2.1.11 Sexual development

Sexual Development Including the Development of Sexual Identity and Preferences

Sexual development is a complex and ongoing process that begins at conception and continues throughout the lifespan. It involves physical, emotional, cognitive, and social changes, and is influenced by a variety of biological, psychological, and social factors.

Physical sexual development includes the development of primary and secondary sex characteristics, such as the growth of breasts and the onset of menstruation in females, and the growth of facial and body hair and the deepening of the voice in males. These changes are triggered by hormonal changes that occur during puberty.

Growth and development are ongoing processes that bring about change in an individual at all times. Sexual development begins as early as intrauterine life following conception and continues through infancy, childhood, adolescence, adulthood, and death. During infancy, there is no knowledge of gender. By the age of three, the youngster recognises his or her gender. Sexual self-awareness (gender role, gender identity) develops throughout infancy. Biological study findings suggests that androgens have a distinct function in determining gender sensitive roles and gender-specific behaviour. Adolescence is a period of transition during which important sexual developments occur. Puberty occurs throughout adolescence and is a crucial milestone in the development of sexuality. The function of the hypothalamic-pituitary-gonadal axis is critical for sexual development during puberty. 

Sexual identity:

Sexual identity refers to an individual’s sense of self in relation to their sexual orientation, which includes their attraction to individuals of the same or different gender. Sexual identity is a multidimensional construct that includes not only sexual orientation, but also sexual behaviour, self-identification, and sexual attraction (Savin-Williams, 2005). It develops and changes over time, and may not always align with societal expectations or stereotypes. According to research, sexual identity is primarily shaped by a combination of genetic, hormonal, and environmental factors (Bailey et al., 2000).

During childhood, most children develop a basic understanding of gender roles and expectations, and begin to identify with a gender based on their physical characteristics and socialization. However, it is important to note that not all children conform to traditional gender roles and expectations and some may identify as gender non-conforming or transgender.

In adolescence, individuals begin to experience sexual attraction and may begin to explore their sexual identity. For some, this may involve experimenting with different sexual behaviors or partners, while for others, it may involve questioning their sexual orientation or gender identity.

During young adulthood, individuals may begin to develop a more stable sense of their sexual identity and may come out to others as lesbian, gay, bisexual, or transgender. However, it is important to note that not all individuals have a clear or stable sexual identity, and some may identify as questioning or fluid.

In adulthood, an individual’s sexual identity may continue to evolve and change, and they may experience different forms of attraction at different times in their life. It is important to remember that sexual identity is a personal and unique experience for each individual, and it is important to respect and support individuals in their journey of self-discovery and self-expression. It is also important to note that societal attitudes and discrimination can affect the development of sexual identity, and can make the process of accepting and disclosing one’s sexual identity more difficult.

Sexual preferences:

Sexual preferences refer to the types of sexual activities or partners that an individual finds appealing or satisfying. These preferences may also change over time, and may not always be consistent with one’s sexual identity. They are influenced by a variety of factors such as cultural, social, and personal experiences, as well as individual differences in personality, values, and beliefs (Mark KP et al., 2018).

From a biological perspective, research suggests that sexual preferences may be influenced by genetics and hormones. For example, studies have found that certain physical characteristics, such as body shape, are more attractive to some people than others, and that these preferences may be related to genetic factors. Additionally, research has found that hormones, such as testosterone and estrogen, play a role in sexual attraction and behavior. For example, high levels of testosterone have been linked to increased sexual desire and attraction to more masculine faces.

From an environmental perspective, sexual preferences may be shaped by a person’s experiences and exposure to different types of sexual behavior and relationships. For example, early experiences with sexual partners, such as those during adolescence, may shape an individual’s sexual preferences and behavior. Additionally, cultural norms and values can also influence sexual preferences by shaping the types of sexual behavior and relationships that are considered acceptable or desirable.

The development of sexual preferences is a complex and multi-faceted process that is influenced by a variety of factors, including biology, environment, and culture. It’s important to recognize that sexual preferences are diverse and can vary greatly from person to person, and that they should be respected.

Gender dysphoria:

Gender dysphoria is a condition characterized by a marked incongruence between an individual’s experienced/expressed gender and their assigned gender, and a strong desire to be treated as the opposite gender, or the conviction of being the opposite gender. This condition is also known as gender identity disorder (GID) or gender incongruence, and it is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11) as a condition that requires treatment.

According to a study conducted by the Williams Institute in 2016, an estimated 0.7% of the U.S. adult population identify as transgender. This estimate is based on a nationally representative sample of over 27,000 adults, and is consistent with other recent studies of the U.S. population. Other studies have estimated the prevalence of gender dysphoria to be around 0.5% in the general population, with higher rates among adolescent and adult individuals seeking gender-affirming health care (Flores, 2022). In the UK according to a survey conducted by the Office for National Statistics (ONS) in 2017, an estimated 1.5% of the UK population aged 16 to 64 identify as transgender. This survey was based on self-reported data and is considered to be the largest study of its kind in the UK. The Equality and Human Rights Commission (EHRC) in 2018, reported that transgender people in the UK face significant barriers to accessing healthcare, with nearly 1 in 4 (23%) of transgender people reporting that they have been discriminated against by a healthcare professional because of their gender identity.

The exact causes of gender dysphoria are not fully understood, but research suggests that it is likely to be a combination of biological and environmental factors. Studies have shown that there are structural differences in the brain of individuals with gender dysphoria and that these differences are related to the development of their gender identity.

One criticism of gender dysphoria is that it is seen as a mental disorder, and some argue that this pathologizes transgender individuals and reinforces societal stigma and discrimination towards them. Critics argue that instead of treating transgender individuals for a disorder, society should be accepting and affirming of their gender identity.

Research also suggests that social and cultural factors, such as discrimination, lack of acceptance, and lack of access to gender-affirming healthcare can exacerbate the distress caused by gender dysphoria. Studies have found that transgender individuals have higher rates of mental health issues such as depression, anxiety, and suicide attempts, and that these issues are often related to experiences of discrimination and lack of social support (De Cuypere, 2006).

Treatment for gender dysphoria typically includes counseling, hormone therapy, and gender-affirming surgeries, which can help individuals align their physical characteristics with their gender identity.

It is important to note that not all individuals who experience gender dysphoria will choose to or be able to access these treatments, and it is important to provide support and understanding regardless of the path an individual chooses.

Psychosexual development:

Sigmund Freud’s theory of psychosexual development proposes that the development of a child’s libido (sexual energy) occurs in five distinct stages, each characterized by a specific erogenous zone, or area of the body that is most sensitive to pleasure. These stages are known as the oral, anal, phallic, latent, and genital stages.

1. The oral stage, from birth to 18 months, is when the child’s primary focus is on their mouth and they derive pleasure from sucking and biting. During this stage, the child’s primary source of pleasure is the oral cavity and anything that goes into it, such as a mother’s breast or a pacifier. According to Freud, fixation at this stage can result in oral habits such as nail-biting, smoking, or overeating.
2. The anal stage, from 18 months to 3 years, is when the child learns to control their bowel and bladder movements, and pleasure is derived from holding in or releasing feces. This stage is characterized by the child’s focus on their anus, and the child will experience pleasure from the act of defecation. Fixation at this stage can result in anality or obsession with cleanliness and order.
3. The phallic stage, from 3 to 6 years, is when the child becomes aware of their genitals and sexual feelings. During this stage, the child will focus on their genitals and will become curious about their own and others’ bodies. The Oedipus complex, a theory in which a child identifies with the same-sex parent and sees the opposite-sex parent as a rival for the affection of the same-sex parent, is also introduced in this stage. Fixation at this stage can result in a weak sense of self-esteem or difficulty in trusting others.
4. The latent stage, from 6 years to puberty, is when the child represses their sexual feelings and focuses on other activities such as school and friendships. During this stage, the child’s libido is dormant and their energy is focused on learning and growing. Fixation at this stage can result in a lack of creativity or difficulty in forming close relationships.
5. The genital stage, from puberty onwards, is when the child reaches sexual maturity and develops the ability to experience sexual pleasure with others. During this stage, the child’s libido becomes active again and they become capable of sexual intercourse. Fixation at this stage can result in sexual maladjustment or difficulty in forming lasting relationships.

It’s important to note that these stages are not necessarily sequential and that a child may revisit earlier stages at different points in their development. Additionally, this theory is controversial and has been largely discredited by contemporary psychologists and psychiatrists. The theory is criticized for its lack of empirical evidence and its focus on heteronormative and patriarchal views of sexuality.

References:

(1) Bailey, J. M., Dunne, M. P., & Martin, N. G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78(3), 524-536.

(2) De Cuypere, G., Elaut, E., Heylens, G., Gijs, L., Selvaggi, G., De Sutter, P., & Monstrey, S. (2006). Long-term follow-up: Psychosocial outcome of Belgian transsexuals after sex reassignment surgery. Sexologies, 15(2), 126-133.

(3) Flores, A., Herman, J., Gates, G. and Brown, T. (2022). How many adults identify as transgender in the United States? [online] Williams Institute. Available at: https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/.

(4) Mark KP, Janssen E. (2018) Understanding sexual preferences: A multivariate approach. J Sex Res. 2018;55(3):332-343.

(5) Savin-Williams, R. C. (2005). The new gay teenager. Cambridge, MA: Harvard University Press.