THE DEVELOPMENT of the sexual system in the human being involves the interaction of biological, social, and cultural factors. In the literature on this subject one repeatedly encounters these terms: sex, gender role, core gender identity, gender identity, and sexuality. It is therefore necessary that the reader have a clear understanding of these concepts.
Review of the Literature
The Sexual System.—Sex is the biological substrate upon which gender identity and sexuality are built. This biological substrate is virtually always weighted in favor of one or the other sex. The individual is then designated as being of the "male sex" or "female sex." Sex is determined by several factors: the chromosomes, the configuration of the external genitalia, the internal genitalia, hormonal production, and later, the secondary physical sexual characteristics produced by hormonal changes at puberty.1 Each individual is endowed at birth with a combination of these factors which determine