Objectives. This study explored the disruption of gender identity and gender role as a result a traumatic brain injury (TBI).

Method. Four adults (two men, two women) who sustained a TBI between the ages of 18 and 30 years and were at least 1 year postinjury participated in six 1-hr interviews concerning changes in (a) perceived masculinity or femininity, (b) involvement in intimate relationships, (c) enactment of gender roles, and (d) organization of activities that support gender roles.

Results. The men expressed greater feelings of gender inadequacy postinjury than did the women and appeared to have greater difficulty resolving rites of passage (e.g., achievement of the adult work role, marriage, parenting) and developmental issues characteristic of the life stage at which they experienced their injury. The men appeared to depend more heavily on traditional gender-specific activities before and after injury to define and support gender role; the women relied more on cross-gender activities. The women appeared to be able to maintain more preinjury activities postinjury than did the men.

Conclusion. Postinjury possession of a personally satisfying sense of gender appears to be related to the ability to maintain much of the preinjury activities that defined and supported the participants’ sense of masculinity or femininity. The ability to satisfactorily resolve rites of passage or developmental issues characteristic of the life stage at which the brain injury occurred appears to be related to the ability to participate in activities that define and express gender role during that particular life stage.

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