Clinical implications of the organizational and activational effects of hormones

Hormones and behavior, 2009

Diamond’s seminal paper laying out his lifetime research into the biological and hormonal basis of gender patterns, sexual orientation, and gender identity in human psychosexual development.


Debate on the relative contributions of nature and nurture to an individual’s gender patterns, sexual orientation and gender identity are reviewed as they appeared to this observer starting from the middle of the last century.

Clinical implications of the organizational and activational effects of hormones, US National Library of Medicine National Institutes of Health, Hormones and behavior, NCBI PubMed PMID: 19446079, 2009 May.

Image credit Russel Kwok.

Particular attention is given to the organization-activation theory in comparison to what might be called a theory of psychosexual neutrality at birth or rearing consistency theory.

The organization-activation theory posits that the nervous system of a developing fetus responds to prenatal androgens so that, at a postnatal time, it will determine how sexual behavior is manifest.

How organization-activation was or was not considered among different groups and under which circumstances it is considered is basically understood from the research and comments of different investigators and clinicians.

The preponderance of evidence seems to indicate that the theory of organization-activation for the development of sexual behavior is certain for non-human mammals and almost certain for humans.

This article also follows up on previous clinical critiques and recommendations and makes some new suggestions.


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