en litteraturstudie om teorier for dannelse av kjønnsidentitet og ...

1 SAMMENDRAG ........................................................................................ 3
2 INNLEDNING ............................................................................................ 4
3 METODE .................................................................................................... 5
4 RESULTAT................................................................................................. 6
4.1 REDEGJØRELSE FOR DEBATTEN OMKRING BARNS DANNELSE AV KJØNNSIDENTITET ....6
4.1.1 HISTORIEN OM JOHN/JOAN...........................................................................................6
4.1.2 JOHN MONEY...............................................................................................................9
4.1.3 MILTON DIAMOND.....................................................................................................13
4.2 FYSIOLOGI ..................................................................................................................15
4.2.1 NORMAL SEKSUELL DIFFERENSIERING ........................................................................15
4.2.1.1 Dannelse av indre genitalia ....................................................................................15
4.2.1.2 Dannelse av ytre genitalia ......................................................................................16
4.2.2 FEIL I DEN SOMATISKE KJØNNSUTVIKLINGEN ..............................................................17
4.2.2.1 Klassifisering .........................................................................................................17
4.2.2.1.1 Gonadedysgenesier .............................................................................................17
4.2.2.1.2 Påvirkning fra maternelle androgener og progesteroner under svangerskapet.......17
4.2.2.1.3 Undervirilisering av barn med karyotype 46,XY og testikler ...............................18
4.2.2.1.4 Virilisering av barn med karyotype 46,XX og ovarier..........................................19
4.2.2.2 Adrenogenitalt syndrom.........................................................................................20
4.2.2.2.1 21-hydroksylasesvikt (1) .....................................................................................21
4.2.2.2.2 11-betahydroksylasesvikt (2)...............................................................................22
4.2.2.2.3 3-betahydroksysteroid-dehydrogenasesvikt (3)....................................................22
4.3 DIAGNOSTIKK OG BEHANDLING ..................................................................................22
4.3.1 DIAGNOSTIKK............................................................................................................22
4.3.2 BEHANDLING.............................................................................................................24
5 DISKUSJON ............................................................................................. 25
6 FIGURER OG TABELLER .................................................................... 30
7 REFERANSELISTE................................................................................. 34
2