Sex-role behavior change: intrasubject studies of boyhood gender disturbance.

Sex-role behaviors were modified in a seven-year-old boy who had been evaluated by an independent psychiatrist as manifesting cross-gender identification. The child's developmental history paralleled the retrospective reports of adult transsexuals. In Experiment 1, the boy was treated in the clinic by a nonprofessional female "therapist" who reinforced "masculine" sex-typed play behaviors and extinguished "feminine" behaviors. The treatment effects generalized to the boy's play with a different set of toys in the presence of male and female strangers, but did not generalize to the boy's play in the alone condition. An intrasubject reversal design was used to replicate the treatment effects. Concurrently, Experiment 2 was conducted to shape the child's athletic skills to a level that would enable him to compete with his peers. The treatment effect for "sockball" was replicated for "kickball" in a multiple-baseline intrasubject design. Future research is suggested to explore variables that would maximize both generalization of treatment effects and parental cooperation over time.