In a previous paper, we discussed a model that considers abnormal eating behaviour epiphenomena of a more profound disorder of lived corporeality and identity (Stanghellini and Mancini, this issue). The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from a first-person perspective. In this paper, alienation from one’s own emotions, disgust and shame for one’s body of persons with FED, (...) will be discussed in the light of the embodiment and identity model of FED. (shrink)

The purpose of this paper is to define and describe the main phenomenological dimensions of the life-world of persons prone to Feeding and Eating Disorders (FEDs), within the framework of a model that considers abnormal eating behaviour an epiphenomenon of a more profound disorder of lived corporeality and identity. The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from (...) a first-person perspective. Alienation from one’s own body and the need to feel oneself only through the gaze of the others can be illuminated by looking at it in the light of the Sartrean concept of feeling a lived-body-for-others. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Ethics of Surgical Interventions for Body Integrity Identity Disorder and Gender DysphoriaNicanor Pier Giorgio Austriaco, O.P.IntroductionOn May 20, 2009, Fox News featured a report that described the life of a man named "John" who had spent his life struggling with Body Integrity Identity Disorder (BIID).1 In a phone interview, John admitted that he remembers wanting to amputate his leg when he was between seven and (...) eleven years of age, by sticking his leg under the rear wheel of a bus. He never went through with it but continued to experience an intense desire to amputate his healthy limb for the following fifty-plus years. Described for the first time in 1977 as apotemnophilia, BIID was originally thought to be a psychological disorder characterized by sexual arousal associated with the desire to be an amputee. However, it was renamed when Dr. Michael First, a professor of clinical psychiatry at Columbia University, proposed that the primary motivation behind the condition was an issue of identity rather than of sexual desire.2 This proposal is controversial.3 Despite much [End Page 1003] debate, BIID was not included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was published on May 18, 2013.In this essay, we will consider the ethics of surgical interventions for BIID and Gender Dysphoria (GD).4 We begin with a discussion of the principle of totality that distinguishes ethical from unethical modifications of the body. We will refer specifically to the latter category of surgical interventions as "mutilations," though the Catholic moral tradition's use of the term is itself ambiguous.5 This is followed by an extensive moral discussion of (1) amputations of healthy limbs for patients struggling with BIID and (2) sex reassignment surgeries for those who identify themselves as transgender persons. I will propose that an ethical argument can be made to justify the former but not the latter.The Principle of TotalityBecause of the goodness of the human body, its integrity is a good that has to be protected and preserved. The ethical principle that is used to judge the morality of bodily interventions that impinge upon this bodily integrity is the principle of totality.6 It was articulated by St. Thomas Aquinas in his Summa theologiae as follows:Since a member is part of the whole human body, it is for the sake of the whole, as the imperfect for the perfect. Hence a member of the human body is to be disposed of according as it is expedient for the body.... If, however, the member be decayed and therefore a source of corruption to the whole body, then it is lawful with the consent [End Page 1004] of the owner of the member, to cut away the member for the welfare of the whole body.7Over the centuries, Catholic moral theologians appealed to the principle of totality to justify three different scenarios that involved the sacrifice of a bodily organ for the sake of the whole human organism. The first case involves a diseased organ that has to be removed to save the life of the soldier wounded on the battlefield—say a gangrenous, decaying limb as in the example of Aquinas. The second case involves the healthy foot of a man who is trapped on a railroad track that has to be amputated to save his life from a collision with a train, and the third case involves the healthy limb of an individual that has to be amputated in response to a tyrant who orders him to cut off his own hand or lose his head to the executioners instead. In these cases, the sacrifice of the part would be morally permitted as a necessary means of preserving the life of the individual. As Fr. Gerald Kelly, S.J., points out, this final case is particularly significant because it involves a healthy limb whose very presence—and not its diseased or trapped condition—becomes a source of vital harm for the organism.8How does one justify the principle of totality? In 1944, Pope Pius XII explained it this way: "Man's power over his... (shrink)

The discursive production of the ‘self in the context of mental health care has potential implications for how the subjects of intervention come to understand and experience themselves. Eating disorders provide an illustrative example of the ways in which conceptualizations of the self that structure mental health practices can be gendered, because they are mainly diagnosed in women and dominant explanations of their origins are feminized. This discourse analytic study examines the gendered nature of mental health workers’ constructions of (...) the eating-disordered self through the psychological construct of ‘identity’, examining the dominant discourses implicated in the feminization of deficient identity, and addressing the implications of this construction for mental health practice. (shrink)

ABSTRACT This article focuses on issues of gender identity and bodily integrity in the context of profound desires to modify the body. It contends that, while hormonal and surgical interventions in treating gender dysphoria must continue to be considered medically necessary for many people, we do not yet fully understand why it is justified as medically necessary for this condition and not for others with similar features. The article discusses the difference between the medical classification of “ (...) class='Hi'>gender dysphoria” and “body dysmorphic disorder” and the notion of mental distress in embodiment. It discusses the role that gender essentialism may have played in the medical sanction of hormonal interventions and gender reassignment surgeries. Finally, it proffers the alternative justificatory criterion, following Eve Kosofsky Sedgwick, of “propriodescriptive authority” and explains why this justification, though highly subjective, provides better rational grounds for adjudicating which types of body modification can be considered medically necessary, grounds that can include, but also go well beyond, cases of gender dysphoria. (shrink)

Eating disorders can be viewed as “embodied acts” that help to cope with internal and external demands that are perceived as overwhelming. The maintenance of EDs affects the entire identity of the person; the lack of a defined; or valid sense of self is expressed in terms of both physical body and personal identity. According to attachment theory, primary relationships characterized by insecurity, traumatic experiences, poor mirroring, and emotional attunement lead to the development of dysfunctional regulatory strategies. (...) Although the literature shows an association between attachment style or states of mind, trauma, behavioral strategies, and various EDs, the debate is still ongoing and the results are still conflicting. Therefore, we believe it is important to examine and treat EDs by understanding which narrative trajectory intercepts distress in relation to narrative and embodied self-concept. Drawing on clinical observation and a narrative review of the literature, we focus on the construction and organization of bodily and narrative identity. Because bodily representations are the primary tools for generating meaning, organizing experience, and shaping social identity from the earliest stages of life, we focus on the role that bodily interactions and sensorimotor and proprioceptive patterns have played in the development of EDs. We consider the role that lack of attunement, insecure attachment, and relational trauma play in mentalizing, affecting self-representation and emotion regulation strategies. The paper also considers a semantic mode of trauma in EDs that involves a top-down pathway through beliefs and narratives about oneself based on lack of amiability, on devaluation, and on humiliation memories. Finally, we would like to highlight the proposal of an integrated model with multiple access model to psychotherapy that takes into account the complexity of ED patients in whom aspects related to dysregulation, body image disintegration, and post-traumatic symptoms are associated with a suffering sense of self and a retraumatizing narrative. (shrink)

Transgender children who are not treated for their condition are at high risk of violence and suicide. As a matter of survival, many are willing to take whatever help is available, even if this is offered by illegal sources, and this often traps them into the juvenile criminal system and exposes them to various threats. Endocrinology offers a revolutionary instrument to help children /adolescents with gender identity disorder: suspension of puberty. Suspension of puberty raises many ethical issues, and (...) experts dissent as to when treatment should be commenced and how children should be followed up. This paper argues that suspension of puberty is not only not unethical: if it is likely to improve the child’s quality of life and even save his or her life, then it is indeed unethical to defer treatment. (shrink)

In current society, eating is most definitely a gendered act: that is, what we eat and how we eat it factors in both the construction and the performance of gender. Furthermore, eating is a gendered act with consequences that go far beyond whether one orders a steak or a salad for dinner. In the first half of this paper, I identify the dominant myths surrounding both female and male eating, and I show that those myths (...) contribute in important ways to cultural constructions of male and female appetites more generally speaking. In the second half, I argue that the Christian church should share feminism’s perception of these current cultural myths as fundamentally disordered, and I claim that the Christian traditions of fasting and feasting present us with a concrete means to counter those damaging conceptions and reclaim a healthy attitude toward our hunger. (shrink)

The availability, range, cost and quality of food in Western societies have never been more favourable, yet food is also the focus of a great deal of anxiety. There are concerns that our current diets will mean we will get steadily fatter and more unhealthy while consuming ‘junk food', with consequences for our quality of life, our children's behaviour and even the environment. This book challenges these ideas and places the food debate in a wider context. As the political imagination (...) and the scope of social policy have narrowed, the focus on the personal and corporeal has filled this gap, creating an inward, individualised perspective that breeds a personal sense of vulnerability and distracts from issues of broader social importance.The book also examines the current use of ‘food as metaphor’ – the way that ‘bad food’ and obesity, for example, have become code words for an elite disdain for the masses, implicitly promoting the idea that the consequences of poverty are the fault of the poor, and that a solution to the problems of social inequality lies in the consumption of five fruit and veg a day.The author also discusses how health fears around food are used as a lever for greater official control of our everyday lives, from lunchbox inspections and school food crusades, to endless media health advice and scientifically-dubious ‘healthy labelling’ initiatives. The upshot of these connected trends is misplaced anxiety and wasted effort fixing what, for the most part, does not need to be fixed. Our modern food system allows us to be healthier than ever before, while transforming food from fuel into a source of entertainment, pleasure and choice.Rob Lyons is Deputy Editor of Spiked Online. (shrink)

Drawing on the themes of men and masculinity, this article examines texts in the corporate social responsibility (CSR) reports of local multinational enterprises (MNEs) in South Korea, an emerging economy. This article explores how Korean male hegemony is hidden and naturalized in CSR reporting. Focusing on the discursive construction of gender identity, we analyze how CSR reports portray gendered identities in ways that may foster gender inequality by examining how the texts reflect the inferior position of (...) women and marginalized male workers in the workplace. We review 15 CSR reports from Korean MNEs as a primary data source for examining corporate policies and disclosure on gender‐equality issues in the workplace. We explore the inherently embedded meaning of CSR reports to evaluate the masculine tone of gender relations in these texts. To deepen our understanding, we retrieved the original text segments, coded them by using a categorical framework and revisited our data to critically examine our interpretation of the narrative structures that we argue reflect and reproduce certain discourses of masculinity, through the (in)visibility of women, the marginalization of women and (part‐time) men, and the silencing of their voices by the Korean male hegemony. (shrink)

Living in several languages encompasses experiencing and constructing oneself differently in each language. The research study on which this article is based takes an intersectional approach to explore insider accounts of the place of language speaking in individuals’ constructions of self, family relationships and the wider context. Twenty-four research interviews and five published autobiographies were analysed using grounded theory, narrative and discursive analysis. A major finding was that learning a new language inducted individuals into somewhat ‘stereotyped’ gendered discourses and power (...) relations within the new language, while also enabling them to view themselves differently in the context of their first language. This embodied process could be challenging and often required reflection and discursive work to negotiate the dissimilarities, discontinuities and contradictions between languages and cultures. However, the participants generally claimed that their linguistic multiplicity generated creativity. Women and men used their language differences differently to ‘perform their gender’. This was particularly evident in language use within families, which involved gendered differences in the choice of language for parenting – despite the fact that both men and women experience their first languages as conveying intimacy in their relationships with their children. The article argues that the notion of ‘mother tongue’ is unhelpful in this process as well as in considering the implications of living in several languages for systemic therapy. (shrink)

In the postmodern era the impact media have on our lives is continuously growing. Not only do media reflect reality, but they also shape and reconstruct it according to the public's hopes, fears or fantasies. Reality itself is not the sum of all objective processes and things, but it is socially constructed by the discourses that reflect and produce power. On the other hand, the public does not simply accept or reject the media messages, but interprets them according to its (...) social background (Zoonen, 1994, p. 41). My interest lies in identifying how are women represented in the media and what are the dominant images of femininity, as well as the alternative ones. There is a strong connection between image and identity as the latter can not be constructed without the former. Basically, the postmodern subject has been reduced to an image, therefore the image plays an important part in constructing the feminine identity. (shrink)

Despite a “spatial imaginary” which constructs Europe as a location of sexual and gender freedom (Rao, 2014), presently, twenty countries in Europe require sterilisation in order to legally recognise transgender people’s gender identities, including four of the seven countries in the INFERCIT study: Greece, Italy, Turkey, and Cyprus (but not Spain, which since 2007 does not require sterilisation for gender identity recognition [see Platero, 2008]. In Bulgaria and Lebanon no gender identity recognition for trans (...) people is provided by law; the latter lies outside the “European” region) (TGEU, 2014). Compulsory sterilisation—classified as a crime against humanity in the Rome Statute of the International Criminal Court (UN General Assembly, 1998: art. 7.1)—is widely in force against transgender people, who constitute “the only known group in Europe subject to legally prescribed, state-enforced sterilisation” (Hammarberg, 2009: 19). However, forced sterilisation of trans people is not generally conceptualised as a eugenicist or genocidal policy, in part because sterilisation is conflated with gender reassignment surgical interventions which, widely considered as that which brings transgender bodies into being, are in turn conflated with embodied transgender subjectivities. On this view, transgender individuals could not exist except through a medicalised process that, by design, precludes their “natural” reproductive capacities and is generally not accompanied by fertility preservation or the provision of assisted reproduction technologies (Plemons, 2014: 38; De Sutter et al., 2002; De Sutter, 2001). Sterilisation laws are justified through a pathologising discourse on transgender lives which constructs gender reassignment interventions as medical “treatment” of gender identity disorder (Suess, Espineira & Crego Walters, 2014: 73-76). Adopting a depathologising perspective enables us to contextualise compulsory sterilisation (which naturalises the sexually dimorphic, cisgender, heterosexual body) as a form of “gendercide” which has historically been instrumental in the imposition of a Euro-colonial binary gender system (Miranda, 2010; Lugones, 2007). The state-imposition of medical interventions on trans people not only has deleterious effects on their reproductive rights, “effectively undermin[ing] their right to found a family” (Hammarberg, 2009: 21; see OHCHR et al., 2014)—as “family” is hegemonically defined by a heteronormative and bio/ logical kinship order (Butler, 2002; van Anders, 2014). I argue that state regulation of transgender reproduction constitutes a form of institutionalised gendered violence inasmuch as it impedes transgender people’s ability to exercise inherent first-person authority over the materiality and meanings of their gendered embodiments (Bettcher, 2009; Spade, 2013). Efforts to renaturalise gender and kinship inextricably intersect (Kantsa, 2006) in the biopolitical attempt to regulate transgender embodiments and reproduction, which conditions the emerging legal recognition of transgender subjects as a rights-bearing minority (Stryker, 2014). (shrink)

Gender Identity Disorder is classified as a mental illness and included in the DSM-IV and ICD-10. It will also be included in the DSM-V. The psychiatric diagnosis, in spite of some apparent advantages, has significant psychological and social adverse implications. This paper discusses some of the main epistemological reasons to consider gender variance as a mental disorder. It will also evaluate whether reasons of other kinds may justify the inclusion of gender variance amongst mental illnesses.

In this article, I argue that persons suffering from Body Integrity Identity Disorder (BIID) can give informed consent to surgical measures designed to treat this disorder. This is true even if the surgery seems radical or irrational to most people. The decision to have surgery made by a BIID patient is not necessarily coerced, incompetent or uninformed. If surgery for BIID is offered, there should certainly be a screening process in place to insure informed consent. It is beyond the (...) scope of this work, however, to define all the conditions that should be placed on the availability of surgery. However, I argue, given the similarities between BIID and gender dysphoria and the success of such gatekeeping measures for the surgical treatment of gender dysphoria, it is reasonable that similar conditions be in place for BIID. Once other treatment options are tried and gatekeeping measures satisfied, A BIID patient can give informed consent to radical surgery. (shrink)

There has been little considered reflection by Catholic theologians on the concepts of gender identity, gender dysphoria and gender transition. Seeking inspiration in the Scriptures, some Catholic thinkers have interpreted the first three chapters of Genesis and especially the text ‘male and female he created them’ (Gen. 1:27) as requiring all human beings to live in the gender role congruent with their biological sex, and have viewed the biology of sex as self-evident. This article argues (...) that these chapters constitute an appropriate locus for reflection on theological anthropology but that they need to be taken together with other texts and especially with the explicit teaching of Jesus Christ. In the Gospel according to Matthew, the one occasion in which Jesus invokes this passage from Genesis is when he draws attention to exceptional examples in nature and, in a striking phrase, states that some ‘have made themselves eunuchs for the sake of the kingdom of heaven’ (Matt. 19:12). If the Genesis text is interpreted in the light of the words of Christ, the binary division of the sexes, while ordained by God and the basis for a vocation to marry and procreate, admits of exceptions both natural and supernatural. (shrink)

Within the past 40 years, feminist studies/women’s studies/gender studies/studies in gender and sexuality has effectively grown into a globally practised academic discipline while simultaneously resisting the notion of disciplinarity and strongly advocating multidisciplinarity, interdisciplinarity, and transdisciplinarity. In this article, I argue that gaining identity through refusing an identity can be viewed as being a constitutive paradox of gender studies. Through exploring gender studies as a transdisciplinary intellectual discipline, which came into existence in very particular (...) multidisciplinary historical conditions of the feminist movement, I suggest that transdisciplinarity within gender studies takes on a meaning which results in a radical problematization of the academic goal of ‘knowledge production’. Instead of such ‘knowledge production’, transdisciplinarity in gender studies promotes intervention which reaches beyond the concepts of accountability, innovation and corporate management. I argue that Jacques Derrida’s promotion of the Collège International de Philosophie in 1982 in its particular relationship to the tradition of philosophy provides a parallel example of such an attitude. Adding to Joan Scott’s and Clare Hemmings’s insights on gender studies in terms of critique and transformation, I argue that transdisciplinarity as practice of ‘intervention’ is crucial for the construction of gender studies disciplinary identity, based upon apparent non-identity. (shrink)

This is a response to an article published inSociety & Animals in 2008 that argued for the existence of a “species identity disorder” in some furries. Species identity disorder is modeled on gender identity disorder, itself a highly controversial diagnosis that has been criticized for pathologizing homosexuality and transgendered people. This response examines the claims of the article and suggests that the typology it constructs is based on unexamined assumptions about what constitutes “human” identity and (...) regulatory fictions of gender identity. (shrink)

Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified (...) under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body—a phenomenon primarily discussed in the phenomenological tradition in philosophy—seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty’s Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due. (shrink)

Introduction: Adolescence is the most critical life period for the development of eating disorder symptomatology. Although problems in identity functioning and emotion dysregulation have been proven important risk and maintaining factors of ED symptomatology, they have never been integrated in a longitudinal study.Methods: The present study is part of the Longitudinal Identity research in Adolescence -study and aimed to uncover the temporal interplay between identity functioning, cognitive emotion regulation, and ED symptomatology in adolescence. A total of (...) 2,162 community adolescents participated at three measurement points with 1-year intervals. They reported on identity functioning, cognitive emotion regulation, and ED symptomatology.Results: Cross-lagged paths could be fixed for boys and girls and showed bidirectional associations between both dimensions of identity functioning and both rumination and catastrophizing over time. Similarly, these maladaptive cognitive emotion regulation strategies were bidirectionally related to ED symptomatology over time. Finally, indirect pathways pointed to bidirectional associations between both dimensions of identity functioning and bulimia symptoms through rumination and catastrophizing. Only unidirectional associations emerged for drive for thinness and almost no cross-lagged associations were found with positive reappraisal.Conclusion: The present study demonstrates that identity confusion may contribute to the development of ED symptomatology in adolescence through cognitive emotion dysregulation. It also reveals that these ED symptoms hamper identity development through emotion dysregulation. These results stress the importance of targeting both identity functioning and cognitive emotion regulation in the prevention and intervention of ED symptoms. (shrink)

We are women, we are men. We are refugees, single mothers, people with disabilities, and queers. We belong to social categories and they frame our actions, self-understanding, and opportunities. But what are social categories? How are they created and sustained? How does one come to belong to them? Ásta approaches these questions through analytic feminist metaphysics. Her theory of social categories centers on an answer to the question: what is it for a feature of an individual to be socially meaningful? (...) In a careful, probing investigation, she reveals how social categories are created and sustained and demonstrates their tendency to oppress through examples from current events. To this end, she offers an account of just what social construction is and how it works in a range of examples that problematize the categories of sex, gender, and race in particular. The main idea is that social categories are conferred upon people. Ásta introduces a 'conferralist' framework in order to articulate a theory of social meaning, social construction, and most importantly, of the construction of sex, gender, race, disability, and other social categories. (shrink)

Purpose. The aim of this article is an analysis of the main versions of the biodeterminist tradition of re­solving the issue of the nature of gender identity, as well as identification of the advantages of the new version of biodeterminism, which involves elements of social constructivism. Theoretical basis. Social norms determine the extent to which a person has the right to independently determine his or her gender identity, and even more so, to change his or her (...) body according to such gender concepts. Social norms regulate gender relations in society and direct the gender behavior of individuals. However, social norms do not create either the human body, or those biological laws, according to which it functions. Originality. The biodetermist theories of the gender were analyzed from the position of "week" social constructivism. The role of social norms as a factor of gender self-certification, as well as a factor of control over social interference in the functioning of human corporeality is considered. The role of modern medicine as an increasingly influential institutional means of control over the functioning of human corporeality, and therefore, indirectly, and for the implementation of gender identity self-identification is revealed. Conclusions. According to the "week" social constructivism the gender emerges as an integral result of biological, psychological and social construction. The role of personality in the design of the gender has historically grown, but this role can never exclude the influence of biological and social factors that are increasingly becoming the nature of biological and social technologies. Personality can become a victim of these technologies, but he/she can program them, or at any rate selectively use, combine, or to some extent adjust existing biological and social technologies. (shrink)

In this article, the author argues that beliefs about vulnerability and dangerousness are central to conceptions of gender and are constructed and transmitted through conversation. Using data from 13 focus groups, the author demonstrates that ideas about gender and its relationship to vulnerability and danger are pervasive in talk about violence, and that this talk is further marked by ideas about age, race, social class, and sexual identity. These ideas are based, in part, on shared beliefs about (...) human bodies, which reinforce the perceived naturalness of these ideas. The article concludes with a discussion of the consequences of these ideas for the daily lives of women and men. (shrink)

In Kise and Ngyuen’s “Adult Baby Syndrome and Gender Identity Disorder” (2011), the authors refer to their male subject as “Ms B” because he prefers to identify with being a female. But they do not refer to her as being a baby, even though the subject also prefers to identify with being a baby. This shows that although they respect the subject’s gender identity preferences, they do not respect the subject’s age identity preferences. One reason (...) for this might be that some people feel the term “adult baby syndrome” sounds a bit silly and therefore that the wishes of someone having this syndrome are not worthy of being taken seriously, not as seriously, at least, as someone who shows the more scientifically respectable gender identity disorder. A solution here might be to replace the term “adult baby syndrome” with the term “age identity disorder”, perhaps involving “age dysphoria”. This would also be more accurate because not all of those who are discussed under the heading of “adult baby syndrome” wish to be identified as babies, but rather as toddlers or older children. The problem then is that numerous people prefer to identify with being a different age. Such people do not believe they are older or younger than they really are, but neither do those with adult baby syndrome. (shrink)

Using 16 in-depth interviews drawn from a larger sample of Black/white biracial individuals, this article explores how gender shapes the microlevel process of racial identity construction. Skin color stratification within the Black community, combined with a low rate of marriageable men and high rates of interracial marriages among the most educated and affluent Black men, has created a social context that differentiates the interactional experiences of biracial men and women. The findings highlight the need for more complex (...) theoretical conceptualizations of how gender shapes the way that women negotiate their racial identities in post-Civil Rights America. (shrink)

Categories We Live by: The Construction of Sex, Gender, Race, and Other Social Categories, by Ásta. Oxford: OUP, 2018. Pp. 160.

Gender dysphoria (GD) is marked by an incongruence between a person’s biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called “wait-and-see” approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a (...) “third pathway” for the diagnosis and treatment of GD in youths. To make our case, we draw on a recent development in bioethics: the phenomenological approach. Scholars such as Slatman and Svenaeus have argued that the extent to which the body can (or should be) manipulated or reconstructed through medical intervention is not only determined by consideration of ethical frameworks and social and legal norms. Rather, we must also take account of patients’ personal experience of their body, the personal and social values associated with it, and their understanding of its situation in their life: their narrative identities. We apply this phenomenological approach to medicine and nursing to the diagnosis and treatment of GD in youth. In particular, we discuss Zahavi and Martiny’s conception of the phenomenological interview, in order to show that narrative techniques can assist in the process of gender identification and in the treatment of youth presenting with GD. We focus on two case studies that highlight the relevance of a narrative-based interview in relations between patients, HCPs, and family, to expose the influence of social ideologies on how young people presenting with GD experience their bodies and gender. (shrink)

This paper examines how gender and identity function in the personal memoirs of female Holocaust survivors. The memoirs of Nanda Herbermann and Sara Tuvel Bernstein, two survivors of Ravensbrück, the Nazis' concentration camp for women, are explored as case studies of how feminine gender identity influenced female inmates' experiences and recollections of life in Nazi concentration camps. The different backgrounds of these women, as a German Catholic and a Jew, respectively, also affected their lives as inmates, (...) and influenced how they constructed their personal narratives and identities through memoirs. Thus, gender and other aspects of personal identity intertwined both during their time in Ravensbrück and in their writings of their experiences. Their memoirs, moreover, serve as means of personal empowerment as they rewrote themselves into history on their own terms. These memoirs, therefore, enhance our understanding of the gendered and the personal dimensions of the Nazi concentration camp systems and the Holocaust. (shrink)

With the assistance of the corpus analysis tool Wmatrix 4.0, this paper analyzes the semantic categories of the top 10 commercial banks of China and the United States to figure out their social-cultural behavior in the Internet business context. It is discovered that both common and distinctive identities were constructed: the common identities include the professional financial service provider, responsible corporation for employees, and relevant communities with environmental and social consciousness, while the distinctive identities are manifested in the communication strategy, (...) style, and persuasion mode: The Chinese Commercial Banks adopted the proactive strategy for corporate identity construction, are prone to take hierarchical and impersonal communication style, and more focused on the “credibility appeal” and “rational appeal” in persuasion mode; the commercial banks of the United States are more reactive in the communication strategy, position themselves in short distance with the putative audience in communication style, and conform to the typical “affective appeal” regarding the persuasion mode. From the intercultural perspective, the distinctions are the representation of the peculiar high-context culture and low-context culture based on Hofstede's cultural dimensions theory. Chinese banks should try to shorten the cultural gap by adopting communication strategy in conformity with the local cultural when going global rather than sticking to the domestic communication strategy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art as a Political Act:Expression of Cultural Identity, Self-Identity, and Gender by Suk Nam Yun and Yong Soon MinHwa Young Choi Caruso (bio)IntroductionA number of artists of color, including Asian American women, are creating art from the basis of their lived experiences. Within minority groups searching for their cultural identity, establishing self-identity is an important process. For various psychological and sociological reasons, artists (...) seem inspired to seek deeper meaning and a broader participation in cultural work.1 Asian American women artists, in particular, are currently making art as a means of exploring self-identity, cultural identity, and gender issues. Korean/Korean American minority women artists are creating art as a reaction to their cultural upbringing, which questions issues of identity, gender, ethnicity, politics, cultural, and socioeconomic status. These contemporary artists are breaking away from traditional cultural expectations and overcoming social barriers as artists, women, and Koreans/Korean Americans. With the growing public awareness of women's consciousness and sense of self as women in Korea and as an ethnic minority in America, these artists are redefining their identity. Despite the traditional patriarchal Confucian hierarchy; lack of social, institutional, and political support; and stereotypic gender, cultural, and socioeconomic status expectations for women, a few have stepped out of their traditional roles as women and have become successful artists in Korea and America.The artworks of these artists are worthy of investigation because they appear to be a culturally, socially, and politically motivated artistic expression of the complex multifaceted Korean/Korean American life experiences as women and as Korean immigrant members of a cultural (ethnic) minority in American society. Therefore, two main research questions can be posed: [End Page 71]• Given that art can be constructed out of layers of different experiences and influences, to what extent do the dimensions of cultural identity, self-identity, and gender interweave and contribute to the function of art as a political act for Korean/Korean American women artists?• How do Korean/Korean American cultural, social, and female experiences influence the artistic expression of Korean/Korean American women artists?In order to answer these questions, I selected case study methodology2 and adapted elements of interpretive biography,3 and narrative approaches as developed by Wallace and Gruber.4 According to Denzin,5 interpretive biography involves the collection and analysis of personal experiences, life documents, stories, accounts, and narratives that describe turning-point moments in individuals' lives. Denzin argues that personal experiences and personal stories are derived from a larger cultural, ideological, and historical context. The intent of the biographical project is to problematize the social, economic, cultural, structural, and historical forces that shape, distort, and otherwise alter lived experiences.By using narrative case study methods, I explore elements of self-identity formation, cultural identity, gender issues, personal thoughts, artistic expression, meaning of artworks, professional achievement, and life circumstances. I examine each participant's life in the Korean and American historical, cultural, social, and political environments. I interpret participants' outer lives (what they do) and inner lives (feelings, thoughts, inner self) to capture their deep, profound life experiences. I examine salient themes of their art expression and how the role of art and artistic activity is a part of political, cultural, social, and feminist activism. I further investigate their professional activities in order to identify the multiple roles that contribute to personal and professional identity formation.For the purpose of this study, I selected the contemporary Korean woman artist Suk Nam Yun and the contemporary Korean American woman artist Yong Soon Min as primary participants. These two women artists, despite many social and cultural barriers, chose to become artists; feminists; and social, cultural, and political activists; in addition to fulfilling traditional Korean family and domestic roles. Yun and Min are regarded as the leading contemporary Korean/Korean American women artists whose artworks deal with issues of cultural, social, feminist, political, and hybrid identity and art as political activism.Lippard acknowledges that visual images play an increasingly important role in society.6 Art that connects everyday experience with social critique and creative expression becomes a vital means of reflecting upon the nature of society and social existence.7 Artworks can function as... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female (...) student population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female (...) student population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

Disorders of sexual development are a heterogeneous group of disorders in which chromosomal, gonadal or anatomical sex development is atypical. The majority of these children are recognized at birth by ambiguous genitalia. Legal and societal pressures require the physician and parents to assign sex rapidly. Though sex assignment is undebated in several disorders of sexual development, many others need an individualized approach to gender-related concerns. Gender dysphoria is prevalent in disorders of sexual development, and early gender-defining surgeries (...) have potentially lifelong consequences. We use two cases, one of partial androgen insensitivity and another of simple virilizing congenital adrenal hyperplasia to illustrate that in disorders of sexual development, the ethical management principles remain the same at their core despite the vast differences in phenotypes. Sex assignment should maximize functional, psychological and sexual needs. Sex assigned should coincide with gender identity. We propose that we manage such children with the mutual participation of the physician, parents and the child. Though the parents and the physician have the child's best interests when making a decision, the child's developing autonomy should be protected. The communication of the health provider to the parent must be honest if early sex assignment is difficult. (shrink)

We determined the prevalence of eating disorder symptoms among elite Spanish athletes from a broad range of sports and levels of competition and examined the associations between the presence of symptoms and perceived sport-specific weight pressures. We surveyed 646 elite athletes representing 33 sports from top-division teams and two elite athlete training centers in Catalonia. Based on the results of the Eating Attitudes Test-26 responses, 5.1% of athletes were at risk of EDs. The highest rates of ED symptoms (...) were observed in male endurance athletes and female esthetic athletes. Competition level was not a risk factor. The only gender differences in the presence of ED symptoms by competing level were observed in athletes competing at the national level. Female athletes with ED symptoms scored higher on the two subscales of the Spanish version of the Weight Pressures in Sport tool: coach and sport-specific pressures and pressures from teammates and due to uniform. Male athletes with ED symptoms scored higher on the pressures due to uniform subscale. Finally, symptomatic female but not male athletes competing at international and national levels also perceived greater sport-specific weight pressures. (shrink)

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by (...) loss of mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders. (shrink)

The concept of corporal image includes how own body, taking into account their constituent parts, as well as the feelings related the those characteristics. The entrance in academica life provokes alterations in the feeding behavior, and the exposition to the new social environment they can bring as consequence an increase in dissatisfaction. Objective: To investigate the satisfaction with the body image and eating behavior of academics at a university center. Methods: For data collection, the following instruments were used. The (...) evaluation was performed with anthropometric measurements, as size and weight measurements. In order to diagnose the nutritional status, the body mass index was used. In order to evaluate the study variables; we used the Body Checking questionnaires Questionnaire. Male Body Checking Questionnaire, Body Shape Questionnaire and EAT-26. Results: According to the Body Mass Index, the female gender had a higher rate of adequacy (70.4%), in relation to the masculine (58,9%). The EAT-26 questionnaire showed that 85% of male engineering students presented risk for Feeding Disorders, in relation to the female psychology (89.8%). Conclusion: In terms of feeding behavior, the women scored higher than men, which suggests a higher susceptibility to Feeding Disorders development in men. (shrink)

Clinical guidelines now recommend hormonal and surgical interven­tions together with social affirmation for children who experience a gender identity that is discordant with their biological sex. However, fundamental questions regarding the safety, efficacy, and ethics of these approaches remain unanswered. There is an urgent need for high-quality research to establish the overall risks and benefits of the current treatment paradigm. While acknowledging the complexity of the problem, competing interests, and logistical challenges, ethical imperatives and acceptable boundaries for scientific (...) investigation can be set by considering the ultimate good of both the individual person and society as a whole. Within established guidelines for human experimentation, alternative approaches to treatment of gender dysphoria in children can be explored without compromising the dignity and bodily integrity of affected individuals. (shrink)

In recent years, eating disorders among American girls and women have become a subject of national concern. Conventional explanations of eating problems are usually framed in the language of psychology, medicine, feminism, or sociology. Although they differ in theory and approach, these interpretations are linked by one common assumption--that female preoccupation with food and body is an essentially secular phenomenon. In Starving for Salvation, Michelle Lelwica challenges traditional theories by introducing and exploring the spiritual dimensions of anorexia, bulimia, (...) and related problems. Drawing on a range of sources that include previously published interviews with sufferers of eating disorders, Lelwica claims that girls and women starve, binge, and purge their bodies as a means of coping with the pain and injustice of their daily lives. She provides an incisive analysis of contemporary American culture, arguing that our dominant social values and religious legacies produce feelings of emptiness and dissatisfaction in girls and women. Trapped in a society that ignores and denies their spiritual needs, girls and women construct a network of symbols, beliefs, and rituals around food and their bodies. Lelwica draws a parallel between the patriarchal legacy of Christianity, which associates women with sin and bodily cravings, and the cultural preference for a thin female body. According to Lelwica, these complimentary forces form a popular salvation myth that encourages girls and women to fixate on their bodies and engage in disordered eating patterns. While this myth provides a sense of meaning and purpose in the face of uncertainty and injustice, Lelwica demonstrates that such rigid and unhealthy devotion to the body only deepens the spiritual void that women long to fill. Although Lelwica presents many disturbing facts about the origins of eating disorders, she also suggests positive ways that our society can nourish the creative and spiritual needs of girls and women. The first step, however, is to acknowledge that female preoccupation with thinness and food signifies a strong desire for fulfillment. Until we recognize and contest the religious legacies and cultural values that perpetuate eating disorders, many women will continue to turn to the most accessible symbolic and ritual resources available to them--food and their bodies--in an attempt to satiate their profound spiritual hunger. (shrink)

This chapter examines so-called body image disorders, focusing on body dysmorphic disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder. These disorders have been studied extensively by psychologists and psychiatrists from both the "body image" and "body shame" research orientations. Body image disorders have also proved, for feminist thinkers mindful of the gender imbalance in many of these disorders, to be an important locus for cultural criticism, including criticism of psychological and psychiatric perspectives. Those philosophers and anthropologists with (...) a phenomenological bent, particularly those with an interest in the lived body and embodiment, have also found a fruitful terrain in body image disorders. These different disciplines and approaches provide multiple perspectives which are often complementary, occasionally in some tension with one another, but always mutually enriching, and all of them are sketched here. (shrink)

_ Categories We Live by: The Construction of Sex, Gender, Race, and Other Social Categories _ By ÁstaOxford University Press, 2018. xiv + 140 pp.

As philosophers, we may be accustomed to asking ourselves—or at least having to explain to others—why we do philosophy. In Categories We Live By: The Construction of Sex, Gender, Race, and Other So...

Objective: There is lack of information on the presentation of eating disorders (EDs) in Saudi Arabia using gold standard clinical tools. The present study aimed to provide data on the presentation of EDs in Saudi Arabia using clinically validated measures.Method: Hundred and thirty-three individuals (33 male) with a mean age of 22 years (2.63) completed three measures: the Eating Disorder Examination (EDE), a semi-structured interview, the Eating Disorder Examination Questionnaire (EDE-Q), a self-report measure, and the Depression Anxiety (...) and Stress Scale (DASS-21) to measure comorbid symptoms.Results: Individuals in Saudi Arabia reported higher levels of restraint, eating concern and shape concern and a higher global score, but lower levels of weight concern on the EDE-Q compared to the EDE. Female participants reported a higher global score, alongside significantly higher scores on the restraint, shape concern and weight concern subscales than males. The most common ED subtype was other specific feeding or ED. Compared with Western community samples, symptom severity in this purposive sample obtained from community settings was significantly higher in this sample.Discussion: Individuals with eating, weight and shape concerns in Saudi Arabia may feel more comfortable expressing their symptoms on a self-report tool compared with a face to face interview. However, it is possible that a self-report measure may over-estimate the severity of symptoms. The data suggest that clinicians in Saudi Arabia should regularly screen for EDs in all genders. It is also important to note that ED symptoms are a cause for concern in young people in Saudi Arabia. (shrink)

Gender-affirming healthcare interventions are medical or surgical interventions that aim to allow trans and non-binary people to better affirm their gender identity. It has been argued that rights to GAH must be grounded in either a right to be cured of or mitigate an illness—gender dysphoria—or in harm prevention, given the high rates of depression and suicide among trans and non-binary people. However, these grounds of a right to GAH conflict with the prevalent view among theorists, (...) institutions and activists that trans and non-binary people do not have a mental illness and that one can be trans and entitled to GAH without being depressed or suicidal. This paper challenges the orthodoxy that a right to GAH must be grounded in either of these ways and instead argues for a right to GAH grounded in a right to live and act with integrity. The standard view, which this paper explains, is that our rights to live and act with integrity ground a right to religious accommodation in many cases such as a right to not be denied social security due to one’s refusal to work a job on a holy day. This paper argues that if our rights to live and act with integrity can ground prima facie rights to religious accommodation, our rights to live and act with integrity ground prima facie rights to GAH. There are no data in this work. (shrink)

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric (...) disorders (mixed psychiatric group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2= 52.66;p< 0.001) and had a high rate of unresolved loss/trauma (χ2= 18.64;p< 0.001). Comorbid psychiatric diagnoses (n= 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88;SD= 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2= 2.43;p= 0.30) and rates of unresolved loss and trauma (χ2= 0.70;p= 0.40).Post hocanalyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. (shrink)