Gender incongruence | AQA A-Level Psychology Revision

For 7182 specification, first teach in September 2025

AQA A-Level Psychology | Free Revision Notes

Estimated study time: 60 minutes

exam questions by topic 👇

Gender incongruence describes a difference between a person’s experienced gender and the gender assigned to them at birth. These Gender incongruence A-Level Psychology revision notes examine possible biological explanations involving genes, hormones and brain development, alongside social and cultural explanations involving gender schemas, learning and social expectations.

The topic brings together chromosomal and hormonal influences, the processing of gender information and social and cultural learning. The revised AQA specification requires students to compare biological and social or cultural explanations.

Learning Objectives 🎯

By the end of this revision page, you should be able to:

• Define gender incongruence.

• Distinguish gender incongruence from gender dysphoria.

• Explain genetic, hormonal and brain-based explanations.

• Explain how schemas, social learning and cultural expectations may influence gender experience and expression.

• Compare biological and social or cultural explanations.

• Evaluate the explanations using evidence, methodological issues and psychological debates.

Revision Notes 📚

Gender incongruence A-Level Psychology revision overview

The current AQA specification uses the term gender incongruence.

Gender incongruence occurs where there is a difference between:

• The gender assigned to a person at birth.

• The gender that the person experiences or identifies with.

For example, someone assigned male at birth may experience themselves as a woman. Someone assigned female at birth may experience themselves as a man or as having a non-binary identity.

Gender incongruence concerns a person’s gender experience. It is not determined by:

• Clothing.

• Hobbies.

• Personality traits.

• Whether someone follows traditional gender roles.

• A Bem Sex Role Inventory classification.

A person can reject gender stereotypes without experiencing gender incongruence.

Gender assigned at birth

Gender assigned at birth refers to the classification usually made following observation of the infant’s external sexual characteristics.

This classification is commonly recorded as:

• Male.

• Female.

It is normally consistent with other aspects of biological sex, but variations in chromosomes, hormones and anatomy show that biological development is not identical in every person.

Gender assignment is different from the individual’s later experience of their gender.

Experienced gender

Experienced gender refers to the person’s internal experience or understanding of their gender.

It may be:

• The same as the gender assigned at birth.

• Different from the gender assigned at birth.

• Binary.

• Non-binary.

• Gender fluid.

Gender incongruence occurs when the experienced gender and assigned gender do not correspond.

Gender incongruence and transgender identity

A person whose experienced gender differs from the gender assigned at birth may describe themselves as transgender.

However, psychologists should not assume that:

• Every person uses the same term.

• Every person has the same experience.

• Every transgender person experiences distress.

• Every person wishes to change their body or social role in the same way.

Identity terms should be based on the language a person uses for themselves.

Gender incongruence and gender dysphoria

Gender incongruence

Gender incongruence is the difference between assigned and experienced gender.

The term does not necessarily state that the person experiences psychological distress.

Gender dysphoria

Gender dysphoria refers to significant discomfort or distress that may be associated with the incongruence.

The previous AQA specification and older examination materials used the term gender dysphoria. The revised specification uses gender incongruence.

Gender incongruence	Gender dysphoria
Difference between assigned and experienced gender	Distress associated with the difference
Does not automatically imply distress	Distress is central to the concept
Current AQA specification term	Term used in earlier AQA examinations
Concerns gender experience	Concerns the discomfort that may accompany it

A person can experience gender incongruence without experiencing the same level of distress as another person.

Distress may be influenced by:

• Physical characteristics.

• Pressure to perform an unwanted gender role.

• Rejection.

• Discrimination.

• A lack of support.

• Difficulty expressing one’s gender safely.

Earlier AQA mark schemes defined gender dysphoria through the conflict between assigned and experienced gender and the discomfort that could follow.

📌 Exam tip: Use gender incongruence when answering questions under the revised specification. Refer to gender dysphoria when discussing distress or interpreting older research.

Gender incongruence is not the same as non-conformity

A person may behave in a way that does not follow traditional gender roles without experiencing gender incongruence.

For example:

• A man may enjoy traditionally feminine clothing.

• A woman may enter a traditionally masculine occupation.

• A boy may enjoy caring play.

• A girl may prefer competitive sport.

These examples concern gender expression, roles or interests.

They do not establish that the individual’s experienced gender differs from the gender assigned at birth.

Gender incongruence and sexual orientation

Gender identity and sexual orientation concern different aspects of a person.

• Gender identity concerns who someone experiences themselves to be.

• Sexual orientation concerns who someone is romantically or sexually attracted to.

Gender incongruence does not predict a person’s sexual orientation.

Explaining gender incongruence

The AQA specification requires two broad types of explanation:

1. Biological explanations

2. Social and cultural explanations

Biological explanations focus on:

• Genetic inheritance.

• Prenatal hormones.

• Hormone receptors.

• Brain development.

Social and cultural explanations focus on:

• Gender categories and schemas.

• Models and reinforcement.

• Cultural expectations.

• The language and identities available within a society.

• Social acceptance, rejection and expression.

The explanations should be treated as possible accounts rather than proven single causes.

Biological explanations

The central biological assumption

Biological explanations propose that gender incongruence may arise partly from differences in biological development.

A simplified biological pathway is:

genes → prenatal hormones and receptors → brain development → experienced gender

According to this approach, the biological processes influencing the person’s experienced gender may not correspond completely with those producing the external sexual characteristics used for assignment at birth.

For example:

• External sexual characteristics may develop in a typically male direction.

• Some aspects of brain development may follow a pattern more commonly associated with female development.

• The person may consequently experience a female gender.

This general account is sometimes referred to as brain sex theory.

Genetic explanations

Genetic predisposition

A genetic explanation proposes that inherited differences contribute to the likelihood of gender incongruence.

This does not necessarily mean there is one single “gender incongruence gene”.

Gender development is likely to involve:

• Many genes.

• Hormonal processes.

• Receptor sensitivity.

• Environmental influences.

The genetic account is therefore better described as a predisposition than a fixed genetic instruction.

Twin studies

Twin studies compare concordance between:

• Monozygotic twins, who share almost all their genetic material.

• Dizygotic twins, who share approximately half of their variable genetic material.

A concordance rate is the proportion of twin pairs in which both twins show the characteristic being investigated.

If gender incongruence has a genetic component, psychologists would predict:

higher concordance in monozygotic twins than dizygotic twins

Heylens and colleagues reported twin evidence consistent with a genetic contribution to gender dysphoria. This evidence was recognised in an earlier AQA mark scheme as support for biological explanations.

Interpreting twin evidence

Higher monozygotic concordance would support a genetic influence because monozygotic twins are more genetically similar.

However, concordance below 100% would show that genes are not sufficient by themselves.

The findings would be consistent with:

genetic predisposition + other biological or environmental influences

Limitations of twin studies

Monozygotic twins may experience more similar environments than dizygotic twins.

They may be:

• Treated more similarly.

• Dressed alike.

• Encouraged to share activities.

• More likely to identify closely with each other.

• Exposed to similar social expectations.

This makes it difficult to separate genetic and environmental effects.

Twin samples involving gender incongruence may also be small because finding suitable twin pairs is difficult.

Small samples reduce confidence that the findings represent the wider population.

Hormonal explanations

Prenatal hormone exposure

A hormonal explanation proposes that exposure to sex-related hormones before birth may influence:

• Brain development.

• Later gender-related behaviour.

• The person’s experienced gender.

Prenatal hormones are described as having organisational effects because they may influence how the brain and body develop.

Hormones do not simply act at puberty. Their effects can begin before birth.

Testosterone

Testosterone contributes to typically male sexual and brain development.

A hormonal explanation proposes that differences in:

• Testosterone exposure.

• The timing of exposure.

• Sensitivity to testosterone.

may contribute to a difference between physical sexual development and experienced gender.

For example, a person may produce testosterone but have reduced sensitivity to some of its effects.

Hormone receptors

Hormones affect body tissues by binding to receptors.

The effect of a hormone therefore depends on:

• How much hormone is present.

• When exposure occurs.

• Whether receptors function typically.

• How strongly tissues respond.

This principle was previously introduced through androgen sensitivity and sexual development.

Androgen receptor explanation

The androgen receptor gene affects the body’s response to testosterone and other androgens.

Some versions of the gene may reduce the strength of androgen action.

Hare and colleagues investigated androgen receptor variation in relation to gender dysphoria. Earlier AQA assessment material recognised this evidence as support for a biological explanation.

The proposed process is:

1. A person has an XY chromosome pattern.

2. Testes produce testosterone.

3. A variation in androgen receptors reduces sensitivity.

4. Some aspects of development are less strongly masculinised.

5. This may contribute to a female experienced gender.

This explanation concerns probability rather than certainty.

Many people with a particular receptor variation will not experience gender incongruence.

Evidence involving hormone exposure

AQA has previously recognised research suggesting a possible relationship between prenatal hormone exposure and gender dysphoria.

For example, Paterski’s work has been accepted as evidence of a possible hormonal role.

However, biological development involves more than hormone concentration.

Researchers must also consider:

• Receptor sensitivity.

• Timing.

• Interactions with genes.

• Social experience.

Contradictory hormonal evidence

Not every investigation finds clear hormonal differences between people who experience gender incongruence and those who do not.

Gladue reported minimal hormonal differences between groups.

This challenges a simple explanation based on current hormone levels.

However, measuring hormone levels in adulthood may not reveal the person’s prenatal hormonal environment.

A lack of present-day difference does not necessarily show that hormones played no developmental role.

Brain sex theory

Sexually dimorphic brain structures

A sexually dimorphic brain structure is an area that shows an average difference between males and females.

One structure studied in relation to gender incongruence is the bed nucleus of the stria terminalis, usually abbreviated to BSTc.

The BSTc is involved in biological processes related to sex and stress.

The basic brain sex explanation

Brain sex theory proposes that the person’s brain may develop in a pattern associated more closely with their experienced gender than their assigned gender.

For example:

A person assigned male at birth may have a BSTc pattern closer to the average pattern found in females.

This could create incongruence between:

• External physical development.

• Neural development associated with gender experience.

Zhou and colleagues

Zhou and colleagues investigated the BSTc using post-mortem brain tissue.

They found that the BSTc of a small group of transgender women was closer in size to the typical female pattern than to the typical male pattern.

This finding supports brain sex theory because neural characteristics appeared to correspond more closely with experienced gender than assigned sex.

AQA’s 2023 mark scheme and examiner report recognised BSTc evidence as a strength of biological explanations.

A possible biological sequence

Brain sex theory can be represented as:

1. Genes and prenatal hormones affect brain development.

2. Some sexually dimorphic structures develop atypically for the person’s assigned sex.

3. The person’s experienced gender corresponds more closely with this neural pattern.

4. Incongruence develops between experienced gender and external characteristics.

This is a proposed explanation, not a complete established sequence.

Evaluating brain sex theory

Strength: objective biological evidence

Brain structures can be measured using:

• Post-mortem investigation.

• Brain scanning.

• Anatomical comparison.

These methods produce quantitative biological data.

This may be viewed as more objective than relying entirely on self-report accounts of development.

Limitation: small and unusual samples

Post-mortem studies may contain very few transgender participants.

Small samples:

• Reduce generalisability.

• Increase the impact of unusual individuals.

• Make replication difficult.

The people whose brains are available for post-mortem research may not represent the wider transgender population.

Limitation: cause and effect

An association between a brain difference and gender incongruence does not establish causality.

Possible explanations include:

1. The brain difference contributes to gender incongruence.

2. Long-term experience affects the brain.

3. Hormonal treatment affects the structure.

4. Another biological variable causes both.

This is the direction-of-causality problem.

The 2023 examiner report noted that stronger answers used brain sex evidence as support and then questioned whether the dimorphic brain difference was a cause or consequence.

Limitation: hormone treatment as a confounding variable

Some participants in brain research may have received hormone treatment.

Hormones can affect the brain.

Researchers may therefore struggle to determine whether a difference:

• Existed before treatment.

• Resulted partly from treatment.

• Developed through a combination of factors.

A confounding variable makes a simple causal conclusion difficult.

Limitation: group averages do not diagnose individuals

Male and female brain measurements often overlap.

A structure described as larger “on average” in one sex does not allow every individual brain to be classified reliably.

It would therefore be inaccurate to claim that:

• There is one clearly male brain.

• There is one clearly female brain.

• A brain scan can prove a person’s gender identity.

Brain findings concern group-level associations, not a test of an individual’s identity.

Social and cultural explanations

The central social and cultural assumption

Social and cultural explanations propose that gender experience develops within a social world containing:

• Gender categories.

• Expectations.

• Models.

• Rewards and punishments.

• Language.

• Cultural meanings.

These explanations do not necessarily claim that someone consciously chooses gender incongruence.

Instead, they examine how people:

• Learn what gender categories mean.

• Compare themselves with those categories.

• Interpret their own traits and experiences.

• Find language for their identity.

• Decide whether and how to express it.

Important caution

Social and cultural factors may have stronger effects on:

• The recognition of gender incongruence.

• The language used to describe it.

• Whether someone discloses their identity.

• The distress associated with it.

• How safely the person can express their gender.

This does not prove that social exposure creates the underlying identity.

Gender schemas

Gender schema explanation

A gender schema is an organised mental framework containing information about gender.

Children learn cultural beliefs about:

• Appearance.

• Roles.

• Behaviour.

• Activities.

• Personality.

• Relationships.

They also develop a self-schema, containing beliefs about their own characteristics and identity.

Gender incongruence may become apparent when the person experiences a continuing inconsistency between:

• Their personal self-schema.

• The gender schema associated with their assigned gender.

The personal pathway

An older cognitive explanation accepted in AQA assessment material is sometimes described as a personal pathway within gender schema theory.

The proposed process is:

1. A child learns cultural categories of masculinity and femininity.

2. The child develops knowledge about their own traits, interests and experiences.

3. The child compares this self-knowledge with the available gender schemas.

4. Their personal characteristics may fit poorly with the schema associated with their assigned gender.

5. The child may identify more closely with another gender category.

The 2023 mark scheme recognised the personal pathway element of gender schema theory as a possible alternative to biological explanations.

A limitation of a simple schema explanation

Many people have traits that do not match gender stereotypes without experiencing gender incongruence.

For example:

• A boy may enjoy dolls while identifying as a boy.

• A girl may enjoy traditionally masculine activities while identifying as a girl.

• An adult may reject all traditional roles while retaining a binary identity.

Gender non-conformity alone cannot explain gender incongruence.

A schema explanation must focus on the person’s persistent internal experience rather than merely their interests.

Social learning explanation

Models

Children observe gender-related behaviour performed by:

• Parents.

• Siblings.

• Peers.

• Teachers.

• Media figures.

These people act as models.

A social learning explanation proposes that observed gender behaviour contributes to the child’s understanding of possible identities and roles.

Identification

A child may identify with a model they perceive as:

• Similar.

• Attractive.

• Successful.

• Admired.

• High status.

Identification may influence:

• Behaviour.

• Gender expression.

• Aspirations.

• Understanding of possible identities.

However, identifying with a model of another gender does not automatically produce gender incongruence.

Many children identify with a wide variety of models.

Reinforcement

Gender-consistent behaviour may receive:

• Praise.

• Approval.

• Acceptance.

• Social opportunities.

Gender-inconsistent behaviour may receive:

• Criticism.

• Teasing.

• Punishment.

• Rejection.

These consequences may shape whether the person expresses aspects of their gender openly.

For example:

A child who is repeatedly criticised for expressing another gender may conceal their feelings without the feelings disappearing.

Reinforcement may therefore influence expression more clearly than identity itself.

Vicarious learning

Children may observe what happens to other gender-diverse people.

If a gender-diverse model receives:

• Acceptance.

• Friendship.

• Success.

• Social support.

the observer may feel safer recognising or expressing a similar identity.

If the model experiences:

• Ridicule.

• Rejection.

• Violence.

• Exclusion.

the observer may conceal their experience.

Social learning can therefore help explain disclosure and expression.

Cultural explanations

Gender categories are culturally organised

Cultures differ in how they understand:

• Masculinity.

• Femininity.

• Gender roles.

• Gender diversity.

• Identities outside a binary system.

A culture provides the concepts people use to interpret their internal experiences.

A person cannot easily describe an identity when their society provides:

• No accepted terminology.

• No visible models.

• Strong punishment for gender diversity.

• Only rigid binary categories.

Culture and recognition

Greater cultural visibility may allow people to recognise their experience earlier.

For example, media or community information may provide:

• A term for the experience.

• Examples of other gender-diverse people.

• Evidence that the individual is not alone.

• Possible ways to express gender.

An increase in reported gender incongruence could therefore reflect:

• Greater recognition.

• Reduced stigma.

• Increased willingness to disclose.

• Improved access to support.

It does not necessarily show that cultural information caused the identity.

Culture and expression

Cultural norms influence how gender incongruence is expressed.

In one culture, a person may:

• Adopt a different name.

• Change clothing.

• Use different pronouns.

• Express their identity openly.

In another culture, the same person may conceal their identity because of the risk of social rejection.

The underlying experience and its public expression should not be treated as identical.

Culture and distress

Social and cultural explanations may be particularly useful for explaining dysphoria, meaning distress.

Distress may increase when the person experiences:

• Rejection by relatives.

• Bullying.

• Discrimination.

• Pressure to conceal their identity.

• Lack of access to supportive communities.

• Rigid expectations about gender roles.

Supportive environments may reduce distress through:

• Acceptance.

• Respectful language.

• Social belonging.

• Freedom of expression.

This does not necessarily remove the incongruence. It may change how distressing the experience becomes.

Media representation

Media can provide models of gender diversity.

These representations may:

• Increase awareness.

• Offer language for identity.

• Reduce isolation.

• Challenge rigid gender schemas.

• Influence social attitudes.

Media may also present inaccurate or stereotypical portrayals, increasing misunderstanding and stigma.

The wider role of media in transmitting gender expectations is explored in symbolic models and cultural representations.

Childhood experience explanations

Some older psychological accounts proposed that difficult childhood experiences or trauma might contribute to gender dysphoria.

Earlier AQA mark schemes accepted childhood trauma as a possible alternative explanation when evaluating biological accounts.

However, this explanation has substantial limitations:

• Evidence may be retrospective.

• People may recall childhood experiences inaccurately.

• Trauma and distress may be correlated without one causing the other.

• Discrimination related to gender diversity could itself produce trauma.

• The explanation may incorrectly pathologise a person’s identity.

A history of adversity does not demonstrate that adversity caused gender incongruence.

This proposal should therefore be treated cautiously rather than as an established social cause.

Applying social and cultural explanations

Consider the following scenario:

Rowan was assigned female at birth but has experienced a male gender since childhood. Rowan’s family strongly enforced traditional feminine roles and criticised masculine clothing. Rowan concealed his identity for several years. After seeing respected transgender men represented positively online, Rowan found language to describe his experience and disclosed it to supportive friends.

Gender schema explanation

• Rowan learned a rigid cultural schema concerning how girls were expected to behave.

• His personal experience did not fit the schema linked with his assigned gender.

• The mismatch may have made the incongruence especially noticeable.

Reinforcement

• Criticism of masculine clothing acted as punishment.

• This may have reduced open expression.

• It did not necessarily change Rowan’s experienced gender.

Cultural influence

• The family’s traditional expectations made expression difficult.

• A more supportive peer culture later allowed disclosure.

Media modelling

• Transgender men online provided visible models.

• The models gave Rowan concepts and language for understanding his experience.

• Their respected status may have reduced the expected social cost of disclosure.

Balanced conclusion

The scenario does not show that media caused Rowan’s gender incongruence.

The incongruence was experienced before the media exposure.

Media and culture influenced:

• Recognition.

• Language.

• Expression.

• Disclosure.

• Social support.

Comparing biological and social or cultural explanations

Biological explanations	Social and cultural explanations
Emphasise genes, hormones, receptors and the brain	Emphasise schemas, models, norms and social reactions
Mainly associated with nature	Mainly associated with nurture
Suggest a biological predisposition	Suggest gender is interpreted within a cultural system
Can explain early and persistent experiences	Can explain differences in expression and disclosure
Use twin, hormonal and brain evidence	Use cultural, developmental and social evidence
May become biologically deterministic	May become environmentally deterministic
Risk reducing identity to bodily mechanisms	Risk reducing identity to learning or stereotypes
Often struggle with direction of causality	Often struggle to separate identity from expression
Predict some biological similarities among people with incongruence	Predict variation according to cultural opportunities and meanings

Different questions may need different explanations

Biological explanations may be better suited to the question:

Why might gender incongruence develop or appear early?

Social and cultural explanations may be better suited to questions such as:

How does a person recognise and express gender incongruence?

or:

Why does gender incongruence produce different levels of distress in different environments?

The explanations may therefore operate at different levels rather than directly competing.

Evaluating biological explanations

Strength: evidence from several biological levels

Support comes from several types of investigation:

• Twin studies.

• Androgen receptor research.

• Prenatal hormone research.

• Brain structure studies.

Evidence from different biological levels provides converging evidence.

It suggests that biological factors may contribute even though no single factor explains every case.

Strength: early emergence

Some individuals report gender incongruence from early childhood.

Early and persistent experiences may be difficult to explain entirely through conscious decisions or later media exposure.

The presence of early gender dysphoria was recognised by AQA as possible support for biological explanations.

However, children are exposed to gender categories and expectations from birth, so early emergence does not eliminate social influence completely.

Strength: potential reduction of blame

A biological account may challenge the idea that gender incongruence is:

• A deliberate choice.

• A failure of character.

• Caused by poor behaviour.

• Something for which a person should be blamed.

Earlier AQA material recognised this as a possible positive ethical implication of biological explanations.

However, acceptance should not depend on proving that an identity has a biological cause.

Limitation: biological determinism

A strongly biological explanation may suggest that gender identity is completely fixed by genes or brain structures.

This is biological determinism.

It may underestimate:

• Personal meaning.

• Developmental change.

• Social context.

• Variation in how identity is expressed.

Biological influences may create predispositions without controlling every outcome.

Limitation: biological reductionism

Biological explanations may reduce gender incongruence to:

• A gene.

• A brain structure.

• A hormone.

• A receptor.

Gender identity is a complex psychological and social experience.

Reducing it to one bodily mechanism may lose important information about:

• Self-concept.

• Culture.

• Relationships.

• Language.

• Distress.

• Social acceptance.

Limitation: neural differences may be effects

Brain plasticity means that experience can alter neural structures and activity.

A brain difference could be:

• A cause of gender incongruence.

• An effect of long-term experience.

• An effect of hormones.

• The result of an interaction.

Biological evidence therefore does not automatically reveal causal direction.

Limitation: inconsistent evidence

Not all hormonal studies find meaningful differences.

Twin concordance is not complete.

Brain studies often contain small samples.

The evidence supports a possible biological contribution but does not demonstrate one universal biological cause.

Limitation: risk of medicalising identity

A biological explanation can encourage the view that gender diversity is a defect requiring correction.

This may:

• Pathologise variation.

• Treat people as biological abnormalities.

• Ignore social sources of distress.

• Suggest that identity requires scientific verification.

Research should investigate explanations without implying that gender diversity is inherently undesirable.

Evaluating social and cultural explanations

Strength: they explain social variation

Social and cultural accounts explain why people may differ in:

• The terms used for gender.

• Whether they disclose their identity.

• Which forms of expression are available.

• How others respond.

• The distress associated with incongruence.

These factors clearly vary between societies and historical periods.

Strength: they explain the role of stigma

A person’s distress may arise partly from how others respond.

Rejection, bullying and discrimination can create serious psychological consequences.

A social explanation therefore avoids locating every difficulty within the individual.

It recognises that the environment may need to change.

Strength: practical applications

Social explanations suggest practical ways to reduce distress:

• Challenge discrimination.

• Provide supportive environments.

• Increase access to accurate information.

• Use respectful language.

• Offer diverse role models.

• Reduce rigid gender expectations.

These applications do not require attempting to change the person’s identity.

Limitation: early experiences are difficult to explain through later models

Some individuals describe gender incongruence before encountering openly transgender models.

This challenges a simple imitation explanation.

A child cannot straightforwardly copy an identity they have never knowingly observed.

Social learning may explain expression and available behaviour more convincingly than the original experience of incongruence.

Limitation: models do not produce identical outcomes

Many people observe transgender or gender-diverse models without experiencing gender incongruence.

Similarly, many children:

• Play with cross-gender toys.

• Identify with other-gender characters.

• Reject stereotypes.

They still identify with the gender assigned at birth.

Observation and identification are therefore not sufficient explanations.

Limitation: correlation and direction of causality

A study might find that people experiencing gender incongruence report:

• Childhood adversity.

• Rejection.

• Gender-atypical play.

• Greater exposure to gender-diverse communities.

These findings do not establish causation.

For example:

• Rejection might increase distress.

• Distress might change recall of childhood.

• Gender incongruence might lead someone to seek relevant communities.

• Community exposure may not have caused the identity.

Limitation: cultural visibility may affect reporting

More people may report gender incongruence in a supportive society.

This could be interpreted incorrectly as evidence that the culture caused it.

An alternative explanation is that:

• Concealment decreased.

• Language became available.

• Access to support improved.

• People felt safer disclosing.

Reported prevalence and underlying prevalence are not necessarily the same.

Limitation: environmental determinism

A social explanation may become environmentally deterministic if it suggests identity is imposed by:

• Parents.

• Peers.

• Media.

• Cultural labels.

This underestimates the person’s internal experience and individual agency.

People exposed to similar environments can develop very different identities.

Limitation: environmental reductionism

Explaining gender incongruence only through modelling or reinforcement may be environmentally reductionist.

The approach may overlook:

• Prenatal development.

• Genetic influences.

• Hormone sensitivity.

• Brain development.

• Individual cognition.

Social learning concepts are useful but may not capture the full complexity of identity.

Nature and nurture

Biological explanations emphasise nature.

Social and cultural explanations emphasise nurture.

The nature-nurture debate asks whether behaviour is primarily influenced by:

• Heredity and biology.

• Environment and experience.

Gender incongruence is unlikely to be explained adequately by either extreme.

Interactionist explanation

An interactionist explanation proposes that biological and environmental influences work together.

A possible sequence is:

1. Genetic and prenatal factors contribute to a biological predisposition.

2. The person develops an internal gender experience.

3. Culture provides gender categories and language.

4. Schemas help the person interpret the experience.

5. Social reactions influence whether it is expressed openly.

6. Acceptance or rejection affects distress.

7. The person continues constructing their identity through experience.

This account recognises that:

• Biology may contribute to the original predisposition.

• Culture shapes its meaning and expression.

• Social support affects psychological wellbeing.

Expression is not the same as origin

A crucial distinction is:

• Origin: why the person experiences gender incongruence.

• Expression: how the person presents or communicates it.

• Distress: how uncomfortable or harmful the experience becomes.

Biological explanations mainly address origin.

Social and cultural explanations may be particularly effective at explaining expression and distress.

Methodological issues

Reliance on small samples

Gender incongruence has often been investigated using relatively small or specialised samples.

Small samples can:

• Reduce generalisability.

• Make unusual cases influential.

• Prevent meaningful subgroup comparisons.

• Produce findings that are difficult to replicate.

Self-report evidence

Researchers may ask participants to recall:

• Early gender experiences.

• Childhood play.

• Family reactions.

• Onset of incongruence.

Retrospective self-reports may be affected by:

• Forgetting.

• Reconstruction.

• Current beliefs.

• Social desirability.

• The wish to provide a coherent life story.

Correlational evidence

Researchers cannot ethically manipulate:

• Gender identity.

• Prenatal hormone exposure.

• Family rejection.

• Brain development.

Much research is therefore correlational or based on naturally occurring groups.

This limits causal conclusions.

Confounding variables

People experiencing gender incongruence may differ in:

• Hormone treatment.

• Age.

• Mental health.

• Social support.

• Exposure to discrimination.

• Cultural background.

These variables can affect psychological and biological measurements.

Heterogeneity

Heterogeneity means diversity within a group.

People experiencing gender incongruence differ in:

• Identity.

• Age of recognition.

• Expression.

• Physical transition.

• Social transition.

• Distress.

• Cultural background.

A single explanation may not fit every person.

Social sensitivity

Research into gender incongruence is socially sensitive because findings may affect:

• Public attitudes.

• Healthcare.

• Education.

• Families.

• Legal decisions.

• The treatment of gender-diverse people.

Risks of biological research

Biological findings could be misused to:

• Demand a biological test of identity.

• Classify some identities as more valid than others.

• Suggest a biological defect.

• Promote attempts to prevent gender diversity.

Risks of social explanations

Social explanations could be misused to claim that gender incongruence is:

• Caused by parents.

• Produced by media.

• A fashionable imitation.

• Something that can be removed through punishment.

These conclusions are not justified merely because social factors affect expression.

Responsible interpretation

Psychologists should:

• Avoid presenting one explanation as proven.

• Separate identity from distress.

• Avoid blaming individuals or families.

• Recognise individual differences.

• Use respectful terminology.

• Explain methodological limitations.

• Consider the consequences of reporting findings.

Overall comparison

Biological explanations are strongest when:

• Gender incongruence appears early.

• Twin concordance suggests inheritance.

• Hormone or receptor differences are found.

• Brain characteristics correspond with experienced gender.

Social and cultural explanations are strongest when explaining:

• The gender categories available.

• Recognition and disclosure.

• Differences in public expression.

• Cultural variation in identity terms.

• The effect of acceptance or rejection on distress.

Neither explanation is complete

Biological accounts do not fully explain:

• Cultural variation.

• Social expression.

• Differences in distress.

Social accounts do not fully explain:

• Early persistent incongruence.

• Why only some individuals are affected.

• Biological associations.

An interactionist approach is therefore more complete.

Applying both explanations

Consider this scenario:

Ellis was assigned male at birth but has experienced a female gender since early childhood. Ellis recalls this experience beginning before knowing any openly transgender people. As an adolescent, Ellis found positive transgender role models online and began discussing her identity. Her family’s acceptance reduced her distress considerably.

Biological explanation

• Early emergence before visible models is consistent with a biological predisposition.

• Genetic, hormonal or neural development may contribute to Ellis’s experienced gender.

• The evidence does not identify which biological mechanism is involved.

Social and cultural explanation

• Online models gave Ellis language and examples through which to interpret her experience.

• The models did not necessarily create the gender incongruence.

• Family support reduced distress and allowed open expression.

• Culture influenced recognition, disclosure and wellbeing.

Interactionist conclusion

Ellis’s experience may have a biological component, while social context affects:

• How she understands it.

• Whether she expresses it.

• How distressing it becomes.

Hints from the Examiner Reports 💡

The current specification uses gender incongruence, whereas the direct examiner guidance available relates to the previous term gender dysphoria.

Examiner hint: Give a complete definition. In 2023, most students identified a difference between assigned and experienced gender, but fewer gained the second mark by explaining the discomfort associated with dysphoria.

For the revised course, remember:

• Incongruence means a difference.

• Dysphoria means distress that may accompany the difference.

Examiner hint: Use identifiable biological evidence. High-scoring students in 2023 often used brain sex theory rather than making general statements such as “it is caused by hormones”.

Examiner hint: Develop a counterargument. Strong answers used evidence concerning a dimorphic brain area and then questioned whether the brain difference was a cause or consequence of gender dysphoria.

Examiner hint: A strength and a limitation must be separate, developed points. Do not provide two descriptions of biological research without explaining what one supports and what the other challenges.

Examiner hint: Avoid anecdotal claims such as:

“People become transgender because they see it online.”

This does not distinguish recognition and expression from the origin of identity.

Examiner hint: Keep evidence and explanation connected. State:

1. The factor studied.

2. The finding.

3. Which explanation it supports.

4. Why the conclusion is limited.

Examiner hint: Use causality carefully. Twin, brain and social research often shows associations rather than definitive causes.

Examiner hint: Compare explanations directly. Use phrases such as:

• “Whereas biological explanations focus on…”

• “In contrast, cultural explanations account for…”

• “Both explanations are limited because…”

Examiner hint: Use respectful and current terminology. Do not assume that every person experiencing gender incongruence is distressed or wishes to follow the same pathway.

Common Mistakes ⚠️

Mistake: Treating gender incongruence and gender dysphoria as synonyms

Why this is incorrect:

Incongruence describes a difference between assigned and experienced gender. Dysphoria describes distress that may accompany it.

How to improve:

Mention distress only when defining dysphoria or when the scenario describes discomfort.

Mistake: Saying all transgender people experience severe distress

Why this is incorrect:

Experiences vary, and social support may affect the level of distress.

How to improve:

Use phrases such as “may experience” rather than making universal claims.

Mistake: Defining gender incongruence as gender non-conformity

Why this is incorrect:

Interests, clothing or behaviour that challenge stereotypes do not establish that experienced gender differs from assigned gender.

How to improve:

Focus on internal identity rather than roles or hobbies.

Mistake: Confusing gender identity with sexual orientation

Why this is incorrect:

Identity concerns a person’s gender. Orientation concerns attraction.

How to improve:

Keep the two concepts separate.

Mistake: Claiming that one gene causes gender incongruence

Why this is incorrect:

Genetic evidence suggests a possible predisposition rather than one deterministic gene.

How to improve:

Refer to multiple interacting biological factors.

Mistake: Saying twin evidence proves a genetic cause

Why this is incorrect:

Monozygotic twins also tend to experience more similar environments.

How to improve:

Discuss shared environmental influences and incomplete concordance.

Mistake: Claiming a brain difference must be the cause

Why this is incorrect:

The brain may be affected by experience or hormone treatment.

How to improve:

Explain the direction-of-causality problem.

Mistake: Treating male and female brains as completely separate types

Why this is incorrect:

Brain measurements are group averages with substantial individual overlap.

How to improve:

Use “more similar to the average pattern” rather than “a female brain” as an absolute category.

Mistake: Saying hormone levels alone determine identity

Why this is incorrect:

Timing, receptors, brain development and social experience may all matter.

How to improve:

Explain the biological pathway and use cautious language.

Mistake: Saying gender-diverse role models cause gender incongruence

Why this is incorrect:

Role models may provide language, recognition and confidence without creating the underlying identity.

How to improve:

Distinguish origin from recognition and expression.

Mistake: Assuming punishment removes gender incongruence

Why this is incorrect:

Punishment may suppress outward expression while increasing distress.

How to improve:

Separate internal experience from publicly displayed behaviour.

Mistake: Using gender-atypical toys as proof

Why this is incorrect:

Many children enjoy activities associated with another gender without experiencing incongruence.

How to improve:

Look for a persistent difference in experienced gender.

Mistake: Claiming an increase in reports proves a cultural cause

Why this is incorrect:

Increased visibility and safety may allow more people to disclose an existing experience.

How to improve:

Distinguish reported prevalence from underlying prevalence.

Mistake: Giving two separate descriptions instead of a comparison

Why this is incorrect:

A compare question requires explicit similarities and differences.

How to improve:

Compare the explanations by level, mechanism, evidence, predictions and limitations.

Exam-Style Questions ✍️

Questions

1. What is meant by gender incongruence?[2 marks]

2. Explain one difference between gender incongruence and gender dysphoria.[3 marks]

3. Outline one genetic explanation of gender incongruence.[4 marks]

4. Explain brain sex theory as an explanation of gender incongruence.[4 marks]

5. A researcher finds that monozygotic twins have a higher concordance rate for gender incongruence than dizygotic twins.

Explain one conclusion and one limitation of this finding.[4 marks]

6. Avery was assigned male at birth but has experienced a female gender since early childhood. Avery concealed her identity because relatives criticised behaviour they viewed as feminine. After seeing positively represented transgender women online, Avery found language for her experience and disclosed it to supportive friends.

Explain Avery’s experience using social and cultural explanations.[6 marks]

7. Explain why evidence of different brain structures cannot establish that brain differences cause gender incongruence.[4 marks]

8. Compare biological and social or cultural explanations of gender incongruence.[6 marks]

9. Outline one strength and one limitation of biological explanations of gender incongruence.[6 marks]

10. Outline one strength and one limitation of social or cultural explanations of gender incongruence.[6 marks]

11. Discuss biological and social or cultural explanations of gender incongruence.[16 marks]

Answers and Mark Scheme

Question 1

Award up to two marks:

• Gender incongruence is a difference or inconsistency between a person’s experienced gender and the gender assigned at birth.

• The person’s internal gender identity does not correspond with the assigned category.

Distress is not required for both marks.

Question 2

Award up to three marks:

• Gender incongruence describes a difference between assigned and experienced gender.

• Gender dysphoria describes significant discomfort or distress that may accompany the difference.

• A person can experience incongruence without experiencing the same degree of dysphoria as another person.

Question 3

Award up to four marks:

• Genetic differences may create a predisposition towards gender incongruence.

• Twin studies compare monozygotic and dizygotic concordance.

• Higher concordance among monozygotic twins is consistent with genetic influence.

• Concordance below 100% suggests that genes are not the only influence.

• A complete account is likely to involve several genes interacting with other factors.

Question 4

Award up to four marks:

• Brain sex theory proposes that aspects of neural development may correspond more closely with experienced gender than assigned sex.

• Some brain structures are sexually dimorphic.

• The BSTc has been studied in relation to gender incongruence.

• Research has found that the BSTc pattern of some transgender women was closer to the typical female pattern.

• This could create incongruence between external sexual development and gender-related brain development.

Question 5

Award up to four marks:

• Higher monozygotic concordance is consistent with a genetic contribution.

• Monozygotic twins share more genetic material than dizygotic twins.

• The finding does not establish a purely genetic cause.

• Monozygotic twins may also experience more similar treatment and environments.

• Incomplete concordance would show that other influences are involved.

Question 6

Award up to six marks:

• Avery’s family communicated cultural expectations about masculine behaviour.

• Criticism of feminine behaviour acted as punishment.

• The punishment may have suppressed Avery’s expression without changing her experienced gender.

• Online transgender women provided visible symbolic models.

• The models gave Avery language and concepts for understanding her experience.

• Positive representation may have provided vicarious reinforcement or reduced the expected cost of disclosure.

• Supportive friends created a more accepting social context.

• These influences explain recognition, expression and distress more clearly than the original early experience.

Question 7

Award up to four marks:

• Research showing a brain difference is often correlational.

• The difference may have existed before gender incongruence and contributed to it.

• Alternatively, long-term experience or hormone treatment may have changed the brain.

• Another variable may cause both the neural difference and the incongruence.

• The direction of causality is therefore uncertain.

Question 8

Award up to six marks for direct comparison.

Possible content:

• Biological explanations focus on genes, hormones, receptors and neural structures.

• Social and cultural explanations focus on schemas, models, norms and social reactions.

• Biological explanations mainly emphasise nature, whereas social explanations emphasise nurture.

• Biological accounts may explain early and persistent experiences.

• Social accounts may explain recognition, expression and differing levels of distress.

• Both may become deterministic or reductionist.

• Both rely heavily on correlational or naturally occurring evidence.

• Biological evidence may confuse cause and effect.

• Social evidence may confuse visibility with causation.

• An interactionist approach combines biological predisposition with cultural interpretation and social response.

Higher marks require linked comparisons rather than two independent descriptions.

Question 9

Award up to three marks for a developed strength and three for a developed limitation.

Possible strength:

Evidence from twin studies, androgen receptor research and brain studies provides converging support for a biological contribution. Findings involving the BSTc are consistent with neural development corresponding more closely with experienced gender.

Possible limitation:

Brain evidence cannot establish causal direction. Neural differences might result from experience or hormone treatment rather than causing gender incongruence.

Alternative creditworthy limitations include:

• Small samples.

• Incomplete twin concordance.

• Shared environmental influences.

• Inconsistent hormone findings.

• Biological reductionism.

• Biological determinism.

• Risk of medicalising identity.

Question 10

Award up to three marks for a developed strength and three for a developed limitation.

Possible strength:

Social and cultural explanations account for differences in expression and distress. Rejection may increase distress, whereas supportive environments can allow disclosure and improve wellbeing.

Possible limitation:

Many people encounter gender-diverse models without experiencing gender incongruence. Modelling may explain recognition and expression more successfully than the origin of the person’s identity.

Alternative creditworthy limitations include:

• Correlational evidence.

• Retrospective childhood reports.

• Environmental determinism.

• Gender non-conformity does not equal incongruence.

• Greater reporting may reflect reduced stigma.

• Social explanations may blame parents or media unfairly.

Question 11

A strong response should include:

Knowledge and understanding

• Definition of gender incongruence.

• Difference from gender dysphoria.

• Assigned and experienced gender.

• Genetic predisposition.

• Twin concordance evidence.

• Prenatal hormone exposure.

• Androgen receptors.

• Brain sex theory.

• Sexually dimorphic brain structures.

• The BSTc.

• Gender schemas and self-schemas.

• The personal pathway.

• Modelling and identification.

• Reinforcement and punishment.

• Cultural norms and available gender categories.

• Media visibility.

• Social acceptance, stigma and distress.

Evaluation

• Support from twin studies.

• Support from androgen receptor research.

• Brain structure evidence.

• Converging evidence from several biological levels.

• Shared environment in twin studies.

• Small biological samples.

• Hormone treatment as a confounding variable.

• Direction of causality in brain research.

• Inconsistent hormone findings.

• Biological reductionism and determinism.

• Biological accounts may reduce blame but risk medicalisation.

• Social explanations account for recognition, expression and distress.

• Role models do not necessarily cause identity.

• Gender non-conformity is not the same as incongruence.

• Retrospective and correlational evidence.

• Greater visibility may increase reporting rather than incidence.

• Environmental reductionism and determinism.

• Socially sensitive consequences of both explanations.

• The value of an interactionist account.

Higher-level responses will keep gender incongruence distinct from dysphoria, compare the explanations directly and recognise that biological factors may contribute to origin while social and cultural factors strongly influence interpretation, expression and distress.

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