Don’t Shoot the Messenger

♫♫Did Galileo pray?♫♫  – Ellis Paul

I’ve received a number of emails from a number of folks who have read and understood the implications of the science that I report on here, many of whom thanked me for writing about it in such a way as to allow it to be accessible and understandable.  To them, I’m glad you found the material of use.

On the other hand, nearly everyone one of them also reported that they had noticed that when discussing the science, they find that many disagree with the theory, and often deny that the phenomena that led to it even exists!  I will never be able to reach outright denialists.  If one does not even acknowledge that there are male  individuals who are autogynephilic, then one can’t begin to consider a theory of how that leads to gender dysphoria and transsexuality, and even less to the observation that exclusively androphilic MTF transwomen do not experience autogynephilia!  But, I do think it would be instructive to catalog, deconstruct, and respond to many of the objections to the two type theory.

{NOTE:  If you are coming into the middle of this and are not familiar with the two type theory please start with my FAQ}

The most common objection that I have heard is that “everyone” has rejected this theory.  Of course, by “everyone”, when queried, turns out to be most MTF transwomen on their discussion board.  This is the weakest argument one could imagine.  Consider that when Nikolai Kopernik (Nickolaus Copernicus in Latin) first proposed the heliocentric model of what we now call the “solar system”, and when Galileo Galilei’s observations supported it, it was vehemently rejected since “everyone” knew that the Earth was the center of the universe.  Truth by Popularity is  a common logical fallacy.

One commenter on a Reddit discussion had the temerity to pronounce that the scientific community and examined the theory and shown it to be wrong.  Fortunately, a very world wise woman answered simply, “Liar!”.  The scientific community that has any interest in the field has been steadily testing and showing that the data supports the theory and has been suggesting further studies to test Blanchard’s prediction concerning brain morphology.  {See my essays on Brain Sex}  Lying about the science isn’t considered a valid debating tactic.

Another common gambit is to say that their own personal story, their narrative, proves the theory is wrong.  Sorry, but sexology scientists aren’t terribly interested in what individual people’s narratives are, but what they, collectively, actually do.  Fans of the TV show “House” will recognize the eponymous character’s favorite catch phrase, “Everyone lies.”  Science depends on data; the plural of anecdote is not data.  The data clearly shows that the majority of non-exclusively androphilic MTF transwomen readily admit to having experienced autogynephilia while the majority of (self-reported) exclusively androphilic do not.  {See my essay on Social Desirability Bias for further info on unreliability of individual narratives}

Another tactic I’ve seen is to call into question the character and motivations of those who are doing the research or those that are writing about the science.  {See Alice Dreger’s research into the disgraceful persecution of Prof. J. Michael Bailey}  This is a combination of the ad hominem attack and the Genetic Fallacy, wherein one attempts to refute an augment based on who supports it.  Sorry, but shooting the messenger won’t change the reality underneath the science.  Once a hypothesis is known to the scientific community, the proposer is given credit for having done so, but after that, s/he no longer “owns” it.  Anyone can attempt to refute it, test it, and even modify it to fit reality.  That is exactly what has been happening the past three decades.  The Kurt Freund/ Ray Blanchard two type hypothesis has met every test that has been conducted to date.  {See my essays on supporting the Two Type Hypothesis}

An odd comment made on one of the Wikipedia pages regarding the theory made much of the language that Blanchard used in describing the process by which a scientist makes observations of a phenomena, makes a hypothesis, and then submits it to tests, perhaps by themselves, but certainly by others, and how that develops into a theory.  But the commenter deliberately distorted Blanchard’s acknowledgement that in science, ALL hypothesis and even theories are considered tentative, subject to ongoing tests and modifications, and even outright replacement, if found wrong, as somehow evidence that Blanchard was backing away from the theory, as though he may no longer support it.  Nothing could be further from the truth.  He believes that the theory is solid.  However, this is actually another example of the Genetic Fallacy, one arguing (if wrongly in this case) that the originator no longer supports the argument’s premise.  Again, once a hypothesis is proposed, no one “owns” it.

The most amazing argument that I’ve heard tell is that the theory is “pseudo-science”.  Most of those that utter this do not actually have a clear idea how to define what is and is not good science much less what would constitute “pseudo-science”.  But for the reader that wants to seriously consider this question, I strongly recommend the Wikipedia entry on the subject.  In it not only will one read what philosophers have suggested as solutions to the “demarcation problem”, one will also read the observation that many times when this accusation is made, it is groundless and motivated by a desire to devalue real science that is unacceptable to the accuser.  This clearly applied here as many who would be recognized as fitting the typical profile for autogynephilic transsexuality vehemently deny both being autogynephilic and the theory that describes how it operates to motivate non-exclusively androphilic males to seek somatic feminization.  However, the accusation can and should be directly refuted.

The most popular marker cited to argue that the Freund/Blanchard two type theory is “pseudo-science” is Karl Popper’s test that valid scientific hypothesis should be refutable.  Popper pointed out that Sigmund Freud’s theories of mind couldn’t be refuted because by definition his subconscious mind’s parts could never be directly accessed.  But the Freund/Blanchard hypotheses are based on directly observable phenomena, namely sexual arousal behavior.  Autogynephilia, gynephilia, androphilia, etc. are all observable sexual arousal patterns that may be observed both internally, and externally.  We can refute the theory (in theory) by simply finding that it isn’t true that most non-exclusively androphilic MTF transwomen experience autogynephila and/or that exclusively androphilic transwomen do experience autogynephilia.  This has been tested by a number of investigators and found to support the hypothesis.  But even if these investigators had not found support for the hypothesis, the mere fact that they can attempt to refute it puts the lie to the accusation of it being pseudo-science.

Addendum 6/4/2013:

I find it interesting to learn that researchers and educators in other fields have had similar experiences.  You may wish to read a wonderful blog entry by another scientist and educator, Steven Novella M.D., “Science by Intimidation“

What is a Transsexual?

♫♫She Blinded Me with…  Science…♫♫

In this entry, I’m going to try, real, hard, to explain the science behind what I’ve been writing about here for the past three and some years.  I’m going to try to break it down, telling the story of how it all works… and answer the various questions of the two type taxonomy doubters.

The story begins some years ago, when medical and psychology researchers tried to make sense of those individuals who were requesting ‘sex changes’.  They kept getting confused because the Male-To-Female transsexuals didn’t seem to have just one clinical presentation, one life story.  So, some of them tried to create profiles and categories, usually trying to squeeze them all into a familiar theoretical framework.  A few people found several “types”, some found only two.  But why?  Shouldn’t there be only one?  Some decided that one of the types was a “true” transsexual, and the others a “pseudo” transsexual, or there was one “primary” and the others “secondary”.  Others found two, but called one type “early onset” and another “late onset”, almost as though there were only one type, but with two different symptomology patterns.

For more information see my essay on this early confusion.

But what was the meaning of this?  Many researchers agreed that one set was strictly homosexual with respect to their natal sex, transitioned very young, was feminine since childhood, and the other group had fetishistic transvestism and transitioned later in life.  Thus was born the hypothesis that was first fully articulated and tested by Kurt Freund, that MTF transsexuals always present with one of two unusual sexual interests, “homosexuality” or “femmiphilic fetishism”.  His concept of “femmiphilic fetishism” was that transsexuals “fetishized” both wearing female clothing and other aspects of simulating being like a woman.  He conducted a study in which he divided the MTF transwomen into two groups based on a questionnaire that statistically separated them into mostly heterosexual and mostly homosexual.  Then asked the BIG question, “Do you find wearing women’s clothing sexually arousing?”  He got a very strong statistical signal that said, yes, the mostly heterosexual group was far more likely to be sexually aroused by wearing women’s clothing than the mostly homosexual group.  This was the state of affairs in the late ’70s.

Enter a very bright and personable younger protegee of Kurt Freund’s, Ray Blanchard.  Starting with Freund’s basic hypothesis, he tested a further hypothesis using a modification to Freund’s questionnaire that placed androphilia on one axis and gynephilia on another axis, rather than as polar opposites along a single line.  This allows one to separate the asexual and bisexual individuals from the strongly heterosexual and homosexual, following up on a hunch that Freund’s method tended to lump half the asexual and bisexual individuals into each of the two other groups.  Thinking about it ahead of time, there is no reason to believe that bisexuals or asexuals would be more or less likely to be sexually aroused by wearing women’s clothing, cross-dressing.  But Blanchard had been talking to a number of candidates for surgery and noted that some who reported that they were not sexually aroused by cross-dressing were aroused by imagining themselves to be female.  So he asked about this same behavior of those who did report sexual arousal to cross-dressing and found that it was universal.  Freund was right, but it wasn’t simple fetishism… but something else… for which Blanchard coined the term “autogynephilia”.  In talking to individuals who were, using this new term, autogynephilic, he developed a new hypothesis, that if a male was gender dysphoric and not exclusively “homosexual” with respect to natal sex, then that individual would be autogynephilic.  This sounds like it is the same as Freund’s, and in a way it is, but it expands it slightly because it predicts that asexual and bisexual MTF transwomen would be autogynephilic.  Interestingly, he found that it  was true.  The data supported this hypothesis.

Having outlined the basic hypothesis, lets describe the two types of MTF transwomen.  If we take these differences between the two groups, and the similarities within each group, we can create a description of the “prototypical” member of each.  While no one individual will conform to the prototype in all respects, it still has explanatory value to describe each.

The prototypical feminine androphilic (“homosexual”) transsexual was called a “sissy” by her peers growing up.  She avoided rough & tumble activities.  Her primary social circle consisted of one or two girls.  She actively participated in girls games and imaginary play.  Her parents were embarrassed by her femininity, and may or may not have sought professional help in trying to discourage her behavior.  As a young teen, she became interested in girls fashion and make-up, often exploring how she might look as a girl by dressing up and experimenting with make-up, with occasional trips out shopping or hanging out with her friends.  This did not, of course, involve erotic cross-dressing.  She had crushes on boys at school.  Her peers thought she might be homosexual.  She was hassled, perhaps even bullied, by homophobic boys, but otherwise was reasonably popular in her chosen circle.  She was considered very neat and well dressed in boy’s clothes.  She sought out opportunities to interact with small children and infants, taking on babysitting jobs.  As she approached adulthood, looking at her own nature, her potential future, both romantic and economic, made a rational decision to transition to living as a girl so as to grow up to be a woman socially.  Her family may or may not have disowned her in late adolescence.  As she is naturally feminine and passes quite well, she found that she was socially and romantically more successful as a woman.  She actively dated men while pre-op, but assiduously avoided direct contact with her penis, finding that emotionally uncomfortable.  Being young and lacking capital, she lived several years as a woman, taking feminizing hormones, before having SRS to improve her sex life, replacing genitalia that she didn’t use with those that she did.  She may or may not have found a husband and adopted children.

The prototypical autogynephilic transsexual was accepted as a boy as a child.  She was often a “loner”, finding her hobbies and reading to be more rewarding, but still willing and ready to participate in rough & tumble play.  She often envied girls and observed them more often than most masculine boys.  As she entered puberty, she began erotic cross-dressing in private, often masturbating while dressed, usually with lingerie.  She found this shameful and hid her cross-dressing as best she could.  She entertained thoughts of living as a woman, often in very idealized situations.  As a young adult, she dated women, often finding it necessary to imagine that she was female to “perform”.  She typically hid this fact from her dates.  In an effort to deny her autogynephilic desire for femininity, she may have chosen to pursue a stereotypically masculine, or even hyper-masculine, career such as the military.  She fell in love and found that the previously growing desire to live as a woman abated for a while.  She married and had children.  Her need to cross-dress and use autogynephilic ideation then grew, as the first blush of their romance matured into committed love.  She agonized about it obsessively, trying alternatively to push it out of her thoughts and trying to appease it by cross-dressing.  She chose to dress and groom herself in stereotypically and unmistakably masculine fashion, with perhaps even a full beard.  At one point, perhaps in her early 30s, or in her late 50s, a set-back or other significant personal change brought all of these feelings to the fore… and she made the fateful decision that she could no longer ignore her sexuality.  After having tried to ignore the cognitive dissonance between her successful social identity as a man, husband, and father, and her obligatory autogynephilic image of being female, concluded that the female image is her “true” image.  She then made steps to begin counseling with a gender therapist, obtained prescription for feminizing hormones, began electrolysis and other procedures to effect a more feminine appearance, and then began the painful steps to living full time socially as a “transsexual”, since she didn’t pass very well and had too many social connections who know of her previous status as a man to be truly stealth.  She had SRS within a short time of nominally living as a woman, as she was impatient, feeling like she had waited long enough in her previous life as a man.  Her wife may or may not have demanded a divorce.

From here on in, rather than try to keep to a linear timeline, a history of the science, it may be more instructive to ignore the actual history and imagine a group of scientists who support the theory and a group of doubters, who like the disclaimer in the movies, are all fictional and any resemblance to any person, living or dead, is purely coincidental.  These groups may interact and have a dialog, along the way to discovering and testing the hypothesis and theory so far presented, and perhaps discover more detail and corollaries.

Every new discovery should have a new theory to explain why it works that way.  So Freund and Blanchard searched for one.  The theory that resulted is that autogynephilia is part of a set of phenomena, that when grouped together, is called Erotic Target Location Error (ETLE).  This lumps autogynephilia in with autopedophilia and pedovestism, sexual arousal at the thought of being a child and dressing like a child respectively, known in the ‘scene’ as “age play”.  It also lumps autogynephilia with amputation “wannabees” and “pretenders”, people who are sexually aroused by the thought of being or becoming an amputee or of pretending to be an amputee.  The basic theory of Erotic Target Location Errors is that for every conventional erotic target, there is a subset of people who also find the thought of being or becoming a member of that class of erotic target to be sexually arousing.  Thus, an individual who is attracted to amputees, a “devotee” who also has an ETLE will also “pretend” and if it is very strong, will also be a “wannabee”.  In this theory, the ETLE is both dependent upon and in competition with the conventional erotic target.  If the ETLE is stronger at the moment, the individual will be “asexual”, uninterested in other people.  Conversely, if one falls in love with someone, the ETLE may abate, at least for a while.

For more information, see my essay on Erotic Target Location Errors.

This theory also makes another prediction, that gynephilic “pretenders” and “wannabees” will also be very likely autogynephilic, as their erotic target is female amputees, they will want to become female amputees.  This is in fact what was found; fully 50% of “wannabees” were also autogynephilic.

For more information, see my essay on Autogynephilia in Amputee “Wannabees”.

Every valid scientific hypothesis and theory should be repeatable.  An independent group of scientists should be able to repeat a given experiment or observation and find the same result.  Doubters of the two type hypothesis insisted that it couldn’t be repeated, that the data was a fluke.  Some even wondered aloud if the data was cooked up by Blanchard, saying that he was a charlatan, a fake, a liar, with an ax to grind, that he didn’t like transsexuals and was out to hurt them.  But theories were meant to be tested and repeated.  So a number of scientists, both supporters and skeptics, repeated the studies of MTF transsexuals, asking if they experienced autogynephilia.  Here are the results:

“Type”     Nuttbrock  Smith    Lawrence     Blanchard

Year                  2011     2005         2005           1985

HSTS                    23%       15%           18%             15%

Non-HSTS         73%       60%          56%             75%

Each study was not identical in their method of categorizing someone as either ” exclusively homosexual transsexual” or “non-homosexual” nor identical in the questionnaire that was used to ask about autogynephilia.  For example, Lawrence, in the data above, made the autogynephilia cut at “hundreds” of incidents of arousal to masturbation during cross-dressing.  When she counts all such incidents, 87% of her non-HSTS respondents indicated that they were autogynphilic.  But all of them had roughly the same trend in the data, most “non-homosexual” transwomen acknowledge experiencing autogynephilia while only a few self-reported “homosexual” transsexuals do.  Blanchard’s original data was repeatable.  Blanchard didn’t make up the data.  No one was in any kind of conspiracy, as some doubters have claimed.  In fact, the Nuttbrock group would have loved to have proved him wrong.

Oh, but now our doubters point to the data and show that it isn’t 0% vs. 100%.  So… this theory can’t be right!  Some suggest that there might be another type of transsexual, one that is neither “homosexual” nor autogynephilic.  Others suggest that autogynephilia occurs in both “homosexual” and “non-exclusively-homosexual”.  Those scientists who are familiar with psychological, especially sexological, studies know that not everyone answers the questionnaires accurately, for different reasons.  So they could accept these strong, repeatable, trends on face value.  But, a curious scientist digs deeper.

Anne Lawrence looked at the answers she got from her questionnaires very carefully, suspecting that not everyone answered fully honestly, especially about their sexuality and found,

“six participants classified as homosexual based on their pattern of sexual partnering before SRS reported experiencing autogynephilic arousal before SRS. Two of these participants, both of whom reported “hundreds of episodes or more” of autogynephilic arousal before SRS, had been married to women and had been biologic parents before SRS, suggesting that their reports of no female sexual partners before SRS were inaccurate. Two other homosexual participants, both of whom also reported “hundreds of episodes or more” of autogynephilic arousal, had not been married and had not been biologic parents; one, age 33 at time of SRS, reported only one male partner before SRS; the other, age 44 at time of SRS, reported multiple male partners before SRS. The remaining 2 homosexual participants, both ages 38, reported autogynephilic arousal only “once or twice” before SRS; both reported multiple male partners before SRS and one also reported MtF transgendered partners.  Seven other participants who were classified as homosexual based on their self-reported pattern of sexual attraction before SRS but not on the basis of their pattern of sexual partnering before SRS also reported autogynephilic sexual arousal before SRS. Four of these 7 participants had been married, and 2 of these 4 had been biologic parents; only 1 reported any male sexual partners before SRS. Of the remaining 3 participants, 2 reported no sexual partners before SRS, and 1 reported multiple male, female, and MtF transgendered partners before SRS.”

For this reason, Lawrence looked at the original Smith data and recategorized those who had been married to women but reported their sexuality as “homosexual” to “non-homosexual” and got a stronger statistical signal, which I reported above.

For more information see my essay on Lawrence recategorizing subjects.

Thus, respondents were not accurately reporting their true sexual orientation.  Blanchard had similar suspicions about the reported sexual orientations and about the less than 100% reported autogynephilia in his non-HSTS group, so he did a study to look at the issue of social desirability bias, the tendency for people to respond to questionnaires with answers that they personally believe will make them “look good”.  Using the Crowne-Marlow Social Desirability Scale he found that in non-HSTS subjects, there was a high correlation with wanting to “look good” and down playing autogynephilia and sexual attraction to women, while simultaneously over stating sexual attraction to men.  Knowing this we can get an increased signal strength when we limit the non-HSTS group to only self-reported exclusively heterosexual and the HSTS group to only teenagers, which in the Nuttbrock group gives us 82% vs 14% respectively.

For more information see my essay on social desirability bias in transsexuals.

There are of course, transwomen, who clearly fit the autogynephilic profile, who deny that they ever felt autogynephilia, but most DO own up to it when questioned.  This denial of sexual arousal to cross-dressing is not limited to transsexuals, it is also found in heterosexual cross-dressers, where only 85% of them admit to arousal, the same percentage as exclusively heterosexual transsexuals.  Blanchard wondered if the ones who denied arousal might simply be mistaken, or denying it due to social desirability bias, so he did a study using a device to measure penile erectile responses.  The results clearly showed that those who denied arousal, DID in fact become aroused when listening to erotic cross-dressing narratives.

Thus, the ‘wriggle room’ for there being a “third type” of transsexual is reduced to ever diminishing possibility as one looks ever closer at the actual people. But then a new group of doubters bring up the idea that perhaps autogynephilia is not the cause of their transsexuality, but an after effect.  But not all autogynephilic males identify as women.  Even in those who later transition, female self-identification often occurs only years after intense erotic cross-dressing or other autogynephilic ideation surfaces in childhood or adolescence.  The case histories, though not necessarily their narratives, of AGP transsexuals strongly suggests that autogynephilia causes gender dysphoria and subsequent female self-identification, not the other way around.

One of the best documentations that autogynephilia is the root cause of non-homosexual transsexuality was done by Doctor and Prince, who showed that cross-gender identification was most commonly preceded by years of autogynephilic cross-dressing, that transvestism and non-homosexual transsexuality are both a continuum and a progression,

“Among our subjects, 79% did not appear in public cross dressed prior to age 20; at that time, most of the subjects had already had several years of experience with cross dressing. The average number of years of practice with cross dressing prior to owning a full feminine outfit was 15. The average number of years of practice with cross dressing prior to adoption of a feminine name was 21. Again, we have factual evidence indicative of the considerable time required for the development of the cross-gender identity.”

Further, consider that those MTF transsexuals who transition earliest, who are the most innately and spontaneously feminine, who one would expect would have the greatest gender dysphoria and strongest “female gender identity” from early childhood,  “homosexual” transsexuals, never develop autogynephilia.

For more information on how the two MTF transsexuals each have different developmental routes read my essay on the Origin of Cross-Gender Identity in Transsexuals.

Faced with ever mounting proof of the fact that autogynephila is a universal and prominent attribute of non-HSTS, a group of doubters put forth the very radical and odd notion that autogynephilia is a normal part of female sexuality.  One doubter, Charles Moser, M.D., whose other scientific and therapeutic interests include bondage, dominance/submission, sadomasachism (BD/SM), etc. did a very small study asking natal women to respond to a questionnaire that was cleverly written to obtain positive answers to ambiguous questions that only superficially resembled questions used in instruments that are only valid for gender dysphoric males.  For example, one question asked if one fantasized about having a “sexier” body?  (One would hardly expect that women would fantasize about having an uglier one!)  Another question asked about becoming aroused while preparing for a sexual encounter with a lover.  (Such arousal would arise due to anticipation, not the mere fact of getting dressed in women’s’ clothing!)  Thus, the paper is of no scientific value in exploring the nature of women’s sexuality.

On a curious side note, there is a correlation between BD/SM in which about one out of three autogynephilic males is also into BD/SM and vice versa.

For more information about this study, see my essay on the lack of validity of Moser’s paper.

While it may be comforting to autogynephilic individuals to imagine that their very unusual and intense sexuality is the same as, or at least similar to, natal women, it is not.  Most women are sexually attracted to their sexual partners.  They are aroused by sexual ideation in which their partner is the significant figure, not themselves, their own appearance, nor their mode of dress, which, if present, is of a supporting, rather than leading role.

Finally, another hypothesis is put forth by doubters, despite their obvious lack of naturally feminine behavior, that they are still neurologically “female-like”, at least in some important way, the so called, “feminine essence” or “brain sex” hypothesis.  Blanchard, in response, made the prediction that brain studies would show that BOTH populations would be different than control males, but in different ways.  He further made the prediction that HSTS brains would be shifted toward the female morphology in sexually dimorphic areas of the brain, while AGP transsexuals would not.

The first major paper that was hailed as “proof” that late transitioning, non-homosexual, transsexuals had female-like brains was Swaab’s study that showed that the BSTc was feminized in such transsexuals.  But Swaab himself later showed that the BSTc was only sexually dimorphic in adulthood.  That is to say, that this area is very plastic, responding to sex hormones, the sexually dimorphic structure being an “activation effect”, casting serious doubt on the value of the entire study, that it was very likely that years of HRT was fully responsible for the feminization of the BSTc.  The next “proof” was the hypothalamic uncinate nucleus, INAH3, that also was feminized in non-homosexual transsexuals.  However, as I personally showed, this too was caused by HRT.  Other studies, too numerous to list individually here, are beginning to show that Blanchard’s prediction is correct.

For more information, see my list of essays on Brain Sex.

There will always be doubters and outright denialists.  But to those who read the literature carefully and yes, skeptically, the growing evidence that the Freund/Blanchard two type taxonomy is correct far outweighs the doubts.

Drum keeps pounding… ♫♫

♫♫…rhythm to the brain…♫♫

Data keeps coming in regarding brain imaging studies showing differences between MTF and FtM transsexuals and control males and females.  The question still remains, what does it mean?  Two studies, by two different groups, have measured the cortical thicknesses of transwomen before beginning HRT, to ensure that they are measuring potential organizing effects of endogenous hormones, or other effects, without the confounding activational effects of HRT.  However, the two studies looked at the two different MTF populations.  One, the Zubiaurre-Elorza paper examined only androphilic transwomen (N=18). Given that this group came from Spain, which, as Lawrence demonstrated, has a very low Hofstede Individualism index which is correlated with low percentage of gynephilic transwomen, these 18 were likely to have accurately reported their sexuality as exclusively androphilic.   While the Luders study, as an earlier study reported, examined both gynephilic (N=18) and self reported androphilic (N=6) transwomen.  Given that we know from many other studies of transwomen in high Hofstede Individualism societies, and the fact that the youngest of the Luders group was 23, we would expect that not all six of those who reported that they were androphilic were exclusively so.  In fact, I doubt that more than one or two at most is exclusively androphilic, if any.  Thus arises the question, can we use these two studies to get an early test of Blanchard’s prediction that “non-homosexual” transwomen would show brain difference from controls, but not a shift towards the female typical while the “homosexual” will show just such a shift?

First, some background, since I know that not all readers will be thoroughly up to date on the hypothesis being tested, nor the relevant data supporting it.  I recommend reading the FAQ on the is blog before continuing to read this blog entry, as a starting point.  Given that there is now mountains of data supporting the hypothesis that there are two types of MTF tranwomen, one autogynephilic (AGP) and non-homosexual (with respect to natal sex) and one that is non-autogynephilic and exclusively homosexual (HSTS); and that AGP transsexuals were behaviorally masculine since early childhood, and often even after transition and SRS, while HSTS transwomen had been remarkably feminine in behavior, and often in appearance, since early childhood, Blanchard made the prediction that brain studies would show that BOTH populations would be different than control males, but in different ways.  He further made the prediction that HSTS brains would be shifted toward the female morphology in sexually dimorphic areas of the brain, while AGP transsexuals would not.

This prediction is in opposition to the so called, “feminine essence” hypothesis, which is generally popular among AGP transsexuals, in which they posit that despite their obvious lack of naturally feminine behavior, they are still neurologically “female-like”, at least in some important way.

So far, the very limited data supports Blanchard’s hypothesis and NOT the “feminine essence” hypothesis.  Also so far, no formal study has been conducted that would specifically test these two hypothesis together.

I stated earlier that I didn’t believe that the Luders study group contain many exclusively androphilic (HSTS) individuals.  The reasons I believe this are several fold.  First, they collected most of their group by soliciting via transgender organizations.  As was shown in the Veale study on transsexual sexuality, soliciting through such organizations tends to reach only AGP individuals, as HSTS youth do not tend to be members of such.  Second is the age range of the study entire group.  The youngest was 23.  This would be very unusual for a group of that had a sizable portion of HSTS individuals, given that the median age of transition is 20 years old and the top end is typically 25 years old, and even that old is very rare.  If all six HSTS individuals were 23 to 25, this would be odd.  Also given that the mean age of the entire group is 45, which is a bit higher than the typical mean transition age for a group consisting of only AGP transwomen, this would suggest that there were not many of the total group that was in their early 20′s, certainly not six out of 24 individuals.  Thirdly, as Lawrence has shown, in two different study groups, significant numbers of individuals who claim to be androphilic are inaccurately reporting their sexuality.  Added together, I don’t believe that more than one or at most two, of the Luders study group was actually exclusively androphilic.  I suspect that none of them were.

As we explore the data from these two papers, we need to keep in mind that brains, like bodies, come in different shapes and sizes, more or less.  That is to say, although there are differences between male and female brains, on average, it is difficult to point to a part of the brain and say with absolute certainty, this is a male brain vs. a female brain.  Another thing to keep in mind, if we have a mix of two populations, both may have differences unique to each population… and that when mixed, both of those differences will be detected when we average the data, blurring and blunting the differences, but we should still be able to statistically see a signal in the data, provided we have enough data.

So, lets examine the data.  First, if we look at the high level view, it would appear that there are indeed differences between the control men and women and androphilic transwomen.

In general, female brains have thicker cortices (CTh), at least in some areas, as the comparison between male and female controls shows.  As we had expected, MTF  transfolk are different than male controls, but FtM are not that different from female controls.  The authors described the results thus,

“We have found that control females have greater CTh compared with control males in the frontal and parietal regions; in contrast, males have a larger putamen volume than females. With respect to the transsexual groups, we observed that FtMs have greater CTh compared with control males in the parietal and temporal cortices and did not differ from control females. However, FtMs have a larger right putamen than female controls. On the other hand, MtFs did not differ from control females in CTh and had greater CTh than control males in the frontal and occipital regions. In this group, no differences were found in the putamen. All these findings suggest that FtMs have a defeminized putamen, while MtFs have a feminized CTh.

…

With respect to the CTh of MtFs, we found that this group did not differ from female controls but did from male controls.  These findings suggest that MtFs follow the pattern of cortical thinning typically described for females. Whether the cortical feminization of MtFs depends on a differential cortical androgen receptor distribution, a different efficiency in the androgen receptors or other causes remains to be elucidated.  But what seems clear is that in MtFs the cortical developmental process is affected and follows the direction expected for females. This points out that the developmental approach could help to understand the etiology of transsexualism.”

Let’s compare these results with that of the Luders study, which is mostly (and perhaps entirely) non-exclusively androphilic, which being autogynephilic, Blanchard had previously predicted would show differences from control males, but not in the female like direction:

At first blush, we see that they are indeed, as predicted, different than control males.  Some areas of the cortices are thicker, but not the same regions as control females nor androphilic transwomen.  So, it would seem unlikely that these brain difference are caused by a feminization of the brain, given that the regions are not those found in control females.  But what does cause these particular differences?  While we might be tempted to conclude that this is caused by autogynephilia, it could also be caused by another attribute that is common in this population, higher IQ.  It has been noted that higher IQ is correlated with thicker cortices.

So where to do we go from here?  This visual comparison of the two studies can only be described as tentative.  But the need for such comparisons are clearly understood by these researchers, as the Zubiaurre-Elorza paper explained,

“On the basis of chromosomal sex and behavior, Blanchard and co-workers (Blanchard et al. 1987, 1989, 1996; Blanchard 1989; see also Smith et al. 2005) have proposed the existence of 2 types of MtFs: 1) MtFs that are attracted to males (“homosexual” transsexuals in Blanchard terminology), and 2) MtFs that are attracted to women (“heterosexual” transsexuals according to Blanchard). Further, Blanchard (2008) hypothesized that homosexual MtFs would differ from heterosexual males in brain sexually dimorphic structures, while in the heterosexual MtFs, the differences might not implicate sexually dimorphic structures. More recently, Cantor (2011) has noted that our findings on the white matter microstructure of (homosexual) MtFs (Rametti, Carrillo, Gómez-Gil, Junque, Zubiarre-Elorza et al. 2011) and that of Savic and Arver (2011) on the cortical volume of (heterosexual) MtFs would support Blanchard’s hypothesis. In the present report, we studied MtF transsexuals erotically attracted to males that show a feminization of CTh but not in the putamen.  …  Consequently, to verify Blanchard’s hypothesis would require a specific design that is beyond the scope of the present study.”

For more essays on trans-brains see Brain Sex.

References:

Eileen Luders, et al., “Increased Cortical Thickness in Male-to-Female Transsexualism”
Journal of Behavioral and Brain Science, July 2011

http://dbm.neuro.uni-jena.de/pdf-files/Luders-JBBS11.pdf

Leire Zubiaurre-Elorza et al, “Cortical Thickness in Untreated Transsexuals”
Cerebral Cortex, August 2012

http://cercor.oxfordjournals.org/content/early/2012/08/30/cercor.bhs267.abstract

Katherine Narr, et al., Relationships between IQ and Regional Cortical Gray Matter Thickness in Healthy Adults
Cerebral Cortex, November 2006

http://cercor.oxfordjournals.org/content/17/9/2163.abstract

An Embarrassment of Riches

I hadn’t covered this earlier, and perhaps I should have, but, never too late.  In 2005, Dr. Anne Lawrence published a study in which she canvased a significant number of MTF transwomen that had had SRS from Dr. Toby Meltzer.  This paper is a true treasure trove of data, only a smattering of which I will explore here:

Characteristics of Participants by Reported Pattern of Sexual Attraction
Attraction before SRS/Attraction after SRS:                                                        F/M              F/F                  M/M
Participant characteristic                                                                                         (n = 30)      (n = 50)         (n = 17)
Mean age at SRS (SD)                                                                                                   45 (8.4)      44 (9.1)          34 (9.2)
Mean age at living full-time in female role (SD)                                               42 (11.3)     42 (9.6)         28 (8.8)
Mean duration of real-life experience before SRS, in months (SD)          21 (18)        21 (18)           63 (63)
Mean number of female sexual partners before SRS (SD)                            12 (16)        15 (21)           0.3 (0.8)
Mean number of male sexual partners before SRS (SD)                                0.7 (1.3)    0.8 (1.8)        6.6 (8.8)
Very or somewhat feminine as a child, in own opinion                                41%              45%                 76%
Very or somewhat feminine as a child, in others’ probable opinion       21%              24%                 76%
Autogynephilic arousal hundred of times or more before SRS                 52%              58%                 18%
Married to a woman before SRS                                                                              70%             74%                 12%
Biologic parent before SRS                                                                                        53%              42%                   6%
Mean number of female sexual partners after SRS (SD)                                0 (0)            1.5 (2.6)        0.4 (0.9)
Mean number of female sexual partners after SRS                                          0 (0)            1.0 (1.7)        0.3 (0.8)
in last year (SD)
Mean episodes of sexual behavior with female partners after SRS          0 (0)              21 (48)         0.1 (0.5)
in last year (SD)
Mean number of male sexual partners after SRS (SD)                                   2.9 (3.1)      0.7 (1.6)       6.9 (10.7)
Mean number of male sexual partners after SRS in last year (SD)           1.9 (2.3)       0.4 (1.5)       2.9 (3.9)
Mean episodes of sexual behavior with male partners after SRS             30 (63)         1 (4)                67 (128)
in last year (SD)
More than one male sexual partner after SRS                                                  60%                16%                 65%
In stable partnered relationship after SRS, at any time                               40%                74%                 71%
In stable partnered relationship after SRS, at time of survey                    27%               62%                  29%

Notes:
F/M = Exclusively or almost exclusively attracted to females before SRS, exclusively or almost exclusively attracted to males after SRS.
F/F = Exclusively or almost exclusively attracted to females before and after SRS.
M/M = Exclusively or almost exclusively attracted to males before and after SRS.

This paper has clearly documented the phenomena of autogynephilic pseudo-androphilic shift in sexual behavior after SRS, showing it is fairly common.

Looking at the data for autogynephila, we note that the stably “exclusively” androphilic included 18% that reported extensive autogynephilic arousal.  This would seem to contradict Blanchard’s taxonomy that exclusively androphilic MTF transsexuals do not experience autogynephilia.  However, there is strong evidence that a number of these individuals inaccurately reported their actual sexual orientation as Lawrence dug deeper,

“six participants classified as homosexual based on their pattern of sexual partnering before SRS reported experiencing autogynephilic arousal before SRS. Two of these participants, both of whom reported “hundreds of episodes or more” of autogynephilic arousal before SRS, had been married to women and had been biologic parents before SRS, suggesting that their reports of no female sexual partners before SRS were inaccurate. Two other homosexual participants, both of whom also reported “hundreds of episodes or more” of autogynephilic arousal, had not been married and had not been biologic parents; one, age 33 at time of SRS, reported only one male partner before SRS; the other, age 44 at time of SRS, reported multiple male partners before SRS. The remaining 2 homosexual participants, both ages 38, reported autogynephilic arousal only “once or twice” before SRS; both reported multiple male partners before SRS and one also reported MtF transgendered partners.  Seven other participants who were classified as homosexual based on their self-reported pattern of sexual attraction before SRS but not on the basis of their pattern of sexual partnering before SRS also reported autogynephilic sexual arousal before SRS. Four of these 7 participants had been married, and 2 of these 4 had been biologic parents; only 1 reported any male sexual partners before SRS. Of the remaining 3 participants, 2 reported no sexual partners before SRS, and 1 reported multiple male, female, and MtF transgendered partners before SRS.”

Some of these self identified androphilic individuals who were clearly having sex with female partners before SRS, are just as clearly STILL having sex with female partners after SRS.  This would suggest that they were in fact bisexual in behavior and sexual orientation, which as Blanchard demonstrated, are autogynphilic.  Thus, we don’t really see any exclusively androphilic transwomen reporting autogynephilia and thus the Freund/Blanchard two type taxonomy hypothesis is supported by this data.

Note that even with these older transitioning AGP transsexuals inadvertently included in the stably androphilic group, the mean age of transition is still significantly younger than the originally (and in truth, still) gynephilic transwomen.  Unfortunately, I don’t have the raw data that would allow me to back these individuals out to determine a better value of the mean age of transition, but it is certainly less than the 28 years old found here.  The data also supports an assertion I have long made, that AGP transwomen usually have greater access to capital which allows them to move quickly from full time transition to SRS, while transkids often remain “pre-op” for far longer; a little more than five years on average compared to less than two for AGPs.  (Again, likely to be longer if we backed out the bisexuals.)  Also note that sizable difference between the childhood femininity between the stably androphilic and the originally and stably gynephilic groups.  I’m personally amused that when asked what others might have perceived, that some in the gynephilic groups seem to have sheepishly admitted that others would not have considered them to have been feminine as young children.

On a sad note, the data shows that truly androphilic transwomen have trouble keeping long term partners.  What this data doesn’t show is why.  From personal experience and from having spoken to many others, I can attest that it is due to straight men having difficulty accepting our transsexual medical history.  Straight men fall in love with transkids readily enough… but after the blush of infatuation passes, the fear of friends and family discovering their lover’s transsexual status far too often over-rides their pair bond.

When reviewing this data, we should always keep in mind that we are looking for trends in the data, since people don’t always accurately report their sexual behavior, especially autogynephilic transwomen.  But still, the data clearly supports the Freund/Blanchard two type taxonomy hypothesis.

Reference:

Anne A. Lawrence, “Sexuality Before and After Male-to-Female Sex Reassignment Surgery”

http://link.springer.com/article/10.1007/s10508-005-1793-y

Going to the Chapel… ♫♫

♫♫… and We’re Going to Get Married…♫♫

Dr. Richard Green in his 1974 book on transsexuals, “Gender Identity Conflict in Children and Adults” wrote,

“The men who fall in love with and perhaps marry women who are themselves former males, by and large, have known their partners only as women.  their prior sexual experiences have been only with females.  They consider themselves heterosexual and their relationships heterosexual.  To varying degrees they are consciously and unconsciously aware of the biologic status of their partners, but it would be simplistic and would furthermore blur generally accepted definitions to call these men homosexual.  Rather they are men who respond to the considerable femininity of male-to-female transsexuals, ignoring the dissonant cues of masculinity.”

Those very words, read when I was 17 years old, gave me hope that my dearest wish, to find and marry a straight man, hopefully to also adopt children, just might be possible, in spite of my own mother’s words of encouragement that “No man will ever love you, you know.”  Fortunately, Dr. Green was right, and my mother quite wrong.  Although there are few references, and almost no serious studies, that specifically look at the men who marry transwomen, either “early onset” or “late onset”, I believe from my own observations that most MTF transkids who marry, do find husbands who are straight and narrow (but not narrow minded), because gay men just aren’t interested in transkids.

As by negative proof, Green describes a married couple in his book, a pre-op transwoman and a putatively, self-described, straight man.  In quoting this man, he describes the day he met his ladylove,

“The first time I ever remember was she was walking across the street, and one of the fellows I work with said, “Hey, that looks like a guy wearing capris.”

Thus, this man knew she was a transwoman from the very start, as she was just barely beginning to transition.  From the description given both by Dr. Green and by this man, it is clear that this transwoman was a classic transkid.  This transwoman, in the same section, lamented that she very much wanted SRS, but was getting serious resistance from her husband,

“My marriage is not doing so good.  It’s not good because my husband more and more has turned to — now he’s turned to more and more to homosexuality.  It’s something I’ve found very difficult to live with.  I could understand his turning to another woman, because of my position, but not another man.  It really tears me up.”

Thus, we see that this transwoman has married a gay man who used her as a stepping stone in coming out.  It seemed clear reading the book that this marriage would soon end, because when asked if she thought her husband was possibly against her transitioning she replied,

“Yes, I do, because were were closer before I started dressing as a woman regularly.  The point was when I got my breast  operation.  It was one thing I didn’t understand.  It meant so much for me to get this operation, and when I did get it, he was very cold for about two months afterwards.  He was very nasty to me. and he told me that as time goes by I’m getting more womanly and more adjusted and this is bugging him.”

Thus, he showed that MTF transkids’ husbands are by and large heterosexual, because gay men lose interest as we transition.

Green interviews a number of other men who are either married or engaged to MTF transkids, who were all clearly straight.  Green was mostly right… but in some respects he missed a few nuances.  Back in the early 70′s he failed to differentiate between transkids and autogynephilic transwomen, and the nature of the men who married AGP transwomen.  But we still find hints.  In his book he writes about a candidate for surgery who detransitions when he falls in love with a post-op transsexual.  This individual is in fact gynephilic, and as a man who detransitioned, would be described as heterosexual, but he is also autogynephilic and gynandromorphophilic.

While it is obvious why MTF transkids, who are, after all, genuinely androphilic would wish to find and marry heterosexual men.  It has always puzzled me as to why obviously autogynephilic, and just as obviously, truly gynephilic, transwomen would chose instead to marry men.  Further, just what motivates such men to marry these autogynephilic transwomen?  Lawrence, in her 2013 book speculates,

“… some of them go to great lengths to maintain a facade of “heterosexual normality.”  One can observe this phenomenon on a few internet web sites belonging to MtF transsexuals who fit the autogynephilic demographic (formerly married to women, male-typical occupational history, etc.) and have found men willing to marry them.  On their web sites, these transsexuals clearly convey their pride in their status as married women; sometimes they even display their wedding photographs…”

I can almost see this… but it doesn’t explain the men involved, nor why these transwomen are able to maintain such relationships.  Perhaps we saw a hint of who these men are, and what dynamic maintains the relationship in Green’s book, mutual gynandromorphophilia and autogynephilia?  Consider that Green’s detransitioned transgendered individual likely still experiences autogynephilic arousal to cross-dressing?  Could it be that such men who AGP transsexuals marry are themselves autogynephilic and gynandromorphophilic?

About twenty years ago, a young transwoman in her mid-20′s called me up because she wanted me to meet her new boyfriend.  This news very much surprised me because I had never gotten the impression that she was terribly interested in men.  She had, after all, been in the Navy, on board submarines, for months at a time, and never felt any desire toward her shipmates (me?  I would have gone nuts trying to keep my hands off of them!).   We discussed our conflicting schedules and finally agreed that the best time would also coincide with her support group meeting time.  So off I trudged to an AGP transgender support group meeting.  When I finally met my friend’s new boyfriend, all was made clear… her “boyfriend” was also her “girlfriend”… as he was a classic and typical cross-dresser, fully dressed in women’s clothes for this CD/TG/TS support group meeting. To the outside world, they were a heterosexual couple.  To TG ‘insiders’ it was known that they were a pre-op TS woman and a semi-closeted cross-dresser.

Some time ago, when I was still single, I was introduced to a man who sounded like a potential mate.  He took me to classical music concerts, romantic drives in the country in his sports car, cooked a fine meal… seemed ideal… yet I wasn’t attracted to him, though he was to me, strongly.  He broached the idea of marriage.  It couldn’t have been described as a proposal, likely because he “knew” I would turn him down,   because included in his reasons for why the match was perfect was the idea that we could share the same wardrobe, as we wore the same size 12 dresses.  Although this was personally repugnant, we know for a fact that many autogynephilic transwomen would find this to be ideal.

In the Daskalos paper purportedly about changes in sexual orientation after transition, we see two more examples of exactly such relationships.  In combination with autogynephilic pseudo-androphilia, this makes a potent brew of mutual sexual attraction.  Exactly how many AGP transwomen have found such a mutually agreeable relationship with a cross-dressing man is uncertain.  That such relationships exist is beyond doubt.  This would make for a very interesting research paper.

References:

Richard Green, M.D., 1974, “Sexual Identity Conflict in Children and Adults“, Basic Books

Anne Lawrence, 2013, “Men Trapped in Men’s Bodies“, Springer

Daskalos CT., “Changes in the sexual orientation of six heterosexual male-to-female transsexuals.”

http://www.springerlink.com/content/pu44808u15q78k21/

Anne Lawrence, “Letter to the Editor” (in response to Daskalos)

http://link.springer.com/article/10.1023/A%3A1018725518592

Transkids.us Update

Now that I have taken on the responsibility of maintaining the Transkids.us website (with my husband’s dutiful help, as I’m not all that good with web stuff) we’ve moved the site to a new host and begun to clean-up typos and other issues, including dead links.  We’re not done yet, but it is improving.

In cleaning up some of the typos and silly grammatical errors (it’s amazing what a misplaced comma does to a sentence), I’m once again marveling at the insight of the original authors, especially “Alex Parkinson” (not her real name) in her essay on how GID as a theory obscures the real nature of transsexuality.  If you have never read it, you really should take the time to do so now.  Read it very slowly, as though the words were being spoken aloud by an erudite lecturer.  The essay is amazing for such a young author.

Although the original authors have moved on… which is as it should be for young people to do, I have been wondering where this should go next.  I have come to the conclusion that additional voices, additional essays, would be welcome.  If you are a transkid (transgender youth), who is clearly such, and have insights into the issues being explored at the transkids.us website and/or here on my blog, I would welcome a dialog.  Its been ten years since the original authors took note of the controversy surrounding the publication of Prof. Bailey’s book, The Man Who Would Be Queen, and it is time for a new perspective.

You may reach me at formertranskid@gmail.com

Addendum 3/6/2013:

The edits are pretty much complete.  If you find dead links or serious typos, please let me know?

I’ve been rereading the posts as I edit them.  I was once again struck by how well many of the issues were addressed.  I would strongly recommend that any and all gender therapists and physicians read the recommendations regarding treatment of MTF transkids.  I find it difficult to add much to them, save perhaps to amplify by example.  IF you are a health care provider working with transgendered children or teens, and would care to discuss more explicit and detailed recommendations with me, I would be very interested in working with you.  There are things that I would not wish to discuss in an open forum.

Addendum 4/2/2013:

You may wish to read my earlier comment on why I have inherited the transkids.us website:

Better the Second Time Around

I mentioned this in passing before, that Anne Lawrence had shown in 2010 that there was a very strong correlation with the Hofstede Individualism Index of a country and the percentage of “non-homosexual” (AGP) transsexuals vs. “homosexual”.   Using seven new studies, she has shown that the correlation continues to hold in a paper published just this month.  Now, you may be thinking, “ho hum, wasn’t this shown earlier”.  Well, yes.  But science is all about repeatability.  It could have been that the first study she did was just a fluke, that she had found a coincidence.  But when later data becomes available with exactly the same correlation, it shows it wasn’t a fluke.

But what does it mean?  I believe that she has expressed it fairly well,

As I suggested previously, the observed relationship between IDV and %NHS probably reflects the combined operation of at least two distinct factors.  First, non-homosexual persons probably constitute larger apparent percentages of MtF transsexuals and gender gender dysphoric persons in more individualist societies because these societies place a higher value on individual self-expression (including cross-gender expression), despite the possible socially disruptive consequences of gender transition in men who are typically middle-aged, are often married, and have usually pursued traditionally masculine occupations.  Second, homosexual persons probably constitute larger apparent percentages of MtF transsexuals and gender dysphoric persons in less individualistic (or collectivistic) societies because these societies place a higher value on inclusion and often provide socially approved transgender roles for pervasively feminine, androphilic gender dysphoric men.

Addendum 2/20/2013:

I couldn’t resist playing with the numbers a little.  Combining both papers’ data, the correlation between the Hofstede Individualism Index and the percentage non-homosexual orientation is r=0.866 which is very high.  (For those that don’t love statistics and math, a perfect correlation would be 1.000 and no correlation at all would be 0.000 or “zero”.)  It would be very surprising if the correlation were perfect, since nothing in real life is, but this is really quite high.

I got curious about the scatter plot shown in the second paper… and my intuitive mathematical sense tells me that the function between the Index and %NHS is not linear.  So I graphed what I think the function is, reproduced here:

Individualism vs. Percentage Non-Homosexual

There is one outlier if we use my suggested non-linear relationship, the one dead center in the graph.  This represents Japan with an IDV of 46 and 60% non-homosexual orientation among MTF transwomen.  How do I explain this?  I believe that we need to look at the Hofstede Center’s own description of this index score and note that it may not reflect exactly what societal characteristic is usually captured by the IDV,

Japan scores 46 on the Individualism dimension. Certainly Japanese society shows many of the characteristics of a collectivistic society: such as putting harmony of group above the expression of individual opinions and people have a strong sense of shame for losing face. However, it is not as collectivistic as most of her Asian neighbours. The most popular explanation for this is that Japanese society does not have extended family system which forms a base of more collectivistic societies such as China and Korea. Japan has been a paternalistic society and the family name and asset was inherited from father to the eldest son. The younger siblings had to leave home and make their own living with their core families.

Thus, while Japan is more collectivist, that collectivism differs from other Eastern societies as being focused on non-family groups, e.g. companies and schools,

One seemingly paradoxical example is that Japanese are famous for their loyalty to their companies, while Chinese seem to job hop more easily. However, company loyalty is something which people have chosen for themselves, which is an individualistic thing to do. You could say that the Japanese in-group is situational. While in more collectivistic culture, people are loyal to their inner group by birth, such as their extended family and their local community. Japanese are experienced as collectivistic by Western standards and experienced as individualistic by Asian standards. They are more private and reserved than most other Asians.

My hypothesis is that it is from the impact on family structures that this high correlation stems.

References:

Anne A. Lawrence (2010), “Societal Individualism Predicts Prevalence of Nonhomosexual Orientation in Male-to-Female Transsexualism”

http://www.springerlink.com/content/x556338354658m3w/

Anne A. Lawrence (2013), “More Evidence that Societal Individualism Predicts Prevalence of Nonhomosexual Orientation in Male-to-Female Transsexualism”

http://link.springer.com/article/10.1007/s10508-013-0083-3#page-1

The Hofstede Centre

http://geert-hofstede.com/index.php

Curiouser and Curiouser…

… said Alice.

In a recent paper exploring the sibling sex ratio and birth order of transkids, several interesting new biodemographic findings were disclosed.  First, the already known surplus of older brothers of MTF transkids was observed, along with the fraternal birth order effect of having more older brothers than sisters.  But, curiously, these transkids also had more younger brothers than sisters!  The reason this is so startling is that we have no plausible conjectures on how this could come about, as we do the fraternal birth order effect.

Another curious item is that FtM transkids are more likely to be only children than one would expect by chance.  Blanchard does offer a possible conjecture that this may be an immune response, leaving the mother unable to conceive again.

This new finding in MTF transkids is further evidence that their may be more than one biological mechanism at play.

But to me, the most curious thing to note in this paper is the actual paper, who wrote it, and how it was edited.  It has the feel of having had sections written by different authors, who habitually use different terms for the same phenomena and populations.  As I had written in an earlier essay, those in North America preferred the term “homosexual transsexual” and those in the Netherlands preferred “Early Onset” transsexual.  This paper was co-written by Ray Blanchard, from North America, while the rest were from the Netherlands.  It would appear that both formulations were used in this paper, starting with “early onset” in the title then using “homosexual” in the abstract:

Several sibship-related variables have been studied extensively in sexual orientation research, especially in men.  Sibling sex ratio refers to the ratio of brothers to sisters in the aggregate sibships of a group of probands. Birth order refers to the probands’ position (e.g., first-born, middle-born, last-born) within their sibships. Fraternal birth order refers to their position among male siblings only. Such research was extended in this study to a large group of early-onset gender dysphoric adolescents.  The probands comprised 94 male-to-female and 95 female-to-male gender dysphoric adolescents. The overwhelming majority of these were homosexual or probably prehomosexual.  The control group consisted of 875 boys and 914 girls from the TRAILS study. The sibling sex ratio of the gender dysphoric boys was very high (241 brothers per 100 sisters) compared with the expected ratio (106:100). The excess of brothers was more extreme among the probands’ older siblings (300:100) than among their younger siblings (195:100). Between groups comparisons showed that the gender dysphoric boys had significantly more older brothers, and significantly fewer older sisters and younger sisters, than did the control boys. In contrast, the only notable finding for the female groups was that the gender dysphoric girls had significantly fewer total siblings than did the control girls. The results for the male probands were consistent with prior speculations that a high fraternal birth order (i.e., an excess of older brothers) is found in all homosexual male groups, but an elevated sibling sex ratio (usually caused by an additional, smaller excess of younger brothers) is characteristic of gender dysphoric homosexual males.  The mechanisms underlying these phenomena remain unknown.

The use of the term “homosexual” has often bothered many transsexuals, both autogynephilic and non-autogynephilic alike… but apparently it bothered at least one of authors of the paper as well,

(instead of ‘‘homosexual’’ transsexuals, we will refer to male-to-female transsexuals sexually attracted to men as androphilic MtFs, and to female-to-male transsexuals sexually attracted to women as gynephilic FtMs)

While I applaud the sentiment of using language that is more sensitive to the sensibilities and personal identities of transsexual people, the effort here loses its intended effect since all such males are still called “boys”, and such females are called “girls”, largely defeating the purpose.  Further, the authors simply did not maintain the usage of “androphilic” in preference to “homosexual” as later in the paper they write,

It was reasonable to assume that all or nearly all of the early-onset gender dysphoric boys in this study were, or would be, homosexual, and that nearly all of the control boys were, or would be, heterosexual;

So, it would appear that the final editor failed to clean up the language of the paper to make it consistent with a ‘politically correct’ terminology.  But this failure also allows us to unite the terms, making this paper a ‘Rosetta Stone” of research papers:

Homosexual = Androphilic (or Gynephilic for FtM) = Early Onset

Thus, this paper helps spell out, in an unambiguous manner, that the researchers are indeed talking about the same populations, and that there is now universal agreement that the Freund/Blanchard typology is correct.

References:

Sebastian E. E. Schagen, Henriette A. Delemarre-van de Waal, Ray Blanchard, Peggy T. Cohen-Kettenis, (2012) “Sibling Sex Ratio and Birth Order in Early-Onset Gender Dysphoric Adolescents”

http://link.springer.com/article/10.1007%2Fs10508-011-9777-6

Etiological Conjectures, Part 3

As I related in Part 1 and Part 2 of my discussion regarding etiological conjectures, there are still more questions than answers about how early onset gender atypicality and dysphoria develops.  However, there are some very intriguing clues from the biodemographics of transkids.  As I discussed in an earlier essay on how MTF transkids may be a subset population of the larger exclusively androphilic, gender atypical, but not gender dysphoric children who grow up to be conventional gay men, the biodemographics of MTF transkids seems to be very similar, if not identical, to that of at least some gay men.

Simply put, MTF transkids have more brothers than sisters, far more than one would expect comparing then to the general population.  They tend to have more older brothers than would be expected, showing that for each older brother, the likelihood that a given male would be an MTF transkid is increased by 40%.  Note that the absolute likelihood of being an MTF transkid is still very, very tiny, but the more older brothers that one’s mother had, the more likely this tiny chance is increased.  This effect is also found in conventional gay men, but only those who were feminine as children.

From this statistical anomaly, Blanchard suggested that at least some gay men and MTF transkids have an etiological cause that is effected by their mother’s prior pregnancy experiences.  His conjecture is that prior male pregnancies challenged their mother’s immune system such that they developed anti-bodies to “maleness” in some, as yet to be discovered, fashion.

I would offer a different conjecture.  It is fairly well established that cells from each fetus a women bears releases cells that migrate to all parts of her body.  In effect, she becomes a genetic chimera, carrying the DNA of each of her children (including those who miscarried).  This means that she also carries cells in her body which are genetically “male”, that have a Y chromosome and have supposedly been epigenetically tagged as being “male” during gestastion, prior to escaping via the placenta and migrating into her own body.  I conjecture that the mother’s own epigenetic gene regulation mechanisms are invoked to bring these “male” cells in line with her female body.  If these mechanisms become especially strong, they may tag her own germ cell line prior to oogenesis with epigenetic tags that push the later born male children toward neurological femininity.

Perhaps someday, we will see which, if either, of us guessed right.

References:

Sebastian E. E. Schagen, Henriette A. Delemarre-van de Waal, Ray Blanchard, Peggy T. Cohen-Kettenis, (2012) “Sibling Sex Ratio and Birth Order in Early-Onset Gender Dysphoric Adolescents”

http://link.springer.com/article/10.1007%2Fs10508-011-9777-6

Blanchard, R., & Sheridan, P. M. (1992). Sibship size, sibling sex ratio, birth order, and parental age in homosexual and nonhomosexual gender dysphorics. Journal of Nervous and Mental Diseases, 180, 40–47.

http://www.ncbi.nlm.nih.gov/pubmed/1538206

Blanchard, Bogaert, “Homosexuality in men and number of older brothers”

http://ajp.psychiatryonline.org/cgi/content/abstract/153/1/27?ijkey=e186877631aa1c47de8fd859310668c21bcd25ef&keytype2=tf_ipsecsha

Anthony F. Bogaert, “Biological versus nonbiological older brothers and men’s sexual orientation”

http://www.pnas.org/content/103/28/10771.full

Green, R. (2000). Birth order and ratio of brothers to sisters in transsexuals. Psychological Medicine, 30, 789–795.

http://www.ncbi.nlm.nih.gov/pubmed/11037086

Blanchard, R., Zucker, K., Cohen-Kettenis, P., Gooren, L., & Bailey, J. (1996) “Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males” Archives of Sexual Behavior, 25, 495–514.

http://link.springer.com/article/10.1007%2FBF02437544?LI=true

Johannes Bohacek, Katharina Gapp, Bechara J. Saab, Isabelle M. Mansuy, “Transgenerational Epigenetic Effects on Brain Functions”

http://www.biologicalpsychiatryjournal.com/article/PIIS0006322312007299/abstract

Etiological Conjectures, Part 2

As I alluded in my previous post, scientists also like to speculate and generate conjectures regarding the etiology of transsexuals. In this post, I will explore and comment on some of them.

Many of the earlier conjectures were highly influenced by psychoanalysis, shoehorning observations into existing, yet completely untested, models of psycho-sexual development.  These were largely psychogenic theories, that is to say, that mental process create the condition, either transsexuality or homosexuality.  More specifically, they theorized that family constellations, usually an overly involved mother and a distant father create the conditions whereby a male child gets the erroneous idea that they must be female, as they can’t separate themselves as individuals from their mothers.  Or, the theory might be that fear of losing their precious penis causes them to overly-identify with their mother so that losing it doesn’t  seem such a bad alternative.  (Yes, I’m over simplifying, deliberately, sarcastically.)

Before we completely laugh at the idea of psychogenic illness, we should remember that there are several very real psychiatric illnesses which have been identified and shown, using modern science, to be of such psychogenic origin.  The most heart breaking is Reactive Attachment Disorder, which is common among institutionalized children who as babies and toddlers were literally not cuddled.  The lack of physical / emotional contact with caregivers literally creates a condition whereby these children have severe emotional and behavioral problems as they grow up (but not autism).  Another illness that has a psychogenic origin is post-traumatic stress disorder.  Although traumatic events as adults act as the proximate trigger, horrific events in childhood have been identified as leaving these individuals without the emotional resilience to weather such events.  A history of physical abuse as a child is one of the more commonly identified preconditions for later post-traumatic stress syndrome, likely due to down-regulation of cortisol production.

But, during the early to mid-twentieth century, psychoanalysis claimed illnesses were psychogenic that we now have clearly established as neurological defects including schizophrenia and autism spectrum disorders.  Typically, the quality of mothering was blamed.  (Sound familiar?)  Mothers were blamed for nearly every sort of bad outcome in their children, without ANY corroborating statistics or evidence.  The ugliest of these was calling the mothers of autistic children, “refrigerator mothers” and the mothers of schizophrenic young adults, “schizogenic mothers”.

So, in a similar vein, I call the theories that invoke parenting styles, especially those that blame mothers, for MTF transkids, the “smother mother” hypothesis.  Without ANY corroborating statistics or evidence, many psychoanalysts and their medical colleagues, accepted many of these theories as “true”.  Although it is true that many parents become emotionally distant from a transkid, this is far more likely a result, not a cause, of the child’s gender atypical behavior.  These theories, although largely abandoned by scientists, still seem to have currency with a number of therapists that I’ve talked to.  In one odd conversation I had about two decades ago, an elderly therapist acknowledged that it didn’t seem to be true of her “early transitioners”, but she was convinced that her “late transitioners and transvestites” had come from such families with smothering mothers and distant fathers.  During the conversation, I began to suspect that she was guilty of confirmation bias and of  subtly “coaching” her clients in what she expected them to say, so that they could obtain their “letters”.

To a modern scientifically based intellect, the creation and wide scale acceptance of psychodynamic theories about the origins of both typical and atypical gender and sexual behavior seems incomprehensible.  How could they ever even entertain such odd notions?  But, if we understand that the ideas have at their core, the pre-Darwinian notion that humans are a special creation, unlike any other species on the planet, it starts to make some sense.  While to us, the thought that gendered and sexual behavior comes from a mental process that, if we translated to our rodent cousins, would make it sound, and be, ludicrous:  Baby rat sees Daddy rat’s penis and notices she doesn’t have one… and envies Daddy rat’s penis… so she starts acting like Mommy rat to get Daddy rat’s affectional attention, etc.   But, if humans are special creation, the theory doesn’t have to work for our rodent, or even, or maybe especially (?) our primate cousins.  These notions had their genesis in Late-Victorian Europe, which was then struggling with the implications of Darwin’s theory of natural selection and evolution and spread to North America which is still struggling (!) .

Another hypothesis is that an anomalous hormonal environment causes cross-sex neurological development.  This is bolstered by experimental research in various animal models, usually rodents, in which exogenous hormonal intervention at certain critical times in neurological development induces cross-sex behaviors.  When coupled with the discovery of cross-sex neurological features in the brain, this would seem to clinch the matter.  Yet… and yet… it doesn’t explain how or why these events occur in otherwise phenotypically normal individuals.  Further, phenotypical markers of prenatal hormone exposure, such as the 2D:4D finger ratio have failed to provide consistent, reproducible, results.

Thus was born the “gay gene” hypothesis.  Studies of gay men and MTF transkids consistently show evidence of consanguinity, that male homosexuality and exclusive MTF transsexuality both run in families.  However, the idea of a “gay gene” caused problems with evolutionary theory, since how could such a genetic allele continue to exist against the obvious reproductive disadvantage that being gay (or transkid) naturally presented.  Researchers have spent the past two decades searching for an evolutionary advantage that the relatives of gay men and transkids might enjoy as a “carrier” of the putative “gay gene”.  But years of searching have failed to find such a gene(s).  Perhaps that’s because, there isn’t one?

Finally, we have our new variant on the “gay gene”, the “gay epigene”.  An epigenetic model is based on the recognition that genes are controlled and regulated by other genes using chemical tags, dangling links, attached to the DNA in each and every cell in the body.  These marks are like the conditional branch points, the “flags” or variables, of a computer program.  The interesting thing about such epi-marks is that though it is believed that they should all be erased between generations, many of them are not always fully erased.  This might be a mistake… or it might even be an evolved ability for a crude form of transgenerational gene regulation “memory”.  For example, if an organism needs to adjust it’s metabolism to lean times, like not enough food, by becoming careful about not burning off fat too quickly, it might be advantageous to their progeny to have that adjustment already turned on.  Just such a behavior has been seen in humans, where grandchildren of individuals who knew starvation have slower metabolisms than individuals whose grandparents and parents never knew such lean times.

One of the earliest models to include an epigenetic explanation was from Richard Green M.D., ( a stalwart friend of the transsexual community) and E.B. Keverne, a noted geneticist.  This model suggests that the failure to erase/modify epigenetic markers on the X chromosome that are supposed to be passed down to only one generation, but when passed down past that generation, are theorized to cause severe harm:

A significant skewing in the sex ratio in favour of females has been reported for the families of homosexual men such that there are fewer maternal uncles than aunts. This finding is repeated for a large series of transsexual families in this study. Four hundred and seventeen male-to-female transsexuals and 96 female-to-male transsexuals were assessed. Male-to-female transsexuals have a significant excess of maternal aunts vs. uncles. No differences from the expected parity were found for female-to-male transsexuals or on the paternal side. A posited explanation for these findings invokes X inactivation and genes on the X chromosome that escape inactivation but may be imprinted. Our hypothesis incorporates the known familial traits in the families of homosexuals and transsexuals by way of retention of the grand parental epigenotype on the X chromosome. Generation one would be characterized by a failure to erase the paternal imprints on the paternal X chromosome. Daughters of this second generation would produce sons that are XpY and XmY. Since XpY expresses Xist, the X chromosome is silenced and half of the sons are lost at the earliest stages of pregnancy because of the normal requirement for paternal X expression in extra-embryonic tissues. Females survive by virtue of inheriting two X chromosomes, and therefore the possibility of X chromosome counting and choice during embryonic development. In generation three, sons inheriting the paternal X after its second passage through the female germline survive, but half would inherit the feminizing Xp imprinted genes. These genes could pre-dispose the sons to feminization and subsequent development of either homosexuality or transsexualism.

The latest attempt to explain the presence of homosexuality goes into greater detail of how epigenetic markers canalize (channel) the sex hormone influenced masculinization in males or protect against such masculization in females.  This model assumes that all of the epimarkers should have been erased between generations, but the ones from the cross-sex parent were not fully erased:

It is well established that fetal androgen signaling strongly influences sexual development. We show that an unappreciated feature of this process is reduced androgen sensitivity in XX fetuses and enhanced sensitivity in XY fetuses, and that this difference is most feasibly caused by numerous sex-specific epigenetic modifications (“epi-marks”) originating in embryonic stem cells. These epi-marks buffer XX fetuses from masculinization due to excess fetal androgen exposure and similarly buffer XY fetuses from androgen underexposure. Extant data indicates that individual epi-marks influence some but not other sexually dimorphic traits, vary in strength across individuals, and are produced during ontogeny and erased between generations. Those that escape erasure will steer development of the sexual phenotypes they influence in a gonad-discordant direction in opposite sex offspring, mosaically feminizing XY offspring and masculinizing XX offspring. Such sex-specific epi-marks are sexually antagonistic (SA-epi-marks) because they canalize sexual development in the parent that produced them, but contribute to gonad-trait discordances in opposite-sex offspring when unerased. In this model, homosexuality occurs when stronger-than-average SA-epi-marks (influencing sexual preference) from an opposite-sex parent escape erasure and are then paired with a weaker-than-average de novo sex-specific epi-marks produced in opposite-sex offspring. Our model predicts that homosexuality is part of a wider phenomenon in which recently evolved androgen-influenced traits commonly display gonad-trait discordances at substantial frequency, and that the molecular feature underlying most homosexuality is not DNA polymorphism(s), but epi-marks that evolved to canalize sexual dimorphic development that sometimes carryover across generations and contribute to gonad-trait discordances in opposite-sex descendants.

This model has much to recommend it.  For instance, it would fit with the conjecture I made in my last post regarding the possibility of multiple semi-independent genes controlling sexually dimorphic behavior being involved. Yet,the odd thing about this recently published paper is that the authors seem to have no understanding of the nature of homosexuality and the close relationship it has with transkids, childhood gender atypicality, childhood gender dysphoria in desisting pre-homosexuals, and persisting transkids.  Incredibly, they actually predict that such epigenetic marking will have no correspondence with “gender identity”:

We describe our hypothesis for an epigenetic cause of homosexuality as a series of statements (see Figure 3 for a graphical summary):

a) Empirical studies demonstrate that XX fetuses are canalized to blunt androgen signaling (lower sensitivity to T) and XY fetuses are canalized to boost androgen signaling (higher sensitivity to T).

b) Empirical studies demonstrate the production of XX- and XY-induced epi-marks in embryonic stem cells and extensive sex-specific differences in gene expression at this time. Epi-marks laid down during the embryonic stem cell stage are also established to influence gene expression later in development. This stem cell period is the most plausible candidate time point for the production of epi-marks influencing sensitivity to androgens later in development (canalization of fetal androgen signaling).

c) Epi-marks produced in embryonic stem cells are mitotically transmitted to cell lineages leading to both the soma and the germline, and hence can contribute to pseudo-heritability when they escape erasure across generations (nonerasure in the primordial germ cells and in the zygote and first few cell divisions of the next generation). Animal models as well as human data unambiguously demonstrate that such a multistep escape from erasure does occur at nontrivial frequency.

d) Epi-marks blunting (in XX fetuses) or boosting (in XY fetuses) androgen signaling will be sexually antagonistic (SA-epi-marks) when they have a nonzero probability of carryover across generations and are expressed in oppose sex descendants. Such carryover will contribute to discordance between the gonad and one or more sexually dimorphic traits.

e) Our modeling work shows that SA-epi-marks are favored by natural selection over a broad span of parameter space because there is a net benefit to the carrier (due to canalization of sexually dimorphic development) that is not offset sufficiently by transmission (and fitness reduction) to opposite sex descendants.

f) Genetic mutations causing SA-epi-marks are expected to fix in populations and are therefore not expected to be polymorphic except transiently during their initial spread within a population. Therefore, no association between genotype and homosexuality is predicted.

g) Because the androgen signaling pathways differ among organs and tissues (e.g., use of different AR cofactors), the same inherited SA-epi-mark can affect only a subset of sexually dimorphic traits, e.g., no effect on the genitalia, but a large effect on a sexually dimorphic region of the brain.

h) Shared, gonad-discordant SA-epi-marks that carryover across generations would contribute to the observed realized heritability of homosexuality, e.g., monozygotic twins share the same SA-epi-marks coinherited from a parent.

i) Unshared, gonad-concordant SA-epi-marks, produced during fetal development, would contribute to the low proband concordance of homosexuality observed between monozygotic twins, i.e., they need not share SA-epi-marks generated during development that occurs after the twins have separated.

j) Homosexuality occurs when an individual inherits one or more gonad-discordant SA-epi-marks that are not masked nor erased by the production of de novo gonad-concordant SA-epi-marks that accrue during ontogeny. The SA-epi-mark(s) influence androgen signaling in the part of the brain controlling sexual orientation, but not the genitalia nor the brain region(s) controlling gender identity.

Perhaps they are referring not to the existence of transkids “gender identity” but of the “gender identity” of autogynephilic transsexuals? If so, I would TOTALLY agree with them. But, somehow, I believe that they are simply basing this odd assertion on the mistaken acceptance of our late 20th Century adoption of the separation of sexual orientation and gender identity as being unrelated phenomena, without having read the scientific literature dispelling it.

Thus, we see that cultural biases have and continue to distort scientific discourse into the etiology of homosexual transsexuality.

References:

David E. Simpson, J.J. Hanley, Gordon Quinn, Documentary film: “Refrigerator Mothers”

http://www.pbs.org/pov/refrigeratormothers/#.UNntP6xLnkY

Green, R., Keverne, EB., The disparate maternal aunt-uncle ratio in male transsexuals: an explanation invoking genomic imprinting.

http://www.ncbi.nlm.nih.gov/pubmed/10623499

Rice, et al.  “Homosexuality as a Consequence of Epigenetically Canalized Sexual Development”

http://www.jstor.org/stable/10.1086/668167