GENDER IDENTITY is one's awareness, conscious and unconscious, of one's masculinity and femininity. Its most primitive form, core gender identity, is manifested by a growing knowledge that one belongs to either the male or female sex. This is produced, starting at birth, by the anatomy of the external genitalia, which serves as a sign to the physician who delivers the infant and to the parents, the child, and the community that the ascription of sex was properly made, infant-parent relations and parental attitudes toward maleness and femaleness, and a postulated biological force.
A previous paper of ours on this alleged biological force dealt primarily with data from our patients who seemed to exemplify this force.1 We wish now to review the literature, not merely as an exercise but to add the experience of others to our own to see if there are enough