PSYCHOSEXUAL DEVELOPMENT OF WOMEN WITH CONGENITAL ADRENAL-HYPERPLASIA

Women with congenital adrenal hyperplasia (CAH) (N = 31) and their una ffected sisters or female cousins (N = 15) participated in a study of psychosexual development. All participants were greater than or equal to 18 years of age (mean age, 25 years; range, 18-40). Comparisons wer e also made between the CAH women with the salt-wasting (SW) form of t he disorder and those with simple virilization (SV). A psychosexual as sessment protocol examined six variables: (1) sex assignment at birth (probands only); (2) recalled sex-typed behavior during childhood; (3) gender identity and gender role identification in adulthood; (4) rela tionship status; (5) sexual orientation in fantasy; and (6) sexual ori entation in behavior. Salt-wasting status and sex assignment at birth were also ascertained for the CAH women who either refused to particip ate in the study (N = 10) or could not be traced (N = 13). Compared to the controls, the women with CAH recalled more cross-gender role beha vior and less comfort with their sense of ''femininity'' during childh ood. The two groups did not differ in degree of gender dysphoria in ad ulthood, although the probands showed more cross-gender role identific ation. Three of the non-participant probands were living, as adults, i n the male social role (2 reared from birth as boys and 1 who changed from the female to the male social role during adolescence). The CAH w omen and the controls did not differ in relationship status (married/c ohabiting vs. single). The CAH women had lower rates of exclusive hete rosexual fantasy and fewer sexual experiences with men than the contro ls; however, the CAH women did not have more sexual experiences with w omen than the controls. Comparisons between the SW and SV revealed sev eral differences: the SW were less likely to be assigned to the female sex at birth, recalled more cross-gender role behavior during childho od, were less likely to be married or cohabiting, and had lower rates of sexual experiences with men. The results were discussed in relation to the effects of prenatal androgens on psychosexual differentiation. (C) 1996 Academic Press.