Androgyne becomes bisexual in sexological theory: Plato to Freud and neuroscience

Plato conceptualized primordial humans as androgynes, the children of the moon. The primordial hermaphroditism of the mammalian embryo became known 2 1/2 millennia later in the mid-19th century. By 1864 Ulrichs had transposed the new knowledge from embryology to sexology to explain those to whom he gave the name Urnings (after Uranus who gave womanless birth to Venus from sea spume) as having "a woman's mind trapped in a man's body" (anima muliebris corpore virili inclusa). Urning became displaced by sexual inversion, and eventually by homosexual, a term coined together with heterosexual by Kertbeny as recently as 1869. The embryological principle of primordial hermaphroditism became linked to evolutionary Darwinism by way of Haeckel's principle of recapitulation, epitomized as "ontogeny recapitulates phylogeny." The recapitulation principle became linked, in turn, to the principle of intrapsychic primordial bisexuality, which became a cornerstone of Freud's psychoanalytic theory. Genetics influences the outcome of bipotentiality not directly but by way of hormonal programming of the brain, prenatally or neonatally, rather than pubertally and in maturity. Bipotentiality within the brain has been investigated chiefly in the hypothalamus where male/female dimorphism has been recognized, but its determinants and stages of differentiation, both prenatal and postnatal, remain to be fully ascertained. Neuroanatomical research on the outcome of male/female bipotentiality as gay, straight, or in between is politically and morally opposed by those who postulate a bipotential preference or voluntary choice. In stimulus-response associationism, to which behavior-modification theory belongs, bisexuality is equipotential, and either alternative may be evoked, ostensibly, dependent on the stimulus situation. In ethological theory, the effectiveness of stimulus-response bonding is confined chronologically to a critical period of development and is restricted phylogenetically by an innate recognition mechanism and an innate releasing mechanism. These limits are compatible, however, with some degree of both individual and ethnic variation.

Forensic sexology: paraphilic serial rape (biastophilia) and lust murder (erotophonophilia)

Forensic sexology is not synonymous with either forensic psychiatry or forensic psychology. It is a specialty in its own right, and is needed in the courtroom. Paraphilic sex offenders on trial are misrepresented as being, by their own choice, psychopathic or sociopathic deviates. They are unable to explain their paraphilic criminality to either themselves or society. In a case of serial rape and serial lust murder here presented, the contributory causes are examined and differentiated as hereditary predisposition, hormonal functioning; pathological relationships, sexual abuse; and syndrome overlap with bipolar disorder, schizoid disorder, antisocial personality disorder, epilepsy, and multiple personality. The precipitating causes were differentiated as childhood head injuries, and adult head injury at age 20. Left impact trauma and sexological trauma were sequelae of the adult injury. The full range of diagnostic resources was not available for a prisoner on death row. Capital punishment has not prevented the reemergence in each new generation of serial rape and serial lust murder as an epidemiological, public health problem. Punishment is an ineffectual substitute for epidemiological research into cause, effect, and prevention.

Paleodigms and paleodigmatics: a new theoretical construct applicable to Munchausen's syndrome by proxy, child-abuse dwarfism, paraphilias, anorexia nervosa, and other syndromes

A paleodigm is a formulation of ancient folk wisdom that encodes a causal explanation in a saying or story that penetrates the idiom of everyday language and influences behavior. Although paleodigms are not, per se, causative, they have diagnostic, prognostic, and therapeutic significance in syndromes like Munchausen's syndrome by proxy.

Pedagogical handicap associated with micropenis and other CHARGE syndrome anomalies of embryogenesis: four 46, XY cases reared as girls

Genital hypoplasia (micropenis) and CNS impairments are among multiple anomalies of embryogenesis that are found in association in a syndrome for which the acronym CHARGE has recently been coined. The CNS anomalies are either peripheral or central or both. Their various manifestations are impaired hearing and vision; impaired motor performance and visual-motor coordination; IQ deficit either overall or specific to verbal reasoning or praxic reasoning; and social ineptitude consequent on impaired social maturation. These various impairments constitute a pedagogical handicap which, even though of major severity, is not refractory to clinical treatment and educational therapy.

Matched pair of siblings concordant for 46,XY hermaphroditism with female sex assignment, and discordant for erotosexual outcome

The two siblings in this comparison constitute a matched pair on the basis of concordance not only for prenatal history and diagnosis but also for assigned sex as girls, and for spontaneous hormonal puberty that was not feminizing, but masculinizing. They were further concordant in being surgically and hormonally feminized, with their own informed consent, early in adolescence. Subsequently, they became discordant, for the younger one has lived continuously as a woman, with a feminine gender-identity/role (G-I/R) socially and erotosexually, whereas the older one became self-reassigned to live as a man with a masculine G-I/R socially and erotosexually, hormonally supported on testosterone replacement therapy. Flattening of the chest was readily accomplished by plastic surgery, but phalloplasty was not attempted, primarily because of the technical obstacles and, to a lesser extent, the cost.

Genital examination and exposure experienced as nosocomial sexual abuse in childhood

Three pediatric cases of girls, one with idiopathic precocious puberty and two with a birth defect of the sex organs, exemplify the proposition that genital exposure and the physical examination of the genitals may be experienced subjectively as nosocomial sexual abuse. Negative sequelae persisted into adulthood. The dogma of the new victimology industry is that children never lie about sexual abuse. Consequently providers of pediatric and ephebiatric (pubertal and adolescent) sexual health care already are progressively at risk of being falsely accused of nosocomial (from the Greek nosokomeion, from nosos, disease, + komeion, to take care of: pertaining to or originating in a hospital, as nosocomial disease) sexual abuse.

Bisexually concordant, heterosexually and homosexually discordant: a matched-pair comparison of male and female adrenogenital syndrome

Prenatal hormonal experiments in subprimate species demonstrate conclusively that the pattern of adult mating behavior is masculinized or feminized as a function of prenatal hormonalization of the brain. In primates, especially human beings, postnatal socialization is superimposed on prenatal hormonalization. The syndrome of congenital virilizing adrenal hyperplasia [CVAH] is an experiment of nature in which the fetal brain is prenatally hormonalized by a masculinizing excess of androgen from abnormally functioning adrenal cortices. The syndrome was diagnosed in two children, one a chromosomal, 46,XX female, and one a 46,XY male, who amongst many others were psychoendocrinologically followed into adulthood. Each was able to fall in love exclusively with a female as a partner in sexuoerotic activity, though each experienced also, on an investigative basis, at least one genitosexual encounter with a male. On a behavioral technicality, therefore, each had a history of bisexual practices, whereas subjectively the woman identified herself as a lesbian, and the man as a Kinsey-one heterosexual. Hormonally, it may be inferred that in prenatal life both were ultramasculinized to such a degree that it was impossible for any postnatal interventions to permit the man to become a bona fide homosexual, or the woman a bona fide heterosexual. The full implication of these findings and those of similar cases for homosexual/heterosexual theory remains to be ascertained.

Adolescent sexology and ephebiatric sexual medicine

Ephebiatric sexual medicine is a specialty that still awaits its Vesalius. The age of onset of puberty has decreased by four years in the past two centuries, without a concordant change in social and legal institutions governing sexual and economic autonomy. Concomitant with the reintroduction of the ancient European betrothal system, the adolescent age of first coitus has lowered and averages two years earlier than first contraception. The hiatus is attributed to the moral sanctions against open access to contraception in adolescence. The neglect of sexual learning in teenage allows cases of suicidal and homicidal lovesickness to be undetected and likewise the mental template or "lovemap" of paraphilic pathology in adolescence lacks both preventive measures and treatment. The newest treatment of the paraphilias is with antiandrogen combined with counseling. Positive or negative preparedness for first orgasm or first coitus correlate with positive or negative outcome in subsequent sexuoerotic health. Knowing the sexology of syndromes, for example genetic and endocrine syndromes of childhood, expedites the delivery of sexological health care service in adolescence.

Longitudinal studies in clinical psychoendocrinology: methodology

There are five universal exigencies of being human, against which a person's existence can be evaluated: pairbondage, troopbondage, abidance, ycleptance, and foredoomance. They constitute a template from which a standardized agenda or schedule of inquiry is generated, as needed, for a particular research investigation. The schedule of inquiry is painstakingly designed ahead of time so as to ensure coverage of all the variables relevant to a particular study. For economy of expense and effort, subjects conclude their own prior interviews by summarizing it on tape, with the interviewer making a written record, verbatim, of what will become subheadings in the transcript. Inquiry progresses from an open-ended to a forced choice interrogatory. Topics in the public domain open the way to inquiry on personally sensitive issues. So also do parables drawn from actual cases and used as personalized narrative projective tests. A cumulative record, covering as many as 25 years, is indexed so that relevant material can be located, abstracted, and classified for any particular study. A jury of two or more then uses the abstracted data to fill out a prepared data schedule, using its own standardized scoring or rating criteria. By contrast, an ordinary questionnaire uses standardized questions, and each subject applies his or her own unstandardized scoring or rating criteria in answering them. In the final step, the jury's ratings are tabulated on a master chart that consolidates the scores of a group of subjects and controls, ready for statistical analysis.

Paraphilias: phenomenology and classification

DSM-III incorrectly designates the majority of paraphilias as atypical. Only eight are named, and those because of their forensic history, rather than their pathology and therapeutic need. In this paper, thirty-odd paraphilias are subdivided into six categories on the basis of their phenomenological dynamics. The new concept of the developmental lovemap is introduced for the first time. A new treatment originated by the author in 1966 combines an androgen agonist with counseling therapy.

Five universal exigencies, indicatrons and sexological theory

In sexology as science, except for the special case of introspection, on which the defense of mind-body dualism rests, raw data are obtained, like the raw data of all the other sciences, through the special senses and exteroceptive observation. In Table 1 are shown the verbs and nouns that are needed to relate the five special senses of the observer to the observed, as stimuli are transmitted to their destination from their source. Some of these terms sound somewhat unidiomatic, which is no accident. It is precisely because vernacular English was not designed for scientific usage that some needed terms have been lacking--to the detriment of theoretical mindbody unity. Another missing term in sexology as science is a generic one for any type of unit of raw data. The gap can be filled with the new term, indicatron, in recognition of the fact that sexology's units of raw data all serve to indicate something. Since exactly the same applies to the raw data of any science, then sexology and the other sciences share the same premise. The sociopsychological and the biomedical sciences from which sexology conjointly derives are not separated as being of the mind and the body respectively. They are unified in indicatronics, the science of indicatrons, in which the split between body and mind is semantically irrelevant. The indicatrons of sexology can be classified under five universal exigencies of being human: being pairbonded, troopbonded, abidant, yclept, and foredoomed.

Gender-transposition theory and homosexual genesis

The genesis of homosexuality, and therefore of heterosexuality also, has traditionally been argued as either wholly biological or wholly social-environmental. The theory of gender transposition integrates findings regarding both prenatal hormonal programming of the sexual brain, and postnatal social programming.

Adult erotosexual status and fetal hormonal masculinization and demasculinization: 46,XX congenital virilizing adrenal hyperplasia and 46,XY androgen-insensitivity syndrome compared

Among 30 young women with a history of the treated adrenogenital syndrome (CVAH), 11 (37%) rated themselves as bisexual or homosexual. Among a control group consisting of 15 women with the 46,XY androgen-insensitivity syndrome (AIS) plus 12 with the Rokitansky syndrome (MRKS), the corresponding figure was 2 (7%), both bisexual. Chi-square was significant beyond the 0.01 level. In Kinsey's 1953 sample 15% of women experienced homoerotic arousal imagery by age 20, and 10% had had homoerotic partner contact. The most likely hypothesis to explain the CVAH findings is that of a prenatal and/or neonatal masculinizing effect on sexual dimorphism of the brain in interaction with other developmental variables.

Micropenis: adult follow-up and comparison of size against new norms

In eight cases of micropenis, the follow-up period was from childhood through adulthood (age range 22 to 31). Topical treatment of the penis with testosterone propionate in childhood increased its size relative to the rest of the body before adolescence. In adolescence and adulthood, the penis with a prior history of treatment with testosterone (N = 5) had no size advantage over the untreated one (N = 3). Topical testosterone postponed the age of developing a coping strategy, but not the necessity of developing one. New data (N = 65) for the stretched length of the adult penis give a M +/- SD of 16.69 +/- 1.90 cm, or 6.57 +/- .75 inches.

Psychology of syndromes. IQ and micropenis

In 20 patients with a micropenis, IQs ranged from 81 to 137, with a mean of 117 +/- 14 and a median of 116. The distribution of IQs approximated a normal distribution except that the entire curve was skewed, with the majority (75%) of scores higher than 109. There was no clustering related to diagnosis, age, sex of rearing, or serial testing to account for the skew, which was stronger for verbal than for performance IQ. These findings negated the probability of an adverse intellectual prognosis for patients born with a micropenis.

New phylism theory and autism: pathognomonic impairment of troopbonding

A phylism is a unit of existence, part of an individual's species heritage. It is neither nature nor nurture, but a phyletically dictated product of the interaction of both at a crucial developmental period which may be either prenatal, postnatal, or both. In the syndrome of autism, the phylism of troopbonding is specifically impaired, and other phylisms may be hypertrophic. The phylism of limerent (lover-lover) pairbonding is not impaired, and it may be the source of discordance with other members of the troop. Shyness is an attenuated manifestation of autism. The etiology of impaired troopbonding may be heritable, and almost certainly will prove to be neurochemical also, probably as an analogue of the Lesch-Nyhan syndrome. The lives of autistic children are subject to secondary shaping by the environment of living.