Abstract

Theoretical understanding of psychosexual development, particularly in regard to sexual identity, has undergone several histon'cal changes. Most notable has been the transition away porn a learning paradigm, which held that individuals are psychosexually neutral at birth and that thty develop their sexual identity due to rearing. This has shifed to contemporav acceptance that an interaction of both nature and nurture is responsible for psychosexual development. That there probably exists an inherent predisposition or bias toward a male or female identity, which is infmed by prenatal injuences, is also current theory. However, while this shaft has occurred in the theoretical understanding of the phenomenon, a comparable shift has not occurred in the clinical management of individuals where sex assignment or reassignment is a real issue. The theoretical change and real case management should be concordant.