On the Science of Changing Sex

Once Again, With Feeling…

Posted in Confirming Two Type Taxonomy by Kay Brown on February 4, 2017

critical-thinkingOr, How Do We REALLY Know That There Are Two Types of Transwomen?

One would think that with years of both clinical and scientific evidence to support the Two Type Taxonomy of MTF transexuality, we would no longer have need of essays that explain how we know this to be true, but no… sillyolme, nothing is so obvious as to be truly self-evident.  So, once again, it’s time to write a clear, concise, yet also complete explication of how we know that there are two and only two types of transwomen.

First, we need to know a bit about epidemiological research into etiology.   In medical science we often recognize that a given medical entity exists because of its pattern of symptoms that collectively we call a syndrome.  After recognizing a syndrome, science then attempts to determine an etiology, if it can.   Here it is important to recognize that the existence of a given symptom in itself does not define a syndrome.  Consider fever as a symptom.  Today, after much research, we know that it is caused by our immune system attempting to fight off an infection.  But that infection may be from any of literally millions of different entities, from eukaryotic parasites, bacteria, to viruses.  One would not say that just because two individuals both have fevers, or that a given medicine helps reduce both individual’s fevers, that they have the same etiology.  Yet, when it comes to transsexuals, this seems to be the assumption by both transexuals and the public at large.  As I will show, this is just not the case.

We also need to know a bit about statistics, most critically, about the concept of “effect size” and what it means.  Effect size is a measure of how different two populations are from one another when comparing their mean (average) and their variance (how much spread in a given measure exists within a given population).  If two populations have the same average, they have by definition an effect size between them of exactly zero, no matter the variance within the populations.  But even if they do not have the same average, if the variance in each is so large that it dwarfs the difference in average, it has a small and not very important effect size.  But if two populations have a difference in their average and no overlap in their variance, than there is a large effect size.  We calculate the effect size using a standard formula called “Cohen’s d”.

Why is this important?  Because to determine if there are in fact two (and only two) types, we must show that the Null Hypothesis, the assumption that there is only one type, is wrong by demonstrating that we consistently find that there is a large enough effect size in a number of measures that consistently cluster together.  In science we never “prove” an hypothesis… we only disprove one.  If the null hypothesis holds, there should be no such effect sizes.  So, in this essay, I’m going to review some of the evidence, demonstrating that there are respectable effect sizes and that they consistently cluster together.  Here’s the key, we DON’T have to show that that there are characteristics that give 100% vs. 0%… only that there ARE differences, respectfully large effect sizes, in order to disprove the null hypothesis.

Further Reading on Effect Size

Having prefaced our discussion, let’s describe our hypothetical two types, as described by experienced clinicians:

One group  is exclusively attracted to men, transitions quite young, passed as girls/women with relative ease, were noted to be feminine (sissy boys) by parents and teachers as children, preferred female playmates, avoided rough’n’tumble play, and were unlikely to report finding wearing women’s clothing to be sexually arousing.

The other grouping was sexually attracted to women (as evidenced by extensive sexual experience with women, marriage, and siring children) but may identify as bisexual or asexual, transitioned later in life, rarely passed successfully as women, were considered to have been typical boys (“boyish”) by their parents and teachers, and were very likely to report finding wearing women’s clothes to be, or once had been, sexually arousing.

But what is the evidence and how large are the effect sizes?

Let’s look at some data.  In a study by Lawrence, conducted in 2005 among those who had had SRS by Toby Meltzer, she has three groups, those who had always been exclusively into men (androphilic), those who had always been exclusively into women (gynephilic), and those who claimed that their sexuality has switched from women to men (bisexual).

 

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)
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%

 

So, let’s look at the effect size ages of SRS and of social transition.  When we compare those who had been consistently gynephilic to those who would best be described as bisexual (having claimed sexual attraction to both men and women) we see that Cohen’s d for age of SRS is only 0.11, so tiny as to be essentially zero.  For age of social transition Cohen’s d is 0.0000 = zero.  Thus, we would have to say, for this characteristic and these two populations the null hypothesis is not disproven.  Again, this does not mean that the null hypothesis is proven… only that it is not disproven.  Gynephilic and bisexual transwomen could be the same underlying etiology… or not.

Oh… but let’s look at the androphilic group compared to these other two groups, shall we?  Comparing age of SRS between the bisexual and androphilic Cohen’s d = 1.25, a very large effect size.  Comparing their ages of social transition Cohen’s d = 1.48, also a very large difference.  Finally, looking at the ages of SRS and ages of social transition between the gynephilic and androphilic groups Cohen’s d = 1.09 and 1.44 respectively.  This very powerfully disproves the null hypothesis.  Sexual orientation is definitely important and supports the two type hypothesis.

Lest you think this result is from only one study, consider the even larger Nuttbrock study in which we see that of those who have started HRT, fully one half of the androphilic had done so before they turned age 20, while only one gynephilic individual had done so.

Our description of the two types also mentioned other characteristics, such as gender atypicality and autogynephilia.  Now here, we have a small problem in that we don’t have measures that have a continuous value nor a variance.  These were bivalued.  However, interestingly, because people don’t always answer perfectly, we can use the number of people who answer a given way as a pseudo continuous measure of the real continuous value.  That is to say, if only a small number say yes to a question, it’s likely that the real value is very small.  If a large number answer yes to a question, it’s likely that the real value is very large.  So, let’s look at the values for self image and likely impression to others of being gender atypical.  Oh look, consistent with our earlier conclusion that the gynephilic and bisexual groups were in fact not really different groups, their answers are very similar at 41% vs. 45% and 21% vs. 24%.  These are so close, that we might as well agree that they are identical.  And once again, we see that the androphilic group scores are quite different at 76%.  So, consistent with our earlier conclusion, the null hypothesis that there is only one group is very much disproven.

Before we leave Lawrence’s study, lets look at the issue of autogynephilia.  Again, we have a bivalued question whether one had experienced hundreds (or more) episodes of autogynephilic arousal to wearing women’s clothing.  As before, we see that the gynephilic and bisexual groups are very similar at 52% vs. 58%, while the androphilic group had only 18%.  So, once again, consistent with our earlier conclusion, the null hypothesis that there is only one group is very very much disproven.

Again, lest you think this result is restricted to only this study, we have seen this replicated by Buhrich (1977), Freund (1982), Blanchard (1985), Doorn (1994), Smith (2005), and Nuttbrock (2009), in separate studies spanning four decades, collectively involving over a thousand transsexuals to date.  In fact, this is one of the most repeated and reconfirmed scientific finding regarding transsexuality.

passingtrans

Another characteristic difference mentioned about the two types was passability.  Fortunately, we have a clinical study from the Netherlands which showed a robust effect size d = 0.7 difference between androphilic and non-androphilic transwomen.  The graph above shows the data.  The higher the score, the more ‘readable’ (less passable) the individual.  From the graph, we see that the most passable non-androphilic (gynephilic and bisexual) is just average for the androphilic population.

When we add in the growing evidence that there is a distinct difference between the brains of androphilic vs. gynephilic & bisexual, the null hypothesis that there is only one type is not just merely dead, but most sincerely dead.

Further Reading:

Essay on Lawrence Study

Essays on Evidence Supporting the Two Type Taxonomy

Essays on Brain Sex

Comments Off on Once Again, With Feeling…

Did you hear the one about…

Posted in Transsexual Field Studies by Kay Brown on January 29, 2017

female_scientistOr, Silly Objections

I’ve read and heard so many beyond silly objections to the Two Type Taxonomy that I thought I would start memorializing them.  This will be an ongoing post, with updates occuring as I feel like writing, so I won’t be dating the addendums as is my usual custom.  I will be adding more as I hear or remember more such silliness.  Of course, many of these objections have been thoroughly addressed and laid to rest in my over one hundred essays to date.  Consider finding them on your own as an easter egg hunt by searching / reading all of my blog essays.

Or, better yet, randomly assign them to squares and play Silly Objections Bingo!  Each time you see one of these objections mark your card…

“Autogynephilia can’t be the reason late transitioners transition because HRT would reduce their libido and they would lose interest in transition.”

“Autogynephilia is just an effect of gender dysphoria.”

“Early transitioners don’t have autogynephilia because they got to transition before their gender dysphoria got so bad like mine did.”

“Early transitioners didn’t express autogynephilia because they started HRT before they developed erections.”

“No one would turn their life upside down for a sexual fetish!”

“Autogynephilia only occurs in cross-dressers, not transsexuals.”

“Autogynephilia doesn’t exist; fetishistic cross-dressers are literally getting off on the clothes themselves.”

“Women are autogynephilic too! It’s just normal female sexuality.”

“Straight (androphilic) transwomen are autogynephilic too!”

“There can’t be two types because sexual orientation and gender identity aren’t related.”

“There’s a part of the brain that proves that transsexuals have female brains.”

“I would have transitioned as a teenager too if I had known I could.”

“All transsexuals are the same.  Some just transition at different times.”

“I was feminine when I was young too but hid it from everyone.”

“I have known I was transgender since I was seven years old… so I can’t be autogynephilic.”

“Blanchard, Bailey, Lawrence, and everybody else that support this are just transphobic liars.”

“That theory is so out of date.”

“Autogynephilia? Blanchard just made that up.”

“There’s no proof.  It’s only a theory.  That data has never been replicated.”

“That theory is pseudo-science.”

“That theory has been debunked by scientists (without citation).”

“That paper is fake, Dr. Meltzer is a friend of the community; he would never have given Lawrence access to his patients.”

“Well, I won’t accept it until that paper is peer reviewed by someone other than… (fill in the blank, perhaps with Lawrence, Bailey, Cantor, or anybody else who has already done papers that show evidentiary support for the two type taxonomy)”

“Well, I won’t accept it until I see… (impossibly difficult data to get).”

“We shouldn’t do the science because it will hurt the ‘community’!”

“We shouldn’t talk about this openly until we have won all of our political goals.”

“You only support that because you want people to think you are one of the ‘good kind’ of transsexual.”

“You just hate older transitioners!”

“You compare autogynephilies to pedophiles and that proves you’re wrong!”

“This theory completely ignores the existence of transmen!”

Tagged with:

Comments Off on Did you hear the one about…

Who Knows Best?

Posted in Film Review by Kay Brown on January 14, 2017

Video Review:  Transgender Kids: Who Knows Best?

I just finished viewing BBC Two’s documentary on the contraversy about whether the “affirming” model is best for gender dysphoric, potential transkids.  It is well worth viewing.  It covers the full ground while (mostly) being sensitive to the transcommunity.

But sadly, it fails in several key respects.  One, it completely fails to mention that transkids are nothing like adult transitioners.  At times we catch B roll scenes of adult transsexuals, which one instantly recognizes as autogynephiles.  So this failure to distingish the two may lead naive viewers to mistakenly equate the two.

Also unhelpful, the documentary interviews one person who frankly had no idea what she was talking about regarding sexual dimorphism of the human brain. While correctly saying that one couldn’t simply look at a brain and say whether it came from a man or a woman, she fails to mention that we can see statistical trends.  But worse, she flat out states that brains only become ‘gendered’ by living in a gendered society, completely ignoring research that shows the correlation with sexual dimorphism of the brain and sexual orientation.

The areas that the documentary does cover well is the well known phenomena of desisting of gender dysphoria in most gender atypical young children by the time that they are twelve or so.  They interview a girl who had been extremely dysphoric as a younger child who desisted at puberty.  As I’ve discussed in a previous essay, 80% of such dysphoric children do desist.  The video also mentioned that most of the desisting boys will grow up to be conventional gay men and not transgender.  However, the video introduces a straw man, lumping all “transgender activists” together as saying that we all wish to sweep this inconvenient fact under the rug.  Fortunately, though it was not well show-cased, this was (partially) shown to be untrue as they interviewed an FtM transman / activist / gender therapist who acknowledged this in passing, though he also contradicted himself and made an outright lie in stating “If someone says that they are transgendered, than chances are that they are transgendered”.  We know that this is simply untrue for pre-pubescent children.

The documentary interviews both Ray Blanchard and Kenneth Zucker.  I felt Dr. Blanchard was well spoken and articulate.  But frankly, and this truly surprised me, I came away feeling far less sympathy for Dr. Zucker than before.  Perhaps the editors are partly responsible, in that they used some odd frame editing at times, perhaps they chose the quotes where Zucker was the least sympathetic?  But Dr. Zucker seemed to lack all empathy for these kids and never once affirmed that transition was a viable option that should be considered for persistors.  Further, one got the opinion that Dr. Zucker was taking credit for his treatment having lead to desisting outcomes, that from his attitude while speaking, he would consider a better one than persisting.  (As a persister myself, having been “treated” with just the type of play therapy and later direct talk therapy that he outlines, I find that attitude offensive.  For the record, I firmly hold that neither outcome is better than the other.)  He even insinuated that parents who are ‘affirming’, who helped their children transition, are homophobic, refering to a remark, that may likely be apochraphal, supposedly a quote from a parent, “Well… at least they’re not gay.”  (Most parents who are homophobic are even more virulently transphobic; like my father who begged me not transition, promissing that he would look the other way when I had boyfriends over – just like he did with his gay brother.)  What really was disturbing was his strong attempts to pathologize all gender atypical and dysphoric children as suffering from a wide range of mental illnesses, which was echoed by one of his former colleagues, specifically arguing against the oft noted concerns regarding reaction to stigma (that is, Zucker and his former colleage questioned the conventional wisdom that transkids are depressed and anxious because they are teased, bullied, and considered a dissappointment and embarrassment to family and peers).  Frankly, I was dismayed.

The real heros of the documentary are the transkids who were interviewed.  One’s heartstrings were tugged, as one would expect, but these kids also told their stories with brutal effect.

All in all… a must see.

If you are in the UK, you may watch the video here: http://www.bbc.co.uk/programmes/b088kxbw

Further Reading:

Essay on Desisting and Persisting Gender Dysphoria in Gender Atypical Children

Advice to Parents of Transkids

Comments Off on Who Knows Best?

When in the Course of Human Events…

Posted in Editorial by Kay Brown on January 1, 2017

Kay BrownOr, Why The Two Types of MTF Transsexuals Should Be Recognized and Treated Separately.

These past few years has been an interesting one from the standpoint that we are seeing more papers supporting the Fruend / Blanchard Two Type Taxonomy in that Blanchard’s prediction that the two types would have differential neural corralates (brain differences).  But this past year, we saw two very important papers from Hsu et al. {See previous essay} when combined with previous papers by Blanchard and Veale, lend powerful support to what a number of ‘early onset’ MTF transwomen have been saying more sotto voiced, as Velasques did,

“Teen hsts should not be required to attend support groups for older transsexuals. The two groups have nothing in common and many of us have had upsetting experiences being forced to attend meetings with people who have had a transvestic etiology as opposed to a homosexual one.”

Quite simply, autogynephilic transwomen are sexually attracted to, sexually objectify, and inappropriately romantize ‘early onset’ transwomen and our lives.  Further, they are given licence to make pruriently inappropriate comments and questions regarding such youngsters appearance, attractiveness, genital surgical status, and sexual experiences under the guise that “we are all just girls here”, comments and questions that would not occur in groups of only transkids, and certainly not from women.  As I put it in my 2009 essay on the Transkids website,

“In transsexual support groups, homosexual transsexuals are in a minority position from the beginning. It is human nature to seek out those like themselves, so occasionally an HSTS finds a support group, but soon feels out-of-place and uncomfortable, unable to relate to AGPs and the issues that AGPs most want to discuss. Unless the support group is moderated by an experienced therapist, the naturally more masculine and dominant AGPs, accustomed to male privilege, will tend to monopolize the conversations. Further, since a portion of the AGP population is strongly attracted to other transsexuals, especially to those who are physically and behaviorally more feminine, the HSTS minority may be subject to unwanted sexual advances from the AGP majority. Naturally, finding no real support for, or mirroring of, her own concerns, and made uncomfortable by sexual objectification, the lone HSTS will quickly drift away, leaving the support group to the AGPs.”

Both of these quotes actually understate the problems when ‘early onset’ transwomen are required to attend therapy with autogynphilic transwomen.  We now have laboratory and survey evidence that all autogynephiles, not just a “portion”, are strongly, in fact preferentially, attracted to gynandromorphs, that is, pre-operative, young, physically and behaviorially feminine ‘early onset’ transkids.

I can just hear my reader’s thoughts, “So what?  Lots of people find themselves the subject of attraction.  They deal with it just fine.”  Yes, but consider for a moment that we are talking about young, naive, teenagers and young adults who first attend such therapy sessions with the nearly explicit assumption that they will be in a group of transwomen “that are just like them”.  If your only model of who and what ‘transsexuals’ are is yourself, and perhaps the popular culture’s ever present mantra of “a woman trapped in a man’s body”… then one will enter that room with no adequate defences to both the sexual objectification and to the mind fuck of trying to square the rather odd differences between one’s self and one’s experiences as an obviously gender atypical and androphilic person and the presentation and experiences (not to mention implausable histories) of the autogynephilic majority in the group.  In effect, that youngster begins to ask, “If these are transwomen… then WTF am I?”  I know I certainly had this rather dizzying experience the first time I met “transsexuals”,

“During my second semester in college, I met other transsexuals for the first time, at the [Stanford] clinic. What I found surprised and confused me. They did not seem to be unaffectedly feminine, without effort, but more like men who desired to be feminine and were working desperately to appear so. I was acutely embarrassed for them. Most were much older than me. Many of them had been, or still were, happily and sexually satisfactorily married to women for years. I couldn’t understand why they wanted to live as women.  If I was surprised and confused by them, they were just as surprised and confused by me. I was asked how it was possible that I had been dating, and sexually active with, men, especially as I was pre-op. I had dated four straight boys who had been high school classmates, besides the young men that I met when I left home for college. None of the others at the Clinic had ever dated a man.”

Even this quote from my 2009 essay understates the negative consequences that occured within weeks of that first introduction to autogynephilic transsexuals in that because of it, and the fact that I was experiencing severe housing and food insecurity due to having been effectively disowned by my family, one of these autogynephilic transwomen ‘kindly’ offered to take me in… only to later demand sexual favors in return when the alternative was homelessness.  Had I known the nature of autogynephilic sexuality and mendacity… or had I not been thus improperly included in this session in which Stanford had tacitly vetted the others, this “upsetting experience” would not have occured.

Just as it is inappropriate for ‘early onset’ transwomen to be required or encouraged to attend such mixed group therapy, it is even more inappropriate to place MTF transkids in the same hospital room with an autogynephilic transsexual, as I wrote in my parental advice essay,

“Insist that your child have either a room to themselves, or with another transkid of the same social gender and sexual orientation.  Under no circumstance allow your MTF child to share a room with an adult MTF transitioner.  The hospital administration usually has no real clue about the realities of transsexuality and transsexuals, and think that we are all the same.  No one would think of asking a young lady to share a hospital room with an older straight man… but that is in effect what is happening in hospitals on a regular basis.  Autogynephilic MTF transsexuals are sexually attracted to women, and often, even especially, to young MTF transkids.  Further, a fair number of autogynephilic individuals sexualize the very act, the process of changing sex, both in themselves and in others.  Due to a lifetime of socialization as men, and only limited experience in their new gender role, these individuals often do not recognize appropriate boundaries.  Do not allow your child to be so exposed when they are at their most physically and emotionally vulnerable point in their young lives!  (I myself had a very upsetting incident when I had SRS.  A few years ago, I accompanied a transkid to that very same hospital, who had a similar experience, 28 years after my own. )”

While I do not wish to share the nature of my “upsetting incident” in the hospital, I don’t believe that these experiences are unique to me.  In point of fact, it is not hard, by scanning the web, to find accounts of others describing “upsetting” experiences either in group therapy or while at a hospital for SRS.  In one case I recall, a youngster described the older transistioning members of her group, “pervy”, while another used “skeevy”, when addressing the unwanted and inappropriate sexual attention they received.

I feel strongly, especially now that we have such strong evidence to support both the Two Type Taxonomy AND the now well documented sexual preference for ‘early onset’ MTF transkids, that including them in the same support groups, group therapy sessions, and hospital settings, borders, if not crosses into, malpractice.  MTF transkids should not have to put up with unwanted and very inappropriate sexual attention / harrassment just to get past the “gate-keepers”.

It is past time that WPATH recognize the two type taxonomy and that differential diagnostic criteria be included in the APA Diagnostic and Stastical Manual.

Further Reading:

Information for Health Care Providers

S. Alejandra Velasquez, “Treatment Recommendations for HSTS Transkids”
http://www.transkids.us/recommend.html

Kay Brown, “The Invisble Transsexual”
http://www.transkids.us/invisible.html

Essay on Autogynephiles and Gynandromorphophilia

Essay on “upsetting” experiences with an AGP transwoman

Advice to Parents of Transkids

References:

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Sexual Arousal Patterns of Autogynephilic Cross-dressing Men”
https://www.researchgate.net/publication/308036975_Sexual_Arousal_Patterns_of_Autogynephilic_Male_Cross-Dressers

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Who are gynandromorphophilic men? Characterizing men with sexual interest in transgender women”
http://d-miller.github.io/assets/HsuEtAl2015.pdf

Jaimie F. Veale, Dave E. Clarke and Terri C. Lomax, “Sexuality of Male-to-Female Transsexuals”
http://www.springerlink.com/content/bp2235t8261q23u3/

Anne A. Lawrence and J. Michael Bailey
Transsexual Groups in Veale et al. (2008) are “Autogynephilic” and “Even More Autogynephilic”
http://www.springerlink.com/content/u473w370g11vx758/

Jaimie F. Veale, David E. Clarke and Terri C. Lomax
Reply to Lawrence and Bailey (2008)
http://www.springerlink.com/content/cm2531l3m3148377/

Blanchard R, Collins PI., “Men with sexual interest in transvestites, transsexuals, and she-males”
http://www.ncbi.nlm.nih.gov/pubmed/8245926

Blanchard R., “The she-male phenomenon and the concept of partial autogynephilia”
http://www.informaworld.com/smpp/content~db=all~content=a789560133

Comments Off on When in the Course of Human Events…

…She Loves Me.

Posted in Transsexual Theory by Kay Brown on November 16, 2016

female_scientistAre Autogynephiles also Gynandromorphophiles?

Are cross-dressers also tranny-chasers?  We had already seen a study that clearly demonstrated that transfans are more like straight men than like gay or bisexual men and that they are also at least somewhat autogynephilic.  But we have to ask, are all autogynephilic males also gynandromorphophilic?

In my personal experience, yes, both cross-dressers and “late transitioning” / “late onset” transwomen were in fact avid transfans.  I can’t tell you how often I saw that sexually admiring look from such transwomen, especially when I was decades younger than I am now.  There have also been a few who were hopelessly in love with me who sadly pined for what I could not return.  But that is all anecdotal; we need data.

Well, now we have that data.

In a recent paper following up on their earlier paper, Hsu, et Al., tested the sexual response of 27 known autogynephilic males, cross-dressers specifically recruited for this study, of whom 74.1% reported cross-dressing at least once a week, on average (M=5.26, SD=1.40). They also reported a high average degree of transvestic fetishism (M=4.11, SD=1.19). Consistent with their transvestic fetishism, these men reported a high average degree of autogynephilia (M=6.44, SD=2.47) on the 8-item, sum-scored Core Autogynephilia Scale, although two denied any autogynephilia on this measure despite reporting arousal from cross-dressing.

Using this same Core Autogynephilia Scale (0-8), the mean score of the gynandromorphilic (GAMP) subjects, recruited for their strong interest in transwomen (N=24), was 2.88 (SD=3.47) compared to the straight subjects (N=21) score of 0.35 (0.99) and that of the gay subjects (N=21) of only 0.06 (0.24).  Even more interesting is that when we further divide the GAMP groups into those who self-identify as “bisexual” and “heterosexual”, we see a difference between their autogynephilia scores of 5.20 (3.46) and 1.21 (2.42) respectively.  This is very much in keeping with other research that shows that autogynephilic (AGP) transwomen often exhibit “pseudo-bisexuality” (aka: pseudo-androphilia) in which their interpersonal autogynephilic sexual ideation includes fantasies of having sex with men, as women.  The data suggests that while most of the GAMP subjects were highly AGP, a few might be only mildly autogynephilic.

gampAgain, our question is are all autogynephiles also gynandromorphophiles?  From the data we can see that, why yes, yes they are.  Note that the relative sexual response, using a ‘peter-meter’ is identical between the GAMP and Autogynephilic (cross-dresser) groups.  Both groups show higher sexual response to gynandromorphs (GAM – pre-op feminized MTF transwomen) than to females.  Interestingly, the cross-dresser group has a lower response overall.  This is very much in keeping with earlier work from Blanchard that showed that autogynephilia competes with gynephilia.  In this case, we now have data that shows that it also competes with their co-existing (greater) gynandromorphophilia.

Also, thanks to Veale, who showed that gynandromorphophilia is common in autogynephilic transwomen, we have yet more evidence that AGP transwomen are in the same etiological taxon as non-gender-dysphoric cross-dressers, further supporting the Two Type Transsexual Taxonomy.

Further Reading:

Essay on Sexual Response of Gynandromorphophiles

Previous essay on personal experiences with TrannieHawks

Commentary on the mutual gynandrophmorphophilic relationships between autogynephiles in my essay on transsexual marriages.

References:

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Sexual Arousal Patterns of Autogynephilic Cross-dressing Men”
https://www.researchgate.net/publication/308036975_Sexual_Arousal_Patterns_of_Autogynephilic_Male_Cross-Dressers

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Who are gynandromorphophilic men? Characterizing men with sexual interest in transgender women”
http://d-miller.github.io/assets/HsuEtAl2015.pdf

Jaimie F. Veale, Dave E. Clarke and Terri C. Lomax, “Sexuality of Male-to-Female Transsexuals”
http://www.springerlink.com/content/bp2235t8261q23u3/

Anne A. Lawrence and J. Michael Bailey
Transsexual Groups in Veale et al. (2008) are “Autogynephilic” and “Even More Autogynephilic”
http://www.springerlink.com/content/u473w370g11vx758/

Jaimie F. Veale, David E. Clarke and Terri C. Lomax
Reply to Lawrence and Bailey (2008)
http://www.springerlink.com/content/cm2531l3m3148377/

Tagged with:

Comments Off on …She Loves Me.

Silly Stereotypes

Posted in Editorial, Science Criticism by Kay Brown on November 6, 2016

phrenologyWhen I was being evaluated by the Stanford Gender Dysphoria Clinic, they had me answer a number of questionaires.  Of course, as a naive teenager, not yet having the background in science, especially in psychology, I took them thinking that they might help me get past these evaluations such that I would be OK’ed for SRS.  Only later did I learn that these were not diagnostic but research tools.  Later, I came to recognize them and studied them.  One of them was the Bem Sex Role Inventory.  Interestingly enough, I learned the most damning things about this instrument, not in my psych studies, which I did, but from my U.S. History, Women’s Emphasis Class in 1977.  In that class, I learned about gender stereotypes, their power to shape politics… and as any feminist knows, the personal is political.  Suddenly, for me, my personal experience taking the inventory become political.

Why am I writing about this now?  Because I still see this inventory being touted as though it had any kind of scientific validity as a window into intrisic gender meaning… that it shows any sort of truly sexually dimorphic differences in personality.  It does not.

Then what does it show?  Stereotypes.

The Bem Inventory was developed in 1974 by Sandra Bem, a feminist psychologist.  Bem did not intend it to be, and in fact later bemoaned that it had misused as, a gender identity tool.  It was a tool to explore how individuals hewed, or not, to societal gender stereotypes, period.

I recall, that as I learned about the inventory, how dismayed I was about its use… and how many of the stereotypes made no real sense.  Consider a couple of the terms that were supposed to be “feminine” and “masculine” qualities like “gullible” and “loyal”.  WTF!?!?

In 1974, these were qualities that were considered “feminine” and “masculine”… but not today.  This inventory only helps us understood sexist stereotypes of the mid’70s not who we are today… and certainly does NOT tell us if we are men, women, or transgendered.  It’s far past time to leave the Bem Inventory in the footnotes section of history books.

Further Reading:

“I Took the Bem Sex Role Inventory From 1974 and This Is What Happened”, by Lara Rutherford-Morrison

Comments Off on Silly Stereotypes

Personality, My Dear…

Posted in Science Criticism by Kay Brown on October 6, 2016

phrenology…I Don’t Give a Damn!

or What is the Rate of Co-morbid Personality Disorders in Transsexuals?

I recently came upon a blog that made much of a single paper out of Iran which purported to show that about 80% of transsexuals had a serious personality disorder.  I was shocked at such a result and had to dig deeper.  Well… this paper seems to be an outlier and its use by this blogger (who fits the profile of an angry ex-wife of an autogynephilic transgender-woman turned transphobic crusader) is an example of cherry picking.  Another paper I found was only 24% of the transsexuals had “subthreshold” potential personality disorders compared to 17% of the controls.  (Note, “subthreshold” does NOT mean that they actually had the disorder.)  But why did this first paper get this outrageous percentage of actual disorders when other studies didn’t?

Because they did NOT diagnose anyone, period.  Instead Meybodi used the Millon Clinical Multiaxial Inventory II (MCMI- II), a self-scored inventory and assumed that if they got a high score on any particular scale that they must then have that clinical diagnoses.  This alone is a gross misuse of any instrument; a test score alone is NOT a diagnoses of a disorder.  From the paper, all we know is that their subjects scored higher than a non-reported cut-off, likely the one used by the publishers to indicate the “presence” of a trait.  The researchers fully admit that they did NOT actually interview and determine if the score had any bearing on actual dysfunction.  It is important to note that to have a diagnoses of a disorder, the personality trait must cause significant dysfunction to their lives.  This study failed to evaluate this dimension.  The most common of the purported personality disorders was Narcissistic Personality Disorder at nearly 60%, which given that this paper was from Iran, surprised me greatly.

As Lawrence has shown, the percentage of non-androphilic MTF transfolk is correlated with a given society’s Hofstede Individualism Index, which for Iran is 41, and thus we would expect a very low percentage.  And indeed, anecdotal reports regarding Iran’s MTF population agree.  But we know that from a number of studies and clinical surveys, that exclusively androphilic MTF transsexuals have a LOWER co-morbidity rate.   So what gives?

The answer seems to be that this study failed several basic tenets of science.  First, they failed to provide controls, which had they done so, might have flagged another issue with their methodology, namely that the MCMI-II was written and only validated in ENGLISH and is only valid for those who have at least a 5th Grade literacy level IN ENGLISH.  One assumes that the researchers simply translated the inventory items from English to Farsi and did not conduct a proper re-validation study given the very divergent cultural meanings potentially introduced by this translation?  If so, as Rogers points out, this is a gross abuse,

“Multiscale inventories can be translated into different languages with relatively little effort. The critical issue is that linguistic equivalence (i.e., similar sentences) cannot be equated to clinical equivalence (i.e., similar diagnostic relevance).  Clinical equivalence cannot be assumed, but must be objectively tested. Simple comparisons of vocabulary and syntax (e.g., from English to Spanish) are insufficient to establish clinical validity for translated versions.  An approach to translation validation in which a mere lack of significant group differences between two language or ethnic groups is assumed to mean the tests “work the same way” makes little sense. With depressed patients, for example, the clinician needs to know whether or not depressed persons of different cultures and languages have the appropriate elevations on multiscale inventories. Given our dearth of knowledge regarding translated versions and their cultural differences, psychiatrists and their consultants should be very cautious about using and interpreting translated tests.”

Even if the translation into Farsi was validated, there is the problem of interpretation; a high score on a given scale does NOT necessarily mean that one has a personality disorder.  In fact, emotionally healthy people often have high scores on scales that correlate to Narrissistic Personality Disorder as Stephen Strack explains in his book, Essentials of the Millon Inventories,

“Scale 5 has a research base that suggests that elevated scores indicate either a clinical personality disorder or a healthy adaptional personality style associated with with nonclinical people.  In factor analysis studies, Scale 5 loads positively on items dealing with extroverted traits and behaviors and negatively on items pertaining to maladjustment. … Elevations on Scale 5 are rare in psychiatric samples.  Many nonclinical populations attain elevated scores on Scale 5 including air force pilots in basic training. … Thus the clinical task is to determine whether clinically elevated scales represent a Narcissist Personality Disorder or a narcissistic personality style.  … versions of this scale have not correlated well with structured psychiatric interview schedules.”

Anyone who is familiar with either the literature on, or knows “early onset” / transkids in person knows that they can be quite extroverted, even flamboyantly so, without developing Narcissistic Personality Disorder.  Finally, a study that used structured interviews showed significantly lower co-morbid issues than those studies that used translated personality inventories, from the abstract of the Haraldsen paper,

“Transsexual patients scored significantly lower than Personality Disordered patients on the Global Symptom Index and all SCL-90 subscales. Although the transsexual group generally scored slightly higher than the healthy control group, all scores were within the normal range.  Transsexual patients selected for sex reassignment showed a relatively low level of self-rated psychopathology before and after treatment. This finding casts doubt on the view that transsexualism is a severe mental disorder.”

The conclusion here can only be that we must evaluate the literature on transsexuals and co-morbidity very carefully and critically, not accepting them at face value unless we can determine that they have been conducted with proper methodologies, including proper interview based psychiatric diagnoses, compared against valid controls from both clinically relevant disordered and healthy populations, and shown to be reproducible.  Anything else is just junk science.  {And cherry-picking the worst data you can find to defame transfolk is despicable.}

References:

Maybodi, et Al., “The Frequency of Personality Disorders in Patients with Gender Identity Disorder”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301205/

Bodlund, et Al., “Personality Traits and Disorders in Transsexual” (1993)
https://www.ncbi.nlm.nih.gov/pubmed/8296575

Rogers, R., “Forensic Use and Abuse of Psychological Tests: Multiscale Inventories”
http://www.reidpsychiatry.com/columns/15%20Rogers%2007-03%20pp316-320.pdf

Haraldsen, et. Al., “Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults”
https://www.ncbi.nlm.nih.gov/pubmed/11089727

Comments Off on Personality, My Dear…

Dangerous Thoughts

Posted in Science Criticism by Kay Brown on August 15, 2016

critical-thinkingIt has long been noted by sexologists, and folk in the “kink” scene, that if one has one paraphilic sexual interest, the likelihood that individual will have other paraphilic interests is dramically increased.  Some of these paraphilic sexual interests tend to cluster.  It is these clusters that help sexologist delve into potential underlying common sexual functions that are distorted (hence the the common term “kink”).  One of these clusters is that of Voyeurism, Exhibitionism, Frotteurism, and Paraphilic Rape, that are grouped together as Courtship Disorders.  Another cluster is Autogynephilia & Autoandrophilia (most often found as “transvestic fetishism” = “erotic cross-dressing”),  Autopedophilia, and Apotemnophilia group together as Erotic Target Location Errors.  But there have also been many observations of of clustering of other paraphilias that don’t have obvious connections of an underlying common function (other than sexualility in general).

Given the current political climate and some rather pointed and ugly recriminations and insinuations regarding transgender people and the safety of women & children in sex segregated facilities, it behoves us to seek real data rather than polemical rhetoric.  In a very timely study involving nearly 6,000 subjects chosen because they are members of a twin birth, the incident rates and co-occurances of various paraphilic sexual interests was explored, including “transvestic fetishism” and “sexually coersive behavior”.

As has been known for decades, most people with an Erotic Target Location Error are male.  Males are about nine times more likely to have autogynephilia as females are to have autoandrophilia, with 4.6% of males aroused by cross-dressing and only 0.5% of females.  Please note, the number of females was not zero… only small.  Compare this number to the estimated 3% to 6% of females being exclusive gynephilic.  This ratio also fits the data we have on the relative numbers of gynephilic FTM transmen vs. androphilic/bisexual FTM transmen, adding statitical support to the hypothesis that androphilic/bisexual FTM transmen are autoandrophilic.

First, the good news for transfolk.  There was no independent correlation between transvestic fetishism (both autogynephilia and autoandrophilia) and sexually coersive behavior.  That is to say, that neither autogynephilia nor autoandrophilia alone has any effect on the likelihood, one way or the other, on whether an individual would be sexually coersive.

On the other hand… that’s not the whole story.  As I mentioned above, the likelihood that one will have a co-occuring paraphilic interest is increased with autogynephilia or autoandrophilia, as the data from this paper showed.  And with THAT OTHER paraphilic sexual interest, there WAS a correlation with an interest in sexual coersion.

But, before going deeper into the data, it is important to explain a bit about the study and what constituted interest in sexually coersive behavior in this study.  The question asked whether the thought of persuing a range of behaviors from deliberate deception (not simple dating exageration) to acheive sexual contact, forcing contact, taking advantage of an incapacitated individual, to forcable rape was sexually arousing.  The raw numbers in the population at large were to be honest, more than a little disturbing; They were in fact horrifying.  The number of men who had an interest (not neccessarily actualized / committed such an act) in being sexually coersive was 18.5%.  That’s nearly one in five men indicated that the idea of performing a sexually coersive act was sexually arousing.  The percentage of women who found the thought of performing (not being the victim of) such an act was significantly lower at 3.6%.

Again, while autogynephilia and autoandrophilia alone were not independently correlated with an interest in sexually coersive behavior, when controlling for other paraphilias, this only meant that they were no more likely to have an interest in such coersive acts as the general population.  That is to say, that 18.5% of autogynephilic males without a co-occuring paraphilia is interested in sexual coersive acts.

So the good news isn’t that autogynephilic only males are less likely than other males… only as interested as other males in sexually coersive acts.

The bad news is the fact that paraphilias cluster and that there is an increase in the likelihood of co-occuring paraphilias and that as shown in this paper, sexual interest is some paraphilic behaviors correlates with increased interest in sexually coersive behavior, which in turn would suggest that autogynephilia and autoandrophilic people in general would be more likely to be interested in such acts.  And, sadly for transfolk, this is the case.  The number of autogynephilic and autoandrophilic people (the study lumped male and female “transvestic fetishism” subjects, but given that males are nine time more likely than females to experience transvestic arousal, most of the subjects are male) that are sexually interested in sexually coersive behavior is a disturbingly high 28.3%.  That is to say, that one in four finds the thought of performing a sexually coersive act to be sexually arousing.  Remember, this does not indicate that transfolk are more likely to actually act on such desires, only that they find the thought of it arousing.

Paraphilic Interest          Males          Females           AGP/AAP
Transvestism                     4.6%             0.5%                  100%
Voyeurism                          18.2%             6.3%                 39.8%
Exhibitionism                   4.3%              0.6%                  12.4%
Sadism                                 2.7%             2.3%                   11.5%
Masochism                         4.9%             8.6%                  24.8%
Sexual Coersion               18.5%             3.6%                  28.3%  (AGP/AAP alone: 20%)

What is surprising in this data is that the % of autogynephiles/autoandrophiles that were also interested in voyeurism is so high.  I personally hadn’t seen this suggested in the literature.  We see lots of references to the high co-occurance of sexual masochism.  It may be because of the relative ratios; AGP folks are about twice as likely to be interested in voyeurism as men in general, while they are five times more likely to be interested in masochism as men in general.  Perhaps I shouldn’t be as surprised as I am considering the oft noted intense interest in pornography among AGP transgendered people?  Perhaps pornography could be considered a watered down version of voyeurism?

Going back to risks of paraphilic sexual interests causing actual sexually coersive acts, the authors estimated from this and other data that perhaps one in three sexual assaults may be averted if all paraphilic individuals were identified and provided treatment interventions aimed at keeping them from acting on their sexually coersive interests.  This would, conversely, suggest that two thirds of such assaults are mediated by other factors including Rape Culture in a misogynistic male privileging environment.

Further Reading:

Essay on Erotic Target Location Errors

Essay on Autogynephilia

Essay on Autoandrophilia in Androphilic/Bisexual Transmen

Reference:

Baur, E., et Al, “Paraphilic Sexual Interests & Sexually Coersive Behavior: A Population-Based Twin Study” Archives of Sexual Behavior:  DOI:10.1007/s10508-015-0674-2

Comments Off on Dangerous Thoughts

A Voice of Their Own

Posted in Science Criticism, Transsexual Field Studies by Kay Brown on July 9, 2016

Or, What Do Transkids Think About Puberty Suppression?

transkids

Transkids after transition

In the media and especially in social media, we see lots of discussion regarding what is the appropriate standard of care for transkids.  Many adults seem to be horrified by the idea that kids should be treated at all.  Of course, anyone that thinks about it clearly will see that without puberty suppression, one is already making a decision to treat them with hormones, the ones that the body starts to make at puberty.  Thus, the justification for puberty suppression, under the notion that delaying it isn’t really making a hard and fast decision.

But what of transkids themselves?  What do they think about it all?  How about asking them?  Well, a recent paper does just that, as the paper describes them,

“They were between 13 and 18 years of age, with an average age of 16 years and 11 months, and a median age of 17 years and 4 months. All adolescents, except for one, were treated with puberty suppression. The mean age at which the adolescents started treatment with puberty suppression was 15 years and 10 months. The adolescent who was not treated with puberty suppression immediately started treatment with cross-sex hormones because she was above the age of 18 when treatment was indicated, which is in line with the Dutch protocol. Five adolescents were trans girls (natal boys with a female gender identity) and eight were trans boys (natal girls with a male gender identity).”

Note that puberty suppression was their only option until age 18, a state of affairs that I have argued, and will continue to argue, it both unnecessary and cruel, but better than nothing.  This protocol privileges desisters and indeed all non-gender-dysphoric teens in that an active or implicit decision to deliberately use endogenous hormones to masculinize or feminize (as the case may be) their bodies is socially sanctioned, actively encouraged even, but an active decision on the part of gender dysphoric teens is considered suspect and their ability to make such a decision is deemed problematic.  {Can nobody else see the double-standard?  Why, if this is all about not trusting teens to make this decision, are ALL teens not put on puberty blockers until they are adults?}  All evidence points to the age of 14 being an appropriate age to end, not begin, puberty suppression, to be replaced with conventional Hormone Replacement Therapy.  But concerns about transphobic public resistance prevents this evidence based medicine approach.

{On a personal note, I first learned about HRT at age 15, but my pediatrician recommended my mother send me to psychotherapy to “cure” me instead. I began actively requesting feminizing HRT from the Stanford Gender Dysphoria Clinic at age 17 in 1974.  I was denied this.  I had to wait until I was legally of age and began HRT very soon after my 18th birthday in the summer of ’75.  In those days, puberty suppression was not available.  I deeply regret what that delay did to my singing voice.}

So what did these modern teens have to say?  Here’s a typical comment,

“I think it is hard to set an age requirement. On the one hand I think 12 years is a good age minimum, on the other hand I think that a transgender whose puberty started earlier should have the possibility to start treatment with puberty suppression before the age of 12.” (trans girl; age: 13)

You may wish to read the rest of what they had to say at the actual paper at the link below, as it is not behind a paywall, thankfully.

Further Reading:

Essay on evidence for best age to end puberty suppression based on age of desisting gender dysphoria

Essay by Alejandra Velasquez at the transkids.us website on treatment recommendations for MTF transkids. {Note:  Ms. Velasquez was ~20 when she wrote the essay in 2004}

Essay on Advice to Parents of Transkids

References:

Vrouenraets, L. et al. “Perceptions of Sex, Gender, and Puberty Suppression: A Qualitative Analysis of Transgender Youth”
Archives of Sexual Behavior (2016). doi:10.1007/s10508-016-0764-9

Comments Off on A Voice of Their Own

Brainstorm

Posted in Brain Sex, Confirming Two Type Taxonomy, Female-to-Male by Kay Brown on July 2, 2016

critical-thinkingA new review paper has just been published on the current status of brain structure research in transsexuality.  Interestingly, it was submitted to the Archives of Sexual Behavior two full years ago.  This suggests that it went through a rather thorough peer review.  For myself, the first thing I do when reading a review paper is to see that the reference list is comprehensive to ensure that the authors aren’t cherry-picking.  In this case, they are not.  The paper looks to be very complete and scientifically honest.  You may wish to read it yourself, as it is not behind a paywall, thankfully.

The paper is written rather densely, with a great deal of information and discussion; so much in fact, that I will likely be writing several essays covering a number of topics from it.  At the high level, my regular readers will not be surprised at the primary conclusions drawn from the review, as I had already written about a fair number of the brain research papers.  The authors offer this chief conclusion at the end of the paper,

“The review of the available data seems to support two existing hypotheses: (1) a brain-restricted intersexuality in homosexual MtFs and FtMs and (2) Blanchard’s insight on the existence of two brain phenotypes that differentiate “homosexual” and “nonhomosexual” MtFs”

The review of all of the available brain structure research fully supports the Two Type Taxonomy.  In light of this, the authors recommend that future researchers take care to distinguish between the two types, lamenting that some studies in the review had not made this distinction, and further, that it is important that the control groups also be concordant with sexual orientation,

“The study of mixed samples implicitly assumes that transsexuals are a homogeneous group. This is far from the truth with respect to the onset of GD and sexual orientation.  …  These observations signify that control groups in studies of the transsexual brain must be homogeneous in regards to sexual orientation.”

The authors did find separate studies of androphilic “homosexual” MTFs and non-gender dysphoric gay men that used the same methods, such that a tentative comparison could be made,

“The only study on the CTh [cortical thickness] of homosexual persons that do not present gender dysphoria is by the Savic group (Abé et al.). If we compare this study with that of Zubiaurre-Elorza et al. on the CTh of homosexual MtFs, we see both studies report sex differences showing an F > M pattern in similar structures of the right hemisphere. But there is only one region, the pars triangularis, in which homosexuals and homosexual MtFs both present differences. However, these changes are in opposite directions. The pars triangularis of homosexual MtFs is thicker than in heterosexual male controls, while for homosexuals it is thinner than in heterosexual males. Thus, it seems that for transsexuals this region is feminized but demasculinized [i.e.: “different that straight men, but not in the heterosexual female direction” – K. Brown] in homosexual individuals. Interestingly, in both studies, the affected pars triangularis is in the right hemisphere. Nevertheless, confirming Blanchard’s prediction still needs a specifically designed comparison of homosexual MtF, homosexual male, and heterosexual male and female people.”

This is interesting, that there is a difference between gay men and androphilic transwomen?  But the right hemisphere pars triangularis of all things?  For left hemisphere dominant people, this region of the brain is believed to be involved in the understanding and production of prosody, emotionally nuanced speech modulation.  We know this because individuals who have serious lesions in this area have trouble with prosody.

For more information, read the Wikipedia page on prosody.

Before anyone gets too excited about the possible implications for a neurological marker for androphilic transsexuality that differentiates them from gay men, we need to note that the brain exhibits neuroplasticity.  That is to say, that like a muscle, exercise of particular skills causes the brain to increase in volume and neuron number in those regions used to supply that skill.  If this is about language and more particularly, about language production that imparts an emotional / sexual identity / gender identity through one’s voice, the difference in this part of the brain may be caused by experience and practice.

For more information, read my essays on feminine speech production and on voice recognition.

On the other hand, it just might represent a real difference.  We need more studies.

References:

Guillamon, A et al., “A Review of the Status of Brain Structure Research in Transsexualism” Arch Sex Behav (2016). doi:10.1007/s10508-016-0768-5

Comments Off on Brainstorm