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August 20, 1997

Congenital Adrenal Hyperplasia and Adult Sexual Behavior

Author Affiliations

Johns Hopkins University Baltimore, Md

JAMA. 1997;278(7):549. doi:10.1001/jama.1997.03550070041032

To the Editor.  —In the Commentary on the safety of long-term prenatal glucocorticoid treatment, Drs Seckl and Miller1 state, "Furthermore, it has been suggested that fetal androgens can 'masculinize' the human brain, as adult females with CAH [congenital adrenal hyperplasia] have a higher incidence of lesbianism, less interest in sexual activity, and a negative body image; prenatal dexamethasone may diminish this potential action of fetal androgens." This implies that being a lesbian is a masculinized state and also is a negative outcome. Clearly there is much to be learned about human behavior, and studies that further our knowledge should be applauded. However, homosexuality is not a pathologic condition and should not be framed as such in the medical literature. Furthermore, lesbians are not masculinized women. The perpetuation of these negative stereotypes is a disservice to all gay and lesbian colleagues and patients.