On the Science of Changing Sex

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.

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

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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:

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

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…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/

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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 personality 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

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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

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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

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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

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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

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In the Dark Room

Posted in Book Reviews by Kay Brown on June 23, 2016

darkroomBook Review: In the Darkroom by Susan Faludi

This review is painful to write.  The book was painful to read.  I suspect that it was painful for Faludi to write it.  Faludi is an excellent writer; one that I’ve enjoyed reading before.  But in this book, she must confront the confusion of having a father become a post-op transwoman, at a very late age.  As a reader with my background, having transitioned as a teenager, I remember MY confusion meeting such late transitioning transwomen with no clue as to how different they are from our conception of who and what a transsexual is and/or should be like… reading her book is like revisiting that confusion all over again, but with the addition emotional pain of having known a father all of one’s life – and NOT being able to reconcile the cultural image of a transsexual and the reality of knowing an agressively masculine man as one’s father.

Much of the book also deals with Hungary itself, which frankly, held no interest for me.  Other readers may feel differently.  It should be no surprise that as the book unfolds, told as part travel log to Hungary where her father now lives, part family history flashback that we see disturbing instances of inappropriate autogynephilic, even exhibitionist, behavior in her father such as entering her room while only half clothed, asking her help to get dressed, asking her to participate in wardrobe selection, excusing this behavior as “Oh, come now; We’re all women here.”

Later in her visit, the exhibitionist behavior is even more open, as Stefanie asks, “Can you leave your door open?  You close it every night when you go to bed.”

“Why?”

“Because I want to be treated as a woman.  I want to be able to walk around without clothes and for you to treat it normally”

“Women don’t ‘normally’ walk around naked,” Susan replied.

Also, clearly, Stefanie Faludi, as she is now, is totally clueless as to the level of privilege that she has enjoyed during a lifetime as a man before transitioning to an extremely non-passing transwoman in retirement, reveling in her ability to use gender stereotypes when it suits her, “Now that I’m a lady, Bader (neighbor/handyman hired to do odd jobs) fixes everything.  Men have to help me. I don’t lift a finger,” giving Susan a pointed look, “You write of all of the disadvantages of being a woman, but I’ve only found advantages.”

In Stefanie’s wardrobe Susan finds a treasure trove of classic, over the top, cross-dressing fantasy outfits that as she describes it,

“might have outfitted a Vegas burlesque show: a sequin-and-beaded magenta evening gown with a sweep train, a princess party frock with wedding-cake layers of crinoline, a polka-dotted schoolgirl’s pinafore with matching apron, a pink tulle tutu, a diaphanous cape, a pink feather boa, a peek-a-boo baby-doll nightie with matching ruffled panties, a pair of white lace-up stiletto boots, a Bavarian dirndl, and wigs of various styles and shades– from Brunhilde braids to bleach-blond pageboy to Shirley Temple mop of curls.”

Stefanie even shares with Susan her collection of forced feminization fiction, downloaded from the internet, some of it written by her father, her character, “submitting to the directives of chief housekeeper while an all-female crew of iron-handed maids order “Steven” into baby-doll nighties, Mary Jane shoes, and a French chambermaid’s uniform.”  Of course, her father waves all of this away, “I haven’t looked at that website for two years at least.  It was just a–, like a hobby.  Like I used smoke cigars, but I gave it up  This was all before.”

“And now?”

“Now I’m a real woman,” she said, “But I keep these… as souvenirs.  I put a lot of work into them; I don’t want to throw them out.”

Susan Faludi lets us in on the big secret about such transwomen,

“A reigning tenet of modern transgenderism holds that gender identity and sexuality are two separate realms, not to be confused. “Being transgender has nothing to do with sexual orientation, sex, or genitalia,” an online informational site instructs typically. “Transgender is strictly about gender identity” Yet, here in my father’s file folders was a record of her earliest steps toward gender parthenogenesis, expressed in vividly sexual terms.  And here in FictionMania and Sissy Station and the vast electronic literature of forced feminization was a transgender id in which becoming a woman was thoroughly sexualized, in which femininity was related in terms of bondage and humiliation and orgasm, and the transformation from one gender to another was eroticized at every step.  How to tease the two apart?”

In the book, we can see Stefanie trying to rewrite her history, especially in denial about her having violated a restraining order, breaking into her estranged wife’s house, and attacking her mother’s new boyfriend first with a baseball bat, then stabbing him with a knife, sending him to the hospital.  Stefanie tries to play the abused woman in her retconned life narrative.  It was all his ex-wife’s fault for not being accepting of him as a feminine soul.  Fortunately, Susan, having been there, doesn’t buy into it.

It is clear from reading the book, that Susan Faludi has done her homework regarding the transgender scene of today.  Susan takes a number of well earned swipes at famous transsexual memoirists and authors for their anti-feminist statements and attitudes, among them Julia Serano, Nancy Hunt, Jan Morris, Deirdre McCloskey.  She also does the same with the so called “TERFs”, most especially Janice Raymond.  There is even a passing reference, with one of the very few footnotes in the book, about Bailey, Lawrence, and Dreger being unfairly attacked for discussing autogynephilia.  Unfortunately, she never once explains about the two type taxonomy, leaving the reader with the notion that perhaps ALL MTF transfolk are like her father.

If I have any issue with the book, it is this failure to cover this other big secret in the transgender world.

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He Loves Me, He Loves Me Not…

Posted in Transsexual Field Studies by Kay Brown on June 8, 2016

female_scientistOr, Are TrannieHawks Gay, Straight, or What?

First, we need to define who we mean.  We are not talking about straight men who fall in love with a woman only later to learn that she is a post-op transwoman.  We are talking about men who specifically seek out transwomen, especially pre-op transwomen.  We use the scientific name for this specific sexual interest, “gynandromorphophilia“.  A common question about these men is, are they straight, gay, or what?

GAMMany insist that those who date and especially marry transwomen are bisexual, or perhaps closeted homosexual.  A recent paper by Hsu et al has conclusive evidence that this is NOT the case.  As shown here, gynandromorphophilic (GAMP) men are much more like heterosexual men in their sexual responses, as measured by a ‘peter-meter’ and by self-reported arousal to pre-op transwomen, here defined as gynandromorphs (GAM).  Note that GAMP genital sexual arousal is slightly, but robustly, higher than their attraction to natal females. Given their much lower response to males, we can rule out describing them as “bisexual” or “homosexual” in any real sense. Also note that for all three groups, gay, straight, and GAMP, their subjective arousal seems to be understating their actual arousal to transwomen relative to male and female stimuli.  This suggests that there may be a bit of social desirability bias in all three groups of men.  That is to say, admitting to finding transwomen “sexy” is ‘not the thing’ to do, even for gynandromorphophiles.

The question that comes up is; what is different about tranniehawks and conventionally straight men?  As has been remarked upon by many, including by me, most of them are also autogynephilic.  In this study, that hypothesis was tested and found to be true.  Using Blanchard’s Core Autogynephilia Scale (0-8), the mean score of the GAMP subjects (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 autogynphilia 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) men often exhibit “pseudo-bisexuality” (aka: psuedo-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.

It should be noted that most MTF transkids, including myself, do NOT like having relationships with GAMPs, partially due to unconsciously recognizing their essentially autogynephilic sexuality which is self-reflective and partially due to GAMPs’ focus on pre-op genitalia, which given the “avoidant” nature of most MTF transkids, makes them exceedingly uncomfortable.

Further Reading:

Newer Essay on Autogynephilies and Gynandromorphophilia

Previous essay on personal experiences with TrannieHawks

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

Essay on “Avoidant” behavior in MTF transkids

Commentary on MTF transkids (HSTS) not comfortable with gynandromorphophiles in my book review of Bailey’s The Man Who Would Be Queen

Commentary on MTF “true transsexuals” (transkids) not comfortable with gynandromorphophiles by Dr. Robert Stoller and on “avoidant” behavior in his 1968 book, “Sex and Gender”.

Essay on Autogynephilic Psuedo-Androphilia.

References:

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

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