Sexual Orientation: Neuroendocrine and Psychodynamic Influences

The play behavior of toddlers is also shaped by prenatal androgens.^2,17-19 As children grow and acquire ever greater social experience and cognitive sophistication, their childhood play patterns become incorporated into gender-stereotypical play. During the juvenile phase of development, when gender-segregated play is the norm, the different play styles of the children of different sexes influence their peer relationships. Boys tend to form peer groups that are hierarchical, exclusive of adults, and frequently organized around team sports. Boys' groups are also likely to be intolerant of gender-atypical behavior in other boys and may stigmatize those drawn to such behavior as "sissies." In keeping with play styles present since toddlerhood, peer groups of girls tend to be less aggressive and walled off from adults and more tolerant of gender-atypical behavior. This is not to suggest that girls are somehow "nicer" than boys. Both sexes may be equally friendly or mean. They tend to differ in their attitudes toward gender-role behavior, however.²⁰

Boys and girls on a nonheterosexual developmental pathway are more likely than those on a heterosexual path to be drawn toward nonstereotypical gender-role activities. This developmental phenomenon occurs for reasons that have not been definitively determined, but it has been taken by some investigators as additional indirect evidence of prena- tal neuroendocrine influence on brain embryogenesis.^21,22

As noted above, there seems to be a tendency for boys with atypical gender-role interests to be penalized by other males in a way that is less common among girls. Such penalty comes in the form of bullying, threats of violence, or ostracism often beginning by the juvenile phase of development.^21,23-25 Although the tolerance of girls for cross-gender behavior is greater than that of boys, it is not boundless. For example, a now famous case report discusses the development of a boy who was raised as a girl after an accidental penile amputation in early childhood.²⁶ As a juvenile, she was tormented by female peers and was called "gorilla" because of extremely masculine gender-role behavior, which was incongruent with a female name and gender of her rearing. Such behavior appeared to be an innate attribute of the child's temperament (presumably due to masculinazation of the hypothalamus) and resisted attempts to modify it psychosocially.^27,28 This case illustrates the response of female peers to a girl with extremely boy-like gender-role behavior. Many other instances of prenatal androgenization of girls have been discussed in which complex nature-nurture interactions have been described.¹⁶

Peers are not the only source of difficulties for boys, however. Often older males—even fathers and other relatives—are also intolerant of atypical gender-role behavior. An important reason for difficulties between boys on a homosexual developmental track and their fathers is temperamental incompatibility in gender-role behavior. The son's innate temperamental proclivity toward nonstereotypical gender-role activities provokes anxiety and defensive responses in the father whose attitudes and values about masculinity are likely to be influenced by his own sex-stereotypical gender-role temperament.

Childhood difficulties with same-sex peers and with his father may have additive effects in diminishing a child's self-regard and contributing to his sense of being "different."^29,30 The feeling of not belonging to the mainstream may also be influenced by awareness of romantic and sexual feelings toward those of the same sex.³¹

The term "homophobia" was introduced almost half a century ago to indicate irrational aversion to nonheterosexual persons and has now become part of everyday parlance.^32,33 Arguably, its most distressing manifestation is violence, almost always perpetrated by males, and directed against males more frequently than females.^34,35