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R J STOLLER

Publications and source records attributed to R J STOLLER.

15 recordsLinked to original sources

Psychiatric management of intersexed patients.

The psychiatric management of intersexed patients stems from an awareness that sexual identity is the result of a complex mixture of somatic and psychological components. Decisions in treatment are dependent on the appearance and correctability of the anatomic defects, the age of the patient, and the potential reversibility of the identifications contributing to the manifested sexual identity. In infants and small children, following proper diagnosis of somatic sex and an evaluation of degree of correctability of anatomical defects, decision can be made whether to bring up the child in his genetic sex or not. It is very difficult to change the sexual identity after two and a half years, except possibly in persons who already have considerable question as to their maleness or femaleness. In the psychiatric treatment of children with such disorders, the child and his family should be informed in understandable language what is being done, and the child and usually the parents should be involved in psychotherapy. With the adult, if treatment is necessary, supportive therapy, not psychoanalysis, should be used.

Adult↗

The intersexed patient.

There are at present two opposing points of view on problems of dealing with the intersexed patient (not the typical homosexual or transvestite) who has clearcut anatomical or biochemical qualities of the opposite sex. The first is that in the growing child or adult coming for treatment, the sex the patient should adopt is the summation of somatic sex. The other is that the sex role should be assigned according to the predominant psychological identification already present.A case history of a middle-aged pseudohermaphrodite, castrated in youth but raised from birth as a female and living thus in "homosexual" relations with women until examined and interviewed at UCLA Medical Center is presented to illustrate the psychological problems in sexual identity with which the patient had to cope. Psychiatric investigation revealed how confused the patient's sex identity was until treatment by a team consisting of psychiatrist, psychologist and endocrinologist permitted the patient, even at so late a date, finally to establish what his gender is. The patient was able, despite early rearing as a female and a castrating operation, to swing to a more masculine identification. This was possible because of some uncertainty of sexual role from an early age.

Adaptation, Psychological↗