Prenatal Hormones and Postnatal Socialization by Parents as Determinants of Male-Typical Toy Play in Girls With Congenital Adrenal Hyperplasia


  • Vickie L. Pasterski is now at the University of Georgia. Mitchell E. Geffner is now at the Childrens Hospital Los Angeles.

  • We thank all of the families in Los Angeles and London whose participation made this study possible. We also thank Leah Charmandari for referring patients to this study as well as those involved in the CAH Support Group in the United Kingdom for their time and efforts. Richard Green provided useful comments on a prior version of the manuscript, for which we are grateful. The study was supported by U.S. Public Health Service Grant HD24542 to Melissa Hines, and by funds from City University. Some of the data were submitted by Vickie Pasterski as part of the requirements for the Ph.D. at City University. Vickie Pasterski was also supported in part by USPHS Grant T32 MH18264 (“Research Training in the Psychobiological Sciences,” Codirectors Michael M. Myers and Myron A. Hofer) while with the Department of Psychiatry at Columbia University during the writing of this research report.

concerning this article should be addressed to Vickie Pasterski, Department of Psychology, University of Georgia, 228 Psychology Building, Athens, GA 30602. Electronic mail may be sent to


Toy choices of 3- to 10-year-old children with congenital adrenal hyperplasia (CAH) and of their unaffected siblings were assessed. Also assessed was parental encouragement of sex-typed toy play. Girls with CAH displayed more male-typical toy choices than did their unaffected sisters, whereas boys with and without CAH did not differ. Mothers and fathers encouraged sex-typical toy play in children with and without CAH. However, girls with CAH received more positive feedback for play with girls' toys than did unaffected girls. Data show that increased male-typical toy play by girls with CAH cannot be explained by parental encouragement of male-typical toy play. Although parents encourage sex-appropriate behavior, their encouragement appears to be insufficient to override the interest of girls with CAH in cross-sexed toys.