On the Science of Changing Sex


Posted in Science Criticism by Kay Brown on August 17, 2017

This is a selected bibliography of references from On the Science of Changing Sex.  Not all of the papers that I have referenced in my essays are here, only those that I feel are the most important for those who wish to come up to a minimal level of literacy on the science that conclusively tests the two type taxonomy hypothesis.  Links to essays that provide further analysis of the papers are provided.  You may also wish to read an annotated bibliography, that comments on many of the references also included here, written in 2004 by a young transwoman:  http://www.transkids.us/biblio.html

Incidence rate of Post-Transitioned Transsexual/Transgender:

Benjamin Cerf Harris, “Likely Transgender Individuals in U.S. Federal Administrative Records and the 2010 Census”

transmapThis study shows that there are only 90,000 transfolk who have socially transitioned in the United States out of 300 million people.  This is important because when the public hears “transgender” they think “post-transition”.  Yet, in recent surveys, 1.4 million people “identify” as “transgender”, which means that the public perception of who is “transgender” and who identifies as “transgender” is off by a factor of 15X:  The New Math

SocietySpeaking of incidence rates, there is a correlation between the percentage of the two types of transwomen transitioning and a culture’s level of individualism.  The United States is one of the most individualist culture in the world and has the greatest percentage of gynephilic/autogynephilic transwomen.  Better the Second Time Around

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

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


Two Type Taxonomy

Norman Fisk, M.D. wrote this paper that changed the way that the medical community treated Male-To-Female (MTF) transsexuality.  Previously, in recognition that there were in fact two types of transsexuals / transgender, one that was autogynephilic, in the same etiological taxon as transvestites and one that was exclusively androphilic and appeared to be in the same etiological taxon as feminine gay men, the clinians attempted to “gate-keep” the autogynephilic type from receiving services, leading to extensive misrepresentations by they autogynephilic type that continues today.  This paper proposed that they should both be treated similarly under the new diagnosis of “gender dysphoria”, not as a replacement for the taxonomy, but in recognition that both types were equally in need of palliative medical interventions:

Fisk, N., “Editorial: Gender dysphoria syndrome–the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen.” (1974) Western Journal of Medicine

These next papers have data that supports the Two Type Taxonomy of MTF transsexual and transgender, most importantly, data showing a very strong correlation between sexual orientation and autogynephilia in which putatively exclusively androphilic transwomen report significantly less autogynephilia than non-androphilic transwomen.  They also show that age of social transition, childhood gender atypicality, physical appearance (passability), and brain structure & responses also correlate with the two types.

Two clinically discrete syndromes of transsexualism. Buhrich N, McConaghy N. British Journal of Psychiatry. 1978 Jul;133:73-6.  Abstract online

Two types of cross-gender identity. Freund K, Steiner BW, Chan S. Archives of Sexual Behavior. 1982 Feb;11(1):49-63.  Abstract online

Typology of male-to-female transsexualism. Blanchard, Ray. Archives of Sexual Behavior. Vol 14(3) Jun 1985, 247-261.  Abstract online

Heterosexual and homosexual gender dysphoria. Blanchard, Ray; Clemmensen, Leonard H; Steiner, Betty W. Archives of Sexual Behavior. Vol 16(2) Apr 1987, 139-152.
Abstract online

Nonhomosexual gender dysphoria. Blanchard, Ray. Journal of Sex Research. Vol 24 1988, 188-193.  Abstract online

The concept of autogynephilia and the typology of male gender dysphoria. Blanchard, Ray. Journal of Nervous & Mental Disease. Vol 177(10) Oct 1989, 616-623.  Abstract online

Nonmonotonic relation of autogynephilia and heterosexual attraction. Blanchard R. J Abnorm Psychol. 1992 May;101(2):271-6.  Abstract online

Varieties of autogynephilia and their relationship to gender dysphoria. Blanchard R. Arch Sex Behav. 1993 Jun;22(3):241-51.  Abstract online

C. D. Doorn, J. Poortinga and A. M. Verschoor, “Cross-gender identity in transvestites and male transsexuals” http://www.springerlink.com/content/u63p723776v57m11/

Transsexual subtypes : Clinical and theoretical significance Smith Yolanda L. S.; Van Goozen Stephanie H. M.; Kuiper A. J.; Cohen-Kettenis Peggy T.; Psychiatry research (Psychiatry res.) 2005, vol. 137, no3, pp. 151-160  Abstract online

Anne A. Lawrence, “Sexuality Before and After Male-to-Female Sex Reassignment Surgery” 2005  http://link.springer.com/article/10.1007/s10508-005-1793-y

A Further Assessment of Blanchard’s Typology of Homosexual versus Non-Homosexual or Autogynephilic Gender Dysphoria, Nuttbrock, et al. Archives of Sexual Behavior

passingtransClinicians have long noted differences in physical appearance of the two types in which the exclusively androphilic transwomen were significantly better at passing.  In one study in Canada, differences in height and body size were noted, but a study in the Netherlands failed to replicate this effect.  But when they evaluated physical appearance there was a significant effect:  Searching High and Low,  A Passing Moment

Ray Blanchard, Robert Dickey, Corey L. Jones, “Comparison of Height and Weight in Homosexual Versus Nonhomosexual Male Gender Dysphorics” http://www.springerlink.com/content/w318411nq4q7387u/

Lawrence, A., “Male-to-female transsexual subtypes: Sexual arousal with cross-dressing and physical measurements”

Yolanda L.S. Smith, Stephanie H.M. van Goozen, A.J. Kuiper, Peggy T. Cohen-Kettenis, “Transsexual subtypes: Clinical and theoretical significance”

Tim C. van de Grift, Peggy T. Cohen-Kettenis, Thomas D. Steensma, Griet De Cuypere, Hertha Richter-Appelt, Ira R. H. Haraldsen, Rieky E. G. Dikmans, Susanne C. Cerwenka, , Baudewijntje P. C. Kreukels, “Body Satisfaction and Physical Appearance in Gender Dysphoria” Archives of Sexual Behavior
DOI: 10.1007/s10508-015-0614-1

Research into perceived shifts of sexual orientation in transsexuals has revealed an important feature of the life arcs of non-exclusively androphilic transwomen which causes confusion and ‘noise’ in some studies when the researchers aren’t careful to sort on their primary sexual orientation.  Non-exclusively androphilic transwomen often report that their sexual orientation shifted from primarily gynephilic to bisexual or even “exclusively” androphilic during social transition or soon after SRS.  However, research strongly suggests that this in effect of interpersonal autogynephilic ideation:  How Should I Your True Love Know?

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

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

Matthias K. Auer, Johannes Fuss, Nina Hohne, Gunter K. Stalla, Caroline Sievers, “Transgender Transitioning and Change of Self-Reported Sexual Orientation”

Anne A. Lawrence, “Sexuality Before and After Male-to-Female Sex Reassignment Surgery” 2005  http://link.springer.com/article/10.1007/s10508-005-1793-y

inah3Research on Transsexual Brains shows very strong support for the two type taxonomy in that exclusively androphilic transwomen and exclusively gynephilic transmen show shifts in sexually dimorphic brain structures and responses toward the opposite sex (toward their gender identity) BEFORE Hormone Replacement Therapy (HRT) while non-exclusively-androphilic transwomen do not.  It’s important to know that HRT causes such shifts and thus does not offer insight into the etiology of either type.  Brain Sex

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

Dörner G, Rohde W, Schott G, Schnabl C., “On the LH response to oestrogen and LH-RH in transsexual men.” Experimental Clinical Endrocrinology (1983)

Dörner G., “Neuroendocrine response to estrogen and brain differentiation in heterosexuals, homosexuals, and transsexuals.” Archives of Sexual Behavior (1988)

Dörner G, Rohde W, Seidel K, Haas W, Schott GS.”On the evocability of a positive oestrogen feedback action on LH secretion in transsexual men and women.” Endokrinology (1976)

Ivanka Savic, Stefan Arver, “Sex Dimorphism of the Brain in Male-to-Female Transsexuals”

Lajos Simon, Lajos R. Kozák, Viktória Simon, Pál Czobor, Zsolt Unoka, Ádám Szabó, Gábor Csukly, “Regional Grey Matter Structure Differences between Transsexuals and Healthy Controls—A Voxel Based Morphometry Study”

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

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

Clinicians have been noting that transfolk are more likely to be autistic than the general population, especially Female-to-Male (FtM) transmen.  Interestingly, there is a difference in the autism-like behaviors between exclusively androphilic transwomen and gynephilic transwomen in which androphilic are identical to women and gynephilic identical to men.  Autistic Sky

Jones, et Al, “Female-To-Male Transsexual People and Autistic Traits”, J. Autism Dev. Discord. DOI: 10.1007/s10803-011-1227-8

Several clinicians have noted that there is a difference between exclusively androphilic transwomen and gynephilic transwomen in their sexual behavior with other.  These papers explore the correlation between being “avoidant”, that is, avoid the use of their pre-op genitalia, and sexual orientation / age of gender dysphoria onset.  I Know What Boys Like

S. Cerwenka, et al., “Sexual Behavior of Gender Dysphoric Individuals Before Gender-Confirming Interventions: A European Multicenter Study” (2014)

There is one paper that attempted to statistically test whether the two type topology was in fact taxonic.  The paper had serious methodological problems due to failure to properly sort truly exclusively androphilic transwomen from those who were in fact originally gynephilic but had experienced a perceived shift in sexual orientation.  Autogynephilic and Even More Autogynephilic

Jaimie F. Veale, “Evidence Against a Typology: A Taxometric Analysis of the Sexuality of Male-to-Female Transsexuals” Archives Sexual Behavior
DOI 10.1007/s10508-014-0275-5

Anne A. Lawrence, “Veale’s (2014) Critique of Blanchard’s Typology Was Invalid” Archive Sexual Behavior
DOI 10.1007/s10508-014-0383-2

Exclusive Androphilic Tranwomen

Papers on the Fraternal Birth Order Effect in androphilic males, both conventional gay men and transwomen:

Blanchard, R., “Fraternal Birth Order, Family Size, and Male Homosexuality: Meta-Analysis of Studies Spanning 25 Years”, Archives of Sexual Behavior, (2017),

Cross cultural aspects of androphilic transgender behavior and identity:

Bailey, et al., “Sexual Orientation, Controversy, and Science”, Psychological Science in the Public Interest, doi: 10.1177/1529100616637616

Vanderlaan, et al., “Elevated Kin-Directed Altruism Emerges in Childhood and Is Linked to Feminine Gender Expression in Samoan Fa’afafine: A Retrospective Study” Archives of Sexual Behavior
DOI: 10.1007/s10508-016-0884-2

Vasey, P. et al., “What can the Samoan Fa’afafine Teach Us About the Western Concept of Gender Identity Disorder in Childhood?”, (2007) Perspectives on Biology and Medicine,  http://muse.jhu.edu/article/222247

Vasey, P. “The Evolution of Male Androphilia” Personal Website:  http://people.uleth.ca/~paul.vasey/PLV/Evolution_Androphilia.html

Petterson, L. “Male Bisexuality In Samoa” (2012) University of Lethbridge Thesis  https://www.uleth.ca/dspace/bitstream/handle/10133/3745/PETTERSON_LANNA_MSC2015_THESIS.pdf


Papers on Autogynephilia in the general population:

Langstrom, et al., “Transvestic Fetishism in the General Population”  Journal of Sex & Marital Therapy, (2011) http://dx.doi.org/10.1080/00926230590477934

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

Kevin J. Hsu, A. M. Rosenthal, J. Michael Bailey, “The Psychometric Structure of Items Assessing Autogynephilia”
Archives of Sexual Behavior, DOI 10.1007/s10508-014-0397-9

Papers on the correlation between autogynephilia and gynandromorphophilia:

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Sexual Arousal Patterns of Autogynephilic Cross-dressing Men”

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”

Jaimie F. Veale, Dave E. Clarke and Terri C. Lomax, “Sexuality of Male-to-Female Transsexuals”

Anne A. Lawrence and J. Michael Bailey
Transsexual Groups in Veale et al. (2008) are “Autogynephilic” and “Even More Autogynephilic”

Jaimie F. Veale, David E. Clarke and Terri C. Lomax
Reply to Lawrence and Bailey (2008)

Blanchard R, Collins PI., “Men with sexual interest in transvestites, transsexuals, and she-males”

Blanchard R., “The she-male phenomenon and the concept of partial autogynephilia”

Gender Dysphoria in Adolescence and Childhood

Sumia et al., “Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment”, Journal of Adolescence

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

Zucker KJ\, Wild J, Bradley SJ, Lowry CB., “Physical attractiveness of boys with gender identity disorder.” Archives of Sexual Behavior. 1993 Feb;22(1):23-36.

Stephanie A. Mcdermid, Kenneth J. Zucker, Susan J. Bradley, Dianne M. Maing, “Effects of Physical Appearance on Masculine Trait Ratings of Boys and Girls with Gender Identity Disorder” Archives of Sexual Behavior

Sari R. Fridell, Kenneth J. Zucker, Susan J. Bradley, Dianne M. Maing, “Physical attractiveness of girls with gender identity disorder” Archives of Sexual Behavior

Kristina R. Olson, Aidan C. Key, Nicholas R. Eaton, “Gender Cognition in Transgender Children“, Psychological Science

Thomas D. Steensma, Roeline Biemond, Fijgie de Boer and Peggy T. Cohen-Kettenis, “Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study”

Sarah M. Burke, Willeke M. Menks, Peggy T. Cohen-Kettenis, Daniel T. Klink, Julie Bakker, “Click-Evoked Otoacoustic Emissions in Children and Adolescents with Gender Identity Disorder”  Archives of Sexual Behavior, DOI 10.1007/s10508-014-0278-2

Androphilia and Autoandrophilia in Transmen and Women

While not as well researched as the correlation between autogynephilia and gynephilia in transwomen and men, there is some regarding non-gynephilic transmen.  Autoandrophilia occurs in 0.4% to 0.5% of women in the general population (compared to autogynephilia in 2.8% to 4.5% of men).   Mirror, Mirror on the Wall

S. Colton Meier, Seth T. Pardo, Christine Labuski, Julia Babcock, “Measures of Clinical Health among Female-to-Male Transgender Persons as a Function of Sexual Orientation”

Walter Bockting, Autumn Benner and Eli Coleman, “Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality”

Eli Coleman, Walter O. Bockting, and Louis Gooren, “Homosexual and bisexual identity in sex-reassigned female-to-male transsexuals”

Robert Diekey and Judith Stephens, “Female-to-male transsexualism, heterosexual type: Two cases”

Dorothy Clare and Bryan Tully, “Transhomosexuality, or the Dissociation of Orientation and Sex Object Choice”

Meredith L. Chivers and J. Michael Bailey, “Sexual Orientation of Female-to-Male Transsexuals: A Comparison of Homosexual and Nonhomosexual Types”

Stefan Rowniak and Catherine Chesla, “Coming Out for a Third Time: Transmen, Sexual Orientation, and Identity”

Robert J. Stoller, “Transvestism in Women”

Langstrom, et al., “Transvestic Fetishism in the General Population”  Journal of Sex & Marital Therapy, (2011) http://dx.doi.org/10.1080/00926230590477934

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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An Issue Whose Time Has Come:

Posted in Brain Sex by Kay Brown on August 12, 2017

jnr23934-toc-0001-mSex/Gender Influences on Nervous System Function

The recent spring issue of the Journal of Neuroscience Research was wholely dedicated to papers on sexual dimorphism of the brain.  Of course, many will debate that there is in fact any influence of sex, much less gender (identity), on nervous system function.  I’ve written about this before, how the politics can lead some to make the charge of “neurosexism”, deserved or not.

Larry Cahill, the editor remarked about it thus,

” “Be careful, it’s the third rail.” I received this strong advice to steer clear of studying sex differences from a senior colleague around the year 2000 when my research into brain mechanisms of emotional memory began drawing me into the issue of sex differences—or better yet, sex influences—on brain function. And in a way, he was right. For the vast majority of his long and distinguished neuroscience career, exploring sex influences was indeed a terrific way for a brain scientist not studying reproductive functions to lose credibility at best, and at worst, become a pariah in the eyes of the neuroscience mainstream.  …  Fortunately, times are changing. The past 15 to 20 years in particular witnessed an explosion of research (despite the prevailing biases against the topic) documenting sex influences at all levels of brain function. So overpowering is the wave of research that the standard ways of dismissing sex influences (e.g., “They are all small and unreliable,” “They are all due to circulating hormones,” “They are all due to human culture,” and “They don’t exist on the molecular level”) have all been swept away, at least for those cognizant of the research.”

This is an exciting development and this issue is full of great information.  The best thing about it?  It is NOT behind a paywall.  The entire issue is free to read.  And read it you must if you are to remain at the cutting edge of sex influences on the nervous system.

The papers discuss a wide range of topics including the neurology of people with Disorders of Sexual Development (i.e. “intersex”) to the rather dry and esoteric.  I’ve been enjoying reading them and will likely be referencing them in future.

Further Reading:

Essay on the effects of HRT on Transsexual’s Brains and the politics of Brain Sex

“Two minds – The cognitive differences between men and women” By Bruce Goldman


Journal of Neuroscience Research
An Issue Whose Time Has Come: Sex/Gender Influences on Nervous System Function
January/February 2017, Volume 95, Issue 1-2
Version of Record online: 7 NOV 2016 | DOI: 10.1002/jnr.23934

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These Transsexuals Were the First Banned…

Posted in Editorial by Kay Brown on July 26, 2017

Kay Brown 2010… from the US Armed Forces.  Here’s what they did next.

“A well regulated militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”

I always interpreted this, our 2nd Amendment to our constitution to actually mean that the right to serve in the defence of our country, could not be “infringed”.   But clearly, bigotry and prejudice have prevailed over the centuries… as they did today when our current “Commander-in-Chief”, spouting more lies, but really serving the interests of bigots, re-instated the ugly and wholly unnecessary policy of excluding any and all transsexual and transgender people from military service “in any capacity”.  I believe whole-heartedly that this policy is unconstitutional on the face of it.

This policy has touched upon my own life and that of many other transfolk, both those I have known and admired, and those unknown, but still worthy of respect.

When I was in my mid-teens, my mother would leave brochures for the Navy around for my brother and I to find.  She tried very hard to get us both to join up.  I knew that was NOT for me, as I was trying desperately to transition as soon as I possibly could… and joining the Navy would not help in that effort.  Plus, hey, as an obviously gender atypical androphilic male, there was no way that I could pass as a straight man.  As it was, on my 18th birthday, my father came over to give me a combination birthday and high school graduation gift of a clock-radio, the only gift that I was given by anyone on this occasion.  He also informed me that I was no longer welcome to live in my mother’s house.  How brave of my mother to use my father to deliver the message.  I would not be welcome to stay at my father’s small apartment either… as it was too close to the family.  I would be given a small allowance if I remained away from the family from then on… to be a “remittance man”.  So, as I struggled to maintain myself, my brother soon joined the Navy to be trained as an avionics technician.

When I was 22 years old, in 1979, during a time of much stress, as I had been intermittently homeless and living in rather unsavory conditions at times, I was working as a very low paid electronics repair tech, a skill I had learned coming up the ranks from electronic assembler.  I had very skilled hands and could delicately remove and replace microelectronic components that most men could not.  One of our customers was an Air National Guard unit who didn’t have anyone who could fix the type of radios that I could.  One of their non-comms responsible for their electronics maintainance tried very hard to get me to sign-up.  As a pre-op transsexual, I knew that I could never do that as it was then well-known that the DOD policy was that no homosexuals nor transsexuals were allowed.  Being both androphilic and a pre-op, I would be considered doubly unqualified.  But I could REALLY have used the money and experience of serving.  (No soup for you!)

That year, I would meet two transwomen who had served in the military and both been discharged for being trans.


Dr. Joy Shaffer and Kay Brown in the mid-80s

The first was Joy Shaffer.  She had joined the Air Force as a teenager and served for something like 18 months before events unfolded in which she admitted that she was trans.  She was administratively discharged, honorably, such that she was eligible for G.I. benefits which she used to earn a degree in biochemistry from CalTech, with honors, in only three years, transitioning there as a student.  When I met her a few months after her graduation, she was working as a research assistant for a scientist working to understand the biochemistry and epigenetics of osteoarthritis.

clar05aThe other was Joanna Michelle Clark.  Joanna had been in the Navy, rose to Chief Petty Officer, thus our favorite nickname for her, “Chief”.  She, like so many other ‘late transitioners’ had been married.  But, as her gender dysphoria grew, she divorced, left the Navy, honorably, with no reference to being transsexual, and began transition.  She sought treatment at the Stanford Clinic in the early ’70s.  (She has some amusing stories about her own interviews with Dr. Fisk.)  Afterwards, she was recruited into the Army National Guard.  She had fully disclosed her earlier identity, medical status, and experience in the Navy.  As there were no policies concerning transsexuals at the time, she was inducted.  Ah… but folks at the Pentagon finally noticed her existence about a year and a half later.  They changed the policy and then booted her, dishonorably, for having violated the new policy!  She fought back but managed only to get her discharge changed to honorable, as she had never lied about her medical status at any point and it was the DOD who had changed their policies… and attempted to apply an illegal ex-post-facto charge against her.

This experience radicalized Joanna to become a true activist.  One of the first things she did afterwords was convince and work with Willie Brown to change California law to allow transsexuals to change their ID, including their driver licence, before SRS.

ACLUIn 1980, Joanna Clark, Joy Shaffer, and several other transsexuals, including myself, founded the ACLU Transsexual Rights Committee, with Joanna as the Committee Chair.  The committee worked on a number of initiatives including the issue of access to medical care which was under serious threat at both governmental and private insurance providers.  (Our nemesis, author of The Transsexual Empire, Janice Raymond was one of the culture warriors on the other side, writing transphobic whitepapers arguing against coverage for transition medical services.)  A key argument against medical coverage for SRS was that it was “experimental”.  I had insurance through my employer that should have covered my SRS, which I had gone deeply in debt (relative to my meager income at the time) to pay for.  But my carrier refused reimbursement based on “experimental”  I and an FtM transman who had been also refused reimbursement using this same “experimental” clause agreed to contest this rejection.  The committee put together a case for class action suit with ACLU backing and myself and the brave transman as key plaintiff.  But the insurance company stymied us by paying our claims and admitting that our surgeries were no longer “experimental”.  I thought we had won!  No, we got snuckered, the insurance companies started writing specific exclusionary language into all future policies.  We calculated that the cost of doing that exceeded the costs of coverage.  This was done out of bigotry, not rational business, just as the exclusion of LGBT people in the military is one of bigotry.

Joy went on to earn a medical doctorate at Stanford Medical School, became board certified in internal medicine, later to found a large private LGBT friendly medical practice in San Jose.  As well as having the largest transgender private practice in the world, Joy served on the front lines against the HIV/AIDS epidemic taking on patients when others wouldn’t.  When anti-retro-viral drugs started saving lives, she celebrated telling me, “We are fucking curing AIDS!”

Joanna, deeply moved by the growing death toll of the early AIDS epidemic went on to a new mission in HIV/AIDS education.  Violating copy right law, systematically pulled scientific and medical papers from behind paywalls and placed them on first a BBS then later a website, to disseminate lifesaving information on HIV/AIDS, work that she continues to this day.

Had the DOD not changed their policy so as to boot Joanna and Joy, both the transgender/transsexual and gay communities would have lost the services of some of our greatest champions and heroes.  Some good has come out of evil bigotry.

So, back to today’s announcement.  How many transsexuals, you know, the ones that actually “change sex” and need medical intervention are there in the U.S. armed services?  Forget those silly numbers that have been thrown around.  Using proper statistics of how many transfolk have actually transitioned in the U.S., the total is only 90,000 out of close to 300 million residents; with only 2 million Americans in uniform, that means only 600 transsexuals.  That’s it.  600.  Wow, that’s going to cost… far less than they already spend on little blue pills for men who can’t get it up.  And the DOD knows it.

Further Reading:

Wikipedia Page on Joanna M. Clark

Essay on the true number of transitioned transfolk in the U.S.

Scientific American: Cost of Medical Care for Transgender Service Members Would Be Minimal, Studies Show.

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I’ve Done My Research…

Posted in Editorial by Kay Brown on July 18, 2017

20106662_827148660781856_9051171404874056968_nOr… Bringing a Plastic Picnic Knife to a Gunfight

If one were to trust the discussions on various internet fora, and even occasionally a direct email, one would think everyone in the trans* community was an expert on trans* sexuality and experience.  One would think that they all have read the science papers and have considered the evidence.  One would be very wrong.

One transwoman told me on a forum (my own facebook page of all things) that she had read all of Blanchard’s papers and knew that they were all bogus.  I then mentioned another paper by Freund… whereupon she jumped down my throat about how stupid I was to use psychoanalytic arguments.  Oopies… “Gee,” says I, “I thought you said that you had read of all Blanchard’s papers.  If so, you would know that I was referring to Blanchard’s early mentor and collaborator, co-author of his early papers on trans*, Kurt Freund, NOT Sigmund Freud!”  I had caught this individual in a flat out lie.  She had never actually read Blanchard’s, or anybody else’s, papers on the science.  No, she was regurgitating what she had read about Blanchard, from authors who had written about Blanchard after having read about Blanchard from other authors who had written about Blanchard, etc., many suggesting that Blanchard and his cronies are in a conspiracy to defame transwomen.  (Hint:  No, they are not.)

Of course, it is not just Blanchard’s papers that need to be read and understood if one is to understand the hypothesis and evidence involved.  One also must read the papers that followed up on Blanchard’s papers.  And one must also read the papers that preceded his, of which Blanchard was following up upon (for example, Freund’s).  There are literally hundreds of papers that one must read and understand, deeply understand.  It helps if one has a very strong background in psychology, biology, and neurology.  (Did I mention that I have a degree in psychology, strong minor in biology, as well as the degree in physics?)

Oh, for certain there are a few who have actually read the papers… but mostly in an attempt to refute, rather than understand.   Many, perhaps most, don’t actually read the papers, but just skim the abstracts.  This is understandable since many of these papers are behind paywalls.  But this is not a useful means of understanding the evidence, since many of the abstracts were written with the intention of ‘spinning’ the evidence, either into something more exciting than the data actually supports, or attempting to downplay what it actually supports.  From this, a number of trans* commenters have created a mountain of misrepresentations of the papers.

For example, that most risible of “papers” that purported to demonstrate the existence of autogynephilia in non-trans women put out by Moser, if you trust the abstract, one gets a completely different conclusion than what one gets when one reads the actual paper with an understanding of how such science should be conducted, and know that in this case, it wasn’t.

But another example I was confronted with by email just recently, was a part-time cross-dresser angrily contesting my use of the Nuttbrock study as further evidence that supported the two type taxonomy of MTF transgender.  Unwinding the misconceptions that he had, it became clear that he based his contention that Nuttbrock did not support the two type taxonomy on the title and abstract of the paper.  He had never actually read the paper, nor had bothered to follow the links I provide to essays I wrote that quote and organize the DATA from the Nuttbrock study.  The data I had because I wrote to Nuttbrock asking pretty please for a copy of the paper and was graciously provided one.

inah3Another problem is trusting the authors of papers when they cite other papers to correctly interpret what those cited paper’s data actually support (or refute).  For example, I keep seeing papers (and transwomen on internet fora) citing Swaab’s earlier papers on transsexual brain studies as though they supported the brain sex hypothesis for gynephilic transwomen, when in fact, they do not.  (As a reminder, all of the subjects had been on HRT for years and we now know that HRT causes shifts in brain structure.)  To spot these errors, one has to understand the entire corpus of published papers and carefully, and yes, skeptically, construct a picture of what the collective evidence does and does not support.

Unless one has done that, coming at the so-called “Blanchardists” ( including myself ) saying that you have done your research… well, that’s just bringing a plastic picnic knife to a gunfight.

Further Reading:

Essay on Moser’s purported study on autogynephilic in women

Essay on Swaab’s BSTc and INAH3 papers

Essay on Nuttbrock study


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Baby Hunger…

Posted in Editorial, Transsexual Theory by Kay Brown on July 9, 2017

female_scientistOr, Rubbing Salt Into the Wound

A couple days ago, a young androphilic transwoman from Portugal, who has been a correspondent for several years, since her late teens, wrote to me asking my opinion of androphilic transwomen’s desire for children.  She, like me, definitely has always desired to be around and to mother children.  She had recently been employed as a caregiver at a children’s group home and had loved it.  She recently entered nursing school and looks forward to someday marrying a loving man and adopting children, preferably babies.  She thought it was be a good idea for me to write an essay on this topic.  So, here it is.

Stoller, in his 1968 book, Sex And Gender, described androphilic transwomen as ardently wanting children including mothering, indeed bearing, infants,

sex-and-gender-the-development-of-masculinity-and-femininityThe ultimate progression for the transsexual … has not yet been reached in our society: he would not only like to have is body appear completely female but he would like to have his internal organs so changed (for example, by transplants) that he would now have is own functioning ovaries and uterus, ultimately to bear a child truly his own.

Stoller described a typical androphilic transwoman and concluded with “The patient is now married and hopes to adopt children.”

When I was first interviewed by Norman Fisk at the Stanford Gender Dysphoria Clinic as a 17 year old in early 1975, I told him of my hopes and dreams of finding a husband and adopting children.  I recall telling him about how much I enjoyed the two summers I had spent as a swimming instructor teaching very young children and of the then previous summer employed as a nanny taking care of two boys, aged four and ten, from early morning to dinner-time.  I had of course, actively sought out babysitting jobs all through Jr. and Sr. high school, with a promise to all of my regular families that I would break any previous engagement for a job.  I don’t remember him making fun of me.

I achieved both of these goals, though it took a lot longer that I had anticipated.  There were many things that had to be achieved first and many pit-falls to avoid along the way.

There are many obstacles for androphilic transwomen to overcome before becoming an adoptive parent.  First, one must have the social stability, an excellent support network, and sufficient family income to afford to raise a child.  Many never reach that goal.  Having a husband with a good income is a dream that is often out of reach.  Second, one has to navigate a system that would much rather find a home for a child with non-LGBT parents, especially for newborns.  Adopting a newborn, even for middle-class non-LGBT families, is difficult as there are always far more prospective families looking to adopt a baby than there are babies available for adoption.  It is becoming easier in some locales for LGBT people to foster-adopt older hard-to-place children, but it still requires surviving an extensive vetting process.  That process will black-ball any who have even the most minor of criminal records.  One also has to have the temperament and above average parenting skills to take in a child who will come with emotional challenges and maladaptive behaviors from early life experiences in a chaotic birth home.  In many locales, in spite of recent legal and social advances for LGBT people, being transsexual will mean not being seriously considered as an ‘appropriate’ placement.


Kay Brown with her adopted daughter Liz

I first became a licenced foster parent in California in 1984, almost by happenstance when Cassandra, a 14-year-old lesbian, needed a supportive home of the sort that I could provide.  Now, 33 years later, she still calls me her Mom.  In the early ’90s while living in Oregon, I sought to become a foster, hopefully adoptive mom of a younger child and carefully researched the possibility.  I put out on the transgender social networks looking for any who had been able to do so.  I found exactly one androphilic transwoman on the east coast who was fostering her sister’s children while her sister was in prison.  (Children’s Services gives priority to relatives for placement whenever possible.)  That was it.  One family.  Special case.  I was breaking new ground when seven-year old Liz was placed in my household.  (There were several women living there.)  Liz was adopted on her ninth birthday.  I have since found one other androphilic transwoman who foster-adopted three siblings sometime after me.

There is always the possibility of surrogacy.  But that takes even more socio-economic status.  I have only one reference that may qualify as surrogacy.  Dawn Langley Simmons, who was white, married a black man then apparently faked pregnancy timed to the delivery of a mixed race baby.  The sire may have been her husband or the baby may have simply been unwanted.  We don’t have the details.

There have also been tales and hints that some androphilic transwomen have been aided by close relatives or friends volunteering to be gestational surrogates.  But those stories are kept very private for good and sufficient reasons.

There was a private effort in the transsexual community to develop ethical  biotechnology that would allow transwomen to carry a child to term in ways not too different from that prophesied by Robert Stoller… but that research did not reach our final goal.  Now, there are new developments regarding uterine transplants that may offer the final key.  Sadly, I’m too old now to participate, but I most certainly would if I were younger.

We have enough evidence here to show that at least some androphilic transwomen do have an intense interest in being mothers of both infants and small children.  But actualizing that desire is extremely difficult for most.

So, we see that though it is difficult for an androphilic transwoman to find a loving husband and build a family through adoption, it is not impossible.  But one wouldn’t know that from reading the literature on transsexuality when they discuss whether transwomen are interested in children, have maternal feelings.

In the 1974 paper describing psychiatric grand rounds at UCSD, “Gloria”, a 20-year-old androphilic pre-op transwoman already in a stable relationship with a straight man reported that she too hoped to adopt a new-born, to which an oh so ‘kindly and understanding’ physician throws shade on her coping skills, her character, and her motives for wanting to raise a child,

No matter which way this goes, Gloria is going to have trouble adjusting. A normal woman has trouble when she bears a child or adopts one; this new woman is going to have many more troubles.  At this point she wants a baby because that is part of her image of being a woman. And yet I do not know whether she really wants a baby or whether this is just the image, just as she stated that she doesn’t feel sexy if she doesn’t have a vagina.

But then we come to the most ugly of all comments coming from John Money in an abstract of a case series paper from 1968 in which we can easily discern that he is lumping together androphilic and autogynephilic transwomen together when he writes,

“All 14 patients desired adoptive motherhood, with a preference for small children, though not newborn babies. In general, the group appeared to possess a feminine gender identity, except for a masculine threshold of erotic arousal in response to visual imagery and an unmotherly disengagement from the helplessness of the newborn.”

Remember how hard it is for a post-transtion transwoman to become a mother, especially of newborns?  Remember how the clinicians made fun of “Gloria” for wanting to be such a mother?  Now, do you think it is possible that transwomen can pick up on that negative attitude, perhaps realize that if they state a desire for what is clearly unlikely to happen that it might be interpreted as having unreasonable life goals?  (One of the selection criteria that clinics used in the ’60s was whether their clients had reasonable expectations for their lives post-op.)  Further, is it in fact a good idea to pine for what can never be?  So… calling them “unmotherly” for looking to adopt hard-to-place children rather than hoping for that one-in-a-million chance to adopt a healthy baby was just rubbing salt into the wound.

So ingrained is our view that interest in children is a measure of womanly virtue it effects how autogynephilic transwomen attempt to portray themselves.  A few years ago, continuing my search for transwomen’s experiences regarding adopting children, I chanced upon an online forum where a number of transwomen were discussing how one could tell the difference between a “transsexual” and a “wannabe” [sic] by whether they noticed small children or not.  Of course, they all congratulated themselves on their interest in small children, telling stories of how they had noticed children in social settings, as did the women, while the men in their company, or even other (presumably “wannabe”) transwomen, had not.  Curious, I traced down each of these transwomen’s identities (people leave a lot of breadcrumbs behind them) and discovered that every one of them was in fact a late transitioner and more than one of them had very masculine occupations and interests.  They had not evinced any notable efforts to pursue being motherly, indeed, some had barely maintained contact with their own children from marriages prior to transition.  Their participation in this discussion was more in line with social desirability bias, impression management, and self-enhancement than in honest self-evaluation.  It fits with the well-known (to cognizant clinicians at least) phenomena of autogynephilic transwomen editing their history, experiences, and desires to more closely approximate those of “classic transsexuals”.

We need to conduct research on whether transsexuals and transgender people of all kinds are interested in being parents.  Interestingly Michael Bailey suggested a great instrument for this task in his book the Man Who Would Be Queen:

1. I greatly enjoy spending time with young children.
2. I get a lot of pleasure from holding babies.
3. I would enjoy taking care of a baby for a friend or relative.
4. I daydream about having a baby of my own.
5. Often when I see babies, I experience warm, positive feelings.
6. When I think about it hard, I have strong doubts whether the
rewards of raising an infant are worth the work and responsibility. (reverse scored)

This could be seven value Likert scored from “Definitely Do NOT Agree” to “Definitely Agree”.  Any interested in conducting the survey?

Further Reading:

Essay on Robert Stoller’s description of a “typical” androphilic transsexual.

New York Times Obituary for Dawn Simmons

Scientific American: How a transgender women could get pregnant


Judd, et al., “Male Transsexualism”, (1974) Western Journal of Medicine



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Because Boys Must Be Boys…

Posted in Brain Sex, Editorial by Kay Brown on July 5, 2017

Teenage-brain…Its a Fact of Human Nature, and Girls Must Grow Up to Be Mothers!

Over the years that I’ve been writing this blog, I’ve deliberately avoided using the popular term “gender non-conforming”, using the term “gender atypical” instead.  It may have struck some of my readers as odd and idiosyncratic, given that so many others use the “GNC” term.  But, I have done so for several important reasons, some based on science, some on political-philosophical grounds.

The scientific reasons are easier to explain.  There is no “standard” to which behavior should “conform”.  There is only behavior, period.  However, if we look at, study in depth as scientists, a species we can say that there are behaviors that are far more commonly performed by them than other behaviors seen in other species.  These we can label as “typical” for that species.  If we see a behavior in a given individual of a species that is uncommon for that species, we may label it “atypical”; but we would never label it “non-conforming” since we can’t really say what standard that a given species should “conform” to.  Behaviors are selected by evolution depending upon whether they increase the reproductive ‘fitness’ of the individuals exhibiting them.  The same logic applies to sexes within a given species.  We may observe sexually dimorphic behaviors in a given species.  That is, we will label a behavior sexually dimorphic if we see that it is much more commonly performed in one sex than the other.  If we see an individual performing such a behavior that is uncommon in that given sex, we may label it “atypical” for that sex; but to label it “non-conforming”?  That’s smacks of invoking an outside agency which has the authority to define a standard for such behavior that the theory of natural selection does not provide.  Just as with non-human species, humans do not stand outside of nature.  There is no agency that defines for our species a standard by which to judge whether a given behavior does or does not “conform”.

The political reasons include my personal objection to the very notion that there should be such a “standard”.  But even deeper, is my objection to the post-modernist idea that there are no intrinsic sexually dimorphic behaviors in humans, that there are only socially constructed roles.  This notion would state that since all differences in behavior observed between the human sexes are socially constructed and maintained, there must be a socially defined standard to which we can conform or not.  Another idea that I object to is that of a divinely ordained standard that we must conform to, which has the same effect.  Thus, both of these ideas reduce any behavior that is seen in an individual that is uncommon in that person’s sex to an act of “gender non-conformity” either by accident or by will… but never by nature.  I find both the notion that we stand outside of nature to be scientifically preposterous and philosophically offensive.   Further, those who seek humane treatment for gender atypical individuals will find that they must contend with those who hold these ideas often falling back on unquestioned prejudices, the nature of which is determined by which value system through which they view such gender atypical individuals, post-modernist or religious.

Before going into details about the nature of the prejudices and what we must contend, let’s explore how we know that human beings do have sexually dimorphic behaviors that have both neural correlates and developmental pathways leading to them.  It’s important to differentiate between behaviors that are demonstrably sexually dimorphic because of neural correlates and those that are merely cultural role enactments and false gender stereotypes.  Thus, for purposes of this essay, I differentiate between a strong social construction hypothesis which says that all differences in behavior are purely from culture and a weak social construction hypothesis that says that some behaviors and gender roles are socially constructed around truly sexually dimorphic behaviors and gender role limitations built around cultural prejudice and false stereotypes.  It is the strong social construction hypothesis that I will show is not supported by the evidence.

In other pages of this blog, I’ve made reference to the single most sexually dimorphic behavior in humans: androphilia (sexual attraction to adult males).  In female humans, it is extremely common to be attracted to men.  Approximately 98% of women are attracted to men while only approximately 5-10% of men were attracted to men.  One could object to this being a ‘natural’ phenomena and say that social expectations have defined this.  But it would not fit the evidence that has been amassing that sexual orientation is neither “chosen” nor “taught”.  Further, why should humans be unique in the world?  Most mammalian species are sexually dimorphic in their sexual attractions.  (No, I’m not denying that same sex behavior occurs in non-human species… only saying it is not as common as other sex attraction.)  But, this isn’t the end of the story.

Sexual orientation in adults is presaged by gendered behavior as young children.  That is to say, that humans have sexually dimorphic behaviors as young children and that sexual orientation is highly correlated with those behaviors.  Children that grow up to be homosexual evince notable gender atypicality.  The key behaviors that are noted to be gender atypical in boys are avoidance of rough and tumble play, avoidance of physical aggression, preference for female playmates and play style, etc.  But here is where we start to see the issue of having to contend with those prejudices.  Some cultures attach serious negative stigma to gender atypicality while others do not.  Most of my readers will likely live in cultures that do and will recognize the ugly recriminations in the song, “Boys Will Be Boys”; “You bloody sissy, who said you could cry?” down to the call to an authority defining the standard to which a child must conform, “Doctor, Doctor, tell me where did we go wrong?”.

But we in our enlightened age know that the parents did nothing wrong… (yes, you may take that to be sarcasm).

In other essays on this blog, I’ve explored some of the science that shows that sexual orientation is correlated with childhood gender atypicality, the Fraternal Birth Order Effect, etc.  I’ve discussed possible etiological hypothesis.  I have in the past written about the disappointment with using the 2D:4D digit ratios as a means of exploring the possible effect of varying androgens as being correlated with sexual orientation.  But now, I want to share a really amazing bit of evidence that shows that perinatal exposure to androgens is likely to be responsible for masculinizing the human brain and its absence affecting early childhood gender atypicality, as Vicky Pasterski puts it,

By now, the majority of scientists studying the topic likely agree that homosexuality is definitely not a choice and probably not due to socioenvironmental factors. At the same time, there appear to be no physical indicators of disrupted fetal sexual differentiation in homosexual men that would fit with the basic premise of the hormone theory of sex development. However, it is possible that alterations in the androgen surge that occurs in the early postnatal period, also called mini-puberty, could have effects that are not immediately or physically obvious. Based on the finding that penile growth in the first three months of life correlates with a concomitant surge in serum testosterone levels considered the possibility that penile growth may act as a proxy for neonatal androgen exposure and that change measurements may be related to later neurobehavioral outcomes. In a longitudinal study of 81 typically developing boys, we found that the strength of the early postnatal androgen surge, from birth to approximately three months of age, predicted masculine behavior at 4 years old. By controlling for effects of prenatal androgen exposure using measurements of penile length and anogenital distance (AGD; sexually dimorphic and roughly twice as long in males compared to females) at birth, we showed that penile growth in the first three months of life, but not thereafter, accounted for significant variance in later sex-typed behavior. In the overall regression analysis, which controlled for various factors, penile length at birth was not related to sex-typed behavior. This suggests that disruption to male mini-puberty could have implications for future sex-related outcomes that are masked by a typical appearance at birth. Further, this provides support for the hypothesis that early (postnatal) hormone exposure influences aspects of sex-typed development in men, in a similar fashion to prenatal hormone exposure that is presumed to affect women.

1-s2-0-s0018506x15000033-gr1_lrgIn Pasterski’s research, she divided the boys into three groups (tertiles) based on their gendered behavior from the Pre-School Activities Inventory and mapped against the growth rate of their genitals in the first months after birth, which has been shown to correlate with androgen exposure.  (Though to be complete, it may also correlate with androgen receptor sensitivity, but for my purposes, that would have the same epistemic value.)  The results are dramatic, we see with no ambiguity that the rate of growth of genitalia is positively correlated with gender typical behavior.   That also means that the inverse is true.  Gender atypical behavior is inversely correlated with perinatal genital growth.

Had the strong social construction hypothesis of all gendered behavior been true, there would have been no correlation.  We can reject this hypothesis.  At best, we have a weak social construction hypothesis of gender roles around very real sexually dimorphic differences.  Those that lampoon this conclusion by calling it “Lady Brain” theory are just plain wrong.

It has been previously noted that gender atypically behaving children have differences in facial “attractiveness”.  This fits well with the above research as male children who have not had this intense “mini-puberty” would likely remain neotenous and thus feminine in appearance.  This likely also extends past adolescence to explain the rather dramatic differences in passability between androphilic transwomen and gynephilic transwomen.  Being gender atypical in brain organization, it would naturally lead to later androphilia, gender atypical motor skills (feminine walk and hand gestures), and gender atypical vocal production (feminine or “gay lisp”).

Given the religious (or related social views of gender) prejudice, one can easily see how children who exhibit these gender atypical behaviors are placed under tremendous pressure to “conform” to gender behavior standards that tend to skew to the gender typical, or even an exageration of typical behavior.  Children who meet this standard are prized and praised above other children.  That is to say, extreme gender typicality is valorized as well as held as the gender normitive standard and granted privilege over children who fail to meet this standard.

Here I opine, perhaps even hypothesize, that this pressure to conform to normative gender role standards has distorted what would be the natural course of development of gender atypical children and has led to the creation of the artificial gender normative role of Western Gay and Lesbian culture, especially the “Straight Looking / Straight Acting” Gay male standard to which otherwise gender atypical male children are required to adhere.  To the non-gay community members, the benefit of artificial standard was originally to force gay people to remain deep in the closet.  As the Western Gay Liberation movement gained ground, those who had tacitly accepted this standard began to subtly and not so subtly enforce it.

One would, at first glance, believe that those who hold the strong social construction hypothesis as true would then have no qualms about accepting gender atypical children and adults without reservation as breaking stereotypes.  But, as we can easily discern, they often do not, as demonstrated by the minority movement within the gay and lesbian (mostly lesbian) communities of being “gender critical”.  They philosophically approve of people being gender atypical… but only to a very specified point, accepting the gender normative roles that were established during the early Gay Liberation Movement.  The moment that an individual steps past that point, there will be those who will denounce them as hewing to the very stereotypes that they break, but in the opposite gendered sense, denying that underlying sexually dimorphic behavior as valid.  In some cases, public denouncements of the very existence of gender atypical males have been made (e.g. Jean O’Leary’s public denouncement of Silvia Rivera, early androphilic transactivist, as “mocking women” at the 1970 Stonewall commemoriation for wearing feminine clothing).  On the internet today, this same gender role proscription is made where androphilic transwomen are chastised in the ugliest terms, “just because you’re a gay man doesn’t mean that you can be excused for objectifying women (by looking and acting like one).”  Thus, we see that gender role policing based on accepting gender normative standards exists even in the modern LGB communities.

Further Reading:

Essay on motor movement in gender atypical males.

Essay on vocal production in gender atypical people.

Essay on passability differences between gynephilic vs. androphilic transsexuals.


Pasterski, V., “Fetal Androgens and Human Sexual Orientation: Searching for the Elusive Link”, (2017) Archives of Sexual Behavior

Pasterski, V., et al., “Postnatal penile growth concurrent with mini-puberty predicts later sex-typed play behavior: Evidence for neurobehavioral effects of the postnatal androgen surge in typically developing boys”, (2015) Hormones and Behavior

Song Reference:

Boys Will Be Boys
(Leon Rosselson)

Boys will be boys, it’s a fact of human nature
And girls will grow up to be mothers

Look at little Peter, isn’t he a terror?
Shooting all the neighbors with his cowboy gun
Screaming like a jet plane, always throwing something
I just can’t control him. Trouble – he’s the one.

Ah but boys will be boys, it’s a fact of human nature
And girls will grow up to be mothers

Look at little Janie, Doesn’t she look pretty?
Playing with her dolly, proper little mum
Never getting dirty, never being naughty
Don’t punch your sister Peter, now look at what you’ve done

Ah but boys will be boys, it’s a fact of human nature
And girls will grow up to be mothers

What’s come over Janie, Janie’s turning nasty
Left hook to the body, right hook in the eye
Vicious little hussy, now Peter’s started bawling
What a bloody sissy, who said you could cry?

Because boys must be boys, it’s a fact of human nature
And girls must grow up to be mothers

Now things are topsy turvy. Janie wants a football
Peter just seems happy pushing prams along
Makes you feel so guilty. Kids are such a worry
Doctor, doctor, tell me, where did we go wrong?

Because boys must be boys, it’s a fact of human nature
And girls must grow up to be mothers

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It was the best of times…

Posted in Transsexual Field Studies by Kay Brown on June 21, 2017

Kay Brown 2010…It was the worst of times   Or, That ’70s Show

In the May 1974 issue of the Western Journal of Medicine, two back to back articles appeared, one from a number of doctors reporting on a grand rounds at UCSD hospital that included Robert J. Stoller and one from Norman M. Fisk.  Reading them both now is not only a window on the past, but explains where we are now and how we got here.

I can’t write about this period without flashing back on my own life and what was happening at the time.  In May of ’74, I was just about to turn 17, finishing my Junior year in high school.  My favorite class was “Individual Voice”, solo singing but I was also really enjoying one other class, “Cosmology; Stellar and Galactic Evolution” I was taking at a local college, taught by a NASA astronomer.  I got an “A” in the class, of course.  I was also summer job hunting and landed my dream job as a nanny taking care of two boys for a local family for $50 a week (~$250 in today’s money).  I was also desperately searching at the library for any and all information I could find on transsexuality and how I could get HRT and SRS.  That search led me to the Stanford Gender Dysphoria Clinic and Dr. Fisk.

In early ’75, after much drama with my parents, who were separated and soon to be divorced, I finally convinced them to let me go to the clinic (but failed to mention that they performed SRS, etc.), which meant first being evaluated by Dr. Fisk.  During the first interview, I got the very distinct impression that he didn’t believe a word I said, though it was all the absolute truth.  From his article, we can see why,

“The concept of gender dysphoria syndrome grew out of clinical necessity very much in an organic, naturalistic fashion.  This occurred because virtually all patients who initially presented for screening provided us with a totally pat psychobiography which seemed almost to be well rehearsed or prepared, particularly in the salients pertaining to differential diagnoses. It would be accurate to say that of the initial 30 to 40 non-psychotic patients screened, all presented as virtual textbook cases of classical transsexualism.  Remembering the old medical saw that “the last time one sees a textbook case is when one closes the textbook,” it was apparent that this group of patients were so intent upon obtaining sex conversion operations that they had availed themselves of the germane literature and had successfully prepared themselves to pass initial screening.  In some instances they had rehearsed friends, spouses and family members in a similar fashion.”

During a later interview, in the company of my mother, who with obvious disapprobation and the mistaken notion that the clinic was to “cure” me, answered his questions about my early childhood saying,

“He was very different than his brothers.  All of their friends were boys, his were all girls. … He was very prissy.  I could dress him in clean clothes on Monday and they would still be clean on Friday. … I’ve known he wanted to live as a girl for years.  I just felt that was wrong.”

In the next interview, in company with my father, who tried to argue with him about what should be done about me after learning that I had been diagnosed as transsexual, Dr. Fisk replied,

“Denial will not serve.  You will win some battles but lose the war.”

That made Dr. Fisk my hero for life!  And he should be a hero to every transsexual who has come after, since it is Dr. Fisk who changed the way transgender people are treated that continues today,

Within the first two to three years of our investigation, it became apparent that when non-fabricated or, more precisely, honest and candid psychobiographies were obtained from our patient population, there was indeed a great deal of diversity and deviance from what had been defined as the symptoms of “classical transsexualism.”  Moreover, the overtly present common denominator was the high level of dysphoria concerning the individual’s gender of assignment or rearing  … employing the diagnostic term gender dysphoria syndrome, our indications for surgical sex conversion therapy have been broadened. Patients now clearly understand that had they been interviewed five or ten or twenty years ago, they would have been diagnosed as not being classical transsexuals. These patients are informed that a diagnosis of transsexualism is not in our view the only valid criterion for deciding who receives surgical sex conversion. Moreover, we practice the rather pragmatic dictum that nothing succeeds quite like success and therefore our criteria for surgical sex reassignment or conversion are more phenomenologically oriented. … Obviously, by liberalizing the indications for sex conversion through conceptualizing patients as having gender dysphoria, we also are committed to provide a program for patients encompassing many factors related to a total overall rehabilitative experience. These include vocational counseling and guidance, psychological and psychiatric supportive therapy, grooming clinics where role-appropriate behaviors are taught, explained and practiced, legal assistance, and, probably of most benefit, an opportunity is afforded to meet and interact with other patients who have successfully negotiated gender reorientation or who are in various phases of reorientation. This program employs some former patients as counselors to persons with gender disorders.

But that’s not to say that my experiences with the clinic were all good.  In fact, personal repercussions of some of what Fisk describes in glowing self-congratulatory fashion were severe.  I’m not alone in experiencing these issues.  While Fisk’s liberalization had eliminated the absolute need for a differential diagnoses for purposes of determining who was to receive services, it has led to a false belief within the trans* communities that there are no differences on the one hand and to the harmful homogenization of treatment protocols on the other.  It is important to note that the Stanford clinic did know that there were in fact two types and organized their services around helping those most in need of “gender reorientation”.

Having seen the best of times… we now turn to the worst of times.

During psychiatric grand rounds at a UCSD hospital, a 20 year old androphilic transwoman is paraded in front of a large group.  The author of the article describing the event uses masculine pronouns to introduce her to his readers and give a bit of her history, then switches to feminine pronouns.  Here’s an excerpt,

“She was told that this interview would be part of a training session on transsexualism so that people in the Department of Psychiatry could learn more about it. She was also told that this session will have no bearing on her treatment, continuing evaluation, or the decision regarding her operation. She understands that coming here is entirely voluntary.  (The patient, whom we shall call Gloria, was escorted into the room. She wore women’s clothing, was heavily made up, and quite attractive.  She was introduced to Dr. Parzen, who interviewed her before a group of approximately 100 staff members and residents. The following are selected excerpts from that interview.)”

Does anyone today believe that “Gloria” didn’t fully understand that her voluntary cooperation was actually mandatory if she was to successfully navigate this clinic’s hoops?  Certainly she did given the times, as Dr. Parzen says,

“These patients become good actors and tend to be paranoid toward anyone who might push them to betray themselves in a way that might jeopardize their surgical treatment.  Gloria had already established a personal relationship with Dr. Millman, and his feelings about her will ultimately determine what will happen to her.”

The doctors had ultimate power of granting or denying services and transfolk knew it!  What’s interesting is that the doctors knew that the they knew it, but saw nothing wrong with this imbalance of power save for complaining about what transsexuals do in the face of such asymmetric power,

Certainly she is quite protective about herself at this point. She is awfully close to getting what she wants, and she isn’t going to tell me anything that might interfere with that. She does not know my orientation, and she isn’t crazy, and therefore isn’t going to present material that might be interpreted wrongly from her point of view.  Transsexual patients classically tend to be very manipulative and very secretive. They tell you what they want you to know, and they have learned through much experience to read and to manipulate medical staff.

I could go on with the odd ideation that these physicians have that relied on classical Freudian psychoanalysis, not to mention the incredibly disrespectful things these doctors said about “Gloria” and transgender people in general, but I don’t need to as the articles have been scanned and available for all to read.

Further Reading:

Essay on differential diagnoses and transsexual taxonomy use in the 1970s.


Fisk, N., “Editorial: Gender dysphoria syndrome–the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen.” (1974) Western Journal of Medicine

Judd, et al., “Male Transsexualism”, (1974) Western Journal of Medicine

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Coming of (r)age in Samoa…

Posted in Science Criticism, Transsexual Field Studies, Transsexual Theory by Kay Brown on June 20, 2017

critical-thinkingOr, The Fa’afafine in Context

It seems to me that research focused on the fa’afafine of Samoa has become all the rage of late, at least for those interested in feminine androphilic males / “homosexual MTF transgender” folk.  The interest has at its heart, the hope that it represents a culture that is closer to what we might have had before large-scale civilizations began, one closer to what humans may have evolved within.

First, Samoan culture is very collectivist.  Although we don’t have a formal Hofstede Individualism Index value for Samoa, most commentators I can find all agree that it would be very low, perhaps lower than just about any other on the planet.  They do everything in groups, traditionally even living together under one roof without walls.  Family and extended family are everything.  Thus, if we were to predict the ratio of androphilic vs. non-androphilic transwomen based upon the relationship between the Hofstede Individualism Index and the percentage of non-androphilic transwomen found by Lawrence, we would expect almost no non-androphilic transwomen.  And indeed, one never sees them mentioned in connection with Samoa.

In Samoa, there is almost no stigma attached to being a feminine male.  Feminine male children are not bullied.  Fa’afafine adults are not discriminated against in employment.  There is little to no stigma attached to masculine men finding Fa’afafine sexually attractive.  This is not to say that there isn’t any problems for them.  Christian missionaries and Western colonization has brought homophobic laws and attitudes.  But because there is little to no stigma attached, androphilic males are free to express as much or as little femininity as they find in themselves with little incentive to attempt to suppress it as occurs in many other cultures.

However, before anyone lauds the Samoan culture as being the transgender (or gay) paradise, consider one other factoid.  I can’t find any reference to any fa’afafine who is in a long-term relationship with a lover.  I’ve never seen any reference to their families celebrating a marriage to a man.  The fa’afafine may be called “in the manner of a woman” (as the term loosely translates), but they aren’t given that social status.  They are granted a status as what many anthropologists would call a “third gender”.  But that gender is not seen as equal to women in status and marital desirability.

fafafineFa’afafine are universally androphilic and have sex with masculine men.  They don’t have sex with each other because they are attracted to masculinity which is not especially abundant in fa’afafine.  But those episodes with masculine men are typically “one night stands”.  I can’t believe that they wouldn’t choose to have long-term romance in a committed relationship.  Although not well publicized, and not nearly as common as we might like, such long term relationships do exist between masculine men and androphilic transwomen in Western cultures.  So I must conclude that it is the Samoan culture that in effect prohibits or discourages such relationships.  I would like to be proven wrong on this… I really would.

An educated reader will perhaps recognize my quip of a title from Margaret Mead’s 1928 book.  They may also know of how she was attacked by Derek Freeman.  Maybe I’m just biased by my friendship with Alice Dreger, since I don’t believe a word Freeman says… but the episode does offer a cautionary tale regarding the potential changes that Christian missionaries have already brought to Samoa.  I’ll leave it at that, since those who are better acquainted with the controversy will know what I mean.

One of the interesting aspects of androphilia in males is the question of evolution, to wit, if genetics play a role, and there is strong evidence it does, than why hasn’t it been selected out of the human population?  How can a trait that confers a significant reproductive disadvantage be maintained in the gene pool, should that allele(s) be under very high anti-selection pressure?  One hypothesis is the “Kin Selection” effect in which androphilic males are indirectly “fit”, reproductively successful, because they increase the resources available for their near relatives.  Paul Vasey has been testing this idea in both Western gay men and fa’afafine.  Interestingly, it doesn’t appear to be true among Western gay men, but does appear to be true among fa’afafine who exhibit strong materterally supportive behaviors toward the children of their siblings.  The speculation is that something about the suppression, the crushing, of the natural femininity of androphilic males in Western nations also suppresses this materteral behavior.  I would suggest that we also look at Western androphilic transwomen, being careful to sort by the quality of familial relationships.

Since the culture is presupposed to be closer to that of our pre-civilization ancestors, the question of who the fa’afafine are sexually attracting may offer other insights into the early evolutionary selection pressures on masculine men, specifically the notion of competition for mating opportunities between women and feminine androphilic males.  Lanna Petterson explored this in a study published as her thesis (also published in journals) in which she presented images of faces, men, women, and very plain emojis on a computer screen, asking her subjects to evaluate and report how sexually attractive they found them.  The images were limited only to the faces.  They were composites that had been digitally modified to enhance their sexual dimorphism.  (Frankly, of the two images she included in the appendix of her thesis, I personally found them disturbing, seeming to be slipping over a cliff into the uncanny valley below.  I can’t but help thinking that the results may have been influenced in part by this.)  Unknown to her subjects, the response time latency was also recorded by the computer.  Earlier studies have shown that people tend to linger over images that they find erotically rewarding.  From this data, she comes to the conclusion that the men who are having sex with fa’afafine are “bisexual”.

Sigh… Looking at the data, as well as what we know from other studies of men who seek out transwomen (chasers), I have to seriously question this conclusion.  First, very much like what androphilic transwomen experience in the West, 65% of the men had never had a sexual encounter with a man and 75% had not within the past year.  As Dr. Richard Green wrote about the men who dated Western androphilic transwomen,

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

For many of the masculine Samoan men in Petterson’s study, I believe would fit this description as well.  Another portion of the men I believe would likely fall into the category of gynandromorphophilic (GAMP).  From a wonderful study by Hsu, we know that such men tend to be autogynephilic as well.  Although Samoan autogynephilic men are not likely to transition to presenting as women, that does not mean that they won’t seek out their prefered external sexual partners, women and feminine males, to wit fa’afafine.

From personal experience and hints from clinician and sexologist comments (e.g. Stoller and Bailey, separately), Western androphilic transwomen avoid gynandromorphophiles. One of the hallmarks of gynandromorphophiles is that they prefer pre-op and “functional”, that is, willing to allow these men to touch their penis, as Stoller remarked, “… she considered anyone who was not interested in her penis as normal…”

From reading between the lines of Petterson’s thesis, it appears that she made the assumption that sexual role “flexibility” denoted greater bisexuality.  I would argue just the opposite, that it is a signifier of potential gynandromorphophilia.  Also, I would predict that such men would have a different and “disturbed” response time when presented with faces to evaluate due to their underlying erotic target location error proneness.  While it is true that people tend to linger over images that they find erotically rewarding, they also tend to have trouble responding quickly to associations that reside further away from each other in their personal experience (e.g. implicit bias testing).  Indeed, this issue is shown in the data… that those who are willing to perform fellatio on fa’afafine had longer response latency, even to the crude emojis.

A minority of the masculine men having sex with fa’afafine are also only having sex with other masculine men, but not women.  This would suggest masculine presentation / identity exclusive androphilia, not bisexuality.  Not all fa’afafine present as extremely feminine as adults – some are fairly conventionally masculine, as average gay men would be in the West.  It would appear to me that not all androphilic males in Samoa developed an identity as fa’afafine as a child and that they are having sex with each other and to at least some of the fa’afafine, perhaps those who are less hypomasculine?

Although Petterson rejected the hypothesis that her masculine male subjects included both primarily androphilic and gynephilic subjects based on statistical tests of her response time data for normal distribution.  I believe that the effect of there being three different populations masked this fact.

Although Samoa and the fa’afafine culture seem so different than that of the West, I believe that the feminine androphilic subcultures in the West, that of feminine gay men, drag, and feminine androphilic transsexuals and our experiences very much parallel each other in important ways and future research will bear this out.

Further Reading:

Essay on relationship between Hofstede Individualism Index and non-androphilic MTF transsexual transitions

Essay on cultural influence on androphilic male presenation

Essay on Gynandromorphophilia


Vasey, P. et al., “What can the Samoan Fa’afafine Teach Us About the Western Concept of Gender Identity Disorder in Childhood?”, (2007) Perspectives on Biology and Medicine,  http://muse.jhu.edu/article/222247

Vasey, P. “The Evolution of Male Androphilia” Personal Website:  http://people.uleth.ca/~paul.vasey/PLV/Evolution_Androphilia.html

Petterson, L. “Male Bisexuality In Samoa” (2012) University of Lethbridge Thesis  https://www.uleth.ca/dspace/bitstream/handle/10133/3745/PETTERSON_LANNA_MSC2015_THESIS.pdf

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Fraternizing with the…

Posted in Transsexual Field Studies by Kay Brown on June 18, 2017

critical-thinking… Allies  Or, The Fraternal Birth Order Effect: Early Onset Transwomen vs. Gay Men

In a very recently published meta-study conducted by Ray Blanchard further exploring the Fraternal Birth Order Effect (FBOE), in which he had earlier noted that androphilic males tend to have more older brothers than sisters, he deals with several concerns and new research questions.  First, there had been some concerns with how best to handle the potential effects of family size.  But what really interests me is that here, for the first time, he carefully considers the effect of transgender (feminine presentation / identity) vs. non-trans androphilic men (masculine presentation / identity i.e. conventional gay men).  The results are striking!

“The pooled Older Brothers Odds Ratio for the feminine groups was 1.85, and the value for the non-feminine groups was 1.27. The corresponding risk ratios were 1.52 and 1.19.  The differences between groups were highly significant.  To sum up the results so far in common language:  Feminine homosexual males have more older brothers than non-feminine homosexual males, and non-feminine homosexual males, in turn, have more older brothers than heterosexual males.”

These results weren’t just “statistically significant”, the effect was very great with the 95% Confidence Levels not even overlapping!

But we should introduce a note of caution here.  The feminine androphilic data was very heterogeneous as can be seen in this plot of the data.  This may be caused by the differences between cultures sampled from all over the world.  Some of this data is from Samoan Fa’afafine, some from Western gender dysphoria clinics in the US, UK, and Spain, some from non-Western cultures like Brazil and Korea.  Blanchard also noted this issue and suggested exploration of this might interest some future researcher as more data becomes available.  But in any case, we are shown some very intriguing data that strongly suggests that we may be seeing a difference in etiology between feminine and masculine androphilic males.

Blanchard discusses possible conclusions regarding this,

“A … possibility is that the neurodevelopmental pathway triggered by older brothers is inherently more feminizing than path ways triggered by other etiologic factors (e.g., ‘‘gay’’ genes or prenatal hormone exposure). Thus, a group of homosexual males selected for generalized femininity is likely to contain a higher proportion of individuals who acquired their sexual orientation via the older brother pathway. Other hypotheses, equally speculative, are also possible. … Blanchard and Bogaert (1996) proposed that the FBOE reflects the progressive immunization of some mothers to male-specific (i.e., Y-linked) antigens by each succeeding male fetus and the concomitantly increasing effects of anti-male antibodies on sexual differentiation of the brain in each succeeding male fetus. According to this maternal immune hypothesis, cells (or cell fragments) from male fetuses enter the maternal circulation during childbirth or perhaps earlier in pregnancy. These cells include substances that occur only on the surfaces of male cells, primarily male brain cells. The mother’s immune system recognizes these male-specific molecules as foreign and produces antibodies to them.  When the mother later becomes pregnant with another male fetus, her antibodies cross the placental barrier and enter the fetal brain. Once in the brain, these antibodies bind to male-specific molecules on the surface of neurons.  This prevents these neurons from ‘‘wiring-up’’ in the male-typical pattern, so that the individual will later be attracted to men rather than women.”

Something not discussed, indeed I’m not sure how it can even be explored – unless the curve in the data shown for the odds of an older brother per other sibling is evidence for the effect of first born males experiencing self-induced maternal immunity creating the same etiological pathway.  I would also expect that some first born males may have this etiology due to previous maternal miscarriages and abortions of male fetuses since they too would be expected to have Y-linked antigen challenges to the maternal immune system.

Still, and all, very exciting paper well worth reading.


Blanchard, R., “Fraternal Birth Order, Family Size, and Male Homosexuality: Meta-Analysis of Studies Spanning 25 Years”, Archives of Sexual Behavior, (2017),

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When the Numbers Add Up…

Posted in Transsexual Field Studies by Kay Brown on June 17, 2017

female_scientistOr, Scientific Numerology

Sometimes, when one spots numbers that seem to be awfully familiar, they cause us to wonder.  Well, I think I spotted either an amazing random coincidence, or a basic connection between the incidence of autogynephilia and autoandrophilia in the general population and the incidence of potential gender dysphoria found in teenagers.  Check out these numbers.

From the Sumia study  0.5% girls compared to 2.2% of the boys had indicated such potentially clinically significant dysphoria.  Note that this is indeed potential, not clinically significant distress.  While in the Langstrom study 2.8% of men and 0.4% of women reported at least one episode of transvestic fetishism.

Again 0.5% vs. 0.4% for natal females and 2.2% vs. 2.8% for natal males.

So, random coincidence?  Or underlying correlation?  We need further study.  But I’m willing to put a high confidence estimate that this reflects that the GIDYQ-A is picking up on the connection between autogynephilia / autoandrophilia and mild gender dysphoria.

Further Reading:

Essay on Autogynephilia causing gender dysphoria in late onset transwomen


Sumia et al., “Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment”, Journal of Adolescence

Langstrom, et al., “Transvestic Fetishism in the General Population”  Journal of Sex & Marital Therapy, (2011) http://dx.doi.org/10.1080/00926230590477934

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