcare information/providers, material hardship (finances, distance), and safe physical resources. Importantly, these challenges intersected to either enhance or further limit accessibility.

Participants discussed challenges in finding information related to local healthcare providers who could work with TGD youth. One parent said:

We didn’t know where to go; doing random Google searches does not get you what you need, and looking that up on our providers care site, there was nothing. I mean, I could find 50 endocrinologists, but none of that told me if they would be able to help with this situation.

While an internet search revealed resource lists of health providers in some communities in the state, many communities had no such information consolidated or readily available online. In addition to online searches, participants noted that they also sought information regarding TGD healthcare from their child’s primary doctor. They noted that, while well-intentioned, their child’s doctors often did not have referrals for healthcare services for TGD youth. Ultimately, most families in the study relied on information provided by other TGD youth or organizations that provide support for TGD youth and their families. A youth shared how they were able to access information word-of-mouth through other TGD connections: “if I didn’t go to the [LGBTQ] center, and if I didn’t meet my friend who told me about [TGD healthcare provider], I don’t know what would have happened.”

Even when families found and accessed TGD-affirming physicians, they shared concerns about high turnover rates and a general lack of physicians in their areas. This was particularly salient for rural TGD youth. One youth shared feeling as if they had to re-establish rapport regularly due to changing physicians at the clinic, speculating that turnover could be related to working in a high-stress clinic that also provides abortion services, where protesters regularly gather and individuals experience harassment when entering and exiting the clinic.

Safety, therefore, was of particular concern to the youth and parents. They described accessing gender-affirming care through “women’s clinics”, walking through protesters, and being yelled at. One youth said:

Where I go, it’s [women’s clinic]. So they do more women’s health care. They do abortions and stuff there, too, so it’s like that’s why they have that much security cause you go through a metal detector, and the door’s locked. And then he has to unlock the door for you…But then they also do trans stuff on top of that.

Another youth described the safety planning required to enter the facility where they accessed services.

There are lots of anti-abortion people. They’re all like, there’s a building right next to them, and they have a sign that’s like, ‘Planning getting an abortion? We can help you, because we’re religious.’ They have a big truck with a really graphic image on it, which is probably fake, and they have tables and flyers. Before my first appointment, they called me and was like, ‘When you get there, just drive on in like you work there. Just ignore them, and they probably won’t try to talk to you.’

Experiencing protesters, having to go through security protocols, and other similar experiences were common for youth accessing TGD healthcare in a women’s clinic setting.

Finally, families described material hardships related to accessibility such as affordability, insurance restrictions, and travel to access resources, even in homes with adequate family support and resources. Parents experienced insurance companies’ coding mistakes that led to lengthy conversations with Human Resources to ensure that hormones and other medical needs were covered for their child. They also described instances in which visits were not covered by their insurance provider, but they were unaware until after the appointment was billed and sometimes after multiple appointments. TGD youth were also aware of the costs for medical care. One participant said:

I mean, I have a friend, and he’s getting top surgery in June or July, which is awesome for him. But I’m not. And it’s very expensive. I know, I have to wait at least another two years, if that, if I have the money. So it’s just kind of bittersweet, I guess. Because I’m really excited and happy for him. Because he’s been wanting this since- For so long.

Travel was another accessibility issue. Most of the youth in this study had to travel, sometimes an hour or more, to access a physician who competently addressed their healthcare needs.

3.2.2. Affirming Care

Affirming care was described by youth and their parents as affirming practices within the healthcare setting, having knowledge and attitudes that met their needs, and affirming spaces to access healthcare. Families identified specific instances in which name and pronoun use, providing education and referrals, and gendered space impacted their perceptions of the care they received as affirming or presented challenges to accessing affirming care.

Affirming practices were identified by participants as a broad range of affirming behaviors exhibited by or desired from healthcare providers, including using correct names and pronouns, requesting consent before engaging in services, and providing education to TGD youth as they engaged in hormone therapy. These behaviors significantly impacted participants’ perceptions of their experiences.

I mean even just the normal things, asking pronouns. One thing I’ve been reading some about is consent and this isn’t just for trans (people), but obviously it could make a big difference. Even when the doctor comes to check your pulse, ‘Is it okay if I grab your arm and then I’m going to check.’ …Just that kind of consent would be in having a more trusting and comfortable relationship.

One family in the study discussed an event that had a significant impact on their experience. A parent described it, saying,

She brought us in, and she went over it all, she showed us everything. I mean, she went into detail. And then she gave us a sharps bucket, she gave us all kinds of extra needles for practicing, and for using, gave us all this stuff. It was like this, we call it his little trans starter kit, she gave us. She was so, I mean, that made such a world of difference for us. She was amazing…

Affirming behaviors from medical professionals created an environment in which TGD youth felt more comfortable accessing the care they need.

Participants also relayed concerns about healthcare professionals’ education on gender-affirming healthcare and their inability to provide safe and effective referrals. Participants regularly went first to their general practitioners for references for gender-affirming care.

We didn’t know where to start. We really like our general practitioner, so we just set up his regular physical and started by talking to her, and she said, ‘Well, I don’t feel comfortable with that. I’m not an endocrinologist, and I don’t know enough about it,’ and she said, ‘And I would not recommend the endocrinologist in town. There’s only one.’ And she said, ‘That’s just, he does not seem like the right fit.’ She tried to help us, but we ended up getting a reference from a friend at the Center, and we go to the (Clinic’s name).

Participants noted that their practitioners seemed uncomfortable and uninformed when discussing gender-affirming care and saw gender-affirming referrals through their general practitioner as a barrier to finding care. “I think it would be easier to access that stuff through your family doctor, just going, and if you would tell them, and then they would be like, ‘Oh here’s a bunch of things we can do for you, whichever works best.’” One participant acknowledged the discomfort expressed by their general practitioner when a referral was requested, “I think doctors should be more educated on the topic because my doctor doesn’t really know a lot about trans people in general. She has a general idea, but she doesn’t know anything pretty much.” Many participants were able to find a referral to a practitioner who offered affirming care through interpersonal relationships, but they expressed concerns about accessing healthcare for other medical needs.

Yeah, and I mean so far we’ve been very lucky. He’s got a great primary care physician who’s… We’re fine. But just, every time we see somebody new, I mean I made a point when choosing a primary care physician that that would be something on the list. But if he ever has to see a specialist, or if he ever has to go to the emergency room, who knows what we’re going to find?

Concerns about accessing healthcare professionals outside of gender-based care, such as the emergency room or other emergent healthcare needs, was a concern for participants.

Additionally, participants acknowledged the need for those healthcare professionals who provide gender-affirming care to remember that youth accessing their services are not medical professionals themselves and require education and information about the care they are receiving. One participant said, “I think for young trans kids, I feel like they just…I didn’t know a lot even, and I feel my doctors didn’t really tell me enough. And I never really got what was going on. I would ask my mom and she would just tell me we’re moving in the right direction.” There may be a presumption from medical providers that youth accessing their services understand gender-affirming medical care because they sought out those services.

Gendered spaces also impacted participants’ access to affirming care. Specifically, a transmasculine youth shared discomfort about accessing women’s clinics.

It kind of made me uncomfortable at first. It still kind of makes me uncomfortable. Because I was talking to my friend, and he’s cis. And I was just like, “Oh yeah, I go to (clinic’s name).” And it was like, uh, women… Not women, but it says women in the title. And it’s pink on the card, and just like, I’m not a woman, but I go there. So it makes me kind of uncomfortable.

Another youth participant noted discomfort accessing services in a “women’s” space.

I’m like, ‘Oh, I’m not a woman, but I’m going here,’ and if I’m walking, I was like, ‘I hope no one sees me walking in here.’ Or if I talked to other people, they’re like, ‘Oh, where do you go?’ I was like, ‘Oh, I go to (Clinic’s name).’ It was like, ‘What?’

Participants mentioned a desire to have a space that was broadly available for gender-based care, “It would be amazing if there were a center here. Just gender in general, gender medical-based center that you could go to for all those things.” Even if women’s clinics are able to provide gender-affirming care, the gendered nature of the center can impact the affirming care TGD youth receive in those spaces, even if healthcare professionals there provide affirming care for TGD youth within the facility.

4. Discussion

This study explored the healthcare experiences of four TGD youth and their parents in one Midwestern state. Through extensive interviews, two broad themes arose that were explored in this paper: accessibility and affirming care. Findings reveal that even in supportive families with access to financial resources and community support, TGD youth face barriers to accessing affirming healthcare. Specifically, accessibility was limited by lack of information on TGD healthcare providers, financial resources and insurance restrictions, and safety of physical locations. Affirming care included knowledgeable and affirming providers and healthcare spaces and specific practices that demonstrated competence and care to TGD youth. These findings enhance our understanding of healthcare among TGD youth in the Midwest U.S.

A key finding from this study is the fact that even in supportive families, TGD youth experienced barriers to accessing TGD-affirming healthcare, including finding resources, financial barriers, and geographic limitations. Parents regularly discussed spending hours on the internet, talking to other parents, visiting LGBTQ+ resource centers, and calling doctors and clinics to find competent and affirming care for their child. This echoes findings from recent research that TGD youth lack access to competent healthcare providers [ 21 , 22 , 23 ]. Importantly, each family in this study had adequate health insurance coverage and yet still faced financial barriers to care, including travel to access resources and insurance challenges. Prior research has identified insurance and finances as a barrier to accessing TGD-affirming care [ 21 , 22 ]. Travel to access gender-affirming healthcare has not been specifically examined in TGD healthcare literature; however, it has been identified as a barrier to TGD and sexual minority youth access to affirming community-based resources [ 29 ].

Another finding from this study illustrates the importance of affirming practices from medical and mental healthcare providers. Several of the families in this study started their gender-affirming healthcare experience with the child’s primary care physician. Many of those providers were uncomfortable providing care or making referrals. Families also worried about what kind of care they might receive if their TGD youth had to go to the emergency department. This suggests that access to gender-affirming care is not just about access to gender-specific care, but also access to medical and mental healthcare providers and systems that are affirming regardless of what type of care a person needs.

4.1. Limitations

This study has important limitations to note. As an exploratory multiple case study, the findings should not be generalized to other populations or geographic settings. The nature of the study required parental permission and involvement, which meant parents who agreed to participate were more supportive than in other families with TGD youth. Finally, despite attempts to diversify the sample by both race/ethnicity and gender identity/expression, the final sample of families were all white and had TGD children who were transmasculine or non-binary; youth/families of color and transfeminine youth were not included. We make conclusions carefully considering these limitations.

4.2. Implications

The findings from this study are relevant to the current sociopolitical context for TGD youth and, combined with other evidence, have important implications for policy and practice. Given the rise of anti-TGD legislation and rhetoric, including particular emphasis on reducing access to healthcare services for TGD youth [ 9 ], it is critical that social workers, healthcare providers, and other professionals advocate for inclusive policies that promote access to affirming care for TGD people. Resisting anti-TGD legislation is an important place to start; however, professionals and advocates should also promote gender-inclusive policies at city, state, and national levels. Advocating for non-discrimination policies that are inclusive of gender identity and expression is an essential step toward promoting healthcare access and reducing discriminatory practices. Opposing additional access and affordability barriers to healthcare for TGD youth is both an ethical imperative and grounded in sound policy reasoning. The nondiscrimination provisions of the Affordable Care Act and other federal law, such as the Title IX civil rights provisions barring discrimination based on sex, may be interpreted as protecting the rights of TGD youth to equal access to care [ 30 ].

Additionally, this study’s findings highlight the enormous challenges which insurance policy and practice can pose for families of TGD youth. The families in this study all had access to private health insurance, a status associated with fewer insurance denials of TGD-related healthcare among adults, as compared to those with public health insurance [ 31 ]. Nonetheless, families reported routine insurance challenges, indicating the importance of improving both insurance policy and practices. From a policy perspective, the challenges families faced may reflect the important state and regional differences which motivated the present study’s attention to experiences in a Midwestern state. Current data on state-level TGD exclusion and inclusion in health insurance coverage indicate that nearly all Midwestern and Southern states do not have policies requiring coverage of TGD-related healthcare by private health insurance companies [ 32 ]. Moreover, state Medicaid policy in several Midwestern and Southern states explicitly excludes TGD healthcare coverage [ 32 ]. With many states’ policies to draw on as models, the clear policy implication is to expand bans on TGD exclusion from private and public health insurance coverage.

In addition to policy change, insurance-related practices emerged as a barrier to families, suggesting the importance of extending education and training to people who work with insurance claims. This might include healthcare organizations’ billing department employees and insurance companies’ customer service staff. While these are not the clinicians who often have direct contact with TGD youth, their work in coding, checking, and resolving insurance issues requires sufficient education and training to understand the experiences and healthcare needs of TGD youth and therefore interpret and process insurance claims correctly.

At the practice level, all participants in this study noted a lack of training for medical and mental health providers related to working with TGD people. As providers become more aware of, and more TGD youth access healthcare services for other healthcare needs, such as emergency room services, the need for training for all medical personnel will continue to expand. Eisenburg et al. [ 33 ] advocated for physical and healthcare provider training on a regular basis, and creating a system for tracking who has been trained and who is willing to provide support for TGD youth. This would help not just with training healthcare professionals but with providing resources for families to identify potential doctors or clinicians for their child. Training should consist of topics such as TGD-affirming language, debunking myths about TGD people and youth, and other medically relevant resources [ 33 , 34 ]

Relatedly, a critical practice implication of this research is a greater need for access to TGD-affirming resources. Physicians, mental health providers, and other groups such as LGBTQ+ community organizations should create and sustain a TGD-specific resource guide [ 33 ]. Such a guide can support both providers and families with finding affirming and accessible healthcare resources, reducing time spent seeking resources, helping providers make referrals to affirming providers, and providing autonomy to TGD youth who might not have familial support. This type of guide could be similar to resource guides present in large cities and urban areas, but at the county level. Additionally, the resource guide should be put into a pamphlet or brochure to ensure access for people with limited or no internet access.

Given our focus on youth, it is critical to discuss the importance of medical decision-making for TGD people under eighteen. Clark and Virani [ 34 ] explored the ethical concerns of providing medical care for TGD youth and found that TGD youth have the individual capacity to make decisions related to their own gender care. Importantly, the age of consent for medical treatment may vary by state and medical intervention, creating a potential barrier for access to affirming care. Even providers skilled in TGD care should expand their knowledge of frameworks such as positive youth development and how it intersects with TGD justice and empowerment [ 34 ].

Finally, there are important implications for research to note. We focused our study on one state in the Midwest; future research should continue to explore understudied geographic areas, including the Midwest, but also rural communities, the Southern U.S., and relevant global contexts. Additionally, future research should consider how to promote active and inclusive participation from participants while also generating findings that are more generalizable to larger groups of TGD youth. Survey methods that compare the experiences of TGD youth across states with varying policy contexts and sociopolitical environments may also be useful. Finally, innovative and less oft used methods, such as multiple case studies, provide researchers with tools to explore healthcare and health experiences with TGD and other marginalized youth in unique and nuanced ways. It may be helpful to use this type of method with states or healthcare systems as the ‘cases’ to better understand TGD youth’s experiences within these different contexts.

5. Conclusions

Numerous studies have shown that TGD youth face multiple barriers to accessing gender-affirming care. This study explored those access-oriented and gender-affirming-care-oriented barriers for white TGD youth in the Midwest who have supportive families. Even with supportive and financially stable families, these families identified barriers to accessing gender-affirming care. These barriers included a lack of access to physicians, accessing gender-affirming care financially and geographically, a lack of information and resources about gender-affirming care, and safety concerns of accessing gender-affirming care. Families identified a lack of affirming care as a barrier to access when attempting to access information on healthcare providers with knowledge about or referrals for gender-affirming care for TGD youth, when seeking information or referrals from healthcare providers, and when required to engage gendered space to access gender-affirming care. These barriers present important implications for practice and further research.

Author Contributions

Conceptualization, M.S.P., T.D.M.; methodology, M.S.P., T.D.M.; formal analysis, M.S.P., T.D.M., D.H., J.A.; writing—original draft preparation, M.S.P., J.A., M.M.C.T., I.S.; writing, T.D.M., D.H.; supervision, M.S.P.; project administration, M.S.P.; funding acquisition, M.S.P. All authors have read and agreed to the published version of the manuscript.

This study was funded by the University of Kansas General Research Fund. The University of Kansas School of Social Welfare Research Office provided funding for the open-access fees.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board of The University of Kansas (protocol code 144088 and 6/7/2019).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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• 28 May 2024

Heed lessons from past studies involving transgender people: first, do no harm

• Mathilde Kennis 0 ,
• Robin Staicu 1 ,
• Marieke Dewitte 2 ,
• Guy T’Sjoen 3 ,
• Alexander T. Sack 4 &
• Felix Duecker 5

Mathilde Kennis is a researcher in cognitive neuroscience and clinical psychological science at Maastricht University, the Netherlands.

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Robin Staicu is a neuroscientist and specialist in diversity, equity and inclusion at Maastricht University, the Netherlands.

Marieke Dewitte is a sexologist and assistant professor in clinical psychological science at Maastricht University, the Netherlands.

Guy T’Sjoen is a clinical endocrinologist and professor in endocrinology at Ghent University Hospital, Belgium, the medical coordinator of the Centre for Sexology and Gender at Ghent University Hospital, and one of the founders of the European Professional Association for Transgender Health.

Alexander T. Sack is a professor in cognitive neuroscience at Maastricht University, the Netherlands.

Felix Duecker is an assistant professor in cognitive neuroscience at Maastricht University, the Netherlands.

You have full access to this article via your institution.

Over the past few decades, neuroscientists, endocrinologists, geneticists and social scientists have conducted numerous studies involving transgender people, meaning those whose gender identity does not conform to that typically associated with the sex to which they were assigned at birth. Justifications for doing such research have shifted over the years and, today, investigators are increasingly focused on assessments of transgender people’s mental health or the impact of hormone therapies.

But such work raises challenges. Despite researchers’ best intentions, these studies can perpetuate stigmas and make it even harder for transgender people to access appropriate medical care.

Here we focus on neuroscientific approaches to the study of transgender identity to explore how investigators might navigate these concerns.

Brain scanning

In 1995, neuroscientists at the Netherlands Institute for Brain Research in Amsterdam published findings from a post-mortem study, which included six transgender individuals 1 . They found that the volume of part of the brain’s hypothalamus — called the bed nucleus of the stria terminalis, which tends to be larger in men than in women — corresponded to the gender identity of the transgender individuals, not to their sex assigned at birth. Although the data were only correlative, the researchers suggested that people identify as transgender because of changes in the brain that happen before birth — in other words, that someone can be born with a male-typical body and brain characteristics more typical of a female brain, and vice versa.

Sex and gender in science

Since it was published, the paper has been cited more than 1,000 times, and at least a dozen researchers have probed this theory and related ones using tools such as structural and functional magnetic resonance imaging (MRI).

Although the results of these analyses have been inconsistent, several ideas have nonetheless arisen about a neurobiological basis for gender dysphoria — the distress associated with a person’s gender identity not aligning with the sex they were assigned at birth. These include the ‘own-body perception’ theory 2 , which proposes that a reduced structural and functional connectivity between certain brain networks is responsible. (Previous work has associated these networks with brain regions thought to be involved in people’s ability to link their own body to their sense of self 3 .)

As analytical tools and methods advance, brain research is becoming more sophisticated. The number of neuroscientific studies that include transgender participants has increased considerably since 1991 (see ‘On the rise’).

Some neuroscientists are using functional MRI to study the effects of hormone therapy on brain structure 4 and to examine cognitive processes such as face perception 5 . Others are applying machine-learning techniques to establish whether features in brain scans of cis- and transgender people correlate with their gender identity 6 . Researchers are also trying to assess whether particular features identified in brain scans make it more likely that transgender individuals will benefit from gender-affirming hormone therapy 7 . And some are conducting ‘mega-analyses’ — pooling the brain scans of hundreds of participants — to identify brain characteristics that are specific to transgender people 8 .

Help or harm?

One concern arising from such studies is that neuroscientific findings related to transgender identity could make it even harder for some people to access medical treatment that could help them.

In countries or regions where gender-affirming medical treatment is available, individuals often need a diagnosis of ‘gender dysphoria’ or ‘gender incongruence’ to be eligible for hormone therapy or gender-affirming surgery, and to be reimbursed for such treatments. Results from brain scans could be included in the suite of measurements used to assess whether someone is experiencing gender dysphoria or incongruence.

Those in favour of such requirements argue that it is necessary to prevent people taking irreversible steps that they might regret. Hormonal therapy can have adverse effects on fertility, for instance 9 . However, many transgender people argue that whether someone can receive gender-affirming hormone therapy or other treatment shouldn’t depend on a health-care practitioner deciding that they experience ‘enough’ gender dysphoria to be eligible 10 . The current approach, combined with a shortage of specialists qualified to make such diagnoses, has been linked to long waiting lists. In the Netherlands, waiting times can be more than two years .

A second possibility is that neuroscientific findings related to transgender identity will fuel transphobic narratives 11 .

Take the debate on social media and other platforms about gendered public spaces in countries such as the United States , the United Kingdom and Brazil 12 . Some people argue that allowing transgender women to access infrastructure, such as public toilets or women’s prisons, threatens the safety of “real women” . Neuroscientific research is sometimes misused to bolster flawed claims about what ‘real’ means.

Moreover, such studies could exacerbate tensions between scientific and transgender communities.

Scientists are aiming to identify brain characteristics that are specific to transgender people. Credit: Alain Jocard/AFP/Getty

Although cis- and transgender researchers have taken steps to improve people’s understanding, there is a history of tension between the scientific and transgender communities 13 . In the late 1980s, for instance, a sexologist argued that trans women who are mainly attracted to women experience sexual arousal from their own expression of femininity. He described their feelings of gender dysphoria as resulting from paraphilia — a sexual interest in objects, situations or individuals that are atypical 14 . This theory has not held up under broader scientific scrutiny 15 , but it has become notorious in the transgender community and, from our discussions with transgender people and discussions by other groups 16 , it is clear that such studies have reduced transgender people’s trust in science.

How four transgender researchers are improving the health of their communities

In 2021, for example, a neuroimaging study with transgender participants was suspended in the United States after backlash from the transgender community. The study would have involved showing participants images of themselves wearing tight clothes, with the intention of triggering gender dysphoria — an experience that is associated with depression, anxiety, social isolation and an increased risk of suicide. The study’s researchers had acquired ethical approval from their research institute and obtained informed consent from the participants. Yet they had failed to anticipate how the transgender community would perceive their experimental procedure.

In 2022, to learn more about how transgender people view current neuroscientific approaches to the study of transgender identity, we conducted focus-group interviews that lasted for three hours with eight transgender participants — all of whom had differing levels of knowledge about the topic.

The group expressed concern that studies that look for a neurological basis to transgender identities could have a pathologizing effect. “I think questions of aetiology are just inherently wrong,” one participant said. “We don’t ask ‘Why is someone’s favourite colour blue?’. These are questions that come from wanting to pathologize.” Participants also agreed that a biological-determinist approach does not do justice to the complex and layered experience of identifying as transgender.

Decades of work aimed at establishing how science can benefit minority groups 17 suggest that neuroscientists and other scholars could take several steps to ensure they help rather than harm transgender, non-binary and intersex individuals and other people who don’t conform to narrow definitions around sex and gender. Indeed, the four actions that we lay out here are broadly applicable to any studies involving marginalized groups.

Establish an advisory board. Researchers who work with transgender participants should collaborate with an advisory board that ideally consists of transgender people and members of other groups with relevant perspectives, including those who have some understanding of the science in question. Funding agencies should support such initiatives, to help prevent further distrust being sown because of how studies are designed.

Set up multidisciplinary teams. Researchers trained in neuroscience will view phenomena such as transgender identity through a different lens from, say, those trained in psychology. To prevent the outcomes of neuroscientific and other studies being described and published in an overly deterministic and simplistic way 18 , research teams should include social scientists. Ideally, such collaborations would also include transgender researchers or others with diverse gender identities, because their input would help to prevent a cis-normative bias in study design and in the interpretation of results. Indeed, our own group has benefited from this diversity (one of us is transgender).

Prioritize research that is likely to improve people’s lives. Neuroscientists and others engaged in research involving transgender participants, non-binary people or individuals with diverse gender identities should prioritize research questions that are likely to enhance the health of these groups. Although the applications of basic research can be hard to predict, investigations into the neurobiological impacts of hormone treatment on the brain, for instance, could be more directly informative to health-care practitioners and transgender individuals than might investigations into the underlying bases of transgender identity.

Rethink how ethical approval is obtained. Ethical boards at universities typically consist of scientists with diverse backgrounds. But it is unrealistic to expect them to be educated on the sensitivities of every minority group, whether in relation to gender, religion, ethnicity or anything else. One way to address this problem is for ethical boards to require researchers to state what feedback and other information they have gathered through community engagement. A university’s ethical review committee could then evaluate whether the researchers have done enough to understand and address people’s concerns and sensitivities.

Our aim is not to halt scientific enquiry. But when it comes to transgender identity, knowledge cannot be pursued in isolation from the many societal factors that shape how that knowledge is received and acted on.

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Article contents

Gender in a social psychology context.

• Thekla Morgenroth Thekla Morgenroth Department of Psychology, University of Exeter
•  and  Michelle K. Ryan Michelle K. Ryan Dean of Postgraduate Research and Director of the Doctoral College, University of Exeter
• https://doi.org/10.1093/acrefore/9780190236557.013.309
• Published online: 28 March 2018

Understanding gender and gender differences is a prevalent aim in many psychological subdisciplines. Social psychology has tended to employ a binary understanding of gender and has focused on understanding key gender stereotypes and their impact. While women are seen as warm and communal, men are seen as agentic and competent. These stereotypes are shaped by, and respond to, social contexts, and are both descriptive and prescriptive in nature. The most influential theories argue that these stereotypes develop in response to societal structures, including the roles women and men occupy in society, and status differences between the sexes. Importantly, research clearly demonstrates that these stereotypes have a myriad of effects on individuals’ cognitions, attitudes, and behaviors and contribute to sexism and gender inequality in a range of domains, from the workplace to romantic relationships.

• gender stereotypes
• gender norms
• social psychology
• social role theory
• stereotype content model
• ambivalent sexism
• stereotype threat

Introduction

Gender is omnipresent—it is one of the first categories children learn, and the categorization of people into men and women 1 affects almost every aspect of our lives. Gender is a key determinant of our self-concept and our perceptions of others. It shapes our mental health, our career paths, and our most intimate relationships. It is therefore unsurprising that psychologists invest a great deal of time in understanding gender as a concept, with social psychologists being no exception. However, this has not always been the case. This article begins with “A Brief History of Gender in Psychology,” which gives an overview about gender within psychology more broadly. The remaining sections discuss how gender is examined within social psychology more specifically, with particular attention to how gender stereotypes form and how they affect our sense of self and our evaluations of others.

A Brief History of Gender in Psychology

During the early years of psychology in general, and social psychology in particular, the topic gender was largely absent from psychology, as indeed were women. Male researchers made claims about human nature based on findings that were restricted to a small portion of the population, namely, white, young, able-bodied, middle-class, heterosexual men [see Etaugh, 2016 ; a phenomenon that has been termed androcentrism (Hegarty, & Buechel, 2006 )]. If women and girls were mentioned at all, they were usually seen as inferior to men and boys (e.g., Hall, 1904 ).

This invisibility of women within psychology changed with a rise of the second wave of feminism in the 1960s. Here, more women entered psychology, demanded to be seen, and pushed back against the narrative of women as inferior. They argued that psychology’s androcentrism, and the sexist views of psychologists, had not only biased psychological theory and research, but also contributed to and reinforced gender inequality in society. For example, Weisstein ( 1968 ) argued that most claims about women made by prominent psychologists, such as Freud and Erikson, lacked an evidential grounding and were instead based on these men’s fantasies of what women were like rather than empirical data. A few years later, Maccoby and Jacklin ( 1974 ) published their seminal work, The Psychology of Sex Differences , which synthesized the literature on sex differences and concluded that there were few (but some) sex differences. This led to a growth of interest in the social origins of sex differences, with a shift away from a psychology of sex (i.e., biologically determined male vs. female) and toward a psychology of gender (i.e., socially constructed masculine vs. feminine).

Since then, the psychology of gender has become a respected and widely represented subdiscipline within psychology. In a fascinating analysis of the history of feminism and psychology, Eagly, Eaton, Rose, Riger, and McHugh ( 2012 ) examined publications on sex differences, gender, and women from 1960 to 2009 . In those 50 years, the number of annual publications rose from close to zero to over 6,500. As a proportion of all psychology articles, one can also see a marked rise in popularity in gender articles from 1960 to 2009 , with peak years of interest in the late 1970s and 1990s. In line with the aforementioned shift from sex differences to gender differences, the largest proportion of these articles fall into the topic of “social processes and social issues,” which includes research on gender roles, masculinity, and femininity.

However, as interest in the area has grown, the ways in which gender is studied, and the political views of those studying it, have become more diverse. Eagly and colleagues note:

we believe that this research gained from feminist ideology but has escaped its boundaries. In this garden, many flowers have bloomed, including some flowers not widely admired by some feminist psychologists. (p. 225)

Here, they allude to the fact that some research has shifted away from societal explanations, which feminist psychologists have generally favored, to more complex views of gender difference. Some of these acknowledge the fact that nature and nurture are deeply intertwined, with both biological and social variables being used to understand gender and gender differences (e.g., Wood & Eagly, 2002 ). Others, such as evolutionary approaches (e.g., Baumeister, 2013 ; Buss, 2016 ) and neuroscientific approaches (see Fine, 2010 ), focus more heavily on the biological bases of gender differences, often causing chagrin among feminists. Nevertheless, much of the research in social psychology has, unsurprisingly, focused on social factors and, in particular, on gender stereotypes. Where do they come from and what are their effects?

Origins and Effects of Gender Stereotypes

A stereotype can be defined as a “widely shared and simplified evaluative image of a social group and its members” (Vaughan & Hogg, 2011 , p. 51) and has both descriptive and prescriptive aspects. In other words, gender stereotypes tell us what women and men are like, but also what they should be like (Heilman, 2001 ). Gender stereotypes are not only widely shared, but they are also stubbornly resistant to change (Haines, Deaux, & Lofaro, 2016 ). Both the origin and the consequences of these stereotypes have received much attention in social psychology. So how do stereotypes form? The most widely cited theories on stereotype formation—social role theory (SRT; Eagly, 1987 ; Eagly, Wood, & Diekman, 2000 ) and the stereotype content model (SCM; Fiske, Cuddy, Glick, & Xu, J., 2002 )—answer this question. Both of these models focus on gender as a binary concept (i.e., men and women), as does most psychological research on gender, although they could potentially also be applied to other gender groups. Both theories are considered in turn.

Social Role Theory: Gender Stereotypes Are Determined by Roles

SRT argues that gender stereotypes stem from the distribution of men and women into distinct roles within a given society (Eagly, 1987 ; Eagly et al., 2000 ). The authors note the stability of gender stereotypes across cultures and describe two core dimensions: agency , including traits such as independence, aggression, and assertiveness, and communion , including traits such as caring, altruism, and politeness. While men are generally seen to be high in agency and low in communion, women are generally perceived to be high in communion but low in agency.

According to SRT, these gender stereotypes stem from the fact that women and men are over- and underrepresented in different roles in society. In most societies, even those with higher levels of gender equality, men perform less domestic work compared to women, including childcare, and spend more time in paid employment. Additionally, men disproportionately occupy leadership roles in the workforce (e.g., in politics and management) and are underrepresented in caretaking roles within the workforce (e.g., in elementary education and nursing; see Eagly et al., 2000 ). Eagly and colleagues argue that this gendered division of labor leads to the formation of gender roles and associated stereotypes. More specifically, they propose that different behaviors are seen as necessary to fulfil these social roles, and different skills, abilities, and traits are seen as necessary to execute these behaviors. For example, elementary school teachers are seen to need to care for and interact with children, which is seen to require social skills, empathy, and a caring nature. In contrast, such communal attributes might be seen to be less important—or even detrimental—for a military leader.

To the extent that women and men are differentially represented and visible in certain roles—such as elementary school teachers or military leaders—the behaviors and traits necessary for these roles become part of each respective gender role. In other words, the behaviors and attributes associated with people in caretaking roles, communion, become part of the female gender role, while the behaviors and attributes associated with people in leadership roles, agency, become part of the male gender role.

Building on SRT, Wood and Eagly ( 2002 ) developed a biosocial model of the origins of sex differences which explains the stability of gendered social roles across cultures. The authors argue that, in the past, physical differences between men and women meant that they were better able to perform certain tasks, contributing to the formation of gender roles. More specifically, women had to bear children and nurse them, while men were generally taller and had more upper body strength. In turn, tasks that required upper body strength and long stretches of uninterrupted time (e.g., hunting) were more often carried out by men, while tasks that could be interrupted more easily and be carried out while pregnant or looking after children (e.g., foraging) were more often carried out by women.

Eagly and colleagues further propose that the exact tasks more easily carried out by each sex depended on social and ecological conditions as well as technological and cultural advances. For example, it was only in more advanced, complex societies that the greater size and strength of men led to a division of labor in which men were preferred for activities such as warfare, which also came with higher status and access to resources. Similarly, the development of plough technology led to shifts from hunter–gatherer societies to agricultural societies. This change was often accompanied by a new division of labor in which men owned, farmed, and inherited land while women carried out more domestic tasks. The social structures that arose from these processes in specific contexts in turn affected more proximal causes of gender differences, including gender stereotypes.

It is important to note that this theory focuses on physical differences between the genders, not psychological ones. In other words, the authors do not argue that women and men are inherently different when it comes to their minds, nor that men evolved to be more agentic while women evolved to be more communal.

Stereotype Content Model: Gender Stereotypes Are Determined by Group Relations

The SCM, formulated by Fiske and colleagues ( 2002 ), was not developed specifically for gender, but as an explanation of how stereotypes form more generally. Similar to SRT, the SCM argues that gender stereotypes arise from societal structures. More specifically, the authors suggest that status differences and cooperation versus competition determine group stereotypes—among them, gender stereotypes. This model also suggests two main dimensions to stereotypes, namely, warmth and competence. The concept of warmth is similar to that of communion, previously described, in that it refers to being kind, nice, and caring. Competence refers to attributes such as being intelligent, efficient, and skillful and is thus different from the agency dimension of SRT.

The SCM argues that the dimensions of warmth and competence originate from two fundamental dimensions—status and competition—which characterize the relationships between groups in every culture and society. The degree to which another group is perceived to be warm is determined by whether the group is in cooperation or in competition with one’s own group, which is in turn associated with perceived intentions to help or to harm one’s own group, respectively. While members of cooperating groups are stereotyped as warm, members of competing groups are stereotyped as cold. Evidence suggests that these two dimensions are indeed universal and can be found in many cultures, including collectivist cultures (Cuddy et al., 2009 ). Perceptions of competence, however, are affected by the status and power of the group, which go hand-in-hand with the group’s ability to harm one’s own group. Those groups with high status and power are stereotyped as competent, while those that lack status and power are stereotyped as incompetent.

Groups can thus fall into one of four quadrants of this model. Members of high status groups who cooperate with one’s own group are seen as unequivocally positive—as warm and competent—while those of low status who compete with one’s own group are seen as unequivocally negative—cold and incompetent. More interesting are the two groups that fall into the more ambivalent quadrants—those who are perceived as either warm but incompetent or competent but cold. Applied to gender, this model suggests—and research shows—that typical men are stereotyped as competent but cold, the envious stereotype, while typical women are stereotyped as warm but incompetent, the paternalistic stereotype.

However, these stereotypes do not apply equally to all women and men. Rather, subgroups of men and women come with their own stereotypes. Research demonstrates, for example, that the paternalistic stereotype most strongly applies to traditional women such as housewives, while less traditional women such as feminists and career women are stereotyped as high in competence and low in warmth. For men, there are similar levels of variation—the envious stereotype applies most strongly to men in traditional roles such as managers and career men, while other men are perceived as warm but incompetent (e.g., senior citizens), as cold and incompetent (e.g., punks), or as warm and competent (e.g., professors; Eckes, 2002 ). The section “Gender Stereotypes Affect Emotions, Behavior, and Sexism” discusses the consequences of these stereotypes in more detail.

The Effects of Gender Stereotypes

SRT and the SCM explain how gender stereotypes form. A large body of work in social psychology has focused on the consequences of these stereotypes. These include effects on the gendered perceptions and evaluations of others, as well as effects on the self and one’s own self-image, behavior, and goals.

Gendered Perceptions and Evaluations of Others

Our group-based stereotypes affect how we see members of these groups and how we judge those who do or do not conform to these stereotypes. Gender differs from many other group memberships in several ways (see Fiske & Stevens, 1993 ), which in turn affects consequences of these stereotypes. First, argue Fiske and Stevens, gender stereotypes tend to be more prescriptive than other stereotypes. For example, men may often be told to “man up,” to be tough and dominant, while women may be told to smile, to be nice, and to be sexy (but not too sexy). While stereotypes of other groups also have prescriptive elements, it is probably less common to hear Asians be told to be better at math or African Americans to be told to be more musical. The consequences of these gendered prescriptions are discussed in the section “Gender Stereotypes Affect the Evaluation of Women and Men.” Second, relationships between women and men are characterized by an unusual combination of power differences and close and frequent contact as well as mutual dependence for reproduction and close relationships. The section “Gender Stereotypes Affect Emotions, Behavior, and Sexism” discusses the effects of these factors.

Gender Stereotypes Affect the Evaluation of Women and Men

The evaluation of women and men is affected by both descriptive and prescriptive gender stereotypes. Research on these effects has predominantly focused on those who occupy counterstereotypical roles such as women in leadership or stay-at-home fathers.

Descriptive stereotypes affect the perception and evaluation of women and men in several ways. First, descriptive stereotypes create biased perceptions through expectancy confirming processes (see Fiske, 2000 ) such that individuals, particularly those holding strong stereotypes, seek out information that confirms their stereotypes. This is evident in their tendency to neglect or dismiss ambiguous information and to ask stereotype-confirming questions (Leyens, Yzerbyt, & Schadron, 1994 ; Macrae, Milne, & Bodenhausen, 1994 ). Moreover, people are more likely to recall stereotypical information compared to counterstereotypical information (Rojahn & Pettigrew, 1992 ) Second, descriptive gender stereotypes also bias the extent to which men and women are seen as suitable for different roles, as described in Heilman’s lack of fit model ( 1983 , 1995 ) and Eagly and Karau’s role congruity theory ( 2002 ). These approaches both suggest that the degree of fit between a person’s attributes and the attributes associated with a specific role is positively related to expectations about how successful a person will be in said role. For example, the traits associated with successful managers are generally more similar to those associated with men than those associated with women (Schein, 1973 ; see also Ryan, Haslam, Hersby, & Bongiorno, 2011 ). Thus, all else being equal, a man will be seen as a better fit for a managerial position and in turn as more likely to be a successful manager. These biased evaluations in turn lead to biased decisions, such as in hiring and promotion (see Heilman, 2001 ).

Prescriptive gender stereotypes also affect evaluations, albeit in different ways. They prescribe how women and men should behave, and also how they should not behave. The “shoulds” generally mirror descriptive stereotypes, while the “should nots” often include behaviors associated with the opposite gender. Thus, what is seen as positive and desirable for one gender is often seen as undesirable for the other and can lead to backlash in the form of social and economic penalties (Rudman, 1998 ). For example, women who are seen as agentic are punished with social sanctions because they violate the prescriptive stereotype that women should be nice, even in the absence of information indicating that they are not nice (Rudman & Glick, 2001 ). These processes are particularly problematic in combination with the effects of descriptive stereotypes, as individuals may face a double bind—if women behave in line with gender stereotypes, they lack fit with leadership positions that require agency, but if they behave agentically, they violate gender norms and face backlash in the form of dislike and discrimination (Rudman & Glick, 2001 ). Similar effects have been found for men who violate prescriptive masculine stereotypes, for example, by being modest (Moss-Racusin, Phelan, & Rudman, 2010 ) or by requesting family leave (Rudman & Mescher, 2013 ). Interestingly, however, being communal by itself does not lead to backlash for men (Moss-Racusin et al., 2010 ). In other words, while men can be perceived as highly agentic and highly communal, this is not true for women, who are perceived as lacking communion when being perceived as agentic and as lacking agency when being perceived as communal.

Gender Stereotypes Affect Emotions, Behavior, and Sexism

Stereotypes not only affect how individuals evaluate others, but also their feelings and behaviors toward them. The Behavior from Intergroup Affect and Stereotypes (BIAS) map (Cuddy, Fiske, & Glick, 2007 ), which extends the SCM, describes the relationship between perceptions of warmth and competence of certain groups, emotions directed toward these groups, and behaviors toward them. Cuddy and colleagues argue that bias is comprised of three elements: cognitions (i.e., stereotypes), affect (i.e., emotional prejudice), and behavior (i.e., discrimination), and these are closely linked. Groups perceived as warm and competent elicit admiration while groups perceived as cold and incompetent elicit contempt. Of particular interest to understanding gender are the two ambivalent combinations of warmth and competence: Those perceived as warm, but incompetent—such as typical women—elicit pity, while those perceived as competent, but cold—such as typical men—elicit envy.

Similarly, perceptions of warmth and competence are associated with behavior. Cuddy and colleagues ( 2007 ) argue that the warmth dimension affects behavioral reactions more strongly than competence because it stems from perceptions that a group will help or harm the ingroup. This leads to active facilitation (e.g., helping) when a group is perceived as warm, or active harm (e.g., harassing) when a group is perceived as cold. Competence, however, leads to passive facilitation (e.g., cooperation when it benefits oneself or one’s own group) when the group is perceived as competent, and passive harm (e.g., neglecting to help) when the group is perceived as incompetent.

How these emotional and behavioral reactions affect women and men has received much attention in the literature on ambivalent sexism and ambivalent attitudes toward men (Glick & Fiske, 1996 , 1999 , 2001 ). According to ambivalent sexism theory (AST), sexism is not a uniform, negative attitude toward women or men. Rather, it is comprised of hostile and benevolent elements, which arises from status differences between, and intimate interdependence of, the two genders. While men possess more economic, political, and social power, they depend on women as their mothers and (for heterosexual men) as romantic partners. Thus, while they are likely to be motivated to keep their power, they also need to find ways to foster positive relations with women.

Hostile sexism combines the beliefs that (a) women are inferior to men, (b) men should have more power in society, and (c) women’s sexuality poses a threat to men’s status and power. This form of sexism is mostly directed toward nontraditional women who directly threaten men’s status (e.g., feminists or career women), and women who threaten the heterosexual interdependence of men and women (e.g., lesbians)—in other words, toward women perceived to be competent but cold.

Benevolent sexism is a subtler form of sexism and refers to (a) complementary gender differentiation , the belief that (traditional) women are ultimately the better gender, (b) protective paternalism , where men need to cherish, protect, and provide for women, and (c) heterosexual intimacy , the belief that men and women complement each other such that no man is truly complete without a woman. This form of sexism is directed mainly toward traditional women.

While benevolent sexism may seem less harmful than its hostile counterpart, it ultimately provides an alternative mechanism for the persistence of gender inequality by “keeping women in their place” and discouraging them from seeking out nontraditional roles (see Glick & Fiske, 2001 ). Exposure to benevolent sexism is associated with women’s increased self-stereotyping (Barreto, Ellemers, Piebinga, & Moya, 2010 ), decreased cognitive performance (Dardenne, Dumont, & Bollier, 2007 ), and reduced willingness to take collective action (Becker & Wright, 2011 ), thus reinforcing the status quo.

With perceptions of men, Glick and Fiske ( 1999 ) argue that attitudes are equally ambivalent. Hostile attitudes toward men include (a) resentment of paternalism , stemming from perceptions of unfairness of the disproportionate amounts of power men hold, (b) compensatory gender differentiation , which refers to the application of negative stereotypes to men (e.g., arrogant, unrefined) so that women can positively distinguish themselves from them, and (c) heterosexual hostility , stemming from male sexual aggressiveness and interpersonal dominance. Benevolent attitudes toward men include maternalism , that is, the belief that men are helpless and need to be taken care of at home. Interestingly, while such attitudes portray women as competent in some ways, it still reinforces gender inequality by legitimizing women’s disproportionate amount of domestic work. Benevolent attitudes toward men also include complementary gender differentiation , the belief that men are indeed more competent, and heterosexual attraction , the belief that a woman can only be truly happy when in a romantic relationship with a man.

Cross-cultural research (Glick et al., 2000 , 2004 ) suggests that ambivalent sexism and ambivalent attitudes toward men are similar in many ways and can be found in most cultures. For both constructs, the benevolent and hostile aspects are distinct but positively related, illustrating that attitudes toward women and men are indeed ambivalent, as the mixed nature of stereotypes would suggest. Moreover, ambivalence toward women and men are correlated and national averages of both aspects of sexism and ambivalence toward men are associated with lower gender equality across nations, lending support to the idea that they reinforce the status quo.

Gender Stereotypes Affect the Self

Gender stereotypes not only affect individuals’ reactions toward others, they also play an important part in self-construal, motivation, achievement, and behavior, often without explicit endorsement of the stereotype. This section discusses how gender stereotypes affect observable gender differences and then describes the subtle and insidious effects gender stereotypes can have on performance and achievement through the inducement of stereotype threat (Steele & Aronson, 1995 ).

Gender Stereotypes Affect Gender Differences

Gender stereotypes are a powerful influence on the self-concept, goals, and behaviors. Eagly and colleagues ( 2000 ) argue that girls and boys observe the roles that women and men occupy in society and accommodate accordingly, seeking out different activities and acquiring different skills. They propose two main mechanisms by which gender differences form. First, women and men adjust their behavior to confirm others’ gender-stereotypical expectations. Others communicate their gendered expectations in many, often nonverbal and subtle ways and react positively when expectations are confirmed and negatively when they are not. This subtle communication of expectations reinforces gender-stereotypical behavior as people generally try to elicit positive, and avoid negative, reactions from others. Importantly, the interacting partners need not be aware of these expectations for them to take effect.

The second process by which gender stereotypes translate into gender differences is the self-regulation of behavior based on identity processes and the internalization of stereotypes (e.g., Bem, 1981 ; Markus, 1977 ). Most people form their gender identity based on self-categorization as male or female and subsequently incorporate attributes associated with the respective category into their self-concept (Guimond, Chatard, Martinot, Crisp, & Redersdorff, 2006 ). These gendered differences in the self-concepts of women and men then translate into gender-stereotypical behaviors. The extent to which the self-concept is affected by gender stereotypes—and in turn the extent to which gendered patterns of behavior are displayed—depends on the strength and the salience of this social identity (Hogg & Turner, 1987 ; Onorato & Turner, 2004 ). For example, individuals may be more likely to display gender-stereotypical behavior when they identify more strongly with their gender (e.g., Lorenzi‐Cioldi, 1991 ) or when their gender is more likely to be salient, which is more likely to be the case for women (Cadinu & Galdi, 2012 ).

However, many different subcategories of women exist—housewives, feminists, lesbians—and thus what it means to identify as a woman, and behave like a woman, is likely to be complex and multifaceted (e.g., Fiske et al., 2002 ; van Breen, Spears, Kuppens, & de Lemus, 2017 ). Moreover, research demonstrates that the salience of gender in any given context also determined the degree to which an individual displays gender-stereotypical behavior (e.g., Ryan & David, 2003 ; Ryan, David, & Reynolds, 2004 ). For example, Ryan and colleagues demonstrate that while women and men act in line with gender stereotypes when gender and gender difference are salient, these differences in attitudes and behavior disappear when alternative identities, such as those based on being a student or being an individual, are made salient.

Gender Stereotypes Affect Performance and Achievement

The consequences of stereotypes go beyond the self-concept and behavior. Research in stereotype threat describes the detrimental effects that negative stereotypes can have on performance and achievement. Stereotype threat refers to the phenomenon whereby the awareness of the negative stereotyping of one’s group in a certain domain, and the fear of confirming such stereotypes, can have negative effects on performance, even when the stereotype is not endorsed. The phenomenon was first described by Steele and Aronson ( 1995 ) in the context of African Americans’ intellectual test performance, but has since been found to affect women’s performance and motivation in counterstereotypical domains such as math (Nguyen & Ryan, 2008 ) and leadership (Davies, Spencer, & Steele, 2005 ). This affect holds true even when minority group members’ prior performance and interest in the domain are the same as those of majority group members (Spencer, Steele, & Quinn, 1999 ). Moreover, the effect is particularly pronounced when the minority member’s desire to belong is strong and identity-based devaluation is likely (Steele, Spencer, & Aronson, 2002 ).

Different mechanisms for the effect of stereotype threat have been proposed. Schmader, Johns, and Forbes ( 2008 ) suggest that the inconsistency between one’s self-image as competent and the cultural stereotype about one’s group’s lack of competence leads to a physiological stress response that directly impairs working memory. For example, when made aware of the widely held stereotype that women are bad at math, a female math student is likely to experience an inconsistency. This inconsistency, the authors argue, is not only distressing in itself, but induces uncertainty: Am I actually good at math or am I bad at math as the stereotype would lead me to believe? In an effort to resolve this uncertainty, she is likely to monitor her performance more than others—and more than in a situation in which stereotype threat is absent. This monitoring leads to more conscious, less efficient processing of information—for example, when performing calculations that she would otherwise do more or less automatically—and a stronger focus on detecting potential failure, taking cognitive resources away from the actual task. Moreover, individuals under stereotype threat are more likely to experience negative thoughts and emotions such as fear of failure. In order to avoid the interference of these thoughts, they actively try to suppress them. This suppression, however, takes effort. All of these mechanisms, the authors argue, take working memory space away from the task in question, thereby impairing performance.

The aim of this article is to give an overview of gender research in social psychology, which has focused predominantly on gender stereotypes, their origins, and their consequences, and these are all connected and reinforce each other. Social psychology has produced many fascinating findings regarding gender, and this article has only just touched on these findings. While research into gender has seen a great growth in the past 50 years and has provided us with an unprecedented understanding of women and men and the differences (and similarities) between them, there is still much work to be done.

There are a number of issues that remain largely absent from mainstream social psychological research on gender. First, an interest and acknowledgment of intersectional identities has emerged, such as how gender intersects with race or sexuality. It is thus important to note that many of the theories discussed in this article cannot necessarily be applied directly across intersecting identities (e.g., to women of color or to lesbian women), and indeed the attitudes and behaviors of such women continue to be largely ignored within the field.

Second, almost all social psychological research into gender is conducted using an overly simplistic binary definition of gender in terms of women and men. Social psychological theories and explanations are, for the most part, not taking more complex or more fluid definitions of gender into account and thus are unable to explain gendered attitudes and behavior outside of the gender binary.

Finally, individual perceptions and cognitions are influenced by gendered stereotypes and expectations, and social psychologists are not immune to this influence. How we, as psychologists, ask research questions and how we interpret empirical findings are influenced by gender stereotypes (e.g., Hegarty & Buechel, 2006 ), and we must remain vigilant that we do not inadvertently seek to reinforce our own gendered expectations and reify the gender status quo.

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1. Psychology largely conceptualizes gender as binary. While this is problematic in a number of ways, which we touch upon in the Conclusion section, we largely follow these binary conventions throughout this article, as it is representative of the social psychological literature as a whole.

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Module 2: Studying Gender Using the Scientific Method

3rd edition as of August 2023

Module Overview

In Module 2, we will address the fact that psychology is the scientific study of behavior and mental processes. We will do this by examining the steps of the scientific method and by describing the five major designs used in psychological research. We will also differentiate between reliability and validity and their importance for measurement. Psychology has very clear ethical standards and procedures for scientific research. We will discuss these and why they are needed. The content of this module relates to all areas of psychology, but we will also point out some methods used in the study of gender that may not be used in other subfields as frequently or at all.

Module Outline

2.1. The Scientific Method

2.2. research designs used in the study of gender issues, 2.3. reliability and validity, 2.4. research ethics.

Module Learning Outcomes

• Clarify what it means for psychology to be scientific by examining the steps of the scientific method and the three cardinal features of science.
• Outline the five main research methods used in psychology and clarify how they are utilized in social psychology.
• Differentiate and explain the concepts of reliability and validity.
• Describe key features of research ethics.

Section Learning Objectives

• Define scientific method.
• Outline and describe the steps of the scientific method, defining all key terms.
• Identify and clarify the importance of the three cardinal features of science.

In Module 1, psychology was defined as the scientific study of behavior and mental processes. More about behavior and mental processes will be explained, but before proceeding, it will be useful to elaborate on what makes psychology scientific. In fact, it is safe to say that most outside the field of psychology, or a sister science, might be surprised to learn that psychology utilizes the scientific method.

The scientific method is a systematic method for gathering knowledge about the world around us. Systematic means that there is a set way to use it. There is some variety in the number of steps used in the scientific method, depending on the souce, but for the purposes of this book, the following breakdown will be used:

Table 2.1: The Steps of the Scientific Method

Science has at its root three cardinal features that we will encounter throughout this book. They are:

• Observation – Observational research is a type of non-experimental research method in which the goal is to describe the variables. In naturalistic observation , participants are observed in a natural setting. In structured observation , participants are observed in a more structured environment, such as a lab.
• Experimentation – To determine whether there is a causal , or cause-and-effect, relationship between two variables, we must be able to isolate variables. In a true experiment, the independent variable is systematically manipulated, and extraneous variables are controlled , or decreased in variability, as much as possible.
• Measurement –Whether researchers are using a non-experimental, observational design, or an experimental design, it is important for researchers to ensure the scales that are used are valid and reliable . Reliability refers to consistency, in which the same results are achieved at different times and between different researchers. Validity refers to whether or not the study measured the variable it was intended to measure. Validity and reliability will be further discussed in Section 2.3. These concepts help us to know that the conclusions we infer from our data are drawn from trustworthy sources and techniques.
• List the five main research methods used in psychology.
• Describe observational research, listing its advantages and disadvantages.
• Describe case study research, listing its advantages and disadvantages.
• Describe survey research, listing its advantages and disadvantages.
• Describe correlational research, listing its advantages and disadvantages.
• Describe experimental research, listing its advantages and disadvantages.
• State the utility and need for multimethod research.

Step 3 of the scientific method involves the scientist testing their hypothesis. Psychology as a discipline uses five main research designs. These include observational research, case studies, surveys, correlational designs, and experiments. Note that research can take two forms: quantitative , which is focused on numbers, and qualitative, which is focused on words. Psychology primarily focuses on quantitative research, though qualitative research is just as useful in different ways. Qualitative and quantitative research are complimentary approaches, and often fill in important gaps for one another.

2.2.1. Observational Research

In naturalistic observation , the scientist studies human or animal behavior in its natural environment, which could include the home, school, or a forest. The researcher counts, measures, and rates behavior in a systematic way and at times uses multiple judges to ensure accuracy in how the behavior is being measured. This is called inter-rater reliability, as you will see in Section 2.3. The advantage of this method is that you witness behavior as it occurs, and it is not tainted by the experimenter. The disadvantage is that it could take a long time for the behavior to occur and if the researcher is detected, then the behavior of those being observed may be influenced. In that case, the behavior of the observed could become artificial .

Laboratory observation is a type of structured observation which involves observing people or animals in a laboratory setting. A researcher who wants to know more about parent-child interactions might bring a parent and child into the lab to engage in preplanned tasks, such as playing with toys, eating a meal, or the parent leaving the room for a short period of time. The advantage of this method over the naturalistic method is that the experimenter can control for more extraneous variables and save time. The cost of using a laboratory observation method is that since the subjects know the experimenter is watching them, their behavior may become artificial. Behavior can also be artificial due to the structured lab being too unlike the natural environment.

      2.2.1.1. Example of a psychology of gender study utilizing observation. Olino et al. (2012) indicate that a growing body of literature points to gender differences in child temperament and adult personality traits throughout life, but that many of these studies rely solely on parent-report measures. Their investigation used parental-report, maternal-report, and laboratory observation. The laboratory batteries took approximately two hours, and children were exposed to standardized laboratory episodes with a female experimenter. These episodes were intended to elicit individual differences in temperament traits as they relate to behavioral engagement, social behavior, and emotionality. They included Risk Room, where children explore a set of novel and ambiguous stimuli (such as a black box); Stranger Approach, or when the child is left alone in the room briefly and a male research accomplice enters the room and speaks to the child; Pop-up Snakes, or when the child and experimenter surprise the child’s mother with a can of potato chips that contain coiled snakes; and Painting a Picture, which allows the child to play with watercolor pencils and crayons. Observers assigned a 1 for low intensity, 2 for moderate intensity, and 3 for high intensity in relation to facial, bodily, and vocal positive affect, fear, sadness, and anger displays. Outside of these affective codes, observers also used behavioral codes on a similar three-point scale to assess engagement, sociability, activity, and impulsivity. The sample included 463 boys and 402 girls.

Across the three different measures, girls showed higher positive affect and fear and lower activity level compared to boys. When observed in the laboratory, girls showed higher levels of sociability but lower levels of negative emotionality, anger, sadness, and impulsive behavior. Maternal reports showed higher levels of overall negative emotionality and sadness for girls while paternal reports showed higher levels of sociability for boys.

Read the study for yourself: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532859/

2.2.2. Case Studies

Psychology also utilizes a detailed description of one person, or a small group, based on careful observation. This was the approach the founder of psychoanalysis, Sigmund Freud, took to develop his theories. The advantage of this method is that you arrive at a rich description of the behavior being investigated in one or two individuals, but the disadvantage is that what you are learning may be unrepresentative of the larger population and, therefore, lacks generalizability . Case studies are also subject to the interpretation and bias of the researcher in that they decide what is important to include and not include in the final report. Despite these limitations, case studies can lead us to novel ideas about the cause of behavior and help us to study unusual conditions that occur too infrequently to study with large sample sizes in a systematic way.

      2.2.2.1. Example of a psychology of gender study utilizing a case study. Mukaddes (2002) studied cross-gender behavior in children with high functioning autism. Specifically, two boys were followed over a period of about four years who showed persistent gender identity problems. Case 2, called A.A., was a 7-year-old boy referred to a child psychiatry department in Turkey due to language delay and issues with social interaction. The author goes on to describe in detail the family history and how the child showed a “persistent attachment to his mother’s and some significant female relative’s clothes and especially liked to make skirts out of their scarves. After age 5 years, he started to ‘play house’ and ‘play mother roles’… His parents have tried to establish good bonding between him with his father as an identification object. Despite this, his cross-gender behaviors are persistent (pg. 531).” In the discussion of both cases, the authors note that the report of cross-gender behavior in autistic cases is rare, and that their case study attempts to, “…underline that (1) diagnosis of GID in autistic individuals with a long follow-up seems possible; and (2) high functioning verbally-able autistic individuals can express their gender preferences as well as other personal preferences” (pg. 532).

To learn more about observational and case study designs, please take a look at the Research Methods in Psychology textbook by visiting:

https://kpu.pressbooks.pub/psychmethods4e/chapter/observational-research/

2.2.3. Surveys/Self-Report Data

A survey is a questionnaire consisting of at least one scale with some number of questions which assess a psychological construct of interest, such as parenting style, depression, locus of control, communication, attitudes, or sensation-seeking behavior. It may be administered by paper and pencil or computer. Surveys allow for the collection of large amounts of data quickly. The actual survey could be tedious for the participant, and social desirability , when a participant answers questions dishonestly so that they are seen in a more favorable light, could be an issue. For instance, if you are asking high school students about their sexual activity, they may not give genuine answers for fear that their parents will find out. If you wanted to know about prejudicial attitudes of a group of people, it could be useful to choose the survey method. You could alternatively gather this information through an interview in a structured or unstructured fashion. R andom sampling is important component in survey research, where everyone in the population has an equal chance of being included in the sample. This helps the survey to be representative of the population and in demographic variables such as gender, age, ethnicity, race, sexual orientation, education level, and religious orientation.

      2.2.3.1. Example of a psychology of gender study utilizing a survey. Weiser (2004) wanted to see to what extent a gender gap existed in internet use. Utilizing a 19-item survey given to introductory psychology students, he found that males used the internet for entertainment and leisure activities while females used it for interpersonal communication and educational activities. Interestingly, he found that age and internet experience mediated the gender differences.

To learn more about the survey research design, please take a look at our Research Methods in Psychology textbook by visiting:

https://kpu.pressbooks.pub/psychmethods4e/chapter/overview-of-survey-research/

2.2.4. Correlational Research

This research method examines the relationship between two variables or two groups of variables. A numerical measure of the strength of this relationship is derived, called the correlation coefficient , and can range from -1.00 (a perfect inverse relationship meaning that as one variable goes up the other goes down), to 0 (or no relationship at all), to +1.00 (or a perfect relationship in which as one variable goes up or down so does the other). The advantage of correlational research is that it allows us to observe statistical relationships between variables. Additionally, correlational research can be used when a researcher is not able to manipulate a variable, as in an experiment. An example of a negative correlation is when a parent becomes more rigid, the attachment of the child to the parent goes down. In contrast, an example of a positive correlation is that as a parent becomes warmer toward the child, the child becomes more attached. However, one must take care not to conflate correlation with causation. Just because there is a statistical relationship between variables does not mean that one caused the other. A spurious correlation is one where there is a statistical relationship between variables, but no causation between them.

For a list of examples of spurious correlations visit: https://www.tylervigen.com/spurious-correlations

     2.2.4.1. Example of a psychology of gender study utilizing a correlational method. In a study investigating the relationship of gender role identity, support for feminism, and willingness to consider oneself a feminist, Toller, Suter, and Trautman (2004) found that when men scored high on the Sexual Identity Scale (which indicates high levels of femininity), they were supportive of the women’s movement and were more willing to consider themselves a feminist (positive correlations). In contrast, high scores on the Personal Attributes Questionnaire (PAQ) masculinity index resulted in reports of being less likely to consider themselves a feminist (a negative correlation). In terms of female participants, a positive correlation was found between highly masculine women and positive attitudes toward nontraditional gender roles. The authors note, “Possible explanations for these findings may be that women often describe feminists with masculine traits, such as “dominating” and “aggressive.” Thus, the more feminine women in our study may have viewed feminism and nontraditional gender roles as masculine.”

To learn more about the correlational research design, please take a look at the Research Methods in Psychology textbook by visiting:

https://kpu.pressbooks.pub/psychmethods4e/chapter/correlational-research/

2.2.5. Experiments

An experiment is a controlled test of a hypothesis in which a researcher manipulates one variable and measures its effect on another variable. The variable that is manipulated is called the independent variable (IV) and the one that is measured is called the dependent variable (DV) . A common feature of experiments is to have a control group that does not receive the treatment or is not manipulated and an experimental group that does receive the treatment or manipulation. If the experiment includes random assignment, participants have an equal chance of being placed in the control or experimental group. The control group allows the researcher to make a comparison to the experimental group, making a causal statement possible.

     2.2.5.1. Example of an experimental psychology of gender study. Wirth and Bodenhausen (2009) investigated whether gender played a moderating role in the stigma of mental illness in a web-based survey experiment. They asked participants to read a case summary in which the patient’s gender was manipulated along with the type of disorder. These cases were either of male-typical or female-typical disorders. Their results showed that when the cases were gender typical, participants were less sympathetic, showed more negative affect, and were less likely to help than if the cases were gender atypical. The authors proposed that the gender-typical cases were much less likely to be seen as genuine mental disturbances by the participants.

To learn more about the experimental research design, please take a look at the Research Methods in Psychology textbook by visiting:

https://kpu.pressbooks.pub/psychmethods4e/part/experimental-research/

2.2.6. Multi-Method Research

As you have seen above, no single method alone is perfect. Each has strengths and limitations. As such, for psychologists to provide the clearest picture of what is affecting behavior or mental processes, several of these approaches are typically employed at different stages of the research process. This is called multi-method research.

2.2.7. Archival Research

Another technique used by psychologists is called archival research, or when the researcher analyzes data that has already been collected for another purpose. For instance, a researcher may request data from high schools about students’ GPA and SAT/ACT score(s) and then obtain their four-year GPA from the university they attended. This can be used to make a prediction about success in college and which measure – GPA or standardized test score – is the better predictor.

2.2.8. Meta-Analysis

Meta-analysis is a statistical procedure that allows a researcher to combine data from more than one study. For instance, Marx and Kettrey (2016) evaluated the association between the presence of gay-straight alliances (GSAs) for LGBTQ+ youth and their allies and the youth’s self-reported victimization. In all, the results of 15 studies spanning 2001 to 2014 were combined for a final sample of 62,923 participants and indicated that when a GSA is present, homophobic victimization, fear for safety, and hearing homophobic remarks is significantly lower. The authors state, “The findings of this meta-analysis should therefore be of value to advocates, educators, and policymakers who are interested in alleviating school-based victimization of youth, as those adolescents who are perceived to be LGBTQ+ are at a marked risk for such victimization.”

2.2.9. Communicating Results

In scientific research, it is common practice to communicate the findings of our investigation. By reporting what we found in our study, other researchers can critique our methodology and address our limitations. Publishing allows psychology to grow its collective knowledge about human behavior based on converging evidence from different kinds of studies. We can also see where gaps still exist. Research is moved to the public domain so others can read and comment on it. Scientists can also replicate what we did and possibly extend our work if it is published.

Communication of results can be through conferences in the form of posters or oral presentations, newsletters from APA or one of its many divisions or other organizations, or through scientific research journals. Published journal articles represent a form of communication between scientists, and in these articles, the researchers describe how their work relates to previous research, how it replicates or extends this work, what their work might mean theoretically, and what it implies for future research.

Research articles begin with an abstract, which is a 150-250-word summary of the article. The purpose is to describe the experiment and allow the reader to make a decision about whether they want to read it further. The abstract provides a statement of purpose, an overview of the methods, the main results, and a brief statement of the conclusion. Key words are also given that allow for students and other researchers to find the article when conducting a search.

The abstract is followed by four major sections. The first is the introduction, designed to provide a summary of the current literature as it relates to your topic. It helps the reader see how you arrived at your hypothesis, as well as the purpose of your study. Essentially, it gives the logic behind the decisions you made. Also stated in the introduction is the hypothesis. Second is the Method section. Since replication is a required element of science, we must have a way to share information on our design and sample with readers. This is the essence of the method section and covers three major aspects of your study – the participants, materials or apparatus, and procedure. The reader needs to know who was in your study so that limitations related to generalizability of your findings can be identified and investigated in the future. Operational definitions are also stated, a description of any groups included, identification of random sampling or assignment procedures, and information is shared about how a scale was scored. The method section can be loosely thought of as a cookbook. The participants are your ingredients, the materials or apparatus are whatever tools you will need, and the procedure is the instructions for how to bake the cake.

Next is the Results section. In this section you state the outcomes of your experiment and whether they were statistically significant or not. In this section, you can also present tables and figures. The final section is the Discussion. In this section, your main findings and hypothesis of the study is restated and an interpretation of the findings is offered. Finally, strengths and limitations of the study are stated which will allow you to propose future directions.

Whether you are writing a research paper for a class, preparing an article for

publication, or reading a research article, the structure and function of a research article is the same. Understanding this will help you when reading psychology of gender research articles.

• Clarify why reliability and validity are important.
• Define reliability and list and describe forms it takes.
• Define validity and list and describe forms it takes.

Recall that measurement involves the assignment of scores to an individual which are used to represent aspects of the individual, such as how conscientious they are or their level of depression. Whether or not the scores actually represent the individual is what is in question. Cuttler (2019) says in her book Research Methods in Psychology, “Psychologists do not simply  assume  that their measures work. Instead, they collect data to demonstrate  that they work. If their research does not demonstrate that a measure works, they stop using it.” So how do they demonstrate that a measure works? This is where reliability and validity come in.

2.3.1. Reliability

First, reliability describes how consistent a measure is. It can be measured in terms of test-retest reliability , or how reliable the measure is across time, internal consistency , or the “consistency of people’s responses across the items on a multiple-item measure,” (Cuttler, 2019), Finally, inter-rater reliability describes the consistency of results between different observers. In terms of inter-rater reliability, Cuttler (2019) writes, “If you were interested in measuring university students’ social skills, you could make video recordings of them as they interacted with another student whom they are meeting for the first time. Then you could have two or more observers watch the videos and rate each student’s level of social skills. To the extent that each participant does, in fact, have some level of social skills that can be detected by an attentive observer, different observers’ ratings should be highly correlated with each other.”

2.3.2. Validity

A measure is considered to be valid if its scores represent the variable it is said to measure. For instance, if a scale says it measures depression, and it does, then we can say it is valid. Validity can take many forms. First, face validity is “the extent to which a measurement method appears “on its face” to measure the construct of interest” (Cuttler, 2019). A scale purported to measure values should have questions about values such as benevolence, conformity, and self-direction, and not questions about depression or attitudes toward toilet paper.

Content validity is to what degree a measure covers the construct of interest. Cuttler (2019) says, “… consider that attitudes are usually defined as involving thoughts, feelings, and actions toward something. By this conceptual definition, a person has a positive attitude toward exercise to the extent that he or she thinks positive thoughts about exercising, feels good about exercising, and actually exercises.”

Often times, we expect a person’s scores on one measure to be correlated with scores on another measure to which we expect it to be related, called criterion validity . For instance, consider parenting style and attachment. We would expect that if a person indicates on one scale that their father was authoritarian (or dictatorial) then attachment would be low or insecure. In contrast, if the mother was authoritative (or democratic) we would expect the child to show a secure attachment style.

As researchers, we strive for results will generalize from our sample to the larger population. In the example of case studies, the sample is too small to make conclusions about everyone. If our results do generalize from the circumstances under which our study was conducted to similar situations, then we can say our study has external validity . External validity is also affected by how real, or natural, the research is. Two types of realism are possible. First, mundane realism occurs when the research setting closely resembles the real-world setting. Experimental realism is the degree to which the experimental procedures that are used feel real to the participant. It does not matter if they truly mirror real life but that they only appear real to the participant. If so, his or her behavior will be more natural and less artificial.

In contrast, a study is said to have good internal validity when we can confidently say that the effect on the dependent variable (the one that is measured) was due solely to our manipulation of the independent variable. A confound occurs when a factor other than the independent variable leads to changes in the dependent variable.

To learn more about reliability and validity, please visit:

https://kpu.pressbooks.pub/psychmethods4e/chapter/reliability-and-validity-of-measurement/

• Exemplify instances of ethical misconduct in research.
• List and describe principles of research ethics.

Throughout this module so far, we have seen that it is important for researchers to understand the methods they are using. Equally important, they must understand and appreciate ethical standards in research. The American Psychological Association identifies high standards of ethics and conduct as one of its four main guiding principles or missions. To read about the other three, please visit https://www.apa.org/about/index.aspx . So why are ethical standards needed and what do they look like?

2.4.1. Milgram’s Study on Learning…or Not

The one psychologist most students know about is Stanley Milgram, if not by name then by his study on obedience using shock (Milgram, 1974). Essentially, two individuals came to each experimental session but only one of these two individuals was a participant. The other was what is called a confederate and part of the study without the participant knowing. The confederate was asked to pick heads or tails and then a coin was flipped. As you might expect, the confederate always won and chose to be the learner . The “experimenter,” who was also a confederate, took him into one room where he was hooked up to wires and electrodes. This was done while the “teacher,” the actual participant, watched and added to the realism of what was being done. The teacher was then taken into an adjacent room where he was seated in front of a shock generator. The teacher was told it was his task to read a series of word pairs to the learner. Upon completion of reading the list, he would ask the learner one of the two words and it was the learner’s task to state what the other word in the pair was. If the learner incorrectly paired any of the words, he would be shocked. The shock generator started at 30 volts and increased in 15-volt increments up to 450 volts. The switches were labeled with terms such as “Slight shock,” “Moderate shock,” “Danger: Severe Shock,” and the final two switches were ominously labeled “XXX.”

As the experiment progressed, the teacher would hear the learner scream, holler, plead to be released, complain about a heart condition, or say nothing at all. When the learner stopped replying, the teacher would turn to the experimenter and ask what to do, to which the experimenter indicated for him to treat nonresponses as incorrect and shock the learner. Most participants asked the experimenter whether they should continue at various points in the experiment. The experimenter issued a series of commands to include, “Please continue,” “It is absolutely essential that you continue,” and “You have no other choice, you must go on.” Surprisingly, Milgram found that 65% of participants/teachers shocked the learner to the XXX switches which would have killed them because they were ordered to do so.

Source: Milgram, S. (1974). Obedience to authority. New York, NY: Harper Perennial.

If you would like to learn more about the moral foundations of ethical research, please visit:

https://kpu.pressbooks.pub/psychmethods4e/chapter/moral-foundations-of-ethical-research/

2.4.2. Ethical Guidelines

Due to these studies, and others, the American Psychological Association (APA) established guiding principles for conducting psychological research. The principles can be broken down in terms of when they should occur during the process of a person participating in the study.

2.4.2.1. Before participating. First, researchers must obtain informed consent or when the person agrees to participate because they are told what will happen to them. They are given information about any risks they face, or potential harm that could come to them, whether physical or psychological. They are also told about confidentiality or the person’s right not to be identified. Since most research is conducted with students taking introductory psychology courses, they have to be given the right to do something other than a research study to likely earn required credits for the class. This is called an alternative activity and could take the form of reading and summarizing a research article. The amount of time taken to do this should not exceed the amount of time the student would be expected to participate in a study.

     2.4.2.2. While participating. Participants are afforded the ability to withdraw, or the person’s right to exit the study if any discomfort is experienced.

     2.4.2.3. After participating . Once their participation is over, participants should be debriefed, which is when the true purpose of the study is revealed, they are told where to go if they need assistance, and how to reach the researcher if they have questions. Researchers are even permitted to deceive participants, or intentionally withhold the true purpose of the study from them. According to the APA, a minimal amount of deception is allowed.

Human research must be approved by an Institutional Review Board or IRB. It is the IRB that will determine whether the researcher is providing enough information for the participant to give consent that is truly informed, if debriefing is adequate, and if any deception is allowed.

If you would like to learn more about how to use ethics in your research, please read:

https://kpu.pressbooks.pub/psychmethods4e/chapter/putting-ethics-into-practice/

Module Recap

In Module 1, we stated that psychology is the study of behavior and mental processes using strict standards of science. In Module 2, we outlined how this is achieved through the use of the scientific method and use of the research designs of observation, case study, surveys, correlation, and experiments. The importance of valid and reliable measures is described.  To give our research legitimacy, we must use clear ethical standards for research which include gaining informed consent from participants, telling them of the risks, giving them the right to withdraw, debriefing them, and using only minimal deception.

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Emerging Topics in Gender Psychology

Psychology as a discipline has always wrangled with the subject of gender in its myriad forms. The discipline has experienced a significant shift in its approach in more recent years, engaging more deeply with the ways in which gender interplays with the minutiae of our inner worlds and the social, political and cultural landscapes we find ourselves traversing. There has been an increasing prominence and importance of intersectionality, transgender theory, and other radical frameworks and approaches to research, theory, and therapeutic practice which seek to challenge the status quo of psychology. As such, it is becoming abundantly clear that gender and its convergence with other life aspects must be addressed critically within the field. This special issue helps gain an understanding of the contemporary landscape of gender in psychology.

This Topical Collection is focused on research which challenges, critiques, or experiments with approaches to gender across the full spectrum of psychology disciplines. We are also seeking research which explores a facet of gender in psychology which has not been adequately addressed by the existing body of knowledge. Some topics that could be explored in this issue include (but are not limited to):

• Inter- and intra-gender dynamics and relationships

• The psychology of gender in institutions (e.g., pedagogy, medicine, law)

• Masculinity, femininity, androgyny, and wellbeing

• Violence, counterviolence, and gender

• Gendered perspectives and experiences of COVID-19

• Gender in parenting, reproduction, and fertility

• Resilience, refusal, and requital within psychology’s history and contemporary gendered landscape

We invite full-length research articles as well as brief communications of empirical findings, reviews, perspectives, comments, case studies, registered reports, and data notes. We particularly encourage contributions from researchers within the Global South, Europe, Africa, and Asia.

Keywords : Gender; psychology; transgender; masculinities; femininities; gender differences

Brooke Brady

Dr. Brooke Brady, University of New South Wales (UNSW), Australia Brooke has a PhD in psychology from Western Sydney University. She is an interdisciplinary research fellow at UNSW, where she uses technology and creativity to explore intra-individual variability in self-perceptions of age and gender. She is also a conjoint research fellow at Neuroscience Research Australia, and an associate investigator at the ARC Centre of Excellence in Population Ageing Research. Her research interests span cognitive and socioemotional ageing, LGBTIQ+ inclusion and the use of integrated technologies to study dynamic ageing and identity processes.

Shoshana Rosenberg

Shoshana Rosenberg, Independent Researcher Shoshana is a butch dyke living and working on unceded Wurundjeri/Boon Wurrung land in Naarm/Melbourne. Their writing focuses on the intersections of transness, sexuality, health, sonics, and faith. Shoshana is an Associate Editor at the International Journal of Transgender Health, and their debut manuscript “Queer Entanglements: Intersections of Gender, Sexuality, and Animal Companionship” is now available through Cambridge University Press.

Articles (2 in this collection)

Gender is dynamic for all people, authors (first, second and last of 7).

• S. Rosenberg
• Content type: Perspective
• Open Access
• Published: 14 November 2022
• Article: 41

Men’s anxiety, why it matters, and what is needed to limit its risk for male suicide

Authors (first, second and last of 6).

• Krista Fisher
• Zac E. Seidler
• Simon M. Rice
• Published: 04 March 2022
• Article: 18

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Gender Bias In Psychology

March 17, 2021 - paper 3 issues and options in psychology | issues & debates, gender bias in psychology:.

The Two Main Forms of Gender Bia s

(1) Beta-Bias:

Often occurs when female participants are not included as part of the research process and then it is assumed that the findings apply equally to both sexes.

Example:  Taylor et al (2000), has pointed out that early research into the ‘fight or flight’ response focused mainly on male participants, later research that has adopted a more female focus has highlighted that females react in a different way to stress, adopting a more ‘tend and befriend’ approach.

(A)  Androcentrism:

(b) gynocentrism, (2) alpha bias:.

AO3: Implications Of Gender Bias In Research

For example,  Dalton (1964)  controversially suggested that during this part of the menstrual cycle, women are more likely to have accidents, carry out crimes, commit suicide and to have reduced scores in IQ tests.

Why could such findings have a negative impact on females?  Such research findings paint women to be volatile individuals who are victims of their own biological makeup holding little control/free will over their own behaviour. Research findings could also cause women to be discriminated against in the work place (for example), employers who believe women are more likely to have accidents/reduced IQ scores could favour male applicants for jobs assuming that they would be a more competent member of the workforce.

For example, research has suggested that males appear to be less sensitive than females and display more aggressive tendencies.

(3) Bias in Research Method s: The way in which research is carried out can also create gender bias assumptions (that don’t really exist). For example, male researchers tend to be nice, friendly and more welcoming the female participants rather than male participants. This often leads to female participants performing better than male participants in certain research tasks.

(4) Sexism within the Research Process:  A lack of women appointed at a senior level means that female concerns may not be reflected in the research questions asked.

Many individuals argue that the lack of females in the ‘higher’ research roles within psychology is due to the fact that women are usually seen to lack leadership qualities (in comparison to men).  Eagly (1978)  acknowledged that women may be less effective leaders than men but argued that such knowledge should be used to remove gender bias and redress the imbalances in theory and research in psychology.

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How Will Gamers and Investors Respond to Microsoft’s Acquisition of Activision Blizzard?

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Sex: In Psychology, sex is the classification of being male or female. It is biologically determined (caused by chromosomes and hormones), is fixed and cannot be changed, and is innate (due to the influence of nature only).

Gender: This is the psychological sense of feeling masculine or feminine. It is influenced by psychological and social factors, the role of nature and nurture play a part, and is more fluid and open to change (it is more of a sliding scale, whereas sex tends to be a binary choice of male or female). Gender can be changed through gender reassignment surgery.

Gender identity disorder: Most people’s sex and gender correspond (e.g. male-masculine). However, some experience feelings of a mismatch between biological sex and psychological gender. This is classified as gender identity disorder (referred to as gender dysphoria in the Diagnostic and Statistical Manual of Mental Disorders). Some individuals with GID decide to have gender reassignment surgery and become transgender.

Sex-role stereotypes: These are expectations/pre-conceived ideas of what is ‘typical’ male and female behaviours. These may change from time to time and between (and within) cultures, and are communicated in many ways, for example through parents, at school, in the media, and so on. For example, females may be expected to be caring, empathetic, emotional and nurturing, whereas males may be expected to be competitive, ambitious, aggressive and less emotional.

Androgyny & the BSRI

Androgyny: This is the psychological state of possessing a balance of male and female psychological characteristics. For example, a man may possess the emotional skills to be caring, but also is competitive and ambitious. This is thought to be advantageous, as the person can respond appropriately to many different situations in life. When necessary, they can be empathetic, and when another situation demands that they are competitive, they can do this as well. Androgynous people are argued to be more mentally healthy.

The BSRI: Sandra Bem (1974) devised a way of measuring the extent to which a person is androgynous. She created a list of behaviours and characteristics, 20 of which could be classified as ‘masculine’, 20 ‘feminine’, and 20 ‘neutral’ (not particularly associated with either gender). Participants would indicate how true the statement was for them personally on a scale of 1 (never true) to 7 (always true). Masculine behaviours included ‘aggressive’, ‘ambitious’, ‘dominant’, ‘assertive’. Feminine behaviours included ‘affectionate’, ‘compassionate’, ‘gentle’, ‘sympathetic’. Neutral behaviours included ‘adaptable’, ‘sincere’, ‘helpful’, ‘truthful’. A high score for both the masculine and feminine items indicated androgyny in the participant.

Evaluation:

• When it was piloted, the results of the BSRI broadly matched with the participant’s own reported sense of gender identity, suggesting the BSRI is a valid measure of gender.
• It has been argued that androgyny may not be the most beneficial thing for mental health, and that having more masculine traits is more advantageous, challenging the assumptions of Bem.
• Assessing a person’s sense of gender by completing the BSRI reduces the complex concept of ‘gender’ to a series of numbers, therefore not reflecting the reality of gender. Also, the BSRI may be culturally and historically biased, as certain behaviours are seen as ‘masculine’ or ‘feminine’, which may not be true of all cultures at all times.

The Role of Chromosomes & Hormones

• DNA (deoxyribonucleic acid): self-replicating material, located in cells of the body, which is the carrier of genetic material
• Genes: short sections of DNA that determine the characteristics of a living thing
• Chromosomes: objects found in the nucleus of most cells, made from DNA
• Hormones: Chemicals that travel around the body affecting the activity of cells and organs

Chromosomes: Each person has 23 pairs of chromosomes. Each of these pairs carry hundreds of genes containing instructions on physical and behavioural characteristics. One pair of chromosomes are called the sex chromosomes, because they determine an individual’s sex. The female chromosome pair is called XX because both chromosomes are shaped like X’s. The male chromosome pair is described as XY. The Y chromosome carries very little genetic material although it does determine the sex of the child. There is a direct link between an individual’s chromosomal sex (XX or XY) and their external genitalia (vagina or penis) and internal genitalia (ovaries and testes). During prenatal development all individuals look the same – and embryos have genitalia that externally looks feminine. When the foetus is about three months old, if it is to develop as a male, the testes produce testosterone which causes external male genitalia to develop. Biology explains how an individual acquires their sex genetically. It may also explain some aspects of gender because people feel ‘masculine’ or ‘feminine’ in part because of the genitalia they have.

Hormones: Chromosomes initially determine a person’s sex but most gender development is actually governed by hormones. They are produced both prenatally and in puberty. Hormones influence the development of genitalia and/or affect the development of the brain, both of which influence gender behaviour. The effects of particular hormones are as follows:

• Testosterone: a male hormone, which develops the male sex organs and is linked with behaviours such as increased aggression
• Oestrogen: a female hormone which develops female sexual characteristics and is linked with emotional changes during the menstrual cycle (for example, increased irritability)
• Oxytocin: a hormone which facilitates bonding. It is released in large doses after childbirth, making the mother feel a strong emotional connection to their baby. It is produced in lower quantities in men, but in equal amounts in both sexes during sexual intercourse

Hormone Imbalance During Development

Androgen Insensitivity Syndrome: Where a genetic male is not exposed to enough testosterone in the womb, and can look physically female at birth. This happened to members of the Batista family in the Dominican Republic- some male family members appeared female at birth, and were raised female, but once hormonal changes in puberty occurred that physically turned into males, and changed to living as males.

Congenital Adrenal Hyperplasia: Where a genetic female is exposed to too much testosterone. Genitalia can appear swollen, and they may act more masculine (tomboys).

• The case of David Reimer supports the role of chromosomes and hormones. David was born as Bruce, and, when taken to be circumcised as an infant, accidentally had his penis burnt off due to an electrical malfunction. Psychologist John Money worked with the parents, suggesting that ‘gender’ is entirely created by upbringing and the environment, so Bruce was renamed ‘Brenda’, was castrated, and raised as a girl for the first years of life. However, the case was not successful and Brenda, feeling suicidal, was told the truth when a teenager. Brenda immediately changed back to living as a man, calling himself ‘David’. This case shows how the influence of nature overrode the influence of nurture.
• Van Goozen et al (1995) found that when injected with male or female hormones, transgender individuals demonstrated more typical male or female behaviours (in line with the hormones they were receiving). This supports the link between hormones and gender behaviour.
• Tricker et al (1996) found that there were no differences in behaviours amongst participants injected with testosterone or a placebo, weakening the link between hormones and gender behaviour.

Atypical Sex Chromosome Patterns

Klinefelter’s syndrome: This is where there is an abnormal chromosome pattern in males, where there is an extra X chromosome (‘XXY’). 1 in 500 to 1 in 1000 males are affected. The effects of this include:

• Reduced body hair
• Breast development
• ‘Soft’ body contours
• Underdeveloped genitalia
• Poor language/reading skills
• Passive and shy
• Poorer memory/problem-solving skills

Turner’s syndrome: This is where there is an abnormal chromosome pattern in females, where there is only one X chromosome (‘X’). Around 1 in 5000 females are affected. The effects of this include:

• No menstrual cycle
• Broad chest and webbed neck
• High waist-to-hip ratio
• Physically immature
• Higher reading ability
• Poorer spatial, visual, maths ability
• Socially immature
• Atypical sex chromosome patterns lend support to nature in the nature-nurture debate, suggesting behaviour is affected by biological influences. This is helpful to understand gender behaviour more generally.
• Environmental influences may cause the behaviours, for example, females with Turner’s may be treated more immaturely due to their childlike appearance. This weakens the link between chromosomes and gender behaviour.
• There are beneficial practical applications in studying these individuals, are diagnosis can be made more readily and hormone treatments can be used to reduce the effects of the conditions.

Cognitive Explanations: Kohlberg’s Theory

Cognitive theories suggest cognition (‘thinking’) has an impact on gender behaviour, emphasising that environmental factors and brain development influence cognition and cognition influences gender behaviour. Thinking about gender alters as a child’s cognitive capabilities develop, and a child’s sense of their own gender is critical in the acquisition of gender behaviour. Kohlberg suggested that children’s sense of gender develops over three stages, which are gone through gradually.

Stage 1: Gender identity (2-3 ½ years): Children have the ability to correctly identify themselves and others as male or female, although labelling is based more on appearance than reality, e.g. a child might label a man with long hair ‘a girl’. Gender may change over time or situations.

Stage 2: Gender stability (3 ½-4 ½ years): Recognition that the child’s own gender will not change over time (if they are a girl they will grow into a woman). However, children may believe that other people’s gender can change in different situations, e.g. they may believe that if they see a boy putting on a dress that boy will become a girl.

Stage 3: Gender constancy/gender consistency (6-7 years): The child recognises that gender is independent of clothing/hair and so on, and gender is constant over time and situations. At this point, Kohlberg believed that full gender understanding has developed and children become interested in, and manifest, gender typical behaviour. Children in this stage are no longer egocentric (think that everyone sees the world in the same way they do) so can appreciate that other’s thoughts and feelings are different to theirs.

Role models: Once they reach gender constancy, children will begin to seek same-sex role models who they will identify with and wish to imitate. They will not do this before this stage, as they think that ‘gender’ is still something that could change.

• Slaby and Frey (1975) asked young children: ‘were you a little girl or a little boy when you were a baby?’ and ‘when you grow up will you be a mummy or a daddy?’. Children did not recognise that these traits were stable over time until they were 3 or 4 years old, supporting the predictions of the theory. In another study, they found children in the gender constancy stage spent longer looking at same-sex adults, supporting the idea of role models.
• There is evidence that children may acquire a fixed sense of gender before age 6-7- Bussey and Bandura (1992) found that 4 year-olds reported feeling ‘awful’ about playing with gender-inappropriate toys. This weakens the prediction of Kohlberg’s theory.
• There are methodological issues with interviewing children to investigate cognitive theories. Children may not have the vocabulary to adequately express what they are thinking, therefore it may not be a valid way of investigating cognitions. This weakens the evidence for Kohlberg’s theory.

Lab Report Format: Step-by-Step Guide & Examples

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

In psychology, a lab report outlines a study’s objectives, methods, results, discussion, and conclusions, ensuring clarity and adherence to APA (or relevant) formatting guidelines.

A typical lab report would include the following sections: title, abstract, introduction, method, results, and discussion.

The title page, abstract, references, and appendices are started on separate pages (subsections from the main body of the report are not). Use double-line spacing of text, font size 12, and include page numbers.

The report should have a thread of arguments linking the prediction in the introduction to the content of the discussion.

This must indicate what the study is about. It must include the variables under investigation. It should not be written as a question.

Title pages should be formatted in APA style .

The abstract provides a concise and comprehensive summary of a research report. Your style should be brief but not use note form. Look at examples in journal articles . It should aim to explain very briefly (about 150 words) the following:

• Start with a one/two sentence summary, providing the aim and rationale for the study.
• Describe participants and setting: who, when, where, how many, and what groups?
• Describe the method: what design, what experimental treatment, what questionnaires, surveys, or tests were used.
• Describe the major findings, including a mention of the statistics used and the significance levels, or simply one sentence summing up the outcome.
• The final sentence(s) outline the study’s “contribution to knowledge” within the literature. What does it all mean? Mention the implications of your findings if appropriate.

The abstract comes at the beginning of your report but is written at the end (as it summarises information from all the other sections of the report).

Introduction

The purpose of the introduction is to explain where your hypothesis comes from (i.e., it should provide a rationale for your research study).

Ideally, the introduction should have a funnel structure: Start broad and then become more specific. The aims should not appear out of thin air; the preceding review of psychological literature should lead logically into the aims and hypotheses.

• Start with general theory, briefly introducing the topic. Define the important key terms.
• Explain the theoretical framework.
• Summarise and synthesize previous studies – What was the purpose? Who were the participants? What did they do? What did they find? What do these results mean? How do the results relate to the theoretical framework?
• Rationale: How does the current study address a gap in the literature? Perhaps it overcomes a limitation of previous research.
• Aims and hypothesis. Write a paragraph explaining what you plan to investigate and make a clear and concise prediction regarding the results you expect to find.

There should be a logical progression of ideas that aids the flow of the report. This means the studies outlined should lead logically to your aims and hypotheses.

Do be concise and selective, and avoid the temptation to include anything in case it is relevant (i.e., don’t write a shopping list of studies).

USE THE FOLLOWING SUBHEADINGS:

Participants

• How many participants were recruited?
• Say how you obtained your sample (e.g., opportunity sample).
• Give relevant demographic details (e.g., gender, ethnicity, age range, mean age, and standard deviation).
• State the experimental design .
• What were the independent and dependent variables ? Make sure the independent variable is labeled and name the different conditions/levels.
• For example, if gender is the independent variable label, then male and female are the levels/conditions/groups.
• How were the IV and DV operationalized?
• Identify any controls used, e.g., counterbalancing and control of extraneous variables.
• List all the materials and measures (e.g., what was the title of the questionnaire? Was it adapted from a study?).
• You do not need to include wholesale replication of materials – instead, include a ‘sensible’ (illustrate) level of detail. For example, give examples of questionnaire items.
• Include the reliability (e.g., alpha values) for the measure(s).
• Describe the precise procedure you followed when conducting your research, i.e., exactly what you did.
• Describe in sufficient detail to allow for replication of findings.
• Be concise in your description and omit extraneous/trivial details, e.g., you don’t need to include details regarding instructions, debrief, record sheets, etc.
• Assume the reader has no knowledge of what you did and ensure that he/she can replicate (i.e., copy) your study exactly by what you write in this section.
• Write in the past tense.
• Don’t justify or explain in the Method (e.g., why you chose a particular sampling method); just report what you did.
• Only give enough detail for someone to replicate the experiment – be concise in your writing.
• The results section of a paper usually presents descriptive statistics followed by inferential statistics.
• Report the means, standard deviations, and 95% confidence intervals (CIs) for each IV level. If you have four to 20 numbers to present, a well-presented table is best, APA style.
• Name the statistical test being used.
• Report appropriate statistics (e.g., t-scores, p values ).
• Report the magnitude (e.g., are the results significant or not?) as well as the direction of the results (e.g., which group performed better?).
• It is optional to report the effect size (this does not appear on the SPSS output).
• Avoid interpreting the results (save this for the discussion).
• Make sure the results are presented clearly and concisely. A table can be used to display descriptive statistics if this makes the data easier to understand.
• DO NOT include any raw data.
• Follow APA style.

Use APA Style

• Numbers reported to 2 d.p. (incl. 0 before the decimal if 1.00, e.g., “0.51”). The exceptions to this rule: Numbers which can never exceed 1.0 (e.g., p -values, r-values): report to 3 d.p. and do not include 0 before the decimal place, e.g., “.001”.
• Percentages and degrees of freedom: report as whole numbers.
• Statistical symbols that are not Greek letters should be italicized (e.g., M , SD , t , X 2 , F , p , d ).
• Include spaces on either side of the equals sign.
• When reporting 95%, CIs (confidence intervals), upper and lower limits are given inside square brackets, e.g., “95% CI [73.37, 102.23]”
• Outline your findings in plain English (avoid statistical jargon) and relate your results to your hypothesis, e.g., is it supported or rejected?
• Compare your results to background materials from the introduction section. Are your results similar or different? Discuss why/why not.
• How confident can we be in the results? Acknowledge limitations, but only if they can explain the result obtained. If the study has found a reliable effect, be very careful suggesting limitations as you are doubting your results. Unless you can think of any c onfounding variable that can explain the results instead of the IV, it would be advisable to leave the section out.
• Suggest constructive ways to improve your study if appropriate.
• What are the implications of your findings? Say what your findings mean for how people behave in the real world.
• Suggest an idea for further research triggered by your study, something in the same area but not simply an improved version of yours. Perhaps you could base this on a limitation of your study.
• Concluding paragraph – Finish with a statement of your findings and the key points of the discussion (e.g., interpretation and implications) in no more than 3 or 4 sentences.

Reference Page

The reference section lists all the sources cited in the essay (alphabetically). It is not a bibliography (a list of the books you used).

In simple terms, every time you refer to a psychologist’s name (and date), you need to reference the original source of information.

If you have been using textbooks this is easy as the references are usually at the back of the book and you can just copy them down. If you have been using websites then you may have a problem as they might not provide a reference section for you to copy.

References need to be set out APA style :

Author, A. A. (year). Title of work . Location: Publisher.

Journal Articles

Author, A. A., Author, B. B., & Author, C. C. (year). Article title. Journal Title, volume number (issue number), page numbers

A simple way to write your reference section is to use Google scholar . Just type the name and date of the psychologist in the search box and click on the “cite” link.

Next, copy and paste the APA reference into the reference section of your essay.

Once again, remember that references need to be in alphabetical order according to surname.

Psychology Lab Report Example

Quantitative paper template.

Quantitative professional paper template: Adapted from “Fake News, Fast and Slow: Deliberation Reduces Belief in False (but Not True) News Headlines,” by B. Bago, D. G. Rand, and G. Pennycook, 2020,  Journal of Experimental Psychology: General ,  149 (8), pp. 1608–1613 ( https://doi.org/10.1037/xge0000729 ). Copyright 2020 by the American Psychological Association.

Qualitative paper template

Qualitative professional paper template: Adapted from “‘My Smartphone Is an Extension of Myself’: A Holistic Qualitative Exploration of the Impact of Using a Smartphone,” by L. J. Harkin and D. Kuss, 2020,  Psychology of Popular Media ,  10 (1), pp. 28–38 ( https://doi.org/10.1037/ppm0000278 ). Copyright 2020 by the American Psychological Association.

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