Individuals who self-identify as bisexual may be attracted to male and female partners concurrently or at different points during adult life, or may partner with members of both sexes, but with vastly different relationship styles. Recent work in the field of bisexuality has attempted to further refine discussion regarding this sexual orientation. Our gender schema is based on the premise that, like sexual orientation, gender identity is also best understood as a continuum. Furthermore, as with the phenomenon of bisexuality on the Kinsey scale, individuals who consider themselves as being neither fully male nor fully female may describe themselves with a variety of distinct identifications. This gender schema is presented in Table 1 and described below.
Gender identification is scaled along a continuum with nine labeled definitional points.
In addition, a person who feels or acts as both a woman and a man may identify as bi-gendered. The utility of the individually-based gender continuum in clinical practice can be illustrated with the following cases. Both are involved in long-term sexual relationships, one with a woman and one with a man. The commonalities in their stories of adolescence and young adulthood suggest a similar process at work, but leading to different adult outcomes and subsequent medical needs. These three participants reported a sense of conflict arising early in life, resulting from varying degrees of gender dissonance.