Gynecomastia in Adolescence: Effect on Body Image and Personality Adaptation

Abstract

The effect of gynecomastia on personality development was evaluated in 284 boys and men with onset in 88% during adolescence. Pubertal breast nodes or pectoral obesity usually created no adverse adaptations. Some adolescents used the physical defect to rationalize underlying psychopathology or social ineptness. When the breasts were pendulous, epitomizing femininity, the body-image was disturbed. The greater the insecurity and concern over sexual adequacy the more intense were the reactions and compensatory adaptations. Although gynecomastia did not give rise to specific personality responses, it did create anxiety as to the individual's masculine adequacy. The adolescent reacted in a variety of ways--some accepted “feminine” roles, others strove to prove their adequacy as males, a few accepted overt homosexuality, while others manifested a variety of defenses and psychosomatic symptoms. Patients with pendulous breasts required both reconstructive surgery and psychotherapy before and after the mastectomy.