Descriptive Psychopathology: The Signs and Symptoms of ...

341 Chapter 14: PersonalityDeviance without psychopathologyDeviance indicates behaviors and characteristics that are not exhibited by themajority of the population. It does not automatically denote psychopathology.While psychopathology is always deviant, not all deviance is psychopathology.A Vegan has deviant eating behavior because the majority of persons are omnivorous.In contrast, an individual who does not eat meat and other animal productsbecause he believes that all meat products are contaminated as part of a governmentconspiracy is likely delusional, and his deviant eating behavior indicatespsychopathology.In diverse societies, distinguishing deviance reflecting non-pathological variabilityfrom deviance reflecting illness is challenging. Many deviant sexual behaviors,for example, reflect obsessive–compulsive disorder and other illnesses. Many arenon-pathological variants, and some are discussed here.Gender identity and sexual orientationNormal human sexual development requires the compatibility between genetic sex(sex chromosomes), gonads (testes or ovaries), genitalia (external and internalsex organs), other secondary sexual characteristics, and the congruent subjectiveexperience of the gender. Gender consists of the identified sex of the person, andthe person’s gender role behaviors and sexual orientation (hetero- or homosexual).While gender identity is modestly shaped by family and cultural influencessuch as rearing practices, peer gender-specific behaviors and individual traits,endogenous-generated developmental hormones elicit the process of sexual differentiationin humans. 39 Gender-specific steroids during the perinatal period,particularly testosterone, are crucial for the dimorphism of sexual behavior (maleor female) in adulthood 40 and sexually dimorphic human brain structuresdevelop between 4 and 7months of gestation. 41Subjective gender identity incongruent with the assigned gender based onthe appearance of the gentilia or their genetic sex is also under developmentalhormonal influences. 42 In partial androgen insensitivity syndromes (a receptorproblem), gender identity may be male or female with incongruity elicitingdysphoric states. 43 Persons with complete androgen sensitivity disorder are raisedas females and do not exhibit confusion about gender identity.HomosexualityAbout 90% of humans are heterosexual, 1–2% are homosexual, and the rest aresomewhere on the spectrum between the two distinct sexual orientations.Homosexuality is found in humans and many other species. 44 A genetic effectis proposed based on its presence in many species, and in humans the high