Influences of androgen on human neural-behavioral development will be evaluated by studying psychological outcomes in individuals with congenital adrenal hyperplasia (CAH: an autosomal recessive disorder causing increased adrenal androgen production beginning prenatally), as well as by relating normal variability in the prenatal hormone environment to postnatal behavior. 128 children with CAH (4-10 years) will be compared to 128 of their unaffected relatives in the same age range and to 128 demographically matched controls in regard to gender identity, gender constancy, social/cognitive processes involved in the acqusition of gender role behavior, and sex-typical toy, activity and playmate preferences. For 171 additional participants from the general population (who do not have CAH), testosterone in amniotic fluid will be related to postnatal behavior at the ages of 4 1/2, 5 1/2, and 6 1/2 years. Assessments of these children will be conducted using the same measures used to study individuals with CAH. Data will be collected by observation, interview and questionnaire, and cross-sectional and longitudinal approaches will be used. Hypotheses to be tested include: 1. Girls with CAH experience reduced feminine gender identity or are at increased risk for gender identity disorder; 2. High levels of androgen promote male-typical behavioral development in normal as well as abnormal situations; 3. Individual differences in gender role behavior are mediated by alterations in gender identity or in social/cognitive processes related to gender identity; 4. Alterations in gender identity in girls with CAH diminsh with age. The research will add to basic knowledge about the role of androgens in the development of human behavior, and will clarify the relevance to humans of animal models, where gonadal hormones have been found to influence basic processes of neural development and survival. In addition, the research will provide information on psychosexual outcomes in individuals with CAH, information which should prove relevant to other intersex conditions as well, and to other situations where fetuses are exposed to hormone-altering substances (e.g., """"""""fertility"""""""" or contraceptive drugs, alcohol, cocaine, stress, environmental toxins). Finally, the research will further basic scientific understanding of the roles of hormones and social/cognitive processes in childrens acquisition of gender role behavior.
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