Several studies have shown that compared to their unaffected sisters, girls with CAH tend to prefer more male-typical toy choices, such as construction and transportation toys, and more male-typical play behavior, such as rough outdoor play.(93, 94) Meyer-Bahlburg et al (2004) demonstrated that CAH girls age 5-12 years have masculinization of gender-related behavior, but no gender identity issues.(95) Adult women with CAH have also been demonstrated to have masculinized behavior, being most pronounced in SW-CAH, slight but demonstrable in SV-CAH, and questionable in NC-CAH. For the majority of the adult women with CAH, gender identity was clearly female; however, gender dysphoria was identified in 3 out of 42 women with SW-CAH.(96) Long et al (2004) also demonstrated that CAH girls preferred male-typical toys and male playmates, but found that masculinity decreased across developmental stages, such that by adulthood, there was no significant difference in masculinity between controls and women with CAH.(97)

Male predominance of left-handedness has been attributed to early androgen exposure. In support of this theory, girls with CAH have been found to be more left-handed biased than their unaffected sisters.(98) There is also some evidence that CAH women have a post-pubertal spatial advantage.(99)

In both children and adults, psychological adjustment does not appear to be compromised in females with virilized genitalia who are treated early in life and reared as females.(100) However, there are reports of less satisfaction with sexual function in women with classical CAH, particularly in those with the salt-wasting form.(94, 101-103)