Chapter 2. Sissiness, tomboyishness, effeminacy, butchness and the homosexual heterosexuals


SO YOU SAY YOU’RE STRAIGHT: The one in five hidden homosexual heterosexuals  by the late Dr Neil McConaghy book proposal placed here on StraightGuise.com with permission by the author’s daughter, Dr. Finola McConaghy.

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Chapter 2.  Sissiness, tomboyishness, effeminacy, butchness and the homosexual heterosexuals

The commonly accepted belief that homosexuality is associated with effeminacy in men and masculine behaviors in women contributes to the negative view widely held towards it.  Possibly this influenced Kinsey to question it in the 1948 book.  Commenting on “the wide-spread theory among psychologists and psychiatrists that the homosexual is a product of an effete and over-organized urban society” Kinsey agreed that his data, which showed a higher incidence of homosexual outlets in urban compared to rural areas, indicated there was “something in city life which encourages the development of the homosexual”.  As an aside it is noteworthy that Kinsey uses here the term homosexual to designate a person, rather than a behavior, though he specifically objected to this use.  However Kinsey attributed the higher urban incidence to the greater available of homosexual contacts with the urban way of like, with its taverns, night clubs, restaurants, and baths frequented almost exclusively by persons interested in meeting homosexual friends.   Kinsey considered that it was members of the city group which exhibited all the affectations, mannerisms, dress, and the other displays which the rest of the population take to be distinctive of all homosexual persons, though shown only by a fraction.   He added concerning homosexual activity in rural areas that it was found among ranchmen, cattle men, prospectors, lumbermen, and farming groups in general – groups which are virile and physically active.  Such a group of hard-riding, hard-hitting, assertive males would not tolerate the affectations of some city groups that are involved in homosexuality.

That there is no word regarding masculine behaviors in women which carries the opprobrium of the word effeminacy would seem to result from the long held concept of the superiority of men compared to women.   Hence masculine behavior in woman can be considered to have some positive features, whereas feminine behavior in men has been for centuries regarded with some contempt.   Hazlitt in his essay written in the 1820’s “On effeminacy of character” stated it consisted “in a want of fortitude to bear pain or to undergo fatigue, however urgent the occasion….  Instead of voluntarily embracing pain, or labour, or danger, or death, every sensation must be wound up to the highest pitch of voluptuous refinement, every motion must be grace and elegance; they live in a luxurious, endless dream…  They turn back, as it were, on the occasions that should project them forward with manly force and vehemence…  There is nothing more to be esteemed than a manly firmness and decision of character.”   As discussed in more detail in Chapter 4, in the ancient Greek and Roman world, homosexual behavior at least in men who adopted what was seen as the male or active role in the behavior was not considered to be associated with effeminacy and was openly accepted as part of normal sexuality.  The contrasting current reluctance of men and women aware of a homosexual component to acknowledge it presumably results from the negative view in which homosexuality is held, in part due to the associated belief that homosexuality is associated with behaviors characteristic of the opposite sex.

As stated earlier, behaviors demonstrated statistically to be shown by more members of one than the other sex are classified as sex-linked behaviors.  Opposite sex-linked behaviors, feminine behaviors in boys and men, and masculine behaviors in girls and women, particularly when marked, are termed gender nonconforming in the scientific literature.  This chapter reviews the evidence that not only men and women who identify as homosexual show varying degrees of opposite sex-linked behaviors in childhood and currently.  Men and women who identify as heterosexual, but anonymously report awareness of some homosexual feelings, including the homosexual heterosexuals in whom these feelings are not predominant, are more likely to show opposite sex-linked behaviors than those who report no homosexual feelings.

Most of the terms used in the wider community for opposite sex-linked behaviors, namely sissiness in boys, effeminacy in men, and butchness in women, have negative connotations.  Tomboyishness in girls can be seen positively, for example, when shown by adolescent heroines of novels, such as Jo in “Little Women”, demonstrating that some male behaviors are regarded as admirable even when shown by women.  The lack of a consistent negative view of tomboyism may also reflect awareness in the general public that, as discussed subsequently, unlike sissy boys tomboyish girls show little increased likelihood of later identifying as homosexual, though as adults they consider they are more likely to show behaviors considered masculine.  In view of the negative connotations of the community terms, their use is increasingly avoided in the scientific literature.   Also though most adults are aware of the association between homosexuality and effeminate and butch behaviors in adults, reference to it is considered inappropriate in some social groups, as it could imply they have a negative view of homosexuality.  That many do, but wish to conceal this, was the theme of an episode of the Seinfeld T.V. series.   All of the characters, after reacting negatively to the suggestion that Jerry and George were homosexual, added the comment  “Not that there’s anything wrong with that”.   Boys called sissies by their less inhibited peers are commonly also called fags, indicating children and adolescents are aware of an association between sissyish behaviors and homosexuality.  Unpopular boys were commonly labeled in this way in my schoolhood experience.  Men in a number of countries who openly identified as homosexual have reported in their autobiographies being abused with these terms in their childhood and adolescence.  It would appear such labeling of boys has been common, at least for several decades.

Whether this labeling of boys with opposite sex-linked behaviors has occurred since antiquity cannot be determined due to the inadequacy of written records concerning childhood behaviors.  Also in contrast with the earlier situation in classical Greece and pagan Rome, after Christianity was accepted and enforced as the official religion in Europe, homosexuality became not only subject to repression but also considered not fit for discussion.  When it was referred to in  religious and legal writings it was commonly as “the sin that cannot be named” and  “the unmentionable vice”.  Its discussion became widespread again only in the nineteenth century when it came to be regarded as a medical condition and hence appropriate to study.   Currently the situation has somewhat reversed.  Attention given homosexuality in non-gay scientific literature is opposed not by religious groups but by some gay activists who believe this attention encourages stigmatization of homosexuals.  Nevertheless over the earlier period of repression in Christian Europe evidence of awareness of an association between homosexuality and opposite-sex linked behaviors emerged from time to time.  This awareness may have persisted from ancient Greek and Roman times when homosexuality was freely discussed.


Historical awareness of an association of opposite sex-linked behaviors and homosexuality

The association between effeminate behaviors and passive homosexual behavior in men was a recurrent theme in the comedies of Aristophanes and so must have been well known and a source of humor to his audience in Athens in the fifth century B.C.   Passive homosexuality refers to the adoption by men of the receptive role in anal and oral intercourse.  In one of Aristophanes’ comedies, the successful tragic dramatist Agathon is termed by another character an effeminate, and scorned for wearing a combination of male and female clothing, being neither a man or a woman, wanting to be ravished, and offering himself to sexual partners in a passive role.   To take the active role in response was treated in the comedies as a robust expression of masculinity.  Dover in his book on homosexuality in ancient Greece reported the description in legal writings of a man who had an extraordinary enthusiasm for homosexual relationships and always had around him singers and musicians.  Singing and music were seen as not robustly masculine.   Another man accused of being unmanly and womanish was said to wear clothes which could belong to a woman.

Boswell in his book on same-sex unions cited evidence of the association of opposite sex-linked behaviors with homosexuality in Roman literature.  Seutonius wrote that Nero married a man in a public ceremony with a dowry, a veil and all the solemnities of matrimony, and lived with him as his spouse.  Juvenal referred disapprovingly to such ceremonies as “Nothing special: a friend is marrying another man and a small group is attending”, and “A man who once bore the waving shield (of Mars) now dons brocade and a long train and a bridal veil.  A man born to nobility and wealth is given in marriage. ”  Cantarella in her book on bisexuality in the ancient world quoted from Juvenal’s satires a description of shameless homosexuals who dress in female clothing, paint their eyes, gather their long hair in golden nets, and armed with mirrors, rub bread pellets on their faces, to make the skin smoother.  In relation to their imitation of the rites of marriage, he said that it would not be long before they applied to register their marriages in the town hall.  Boswell considered that in the Satyricon of Petronius one of a same-sex couple of free men was clearly the passive partner sexually.  He was consistently referred to as a puer (wife), did the cooking, was fought over by male admirers rather than doing any fighting himself, and disclosed that his mother persuaded him not to be a man.  Boswell concluded he was what modern speakers would term a “queen”, an effeminate male playing the feminine role in a relationship with a man.   His partner, a former gladiator, has long curls which Boswell stated was associated with youth and feminine beauty.  He is accused by his partner of being able to dominate only women and boys.  Greenberg in his 1988 book “The Construction of Homosexuality” pointed out that the stereotype linking lesbianism with masculinity also dated back to the Romans.   In an epigram of Martial, women who make love to women lift weights and engage in men’s sports.   Cantarella quoted a reference to a women described as frightfully masculine, who lived with another woman as with a wife, and shaved her head like an athlete.

Possibly the most detailed evidence of subsequent awareness of the association between homosexuality and opposite sex-linked behaviors in men is found in John Cleland’s banned but widely read pornographic novel, “Fanny Hill”, first published in England in 1749.  The eponymous  heroine reports spying on two young men in a hotel room next to hers, and continues “the elder began to embrace, to press and kiss the younger… as made me conclude the other to be a girl in disguise: a mistake that nature kept me in countenance for, for she had certainly made one, when she gave him the male stamp…  When I came home again, and told Mrs. Cole (her procuress) this adventure, she very sensibly observ’d…  that, as to the thing itself, the less said of it the better…  that among numbers of that stamp whom she had known, or at least universally under the scandalous suspicion of it, she would not name an exception hardly of one of them, whose character was not, in all other respects, the most worthless and despicable that could be, stript of all the manly virtues of their own sex, and fill’d up with only the worst vices and follies of ours:  that, in fine, they were scarce less execrable than ridiculous in their monstrous inconsistence, of loathing and condemning women, and all at the same time apeing their manners, airs, lips, skuttle, and, in general, all their little modes of affectation, which becomes them at least better, than they do these unsex’d, male-misses.”   In Smollett’s 1748 novel “The Adventures of Roderick Random”, one of the captains under whom Roderick served was described as coming aboard elaborately and colorfully dressed, with white gloves, a mask on his face, and using an umbrella to shelter from the sun.  He was surrounded by a crowd of attendants who “seemed to be of their patron’s disposition” and all were impregnated with perfume.  He and his surgeon were caricatured as affected, delicate, and sensitive and were considered to maintain a relationship not fit to be named.

Associations between cross-dressing and homosexuality in a number of European countries since the sixteenth century have been reported by a number of authors.  Richard Sennett in his 1994 book “Flesh and Stone” stated that a feature of Renaissance Venice was a flourishing homosexual subculture devoted to cross-dressing, and that young men lounged in gondolas on the canals wearing nothing but women’s jewels.   Greenberg commented on the clubs and taverns known as molly-houses in eighteenth century London where homosexual men could socialize in more sheltered areas than the parks and walks where homosexual contacts were sought. The molly-houses could be entered by the curious or hostile.  Greenberg quoted a 1709 description by Edward Ward in “The Secret History of Clubs” of the men who frequented one of the molly-houses.  “They adopt all the small vanities natural to the feminine sex to such an extent that they try to speak, walk, chatter, shriek and scold as women do, aping them as well in other respects.”   Another observer attended a party at which he found “He-whores… rigged in gowns, petticoats, head cloths, fine laced shoes….  Tickling and feeling each other, as if they were a mixture of wanton males and females.”   Greenberg reported an episode similar to the raid on the Stonewall gay bar in New York in 1968.  The apparent effeminacy of the men in a molly-house did not prevent them from fighting back, when in 1725 their house was raided.  Trumbach in his 1994 article “London’s sapphists” stated that the term “molly” was that most commonly used to describe the effeminate sodomite.  It originally meant a female whore, so it implied that male sodomites were “he-whores”.    Greenberg pointed out that the molly-culture had international parallels, and that in early eighteenth century France there were circles of men who wore ribbons and powder, curtsied, and called each other by women’s names.  He added that some men with homosexual interests were put off by this and avoided these circles.  Cross-dressing was also found in association with homosexuality in the eighteenth century in the Dutch Republic, Naples, and Sicily.  Greenberg stated that by 1810 the stereotype of the male homosexual as effeminate was so established that when 30 men were arrested in a raid on a tavern in London in that year, the “Vere Street scandal”, people seemed genuinely surprised that many had physically demanding blue-collar occupations.

Additional evidence of awareness that men known to be homosexual had characteristic features was cited by John Clay in his 2001 book “Maconochie’s Experiment”.   A 1842 report to the governor of New South Wales, from Father McEnroe, the Catholic priest on Norfolk Island when the reforming penologist Captain Alexander Maconochie was Governor, alleged that under Maconochie’s less punitive regime there had been an increase in “that most dreadful crime… that called down the fire of Heaven on the guilty cities of Sodom and Gomorrah.”  The report was sent to the authorities in England where it entered the public record, and a subsequent passage was stated to have been deleted for its impurity.   The report continued “ I fear the Captain will have to give rigorous account on the day of Judgment for not attempting at least to put down these crimes that cry to heaven for vengeance.  These miscreants are as well-know among the prisoners, by their dress, carriage and conversation, as (are) the most notorious prostitutes on the streets of Sydney, and strange to say several of these have wormed their way to confidence and to places of ease and trust.”

Greenberg pointed out the association between male homosexuality and opposite-sex linked behaviors was found in cultures outside Europe, one form being what he termed transgenderal homosexuality.   One of the male partners adopted an opposite sex identity, dressing as a woman, and his homosexual activity was modeled on female heterosexuality.   This form had been reported in the past in Asia, Africa, Tahiti, and in the New Zealand Maori, and most notably in North American Indian tribes by the first European explorers.   They gave accounts of men unashamedly wearing women’s clothes, practicing women’s occupations, and engaging in homosexual relations.  In reports of Jesuit priests these men were described as effeminates who never married, and as sodomites dedicated to nefarious practices and corruption, who pretended that this usage came from their religion.  They were named berdaches by the French, the word derived from the Persian bardag, which meant according to Greenberg a young slave.  Williams in a 1996 article stated it meant an intimate friend.   Both writers agreed that in France it was used to describe an effeminate man who assumed the receptive role in homosexual intercourse.

Greenberg reported that female berdaches adopted male social roles and clothing, carried bows and arrows and guns, and had sexual relations with women and married them.  Though some male berdaches were celibate and some had heterosexual or bisexual relations, most had sexual activity with men only. They never took other berdaches as partners, only men whose lived as males.  As unmarried men they could have relations with any other men not forbidden by kinship restrictions. Greenberg commented that the proportion of men who had sexual activity with berdaches was not known but there were some indications it was high.  Presumably as these men were considered to take the active role, this was seen as in ancient Greece and Rome, to be part of normal male sexual behavior.  Many anthropologists considered men adopted the berdache role to avoid the risk of being killed, in view of the emphasis Indian culture gave to fighting as part of the male role. Greenberg pointed out this could not account for the children selected for feminization by their parents.  One Jesuit priest of the period said of the children chosen to be wizards who dress as women, that preference was given to those with an effeminate disposition.   This suggests there was a recognition in the American Indian culture of the predisposition to adult homosexuality in boys with opposite sex-linked characteristics.  Currently some anthropologists consider the term berdache inappropriate, as being an overriding category that could obscure significant and subtle categories within the many Native American communities.  Tafoya questioned whether Lakota berdache, termed Winkte have the same role as the Crow berdache, termed Bote, or the Tewa berdache, termed Kwid’o.   In a 1994 official statement to the American Anthropological Association, a group of Native and non-Native anthropologists and other scholars formally asked authors of introductory textbooks to update the term berdache to “two-spirit persons”.

Greenberg’s reference to female berdaches was brief, paralleling the situation in relation to historical records of homosexuality in women generally. There is therefore limited evidence of an association between lesbianism and masculinity.  In “London’s Sapphists” Trumbach cited a 1709 account by Mrs. Manley of a new sect of aristocratic women sexually involved with other women, who “reserve their heart, their tender amity for their fair friend”.  Some had “something so robust in air and mean, that the other sex would have certainly claimed her for one of theirs” but for the fact they were dressed as women.   Trumbach pointed out that in the eighteenth century homosexuals were at times termed hermaphrodite (having both female and male characteristics).  When used for the cross-dressing men more commonly called mollies who adopted a receptive role in homosexual intercourse, it did not mean that their bodies, but only their behavior combined male and female features.   When used of women it did imply their bodies were masculinized.  Women who combined overt masculine characteristics with desire for women were often supposed to be physical hermaphrodites.  Some were examined by physicians for signs of enlargement of the clitoris, considered the first stage of its transformation into a penis.  Greenberg considered the belief may have originated from a statement of the Roman poet Martial that lesbians had large penises.  Greenberg dismissed it as a fanciful notion, adding that such standard references as Larousse’s Dictionnaire Universal du XIX Siecle kept the fantasy alive.  In fact it is likely that some lesbian women with masculine characteristics did show clitoral enlargement, due to their having adrenal hyperplasia, as discussed in the next chapter.  The alternative view that homosexual feelings in women like those in the men termed mollies were not due to any physical abnormality, was increasingly accepted in the later eighteenth century.  In addition to being termed sapphists, women with homosexual feelings were termed tommies, presumably reflecting the belief they had masculine qualities.   Some combined items of male and  female clothing and cropped their hair.  In 1790 an English newspaper report of two women who lived together in an apparently non-sexual relationship described one as tall, masculine and always wearing a riding habit, and the other as polite, fair and beautiful.  The former was said to superintend the grounds in typical masculine fashion, while the latter, in feminine fashion, oversaw the house.  The women and their friends recognized the implication that they were sapphists, and sought advice as to whether to take legal action.

Trumbach considered that there was a reduction in interest in cross-gendered behaviors in women in the nineteenth century.   However there is an implication of the association of masculinity with female homosexuality in Dickens’ novel, “Little Dorrit” published in the 1850’s.  The novel was written for family consumption, but Dickens’ account could allow the sophisticated reader who to use his expression was “old enough to have heard of such”, to detect the implication while the unsophisticated reader would remain unaware of it.   Dickens’ strong condemnation of masculine characteristics in women would be apparent to both.   In the novel the villainess Miss Wade is depicted as having these characteristics, in contrast to those shown by both “Pet”, the girl initially loved by the hero, and by Little Dorrit, whom he later loves.  Pet is “dimpled and spoilt with an air of timidity and dependence which is the best weakness in the world, giving her the only crowning charm a girl so pretty and pleasant could have been without”.  Little Dorrit is labeled womanly because she is happy to sacrifice her life to her mean spirited and self indulgent father, described as well-looking though in an effeminate style. When she falls in love with the hero her bosom would joyfully throw itself before him to receive a mortal wound directed at his breast, with the dying cry “I love him”.  She believes if you love anyone, you would no more be yourself, but you would quite lose and forget yourself in your devotion to him.

Miss Wade travels alone and is described as reserved, withdrawn of her own haughty choice, and strong and forceful because she describes herself as unforgiving and capable of bearing malice.    The references to her are consistently negative.  A shadow which falls like a gloomy veil across her forehead is said to accord very well with the character of her beauty. She says she isn’t concerned to preserve her good name, and has none, as she is indifferent to its being considered good or bad.  She is consistently described as handsome in contrast to the feminine women who are pretty, and her beauty has a wasted look.  Her face is scornful and could not soften or relent, but could deepen into anger or any extreme of defiance.  Its expression indicated she was self-contained and self-reliant and her proud eyes and cruel mouth showed her unsubduable nature.  Dickens clearly indicates pride is a negative quality in women, while it is positive in men.  The nobility of the lower class admirer of Little Dorrit is indicated by his protestation to her father that “in my poor humble way, sir, I’m too proud and honorable to do it (reveal that the father had been in a debtor’s prison)”.    This statement moved her father, and presumably Dickens hoped, the reader, to tears.

In addition to the presentation of Miss Wade’s characteristics as unfeminine, negative feelings and behaviors are regularly ascribed to her.  Her early statement about the inevitability of events is said to imply the events will be necessarily evil. When she encounters Tattycorum, Pet’s maid, who is also described as handsome with lustrous dark hair and eyes, sullen and passionate, Tattycorum complains of her treatment by her employers.  Miss Wade looks at the girl, “as one afflicted with a diseased part might curiously watch the dissection and exposition of an analogous case”.  Later she writes to Tattycorum offering that if she felt herself hurt she could go to Miss Wade and be considerately treated.  When Tattycorum tells Pet that she had met Miss Wade, Pet asks her to take her hands away adding that she scarcely liked to think of Miss Wade being so near her without her knowing it.  Her father says of Tattycorum that she was a girl who might be lost and ruined if she wasn’t among practical people (that is, themselves).

Subsequently Tattycorum goes to stay with Miss Wade, and Pet’s father and the hero visit to ask her to return.  Miss Wade points out to the ex-maid that she can return to accept her employer’s condescension, to be again the foil to his pretty daughter, and again have the droll name, Tattycorum he has given her, setting her apart and reminding her of her lowly birth.  The employer asks Tattycorum to consider what is in Miss Wade’s heart, adding, “What can you two be together? What can come of it?”  He tells Miss Wade she cannot hide what a dark spirit she has within her and that “If it should happen that you are a woman who, from whatever cause, has a perverted delight in making a sister-woman as wretched as she is (I am old enough to have heard of such), I warn her against you, and I warn you against yourself”.   Several references are made to the power of Miss Wade over Tattycorum, and the scene ends with Tattycorum refusing to return to her employer and Miss Wade putting her arm about her as if she took possession of her for evermore.  Miss Wade later writes that they have been together ever since, sharing her small means.   When Tattycorum later returns to the service of her employer she says she is not as bad as she was, when she had Miss Wade before her all the time, as if it was her own self grown ripe, turning everything the wrong way, and twisting all good into evil.

It can only be surmised that Dickens is indicating that Miss Wade is lesbian though this would seem an interpretation the reader aware of lesbianism would at least consider.  Certainly Dickens draws attention to the possibility that a woman with masculine qualities can be a member of a group who have a perverted delight in establishing an evil relationship with other women.    The features seen by Dickens as appropriate for men but not for women remain those still seen in this way.  In 1974 Bem developed a scale to assess masculinity and femininity by asking undergraduates to list the personality characteristics considered in American society to be more desirable for one sex than for the other.  Those listed for men included being self-reliant, forceful, of strong personality, independent, assertive, aggressive, dominant, and acting like a leader.   Those for women included being childlike, gentle, yielding, compassionate, loyal, sensitive to the needs of others, and shy.   The scale remains commonly used in research investigating the masculinity and femininity of men and women.

It could be questioned that Dickens’ adult readers were aware of homosexuality.  Some of Jane Austen’s must have been, as were the readers of the eighteenth century novels of Smollet and Fielding (discussed in the next chapter).  In “Mansfield Park”, written a few decades earlier than “Little Dorrit”, Austen required this awareness of her readers when she wished to indicated the damaging effect of being reared by adults lacking appropriate ethical and social values.   She did this by having the otherwise attractive Miss Crawford, reared by her immoral Admiral uncle, make an inappropriate joke.  Miss Crawford says that in her experience of naval life she met only admirals rather than lower ranks, adding, “Of Rears and Vices, I saw enough.  Now, do not be suspecting me of a pun, I entreat”.   The italics are in the original, indicating the reference to rear- and vice-admirals is also a punning reference to sodomy.

Austen also alluded to homosexuality in her “History of England”, written when she was aged 16 for the private amusement of her family, suggesting knowledge concerning it was not then uncommon or considered inappropriate in an adolescent girl.  In the chapter on King James the First, she commented  “Sir Henry Percy tho’ certainly the best bred Man of the party, had none of that general politeness which is so universally pleasing, as his Attentions were entirely confined to Lord Mounteagle”.    She said of James  “His Majesty was of that amiable disposition which inclines to Friendships, & in such points was possessed of a keener penetration in discovering Merit than many other people.”  Austen’s biographer, David Nokes commented that in using the word penetration she was bold enough to emphasize the point with another double-entendre.  The historian, Green, writing in 1874 deals with James’s homosexuality perhaps more obliquely and certainly less tolerantly in his “A Short History of the English People”.   After commenting that James was held, though unjustly, to be a drunkard, and was suspected of vices compared with which drunkenness was almost a virtue, he added, “all real control over affairs was … entrusted to worthless favorites whom the King chose to raise to honor.  A Scottish page named Carr was created Earl of Rochester”.  Green quoted a statesman of the time as finding unprecedented the rise to power and fortune of another favorite, Buckingham, solely on the basis of his beauty and gracefulness of person.   Green added “the selfishness and recklessness of Buckingham were equal to his beauty; and the haughty young favorite on whose neck James loved to loll, and whose cheek he slobbered with kisses, was destined to drag down in his fatal career the throne of the Stuarts”.

The evidence is substantial that from the time of Aristophanes to the present men and women identified as homosexual were commonly believed to have characteristics of the opposite sex.


Awareness of an association of homosexuality and opposite sex-linked behaviors in the early psychiatric literature

Greenberg pointed out that in the last few decades of the nineteenth century European and American medical journals begin to discuss male homosexuality in terms of gender deviance, that is as associated with what were regarded as feminine characteristics.  The Swiss psychiatrist Auguste Forel wrote that male homosexuals felt the need for passive submission, they became easily enraptured over novels, and liked to occupy themselves with feminine pursuits, dress like girls and frequent women’s societies.  When Krafft-Ebing examined a defendant in a sodomy case, he concluded the man could not have been guilty of receptive homosexuality as he did not possess the clinical marks of effemination and had not the anthropological and clinical stigmata of the female-man.   Emil Kraepelin in his psychiatric text-book which provided the basis of the present classification of mental disorders, described homosexual men as feminine in movements, walk, bearing, and taste.  They showed a sickly sweet fragile essence, were vain,  flirtatious, placed much worth on externals, and clothed themselves with care.   He added there was not the slightest doubt that contrary sexual tendencies develop from the foundation of a sickly degenerate personality.


The “fuzzy” concepts of sissiness, tomboyism, effeminacy, and butchness

As pointed out earlier, awareness of the association between sissyish, effeminate, and butch behaviors and homosexuality is widespread in the community, though usually openly expressed only by men and women less sensitive to current social values.   As in view of the pejorative connotations of the terms, their use in scientific literature is generally avoided, there has been little interest in establishing their precise meanings.  However the terms referring to children are at times still encountered there.  The current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the official classification of the American Psychiatric Association, used “sissyish” and “tomboyish” to describe behaviors which were examples of “simple nonconformity to stereotypical sex role behaviors”.  They were to be distinguished from gender identity disorder.  It did not state what these nonconforming behaviors were.   As sexuality researchers are also community members they are of course familiar with the lay terms.  Boys who avoid rough and tumble play, sport, and fighting and who show interest in behaviors more characteristic of girls, such as house-work, sewing, cooking, acting or dancing, are those at risk of being labeled sissies.   Girls who show the reverse pattern of interests are those likely to be labeled tomboys.   It is probable additional as yet undefined behaviors shown by boys and girls contribute to the likelihood they receive these labels.  Sissiness, tomboyism, effeminacy, and butchness could be considered “fuzzy” concepts, to use the current term for concepts that lack clearly defined boundaries to their meaning.

When the Sex-linked Behaviors Questionnaire referred to in Chapter 1 was developed, it was decided to include all four terms without giving definitions of them.   The respondents could interpret them in the light of their own experience.  It was thought that in this way the terms might capture relevant sex-linked behaviors for which there was insufficient knowledge to provide appropriate definitions.   As discussed subsequently, this proved correct.  Freund and colleagues in their earlier development of a similar scale in 1974, did not use any of the four terms.  They did ask subjects whether they thought their appearance was masculine or feminine, without defining these terms, so treating them as fuzzy concepts.   Schatzberg and colleagues in 1975 pointed out the lack of scientific interest in the nature of effeminacy in adult males, and found dictionary definitions of effeminacy to be inadequate.  These included “the quality or state of being effeminate: a womanlike delicacy, weakness, or softness in a man”.   They could not find precise definitions in the psychiatric literature in which most studies were of effeminacy in boys.  Clinicians could agree on terming certain men effeminate, but were not able to pinpoint or quantify the factors which lead to that impression, consistent with the concept of effeminacy in adult men being fuzzy.

Schatzberg and colleagues pointed out that “swishy”, “faggy”, and “flaming queens” were related pejorative terms used in relation to effeminate men.   They developed a measure of effeminacy by determining the presence or absence of 67 aspects of men’s speech, gait, posture, movements of the mouth, upper face and eyes, hands, and body.    These included whether the men spoke with soft tones, used dramatic adjectives or superlatives, resorted to sarcastic mimicry, walked in small mincing steps, displayed limp wrists, struck languid poses, fluttered their eyelashes, preened their hair, and had slender or willowy builds.   Using the measure, they found that 16 men who identified as homosexual obtained mean effeminacy scores twice as high as those of 16 heterosexual men.   At the same time six of the homosexual men showed no effeminacy and only one, marked effeminacy; 12 of the heterosexual men showed no effeminacy. Though they demonstrated a relationship between the subjects’ effeminacy scores and their identification as homosexual, Schatzberg and colleagues concluded that knowledge of an individual man’s effeminacy score would be of little predictive value with respect to his sexual orientation.  They were of course using the categorical concept of sexual orientation, accepting that the men were completely homosexual or heterosexual.   Their method of assessing effeminacy in men does not appear to have been used subsequently, perhaps because of its complexity.  A likely additional reason is the current ideologically based reluctance to investigate or indeed acknowledge the presence of effeminate behaviors in men, in contrast to the research attention given their presence in boys.   Unlike the psychiatric literature of the late nineteenth century, the DSM does not refer to effeminacy or butchness in adult men or women, and no studies equivalent to that of Schatzberg and colleagues of effeminate behavior in men have been carried out to investigate butch behavior in adult women.  Again this contrasts with the attention given tomboyism in girls.  The reluctance to study gender nonconforming behavior in adults probably also explains why the behavior of men termed drag queens, which could be considered an extreme form of effeminacy, remains uninvestigated.


Inconsistent scientific recognition of the association of opposite sex-linked behaviors and homosexuality

In a 1993 review I pointed out that in the 1940’s and 50’s an association between marked opposite sex-linked behaviors and homosexuality was reported by pediatricians.  They described boys who dressed in female clothes at every opportunity, used cosmetics and postured like girls, and termed the behaviors effeminate and the boys homosexual, even though they were prepubescent.   Presumably the clinicians accepted the lay belief that these boys would become homosexual in adulthood.  Some expressed the view that the families of these boys were not unusual and that this, and the early age at which the behaviors appeared, suggested the behaviors were biologically determined.

These ideas were unacceptable to social theorists influenced by the ideology of liberation movements of the 1960’s.  In an attempt to eliminate discrimination against minority groups, this ideology emphasized that behaviors that could disadvantage members of these groups were not determined biologically and hence were not innate.   Rather they were determined socially, due to discriminatory beliefs concerning members of minorities.  Once someone was thought to belong to a minority, they were labeled as likely to show behaviors that were subject to disapproval.  This labeling caused the person to adopt the behaviors, along with the minority identity associated with the label.   Hence if some behaviors of a boy were considered feminine, this would lead to the boy being labeled a sissy and a potential homosexual.  He would accept this was true and adopt a more feminine manner and a homosexual identity.  If his social environment was modified so he was not labeled, he would develop the heterosexual characteristics approved by the wider community.  This belief in relation to male homosexuality provided the basis for a popular 1950’s Broadway play, “Tea and Sympathy”, admired at the time for its liberal values.  From the perspective of the subsequent gay liberation movement it was reactionary, maintaining the negative community view of homosexuality.  In the play the non-masculine behavior of the sensitive adolescent hero provoked taunts that he was homosexual.  This feared possibility was dispelled by the timely dispensation of tea, sympathy and seduction by the wife of his school teacher.

The influence of liberation ideology resulted in the beliefs of the earlier pediatricians concerning the relationship of opposite sex-linked behaviors in children and homosexuality ceasing to receive attention.   In the 1960’s it became accepted practice for pediatricians to reassure parents troubled by the cross-dressing and feminine behaviors of their male children or extreme tomboyish behaviors of girl children, that they should disregard the behaviors as the children would grow out of them.   Subsequently some clinicians and researchers followed up boys who showed these behaviors to a marked degree.  They found the majority of the boys in adulthood identified to themselves and to the researchers as homosexual, while a small number became transsexual.   Insufficient research was carried out on girls with extreme tomboyism to determine their outcome in adulthood.

The finding that marked feminine behaviors in boys was related to sexual orientation in adulthood, did not stimulate scientific interest in the milder degrees of opposite sex-linked behaviors present in a larger number of children, including the behaviors considered sissyish or tomboyish by the general community.  Psychiatrists and psychologists who treated children did not attempt to assess whether their clients showed these behaviors.  A 1989 research study found up to half the boys aged five to twelve referred for outpatient psychiatric evaluation showed significant degrees of opposite sex-linked behaviors on scales designed to assess the behaviors, yet the behaviors had not been noted by their therapists.   The authors of the study considered they were overlooked due the therapists’ attention being focussed on the disturbed behaviors for which the boys were referred, and also because the boys showed in addition masculine behaviors. That is to say, the therapists’ judgments were impaired because they were unaware that sex-linked behaviors were distributed dimensionally.   They did not notice the opposite sex-linked behaviors because the boys also showed same sex-linked behaviors.

This could account for the failure of therapists to notice less extreme opposite sex-linked behaviors in children.  It does not account from the failure of researchers to investigate the community belief that boys with less extreme sissyish behaviors were more likely than those with no sissyish behaviors to later identify as homosexual.   The other possibility they ignored was that more of the boys with less extreme sissyish behaviors though not identifying as homosexual, would develop non-predominant homosexual feelings, that is, they would become homosexual heterosexuals.   Researchers showed no interest in the possibility that the less extreme behaviors were on the same dimension as the markedly effeminate behaviors found to be highly likely to be followed by identification as homosexual in adulthood.  A possible reason for this lack of interest was the conclusion of a 1969 study by Zuger and Taylor.  It investigated the incidence of the extreme effeminate behaviors noted by the earlier pediatricians in boys, namely, dressing in female clothes, using cosmetics, jewelry and hand-bags, and showing feminine postures and gait.  The degree of these behaviors in 26 male patients referred for showing a number of the behaviors was compared with the degree shown by 95 schoolboys.  Overlap in the degree of the behaviors was found in six schoolboys and one patient.   The researchers arbitrarily decided that that patient was incorrectly diagnosed, enabling them to conclude the behavior of the other 25 patients was clearly differentiated from that of the schoolboys.   A quarter of the schoolboys were found to show some feminine behaviors.  However these behaviors were not seen as on the same dimension as the extreme opposite sex-linked behaviors shown by the 25 patients.  This conclusion may have encouraged acceptance of the belief that it was only the extreme form of opposite sex-linked behaviors that was of interest to researchers of sexual orientation.

A number of other studies investigating childhood behaviors also found that a significant percentage of normal children showed some degree of opposite sex-linked behaviors, but did not consider whether these behaviors could be dimensional with the extreme form associated with later homosexuality.  Only one study carried out by Kagan and Moss in 1962 sought a possible association with later sexual behavior.  They determined the presence of opposite sex-linked behaviors in 45 girls and 44 boys whom they followed up into adulthood.  Involvement in athletics, in competitive activities, and with mechanical objects in childhood was regarded as masculine. Involvement in gardening, music, cooking, and noncompetitive activities was considered feminine. The selection of the behaviors would appear to have been determined by the lay concepts of sissiness and tomboyishness.  The study found that individual boys and girls showed varying degrees of involvement in the sex-linked activities, the degree remaining constant from the age of 3 to 14.   Reduced involvement in same sex-linked behaviors in boys but not in girls was associated with reduced involvement in heterosexual erotic behavior in adulthood.  The incidence of homosexual behavior was not investigated.


Research investigating the presence of milder opposite sex-linked behaviors in the childhood of identified  homosexuals  

Studies following-up children into adulthood of course take a few decades to complete.  This difficulty may have contributed to the absence of studies investigating whether the milder opposite sex-linked behaviors of sissiness and tomboyishness in children were associated with later homosexuality.  Several studies I reviewed in 1993 provided evidence of this association by the less demanding procedure of asking adults who identified as homosexual or as heterosexual about their childhood behaviors.   In all the studies, as groups, the men who identified as homosexual compared to those who identified as heterosexual reported that as children they had been significantly more likely to be fearful of physical injury, and to avoid fights and involvement in competitive sports.  The homosexual subjects included psychiatric patients, prisoners, members of homosexual organizations and respondents to word of mouth requests.  One study found non-patient male homosexuals in the United States, Guatemala, and Brazil reported similar incidences of increased opposite sex-linked behaviors in childhood.   Another investigated the relationship in women.  It found that over two-thirds of lesbians reported tomboyish behavior in childhood as compared with less than a sixth of women who identified as heterosexual.


Homosexual heterosexuals show opposite sex-linked behaviors

In view of these findings in identified homosexuals, when the prevalence of homosexual feelings in medical students was investigated in the three studies reported in Chapter One, it was decided to also include in the Sex-linked Behaviors Questionnaire items assessing opposite sex-linked behaviors both in childhood and currently.  The childhood behaviors investigated were those reported in their childhood by men and women who identified as homosexual as adults in the studies discussed above.   In addition the behaviors Kagan and Moss found in male children to be followed by reduced involvement in heterosexual behavior in adulthood were included.  Questions investigating sissy, tomboy, effeminate and butch behaviors were framed to allow for the possibility they were fuzzy concepts not able to be precisely defined. The subjects were asked whether at any period during their first 15 years they were (if male) accused of being a sissy or (if female) a tomboy.   They were also asked if currently they thought they if male, showed effeminate traits, or if female, showed the masculine equivalent of effeminate traits (butch).  No definitions were provided for the four terms.

In all three studies consistent relationships were found in the male medical students between their current degree of homosexual as compared to heterosexual feelings and the degree of a number of the opposite sex-linked behaviors investigated.   These included reduced interest in sport, particularly rough and tumble play and contact sport, and avoidance of fighting in childhood and adolescence.   The relationships for the fuzzy items, the frequency with which they were called sissies in childhood, and they currently felt they had effeminate traits, were among the strongest.  The women students showed only a few weak associations between degree of homosexual feelings and opposite sex-linked behaviors.  There was no association with the frequency with which they were termed tomboys in childhood but there was an association with their current feeling that they showed butch traits.  The latter association was found again in the women medical students in a study reported in 1991.

These studies in medical students were the first to show relationships between opposite sex-linked behaviors and traits in the 20% or more men currently aware of homosexual feelings, rather than in the much smaller percentage of men who identified as homosexual in the earlier studies. Dunne and colleagues in their 2000 study also found that of the men and women twins who identified as heterosexual, those who reported any homosexual attraction or behavior and hence were homosexual heterosexuals showed more opposite sex-linked behaviors than those who reported neither.   They did not investigate the strength of their subjects’ homosexual compared to heterosexual feelings.  In the studies of medical students, the stronger the degree of the men’s homosexual compared to heterosexual feelings, the stronger the degree of their opposite sex-linked behaviors.  Most of the students with homosexual feelings were homosexual heterosexuals, with predominant heterosexual feelings.  Hence it could be argued that though the men with predominantly and exclusively homosexual feelings made up less than a quarter of those with some homosexual feelings, they were responsible for producing the relationships found between degree of homosexual feelings and opposite sex-linked behaviors.   That is, it is possible the relationships were so strong in those with predominant and exclusive homosexual feelings, they could be absent in the men and women with non-predominant homosexual feelings, but still be apparent when the two groups combined were compared with the students with no homosexual feelings.  Further studies by myself and colleagues demonstrated this was not the case.   The relationship with opposite sex-linked behaviors was still present in homosexual heterosexual men compared to exclusively heterosexual men when those with bisexual, predominant homosexual, and exclusive homosexual feelings were excluded.  These findings were reported for medical students in 1991, and for male twins in 1994.

It needs to be emphasized that while these studies established that relationships between opposite sex-linked behaviors and degree of homosexual feelings were present in the men and to a lesser extent in the women studied, the strength of the relationships were not great even in the total groups.   It was weaker in those whose homosexual feelings were not predominant, that is the homosexual heterosexuals, as compared to those who reported predominant homosexual feelings.  A minority of those with some homosexual feelings showed no more opposite sex-linked behaviors than the majority of men and women who reported exclusively heterosexual feelings, and a minority of the latter showed levels of opposite sex-linked behaviors within the range shown by the majority of those with homosexual feelings.  These findings mean that the relationship between effeminacy and homosexuality will be more apparent in men and women with predominant homosexual feelings, that is, those most likely to identify as homosexual.  It will be much less obvious in homosexual heterosexuals.  Hence if all men with homosexual feelings expressed them in behaviors, few would be noted to have effeminate mannerisms and the association between homosexuality and effeminacy would escape notice.   This appeared to be the situation in ancient Greece and Rome.   In those societies when effeminacy was noted in the small number of men with homosexual behaviors, they were considered passive homosexuals, a separate group from the remainder who were considered to be only active in their behaviors.

There is some support for the belief that men who take a passive role in homosexual sex are more likely to show effeminate traits. Haist and Hewitt in a 1974 study asked 185 homosexual men whether they preferred the insertor or insertee role in anal intercourse.   Those who preferred the passive as compared to those who preferred the active role, preferred to fellate rather than be fellated, to be submissive to the partner in social and sexual activities, and to be referred to by other homosexuals as “she” rather than “he”.   Weinrich and colleagues in a 1992 study found a strong relationship between childhood opposite sex-behaviors and preference for receptive anal intercourse in 100 men who had sex with men.  In 2003 McIntyre reported a similar relationship in 44 male members of Harvard University’s Gay and Lesbian Caucas.  Stokes and colleagues in a 1997 study compared the sexual behavior of 250 men they termed gay and 310 they termed bisexual.  The gay men had had sex with men in the previous 6 months, and no sex with women in the past 3 years.  The bisexual men had both male and female sexual partners in the previous six months.  The gay men were more likely than the bisexual men to report have engaged in receptive sex, both anal and oral, both in the previous six months, and throughout their lives.  It would seem that men with opposite sex-linked or sissy traits and those with more predominant homosexual as compared to heterosexual feelings are more likely to adopt a receptive role in sexual behavior.   As discussed in Chapter 4, in some contemporary Latin American societies with a strong concept of masculinity, so-called machismo, some men openly report having active homosexual activities as expressions of this masculinity.   However in most contemporary European societies, examples of such behavior are exceptional.  In these societies few men or women openly report homosexual behaviors or feelings, so that those who do are mainly those with predominant homosexual feelings, some of whom will show obvious effeminate or butch mannerisms.  These mannerisms in men  remain a subject for popular comedy as in the television series, “Will and Grace”, and hence reinforce awareness of the association between homosexuality and opposite sex characteristics.  This awareness in turn reinforces the reluctance of homosexual heterosexuals to reveal their homosexuality and so provide evidence that the association is weak.

Though it is weak it has consistently been found in a number of studies irrespective of whether the subjects had marked or minimal homosexual feelings.    These consistent findings support the concept that homosexual feelings in homosexual heterosexuals are on the same dimension as the homosexual feelings which when predominant lead to men and women to identify as homosexual.


Opposite sexual identity and homosexuality: transsexualism

Another sex-linked behavior investigated in relation to homosexual feelings in the studies of medical students was sexual identity, the feeling of being either male or female.   Wishes to be of the opposite sex had been found in the girls and boys with marked opposite sex-linked behaviors who were labeled homosexual by clinicians in the 1940’s.  Many of them insisted they were members of the opposite sex.   However the concept that a feeling of belonging to one or the other sex was a psychological entity identity was advanced only in the 1950’s, when it was named sexual identity.  This occurred in response to the recognition of a  condition which had been previously ignored, and which was subsequently termed transsexualism.  Its recognition followed the development of sex-conversion procedures that enabled women and men to attain the physical appearance of the opposite sex.  The initial procedure, surgical conversion of male to female genitalia, was followed by less successful attempts to convert female to male genitalia, and by use of opposite sex hormones to produce changes such as breast development in men and hair growth in women.  When awareness of the possibility of physical sex-conversion became public, an increasing number of men and a smaller number of women requested the procedure, the men often threatening genital self-mutilation or suicide if denied it.  Many of the men and women who had this intense desire to belong to the opposite sex said they felt they were psychologically of the opposite sex.   They sought physical sex-conversion so that their bodies would correspond with their emotional state.  Many of these men and women reported that prior to seeking sex-conversion they had cross-dressed, at times permanently, so as to appear to be of the opposite sex.

As pointed out earlier, cross-dressing in public had been recognized since antiquity as associated with homosexuality in men.  Trumbach in his discussion of London’s sapphists pointed out that in the eighteenth century reports of women who cross-dressed became of public interest.   Most did not cross-dress to attract women.   Some joined the army or navy to be with their male lovers or husbands or to search for them.  Others cross-dressed to conceal their marriage because employers preferred unmarried servants.   However as discussed earlier, those labeled sapphists or tommies were recognized as having sexual feelings towards women.   Trumbach considered the increased awareness of their existence in the nineteenth century led to greater difficulty in women passing in real life as men, and the public became less interested in their stories.  At the same period sex researchers realized that a number of men cross-dressed in private who were not homosexual.  Their cross-dressing was associated in adolescence with sexual arousal.   These men were termed transvestites, and their condition, transvestism.   Typically transsexual men and women differed in that their cross-dressing was never associated with sexual arousal, but was motivated by the desire to be of the opposite sex.   Unlike typical transvestites, they sought physical sex-conversion when it became available.  Though the increasing availability of sex-conversion procedures resulted in the number of transsexuals requesting it increasing yearly, it is still less than one in some tens of thousands, so that transsexualism is substantially less prevalent than transvestism, shown by possibly over one percent of men.   Nevertheless since transsexualism was first recognized it has attracted far greater public and research interest than transvestism.  It seems that the rejection of one’s sex is found more puzzling and possibly challenging by most people than is cross-dressing.

Recognition of transsexualism led to the new concept concerning human sexuality being advanced.  Worden and Marsh in 1955 stated that “the existence of persons who have this distorted subjective perception of their sexual identity offers an opportunity to study the whole problem of how human beings normally get their sense of being a male or a female”.   Inherent in this statement were two claims.  One was that all human beings have a categorical sexual identity, that is, they feel exclusively male or female.  The second was that the nature and development of sexual identity is similar in both transsexual and non-transsexual men and women.  Both were accepted without controversy.   Initially for women and men to be diagnosed as transsexual and hence suitable for sex-conversion, an essential requirement was that that they had always believed with certainty that they were really members of the opposite sex with the wrong sex organs.  Those seeking sex conversion rapidly learned to give life histories conforming to this requirement.   As a result sex theorists concluded that since their childhood transsexuals had a powerful and unified opposite sexual identity, a sense they were male or female which was contrary to their biological sex.   Accepting that sexual identity in normal women and men had developed in an opposite fashion, the theorists believed that they must have an equivalent sexual identity since childhood, but one which was congruent with their biological sex.   That is, it was believed that normal persons had a sexual identity which was equivalent to and held with the same persistence and intensity as the opposite sexual identity held by transsexuals which drove them to tolerate the significant difficulties of undergoing sex-conversion.  Research was not considered necessary to establish this concept of normal sexual identity.  It was accepted that it was categorical, that is, completely female in non-transsexual women and completely male in non-transsexual men.   The possibility that the degree of sexual identity could vary in strength in relation to the ratio of men and women’s heterosexual to homosexual feelings was not considered.


Sexual identity becomes gender identity and transsexualism becomes gender identity disorder

In the 1950’s and 60’s when the concept of sexual identity was developed, the dominant ideology explaining the psychological development of humans was social constructionism, the belief that this development was entirely determined by social influences.   Sex theorists who accepted this ideology wished to exclude any suggestion that biological factors could play a role.  They decided wherever possible to use the word gender rather than sex, as the word sex could allow for the possibility that biological factors were involved.  Gender was defined as determined entirely by social factors.  Social constructionist sex theorists then claimed an entity existed they termed gender role.  It was defined as all those things that a person says or does to disclose himself or herself as having the status of boy or man, girl or woman, respectively, including sexual orientation.  Accepting the existence of this concept of gender role meant accepting that the areas of human sexuality encompassing sexual identity, sex-linked behaviors identified as masculine or feminine, and the sex to which the person felt attracted were entirely learned.  The concept of gender role also required that all these forms of sexual behavior were sufficiently closely related to be considered part of one entity.  No verification by scientific evidence of the existence of this entity was advanced, and it remains widely accepted despite the lack of such evidence, and indeed despite evidence to the contrary.   The terms sexual identity and sex-linked behaviors were replaced by the terms gender identity and gender conforming behaviors, respectively.  Thus by definition rather than on the basis of research gender identity and gender conforming behaviors were accepted as determined entirely by social factors.  This unscientific procedure encouraged clinicians to persuade parents to raise children with accidentally or genetically produced genital malformations in the sex opposite to their biological sex.  The clinicians believed that social conditioning would cause the children to accept the sex to which they were assigned.  The at times tragic consequences are discussed in the next chapter.

The basic requirement of what was now termed an opposite gender identity for the diagnosis of transsexualism led to transsexualism being renamed gender identity disorder in the DSM.   Recognition of the importance of feelings of opposite gender identity in the girls and boys with marked opposite sex-linked behaviors diagnosed in the 1940’s as homosexual led to their condition also being named gender identity disorder.  According to the DSM, for adults or children to be given this diagnosis they must show a strong and persistent identification as belonging to the opposite gender, and a persistent discomfort with their sex, or a sense of inappropriateness in the gender role of that sex.  They must wish to be or believe they are of the opposite sex, the children expressing negative feelings to their genitalia and adolescents and adults seeking physical sex-conversion.  They must show marked opposite sex-linked behaviors, including cross-dressing, with adolescents and adults frequently passing as the other sex.  The children must prefer cross-sex roles in make believe play, have an intense desire to participate in the stereotypical games and pastimes of the other sex, and strongly prefer playmates of the other sex.


Gender identity disorder and sex-linked behaviors in children and adults: ?dimensional or categorical

The DSM states that gender identity disorder in children is distinguished from simple nonconformity to stereotypical sex role behavior such as tomboyishness or sissiness, by the extent and pervasiveness of the children’s cross-gender wishes, interests and activities.   This implies that gender identity disorder is at the extreme end of dimensions of cross-gender wishes, interests and activities all of which are present to a lesser extent in girls and boys labeled tomboys and sissies.  DSM does not clarify whether tomboy and sissy children’s cross-gender wishes, interests and activities also incorporate a degree of cross-gender identity, or whether they have a totally same gender identity that is, female in tomboy girls and male in sissyish boys.   The DSM thus leaves  open the issue of whether gender identity in children is categorical, that is entirely male or female, or dimensional, so that a child can have a degree of same sex and a degree of opposite sex identity.  If it is dimensional, the degree of opposite sex identity in children might, like sissiness and tomboyism, be related to the degree to which they will experience homosexual feelings in adulthood.

The DSM refers to a series of studies which followed-up boys with gender identity disorder into adulthood.  The studies showed that the onset of opposite gender interests and activities was usually between ages two and four, and their intensity usually decreased with age.  If this did not occur, the boys were likely as adults to show a gender identity disorder (that is, what was previously called transsexualism).   This was rare.  By late adolescence or adulthood three-quarters of the boys with gender identity disorder reported a homosexual or bisexual orientation, with most of the remainder reporting a heterosexual orientation.   The DSM states that these men no longer have a gender identity disorder.   This results in a somewhat contradictory acceptance that the  majority of boys with a condition labeled a disorder become without treatment normal heterosexual or homosexual adults.  DSM does not comment on whether this means that as adults their gender identity is totally male.  It makes no reference to the finding of the 1975 study of Schatzberg and colleagues or the community belief that homosexual men are more likely than heterosexual men to show effeminate behaviors.  It therefore avoids discussing whether effeminacy needs to be distinguished from gender identity disorder, as it says sissiness does.  Presumably the authors of the DSM decided to accept that gender identity is categorical in adults, with men with gender identity disorder having a totally female identity, and the remainder, including transvestites and men with homosexual feelings or behaviors, having a totally male gender identity.


Dimensionality of gender identity in homosexual heterosexuals

The possibility that the gender identity of adults was dimensional and related to their degree of homosexual feelings was investigated in the studies of medical students by myself and colleagues.   The studies by other authors referred to earlier which found that men and women who identified as homosexual reported more opposite sex-linked behaviors in childhood, did not investigate gender identity.  In the studies of medical students, three items were included in the Sex-linked Behaviors Questionnaire to determine if gender identity could be measured dimensionally.    These items asked the students to rate from “never” to “all the time”, the frequencies with which (1) they felt uncertain of their identity as a member of their sex; (2) they felt like a member of their sex; and (3) they felt like a member of the opposite sex.  In the three studies the male students’ reports of a degree of uncertainty or a degree of opposite sexual identity were significantly related to their degree of homosexual feelings.  Similar relationships were also present in the responses of the women students, but not as strongly or consistently as in the responses of the men.  At the same time, the students reported different degrees of frequency of the three types of feelings of gender identity.  So if the three feelings were valid aspects of gender identity, gender identity was not a categorical entity but a series of dimensions.

In the 1994 study of twins by myself and colleagues, the relationship between opposite gender identity with degree of homosexual feelings was investigated with the men with bisexual, predominant and exclusive homosexual feelings excluded.   The homosexual heterosexual men, those with some homosexual but predominant heterosexual feelings, showed stronger uncertain or opposite gender identity as assessed by the three questions than did those with no homosexual feelings.   In their 2000 study Dunne and colleagues also used a dimensional measure of gender identity.   They found both men and women who reported any homosexual attraction or behavior but identified as heterosexual showed a degree of opposite gender identity greater than did those  who reported no homosexual attraction or behavior, but less than did those who identified as bisexual or homosexual.   These findings demonstrated that homosexual heterosexual men and women have stronger feelings of opposite gender identity, as assessed by these dimensional measures, that do the exclusively heterosexual.  It would seem to use the currently popular terms, homosexual heterosexual men who identity publicly as heterosexual are more likely to be “metrosexuals”, and “in touch with their feminine side” than exclusively heterosexual men.    The need for women to be in touch with their masculine side does not seem a requirement of current values concerning sexual differences.


Is gender identity a single entity or a combination of dimensions?

In 1983 Armstrong and I reported a more detailed analysis of the responses of the male medical students in the first two studies to the three items investigating gender identity and related items.   The responses to the three items interrelated to a statistically significant extent.   That is, the degree the men reported they experienced the three aspects of gender identity was similar.  At the same time, the degree related as strongly with the degree they experienced other items, such as desire to be of the opposite sex, feeling they had a mental component of the opposite sex, and feeling they had effeminate traits.   This finding provided further evidence that gender identity is not a categorical entity but a construct with a number of dimensional aspects.  When the men with some homosexual feelings were compared with those with no homosexual feelings, the men with no homosexual feelings showed a weaker sense of gender identity, in that their responses to the three items assessing gender identity were only weakly related to each other and to the other responses investigated.   That is, awareness of consistent feelings of gender identity was much stronger in men with some homosexual feelings than in those with exclusively heterosexual feelings. These consistent feelings in men with some homosexual feelings were of identity with the opposite sex.    In reporting this finding, a parallel was made with the stronger sense of identity of minority groups, particularly persecuted minorities, such as Black Americans or Jews.   If the parallel is appropriate, the findings indicate that social factors make at least some contribution to the establishment of gender identity in non-transsexual women and men.


Are homosexual feelings more strongly related to opposite sex-linked behaviors and gender identity in heterosexual homosexual men than women?

As pointed out earlier, in the initial three studies of medical students reported by myself and colleagues, the majority of students aware of some homosexual feelings were aware of predominant heterosexual feelings, that is, they were homosexual heterosexuals.  The relationships of their degree of opposite sex-linked behaviors with the degree of their homosexual feelings were stronger in men than women.   A 1991 study by myself and Derrick Silove, also of medical students, again found these relationships to be stronger in men than women.  The finding of stronger relationships of these behaviors and feelings in men than women was consistent with the finding reported by Kagan and Moss in 1962, referred to earlier.  Reduced involvement in same sex-linked behaviors in boys but not in girls was associated with avoidance of heterosexual erotic behavior in adulthood.

However there was an apparent contradiction in the reports of the women medical students in the 1991 study.  Those with some homosexual feelings compared to women who reported no homosexual feelings did not report markedly greater opposite sex-linked behaviors in childhood or adolescence.  However they reported that they currently had butch traits.   The finding was consistent with the earlier suggestion that “butch” was a fuzzy concept with the boundaries to its meaning as yet undefined.  Inclusion of the term butch in the Sex-linked Behaviors Questionnaire must have captured opposite sex-linked behaviors related to homosexual feelings in women that differed for those included in the questionnaire, undefined behaviors which led the women to consider they had butch traits.  The nature of these behaviors captured by the term “butch” will need to be determined so they can be included in future assessments of sex-linked behaviors in women.  Dunne and colleagues found the relationship of opposite sex-linked behaviors with homosexual feelings was about the same in the male and female twins they studied, of whom most of those with homosexual feelings or behaviors were homosexual heterosexuals. The scale they used to assess sex-linked behaviors contained different items for men and women.

Opposite gender identity, like opposite sex-linked behaviors, was found to be more strongly related to homosexual feelings in men than in women in the earlier studies of medical students and twins by myself and colleagues.  However in a 1995 study with a colleague, Zamir, a stronger relationship was found between opposite gender identity and homosexual feelings in female than male medical students.  Dunne and colleagues used a scale with different items from the three I had developed, to assess the gender identity of their subjects.  Like it, their scale treated gender identity as dimensional rather than categorical.  They found that the men compared to the women, both of whom had experienced homosexual behavior and/or attraction throughout their lives but did not identify as homosexual, showed greater opposite gender identity.   Further research using different assessment measures would seem necessary before it can be determined whether opposite sex-linked behaviors and gender identity are more weakly related to homosexual feelings and behavior in women than in men.


Continued controversy as to whether gender identity is dimensional: transvestism

Gender identity researchers Spence and Buckner considered scales such as those used by myself and Dunne and colleagues which were designed to measure gender identity dimensionally failed to do so.  They believed instead these scales assessed men and women’s awareness that their behavior failed to correspond to socially dictated expectations of how men and women should behave.  They considered that males and females other than those with gender identity disorder (that is, children with the disorder and adolescent and adult transsexuals) maintained an unambiguous and stable sense of their gender identity.  However they also considered that this sense was existential and so could not be measured.  Hence their belief could not be tested by research.  If they were correct both men and women with some homosexual feelings and transvestites have an unambiguous and stable sense of gender identity consistent with their biological sex.

In the 1970’s an organization of transvestites in Sydney approached me seeking to be subjects for research of their condition.  They considered lack of research and the consequent lack of knowledge concerning transvestism led to their being incorrectly considered transsexual or homosexual.  A colleague, Neil Buhrich, agreed to cooperate with me in carrying out this research.  These self-identified transvestites were all male.  They met once a month in one of their homes, conforming to a club rule that they cross-dressed in taste.  They usually wore semi-formal clothes such as cocktail gowns, with such accessories as necklaces, brooches and wristwatches designed for women.   When cross-dressed they addressed each other by feminine names, frequently a modification of their first name, such as Paula for Paul and Wendy for Warren.  They spoke to each other in their normal masculine voices though some softened them.  Otherwise they attempted to appear as convincing women, making no attempt to parody women, or behave seductively towards others present, male or female.   That is to say they showed few of the behaviors considered by Schatzberg and colleagues to characterize effeminacy.

The transvestite and a comparison group of transsexual men were asked the frequency with which they felt like a woman when nude and when dressed as a woman.    The frequency was the same for the transsexuals, in that they felt like women all the time in both conditions. The transvestites were much more likely to feel like a woman when cross-dressed than nude.   When cross-dressed a half felt like a woman all the time, and all but one of the remainder felt like a woman often, or occasionally.   When nude, a half never felt like a woman.    If these transvestite men’s statements concerning their feelings of gender identity are given the same value as the statements of transsexuals, on which the concept of gender identity was based, their gender identity was not stable.  Giving the statements of the transvestites and transsexuals the same value in regard to determining the nature of gender identity seems justified by the fact that a number of men who earlier in life identified as transvestite, seek sex-conversion in middle-age.  They are then  diagnosed as transsexual or having gender identity disorder according to the DSM.


Effeminacy and homosexuality in adult men: drag queens

Another group of men who cross-dress but do not commonly seek physical sex-conversion are those who identify as homosexual and are called or call themselves drag queens.  As mentioned earlier there is minimal research data concerning these men.   It is therefore not clear whether they cross-dress mainly due to feelings of opposite gender identity, as in transsexualism, for sexual arousal, as in transvestism, to gain attention, or to be more effective as entertainers or sex workers.   It may well be that the reasons differ in individual drag queens.   From observation, at least when in “drag” they would appear to show a sufficient number of the behaviors considered to characterize effeminacy, to obtain high effeminacy scores on the scale developed by Schatzberg and colleagues.   As stated earlier, since their 1975 study there has been little research interest in investigating effeminacy in adult men.  Nevertheless its relationship with homosexuality is sufficiently accepted in the wider community that effeminate homosexual men remain a source of humor in current movies and television series much as they did in the comedies of Aristophanes.  Schatzberg and colleagues found the effeminacy scores of the 16 men they studied were distributed dimensionally with six showing no, four low, five moderate and one, high levels of effeminacy.   It would seem the varying degrees of effeminacy shown by men who identify as homosexual lie along the same dimension on which the marked effeminacy of drag queens when in drag would be at the high end.  The degree to which drag queens when not in drag show markedly effeminate behaviors does not appear to have been studied.    That it could be minimal in some is suggested by the fact that some men who identify as homosexual but do not usually show effeminate mannerisms temporarily adopt some of the behaviors that characterize drag queens.   They cross-dress from time to time for parties or public gay events, adopt female names, and “camp it up” to use another fuzzy term for effeminate behaviors.   The nature of the gender identity they experience at these times has not been explored.   An unknown number of drag queens appear to have a transsexual component, in that they take opposite sex hormones.  Some eventually seek physical sex-conversion.  They then meet the DSM criteria for the diagnosis of gender identity disorder.

Hence the gender identity of drag queens and possibly some homosexual men who temporarily adopt some of their behaviors appears to fluctuate like that of transvestites which varies depending on whether they are dressed as men or women.  The evidence seems substantial that gender identity is dimensional and fluctuating rather than categorical.


Masculinity-Femininity and androgyny

The compartmentalization of research of sexual behavior due to differing interests and backgrounds of researchers has resulted in the development of an area of research into male-female differences independent of that so far discussed.   In the 1940’s psychologists studying normal behavior advanced the concept that a dimension of  “masculinity-femininity” existed as a personality trait in both women and men.   It could be assessed by their responses to scales developed for the purpose.   Masculinity-femininity was then considered to be a single dimension, so that a person high on masculinity would be low on femininity and vice versa.   In 1973 Constantinople trenchantly criticized this area of research as lacking a satisfactory theoretical definition of masculinity-femininity.   She pointed out that items, mainly psychological characteristics, were taken as indicators of masculinity or femininity if in a particular culture at a particular time they differentiated men from women.  No attempts had been made to assess the centrality of the items to an abstract definition of masculinity-femininity.  She also pointed out that when different scales of masculinity-femininity were used to assess the same women and men, agreement between them was low, so that the scales were not measuring the same entity.

Possibly in response to Constantinople’s criticism of the lack of a theoretical definition, in a  1970’s development of feminist theory the concept was advanced that masculinity and femininity were sex roles that were not innate but culturally determined as being appropriate for males and females.  The roles were established in male and female children and adults by their being rewarded with social approval when they showed the behaviors considered appropriate for their sex and punished with social disapproval if they showed those considered inappropriate.  Initially this concept treated masculine and feminine sex roles, like masculinity-femininity, as opposite ends of a single dimension.  Subsequently considerable acceptance was given to what was termed the iconoclastic idea that masculinity and femininity were not opposites but two totally independent and equally important aspects of human personality.   It was considered the ideal individual was androgynous, highly masculine and feminine.  These concepts were basic to the development by Bem of the Sex-Role Inventory, probably still the most widely used scale in this area of research. It asked subjects to indicate how well each of 60 personality traits described them.  As pointed out earlier the traits selected were those judged by undergraduates to be more desirable in American society for one sex than the other.

Studies using the Bem and later developed androgyny scales, reported that androgynous compared to non-androgynous women and men were more psychologically healthy or otherwise advantaged.  This conclusion stimulated considerable controversy, with suggestions that it was ideologically rather than research based.  Measures of psychological health were to a large extent measures of self-esteem.  Sex role scales, which assessed only desirable traits, also measured self-esteem.   It was argued that the apparent relationship of androgyny and psychological health was due to the relationship of psychological health with the self-esteem component of the androgyny scale.   This was supported by findings that the relationship between androgyny and psychological health was due primarily to the masculinity component of androgyny.  The influence of the femininity component was negligible.  Scales for both masculinity and self-esteem share similar items, resulting in masculinity scales measuring self-esteem while femininity scales do not.     Researchers who agreed that masculinity and femininity were independent personality dimensions, disagreed concerning how measures of the two dimensions should be combined to determine androgyny.  As with the earlier masculinity-femininity scales, when different measures of androgyny were used to assess the same population, agreement between them was low.  Men and women defined as androgynous on one scale showed some positively valued characteristic, whereas  those defined as androgynous on another did not.

Currently sections of society have accepted feminist ideology to the extent that women and men are subject to disapproval if they appear to be sexually stereotyped, that is, to be women with mainly feminine and few masculine traits, and men, to be the reverse.   Scales were developed to measure what were termed “hyperfemininity” in women and “hypermasculinity” in men, both seen as undesirable characteristics.  Hyperfeminine women endorsed such items as “Sometimes I cry to influence a man”, “Men need sex more than women do”, “I like to flirt with a man”, and “ Most women need a man in their lives”.  Hypermasculine men endorsed such items as “A real man fights to win”,  “Real men look for fast cars and fast women” and disagreed with such items as “It is important that my partner and I are equally satisfied with our relationship” and “Homosexuals can be just as good at parenting as heterosexuals”.    In a social climate in which hypermasculinity and hyperfemininity are pejorative terms, women and men who assess themselves on scales as androgynous might be saying more about their ability to conform to social expectations than about their masculinity or femininity.  Consistent with this possibility, some sex role theorists have suggested the androgyny scales were not measuring masculinity or femininity but other personality characteristics.

Bem adopted a more extreme position in 1981.   Convinced that sex roles were adopted to conform to social beliefs and values about masculinity and femininity, which she termed schemata, she decided that the concept of androgyny was insufficiently radical from a feminist perspective.  She argued that it should be replaced by a new feminist prescription.  The previous one was that  men and women should become androgynous.   The new one was that society should become aschematic, that is, should abandon the belief that certain behaviors characterize males or females.  Femininity and masculinity would then cease to exist.   In conformity, in the same year another sex role theorist, Pleck, published a book entitled “The Myth of Masculinity”.

These views of sex role theorists required rejection of the possibility discussed in the next chapter that in addition to social factors, biological factors are involved in determining some behaviors commonly regarded as masculine or feminine.  The lack of interest of sex role theorists in studies that did not adopt their perspective explained their acceptance of the astonishing statement that few researchers had chosen to examine the relationship between sex role deviation and homosexuality.  They were presumably unaware of the numerous prospective and retrospective studies reviewed earlier, which demonstrated relationships between homosexuality and opposite sex-linked behaviors in children and adults.   For these sex role theorists apparently only subjects’ answers to  sex-role questionnaires that assess what are considered masculine and feminine personality characteristics provide information concerning sex-linked behaviors.


Masculine and feminine sex roles and sexual orientation

In 1983 Stokes and colleagues reviewed the few studies which had investigated the relationship of masculinity and femininity as assessed by sex role questionnaires, and identification as homosexual.   One, which used the Bem Sex-Role Inventory found homosexual compared to heterosexual men were significantly higher in femininity and lower in masculinity.   One using a Masculinity-Femininity Adjective Check List found homosexual women were significantly more masculine than heterosexual women, and homosexual men showed non-significant trends to be more feminine and less masculine than heterosexual men.  Stokes and colleagues’ own study, which also used the Bem Inventory, found no significant differences between their homosexual and heterosexual subjects.   They pointed out that they had endeavored to include a diverse range of homosexual subjects and many were professional people whose homosexual behavior was not generally known and who had to be reassured of confidentiality.   It was possible these men and women had adopted attitudes and behaviors they considered appropriate to their biological sex with the aim of reducing the likelihood their homosexuality would be suspected.  Stokes and his colleagues concluded from their review that the results provide some limited support for the validity of the popular stereotypes that homosexual men showed feminine characteristics and homosexual women showed masculine characteristics.  Ignoring this empirical evidence reported   by Stokes and his colleagues, Katchadourian and colleagues in their 1979 text-book “Human Sexuality”, stated that masculinity and femininity are culturally defined attributes which had no demonstrable correlation with sexual orientation.


Sex roles, sex-linked behaviors and sexual orientation

The 1995 study by myself and Zamir initiated the bringing together of the independent research areas investigating the relationships of masculine and feminine sex roles and of sex-linked behaviors with sexual orientation. The subjects were medical students rather than men and women who identified as heterosexual or homosexual, so that the majority of the students with homosexual feelings were homosexual heterosexuals.  They anonymously completed the Bem Sex-Role Inventory to determine their masculine and feminine sex roles and the Sex-linked Behaviors Questionnaire to assess their sex-linked behaviors, gender identity, and ratio of homosexual to heterosexual feelings. As in previous studies, the students’ degree of homosexual as compared to heterosexual feelings was significantly related to their opposite sex-linked behaviors, with the relationships being stronger in the men than the women.  The students’ degree of homosexual feelings was also significantly related to their degree of opposite gender identity.  As pointed out earlier, unlike previous studies, this relationship was stronger in the women.   There was no relationship between the subjects’ degree of homosexual as compared to heterosexual feelings and their masculinity and femininity scores on the Bem Sex-Role Inventory. There were some relationships of these scores with sex-linked behaviors. Sex role masculinity in men correlated significantly with preference for rough and tumble play and contact sport in childhood, and femininity in men with its avoidance.   Sex role masculinity in women correlated much more strongly than in men with preference for rough and tumble games and contact sport, as well as initiating fights in childhood and adolescence.  Understandably it also correlated significantly with the women being called tomboys in childhood, as well as their currently believing others thought they had traits of the opposite sex, and they felt they had butch traits.   In this study none of these features correlated with the degree of homosexuality of the women.  As in all previous studies being called sissies in childhood correlated in men with their degree of homosexual feelings.  It did not correlate with their sex role femininity.

These findings together with those reviewed by Stokes and colleagues indicated that the concepts of masculinity and femininity as measured by sex role questionnaires had at most a weak relationship with heterosexual and homosexual feelings or identification as heterosexual or homosexual.  This was the case both for the small percentage of men and women who identify as homosexual, in the studies reviewed by Stokes and colleagues, and for the much larger percentage of mainly homosexual heterosexuals who anonymously report awareness of homosexual feelings, as in the study by myself and Zamir.   The findings of the latter study indicate that masculinity and femininity as measured by sex role scales assess some behaviors that are sex-linked.   In particular sex role masculinity in women was strongly related to tomboyish behaviors in childhood.  As discussed in the following chapter, tomboyism is the sex-linked behavior in women for which the evidence is strongest that it is in part biologically determined.   This raises the possibility that aspects of what are termed masculinity and femininity may also be partly biologically determined.  If this is established, rather than the concepts being myths, or disappearing along with femininity when society becomes aschematic as hoped for by Bem, both concepts will prove indestructible, though with a greater understanding of their nature, it seems they must be deconstructed into a number of dimensions.

After studying difference in the behavior of males and females for several decades, Maccoby in 1987 emphasized the need to discriminate the various meanings of masculinity and femininity, pointing out that at least three were in current usage. One was based on the degree to which subjects show behaviors present more often in members of one as compared to the other sex, that is, sex-linked behaviors. The second was based on the degree to which subjects show behaviors socially expected in members of one as compared to the other sex, sex role behaviors. The third was based on the degree to which subjects show behaviors which are sexually attractive to the opposite sex, for example wearing sexually appealing clothes, being flirtatious, and in boys, being good at sport.  Maccoby pointed out that the three meanings were independent. Rough and tumble play is masculine, according to meanings one and two. However the increased spatial ability of men compared to women, is masculine only according to meaning one. In all cultures nurturance is consistently found to be associated with femininity in its first and second meanings. Teenaged girls at the time they become most actively interested in behaving in ways which are sexually attractive to males, i.e., feminine according to the third meaning, show a drop in their responsiveness to babies.

Despite the evidence discussed, the belief that masculinity and femininity exist as categorical entities remains strong as does the expectation that all men should be masculine and to a lesser extent all women should be feminine, even if there is no agreement as to what these terms mean.  In this situation, the awareness of homosexual heterosexuals that they have a potential to show a degree of opposite sex-linked, that is, effeminate and butch behaviors, and experience a degree of opposite gender identity results in the majority repressing the behaviors and concealing their feelings of gender identity.   Hopefully the deconstruction of the concepts of masculinity and femininity will reduce discrimination concerning gender nonconformity and an appreciation that it may play a positive and possibly essential role in maintaining social relationships, an appreciation perhaps presaged in the concept of the metrosexual, even if this term is used with a degree of amused scepticism.  Reduction in discrimination may also result if the evidence discussed in the following chapter, of the valuable sexual diversity of the human and animal world, becomes more widely known.   Certainly without this reduction the existence of majority of the homosexual heterosexuals, though they make up about a fifth of the population, will remain hidden.

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