The Operationalisation of Sex and Gender in Quantitative Health-Related Research: A Scoping Review

Current trends in quantitative health research have highlighted the inadequacy of the usual operationalisation of sex and gender, resulting in a growing demand for more nuanced options. This scoping review provides an overview of recent instruments for the operationalisation of sex and gender in health-related research beyond a concept of mutually exclusive binary categories as male or masculine vs. female or feminine. Our search in three databases (Medline, Scopus and Web of Science) returned 9935 matches, of which 170 were included. From these, we identified 77 different instruments. The number and variety of instruments measuring sex and/or gender in quantitative health-related research increased over time. Most of these instruments were developed with a US-American student population. The majority of instruments focused on the assessment of gender based on a binary understanding, while sex or combinations of sex and gender were less frequently measured. Different populations may require the application of different instruments, and various research questions may ask for different dimensions of sex and gender to be studied. Despite the clear interest in the development of novel sex and/or gender instruments, future research needs to focus on new ways of operationalisation that account for their variability and multiple dimensions.

Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder

Introduction

Gender identity disorders (GID) are heterogeneous disorders that may be influenced by culture and social norms.

Aim

The aim of this study was to determine masculine and feminine gender roles in a group of Iranian patients with GID and compare these roles with two control groups.

Methods

Twelve male‐to‐female (MF) and 27 female‐to‐male (FM) individuals with GID referred to Tehran Psychiatric Institute in Tehran, I. R. Iran were evaluated by self‐report inventories and were compared with two groups of healthy controls (81 men and 89 women). Diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV) criteria. Data analysis was done using analysis of variance and chi‐squared test.

Main Outcome Measures

Masculine and feminine gender roles were assessed by two questionnaires: (i) Gender‐Masculine (GM) and Gender‐Feminine (GF) scales derived from the Minnesota Multiphasic Inventory‐2 (MMPI‐2); (ii) Bem Sex Role Inventory (BSRI).

Results

In the scales of masculinity, MF‐GID individuals scored as male controls, but lower than female controls. FM‐GID individuals scored similar to female controls and higher than male controls. In femininity scales, MF‐GID individuals and control women seemed similar, and both scored higher than the other groups. FM‐GID persons were considered less feminine than both controls in the GF scale of MMPI‐2, but not in the BSRI. In both scales, FM‐GID persons had higher scores than control women and MF‐GID individuals.

Conclusion

Iranian FM‐GID individuals were less feminine than normal men. However, MF‐GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261–268.

Do the BSRI and PAQ Really Measure Masculinity and Femininity?

The two most used instruments to assess masculinity (M) and femininity (F) are the Bem Sex Role Inventory (BSRI) and the Personality Attributes Questionnaire (PAQ). Two hypotheses will be tested: a) multidimensionality versus bidimensionality, and b) to what extent the two instruments, elaborated to measure the same constructs, classify subjects in the same way. Participants were 420 high school students, 198 women and 222 men, aged 12–15 years. Exploratory factor analysis and internal consistency analysis were carried out and log-linear models were tested. The data support a) the multidimensionality of both instruments and b) the lack of full concordance in the classification of persons according to the fourfold typology. Implications of the results are discussed regarding the supposed theory behind instrumentality/expressiveness and masculinity/femininity, as well as for the use of both instruments to classify different subjects into the four distinct types.

Sex-Role Orientation and Attachment Styles of Sex Offenders

Given the increase of individuals who have a history of sexual offenses, there has been an increase in research on the etiology of sex-offending behavior. The present purpose was to evaluate the relationship between sex-role orientation and attachment styles of males who were sex offenders. Analysis yielded statistically significant differences between comparison ( n = 22) and clinical groups ( n = 21) in gender roles, with little sign of the androgynous gender type for sex offenders. The offender group showed significantly lower frequency of androgyny scores and significantly higher scores on feminine and undifferentiated orientations, supporting the theoretical view of sex offenders as being “cross-sex-typed.” In addition, the sex offender group had a significantly higher mean score on anxious-avoidant relationship attachment. Based on the present findings, there appears to be a need to help sex offenders explore how their gender roles may relate to their sex-offending behavior and assist sex offenders in the development of adaptive relationships with reduced anxiety and ambivalence.