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The terms sexual and sexuality have several meanings in medical and nonmedical writings The most obvious one relates to the functions of the male and female sexual organs through which procreation occurs and the survival of the species is assured as well as to behaviors that serve to attract the opposite sex and ultimately lead
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American males are exclusively homosexual and 8 percent have been more or less exclusively homosexual for at least three years, sometime between the ages of 16 and 65 For females, the incidence is lower, perhaps half that for males It was estimated, on the basis of the examination of large numbers of military personnel during World War II, that 1 to 2 percent of servicemen were exclusively or predominantly homosexual More recent estimates, both in men and women, range from 1 to 5 percent (see LeVay and Hamer) These widely variable gures share a problem with all estimates derived from surveys and questionnaires: they cannot count people who do not wish to be counted The origins of homosexuality are obscure We favor the hypothesis that differences or variations in genetic patterning of the immature nervous system (probably of the hypothalamus) set the sexual predilection during early life Several morphologic studies of the hypothalamus are signi cant in this regard Swaab and Hofman have reported that the preoptic zone is three times larger in heterosexual males than it is in females, but it is about the same size in homosexual males as it is in females As mentioned in Chap 27, LeVay found that an aggregate of neurons in the suprachiasmatic nucleus of the hypothalamus is two to three times larger in heterosexual men than it is in women, and also two and three times larger in heterosexual than in homosexual men If con rmed, these ndings, which have been disputed by Byne, would support the view that homosexuality has a biologic basis Genetic studies point in the same direction Pooled data from ve studies in men have shown that about 57 percent of identical twins (and 13 percent of brothers) of homosexual men are also homosexual The gures for lesbians are much the same The inheritance pattern of male homosexuality comes from the maternal side, implicating a gene on the X chromosome (LeVay and Hamer) Psychoanalytic explanations of homosexuality have never been substantiated Attempts to demonstrate an endocrine basis for homosexuality have also failed The most widely held current view is that homosexuality is not a mental or a personality disorder, though it may at times lead to secondary reactive neurotic disturbances The studies of Kinsey and colleagues indicate that a homosexual orientation cannot be traced to a single social or psychologic root Instead, as indicated above, homosexuality seems to arise from a deep-seated predisposition, probably biologic in origin and as ingrained as heterosexuality The status of bisexuality is undetermined
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The Development of Personality and Social Adaptation (See also Chap 56)
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Personality, the most inclusive of all psychologic terms, encompasses all the physical and psychologic traits that distinguish one individual from every other The notion that one s physical characteristics are determined by inheritance is a fundamental tenet of biology One has but to observe the resemblances between parent and child to con rm this view Just as no two persons are physically identical, not even monozygotic twins, so too do they differ in any other re ned quality one chooses to measure These differences, together with certain predilections to disease, explain why any one person may have an unpredictable reaction to a pathogenic agent Strictly speaking, the normal person is an abstraction, just as is a typical example of any disease However, it is in other, seemingly nonphysical attributes that individuals display the greatest differences Here reference is made
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to their variable place on a scale of energy, capacity for effective work, sensitivity, temperament, emotional responsivity, aggressivity or passivity, risk-taking, ethical sense, exibility, and tolerance to change and stress The composite of these qualities constitutes the human personality or character In the formation of personality, especially the part concerned with feeling and emotional sensitivity, basic temperament surely plays a large part By nature, some children from the beginning seem to be happy, cheerful, and unconcerned about immediate frustrations; others are the opposite By the third month of life, Birch and Belmont recognized individual differences in activity-passivity, regularity-irregularity, intensity of action, approach-withdrawal, adaptivity-unadaptivity, high-low threshold of response to stimulation, positive-negative mood, high-low selectivity, and high-low distractibility Ratings at this early age were found to correlate with the results of examinations made at 5 years Kagan and Moss recognized the trait of timidity as early as 6 months of age and noted that it persists lifelong The more common aspects of personality ie, anxiety or serenity, timidity or boldness, the power of instinctual drives and need of satisfaction, sympathy for others, sensitivity to criticism, and degree of disorganization resulting from adverse circumstances are presumed to be genetically determined Identical twins raised apart are remarkably alike in these and many other personality traits (and have the same IQs, within a few points) (Moser et al) The strong genetic in uence on personality development has also been demonstrated by Scarr and associates The related subject of the development of a moral sense that can be said to be part of an individual s personality has been subject to several competing theories The interested reader is referred to Damon s summary of the topic Disorders of personality and the genetic predisposition to certain personality traits are discussed further in Chap 56 Social behavior, like other neurologic and psychologic functions in general, depends to a great extent on the development and maturation of the brain Involved also are genetic and environmental factors, for one cannot adapt to society except in the presence of other people; ie, social interaction is necessary for the emergence of many basic biologic traits The roots of social behavior are traceable to certain instinctive patterns that are progressively elaborated by conditioned emotional reactions In the long series of human interactions rst with parents, then with siblings and other children, and nally with a widening circle of individuals in the classroom and community the capacity to cooperate, to subjugate one s own egocentric needs to those of the group, and to lead or be led appear as secondary modes of response (ie, secondary to some of the basic impulses of anger, fear, self-protection, love, and pleasure) The sources of these social reactions are even more obscure than those of temperament, character, and intelligence In children, dif culty in social adaptation tends rst to be manifest by an inability to take their places in a classroom However, the greatest demands and frustrations in social development are likely to occur in late childhood and adolescence The development of adult gonadal function and the further evolution of psychosexual impulses create a bewildering array of new challenges in social adaptation These types of social adjustment continue as long as life continues As social roles change, as intellectual and physical capacities rst advance and later recede, new challenges demand new adaptations
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