Which Came First? Chicken Or Egg?
Not too long ago, I got an email from a transwoman, and ‘older transitioner’ who acknowledged without reservation that there was a “correlation” between later transition / gynephilia (non-exclusive androphilic) transwomen and autogynephilia, while tacitly acknowleging that exclusively androphilic early transitioners do not. This was great, but not too surprising, since four out of five such transwomen acknowledge experiencing autogynephilia either currently, or in the past. But she asked, does it mean causation? That is to say, is autogynephilia the prime mover in causing gynephilic (and bisexual / asexual) transwomen to become gender dysphoric and develop a ‘female identity’?
I would have thought it was obvious that it does, and that we don’t need to explicate why. But, no, Sillyolme, nothing in science is self-evident. One really does need to explore the question fairly, making the assumption, the null hypothesis, that it does not, then look to see if the evidence supports that null hypothesis. Only if the data fails to support the null hypothesis should we state that it does.
Let’s start at the begining shall we? First, does autogynephilia exist? Yes, we need to ask this first, as it can’t be a cause of gender dysphoria if it doesn’t exist. And, indeed, many ‘older transitioners’ insist that autogynephilia does not exist. Well, that one is easily answered, because we have at least 100 years of sexologist observations of a minority of males who definately become sexually aroused when wearing women’s clothing and/or when thinking of themselves being or becoming female. Consider this typical description of a teenaged male experiencing an autogynephilic episode from Richard Ekins book Male Femaling – A grounded theory approach to cross-dressing and sex-changing,
“… I was 13 when I stepped, quivering with excitement into a pair of French knickers belonging to my sister. I ejaculated almost immediately… The feeling was glorious and yet quite alarming and I felt as though I was leaking urine. … Some three days after this first ‘event’ I got home from school to find my mother out. I went upstairs to do my homework and through the half-opened door of my mother’s bedroom I saw, hanging over a chair, a pair of her pink directoire knickers, obviously discarded in a hurry as she changed before going out. That soft gleaming bundle turned my whole body and senses into a jelly-like state of desire and longing. I had to wear them, to try and see if I was all right. Would it happen again? My answer was there almost immediately in my swift gathering erection as I struggled out of my clothes. …”
We can find hundreds of such examples, very often showing that this behavior is most noted in early adolescence, but continues into adulthood. In fact, we have an entire genre of erotic fiction and images (still and motion picture porn) dedicated to the tastes of autogynephilic adult male individuals. These examples and the males that experience it are common enough that they also form organizations to join together to support each other emotionally and even politically. So, no, we can’t say that autogynephilia does not exist. The null hypothesis is easily proven wrong. Autogynephilia in some males exists.
OK, now that we know that autogynephilia exists in some males, we can take a known group of autogynphilic males, conduct in depth interviews into just what sorts of things they erotically respond to that the majority non-autogynephilic males don’t. From that we can construct trial psychometric inventories, test items (questions), for an autogynephilia scale, so that we can measure the degree of and autogynephilic factors (types) present in, autogynephilic males. Then carefully test and validate it against known autogynephilic males and a set of control males.
However, some transwomen insist that autogynephilia can’t be the cause of their trans identity, because autogynephilia is common, perhaps near universal, in females. Thus, that would demonstrate that autogynephilia is just part of normal female sexuality.
Does autogynephilia exist in females? Now, remember, we START with the null hypthesis. So, assuming it does NOT exist, can we find (credible) evidence that would disprove the null hypothesis? First, how many sexologists have observed, documented, and remarked on autogynephilic sexual arousal in females?
Wow… I’m hearing an empty, hollow echo in that department. Not one observation, study, or anything… oh wait, I hear some tiny voices outside the hall? Could it be? Why there ARE some folks saying that females do experience autogynephilia… but… what? Oh, yeah… that… ALL of them are autogynephilic males who are claiming that their autogynephilia is the same as what women feel when they wear women’s clothing… after all, wearing “sexy” panties gets them all going, so it must get women going too? Right? Ummmm no.
Seriously, where in the many thousands of diaries, autobiographies, and now online social media blogs published, is there ANY (credible, not catphishing by an AGP male) female individual accounts of anything remotely like the autogynephilia so easily found in a minority of males? Seriously? Where are the copious accounts of how, when they were pre and early teens, that they became intensely sexually aroused upon trying on their big sister’s bra and panties? Or looking in the mirror at their blossoming breasts and become intensely sexually aroused? Or examining their genitals and finding them so arousing that that they masturbate while examining them… cause being female is just so sexy? No? Again that hollow echo.
Oh, but wait, I hear a rising chorus (of autogynephilic males) saying that a Dr. Charles Moser created an autogynphilic inventory for females and tested a group of women. So we ask, as we must assume the null hypothesis, where did he find the known autogynephilic females to interview to create a valid test? How did he validate it? What are the psychometric properties of the instrument? What? No? He did none of that? Well, then what did he do? He carefully rewrote questions from an instrument intended for and validated only for males in a gender clinic setting? Well, looking carefully at the rewrite, they don’t seem to have even a passing bearing on what autogynephilia would theoretically look like in women, or even in androphilic transsexuals. The questions were very carefully written to get positive answers from heterosexual females, as that was the intended (political) goal, to “prove” that straight women were also autogynphilic… but they have no meaning. They don’t measure autogynephilia, they measure mostly anticipatory arousal before dates with men. Well that was dissappointing. One and only one demonstrably invalid study. We still have no evidence to disprove the null hypothesis. So, for now, we must accept that females do NOT experience autogynephilia.
OK, so now we know that autogynephilia exists in males, but there’s no (credible) evidence that it exists in females. But are there really two types of MTF transsexual? Does autogynephilia exist equally as much in exclusively androphilic transwomen? Let’s assume the null hypothesis, that there is only one type, not two. We can use the previously developed and validated, instruments to measure any putative autogynphilia in both exclusively androphilic and non-exclusively-androphilic transwomen and see if there is a difference. Here, we have a number of studies done over the years, Buhrich (1977), Freund (1982), Blanchard (1985), Doorn (1994), Smith (2005), Lawrence (2005), and Nuttbrock (2009).
These studies all clearly indicate a strong correlation with non-exclusively androphilic reporting a high, nearly universal, percentage of individuals acknowleging autogynephilic arousal, either currently, or in early adolescence, and a strong anti-correlation with exclusive androphilia. Diving deeper, consider that in the largest and most recent of these studies by Nuttbrock (N=571), the grouping that had the highest percentage reporting sexual arousal to crossdressing was the gynephilic at 82%, while the group with the least non-exclusively androphilic was those who had begun Hormone Replacement Therapy (HRT) as teenagers, who had the lowest percentage reporting sexual arousal to cross-dressing at 14%.
To support the null hypothesis, there should have been no correlation with sexual orientation. The null hypothesis is NOT supported, there is NOT one group, but two. Futher, the null hypothesis regarding autogynphilia not being correlated with gynephilic/bisexual/asexual transwomen, and only these transwomen, is not supported. Androphilic transwomen and natal female women do not experience autogynephilia.
But this only brings us back to where we started, with my correspondent fully conceding to the above. But she still has a valid question, does this mean causation? After all, we all know that correlation does not imply causation. But here we need to bring up a point, actually, it doesn’t imply it… but causation does require correlation. So, we have our first step toward answering the question. With correlation, we may have causation. But we need to explore further.
One of the most accepted methods of deducing whether there is a cause and effect relationship is found in Bradford Hill’s Criteria.
The list of the criteria is as follows:
- Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.
- Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.
- Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.
- Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
- Biological gradient: Greater exposure (dosage or intensity of cause) should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence (as found in vitamin deficiencies).
- Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).
- Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that “… lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations”.
- Experiment: “Occasionally it is possible to appeal to experimental evidence”.
- Analogy: The effect of similar factors may be considered.
Taking each in turn:
- Strength of the correlation is very high. Four out of five gynephilic transwomen acknowlege experiencing, currently or in the past, autogynephilia. Considering that autogynphilia is very rare in the general male population and non-existent in the female population, this correlation is very, very high. But it gets even higher when considering the experimental results of phallometry of those cross-dressers experiencing gender dysphoria who claim that they did not experience sexual arousal to cross-dressing, did in fact demonstrate mild sexual arousal to cross-dressing narration (autogynephilic erotic fiction) compared to control males.
- Consistency of the correlation is easily shown by looking at the literature referenced above, in which study after study, over four decades, involving around a thousand transwomen, consistently shows the same data, even using different measures of sexual orientation and autogynephilia.
- Specificity is shown in that it is only non-exclusively-androphilic males who experience autogynephilia and that a subset of those males develop gender dysphoria.
- Temporality is demonstrated in that the majority of non-exclusively-androphilic males who become gender dysphoric and come to identify as women report autogynephilia in adolescence which seems to mellow even as their need to cross-dress and their gender dysphoria increases, reaching a threshold, a crisis point, most commonly in their mid-30’s. As Prince (herself an autogynephile) and Doctor documented, “Among our subjects, 79% did not appear in public cross dressed prior to age 20; at that time, most of the subjects had already had several years of experience with cross dressing. The average number of years of practice with cross dressing prior to owning a full feminine outfit was 15. The average number of years of practice with cross dressing prior to adoption of a feminine name was 21. Again, we have factual evidence indicative of the considerable time required for the development of the cross-gender identity.”
- A gradient effect is easily found in autogynephilia in that men who have only very mild autogynephilia typically are content to cross-dress in private, never developing severe gender dysphoria or a female gender identity. There are individuals with partial autogynephilia who only wish to have breasts, who are content with mildly feminizing HRT, cross-dressing in public only occasionally. There are those who come to identify as “Bi-Gendered” or “Gender Fluid” who go back and forth. And finally, there are those whose autogynephilic ideation was intensely focused on being completely female and develop intense and all consuming gender dysphoria who go on to live full time as women, obtain HRT, and SRS. A number of studies have found that intensity and the specific nature of their autogynephilia correlates with these differential outcomes. Further, these effects seem to indicate both a continuum and a progression (criterion #4). There is another dosage effect that though subtle, is of high importance to the question of causation and the nature of autogynephilia itself found by Blanchard in “Nonmonotonic relation of autogynephilia and heterosexual attraction”, from the abstract, “the highest levels of autogynephilia were observed at intermediate rather than high levels of heterosexual interest; that is, the function relating these variables took the form of an inverted U. This finding supports the hypothesis that autogynephilia is a misdirected type of heterosexual impulse, which arises in association with normal heterosexuality but also competes with it”. This non-monotonic relationship was questioned in the Nuttbrock study, as they hypothosized that autogynephilia was a classic conditioned sexual fetish that had arisen as a consequence of cross-dressing and gender dysphoria, and not the cause. But Lawrence easily demonstrated that Nutbrook missed the relationship due to improper mathmatical treatment of the data… and thus the dosage relationship evidence remains valid.
- Plausability. This is almost self-evident. If one’s sexual ideation is exclusively autogynephilic, if each time such an individual sees herself as obligatorially female during sex, that would be strong drive towards gender dysphoria and an incentive to adopt a female gender identity, over time.
- Coherence with laboratory tests are found by looking at brain sex research which shows that non-exclusively-androphilic transwomen are different than exclusively androphilic transwomen AND females, as expected by the theory that autogynephilia is the cause, not the result, of gender dysphoria and a female gender identity.
- Experiments with animals are not possible as we have no animal models of autogynephilia.
- Analogy is found in the amazing similarity of autogynephilia and its effects are found in males with apotemnophilia, the sexual desire for limb amputation, and autopedophilia, the sexual desire to be a child. In fact, a very high percentage of heterosexual apotemnophiliacs are also autogynephilic, experiencing an Erotic Target Location Error in which they wish to become female amputees.
So, we can see that we meet nearly all, saving only experimental evidence, to support the conclusion that autogynephilia is the cause, and not the result or merely a co-occuring factor, of gender dysporia and female gender identity in non-exclusively-androphilic transwomen.
… or How the Science of Changing Sex is Distorted by the Transsexual Community
Funny how I have been carefully writing about the science regarding transsexuality and transgender sexuality and trying to be very careful about NOT cherry picking or distoring the evidence by either mistating or omitting key points? Well… now I seem to have competition at The TransScience Project. Of course, it appears that they are cherry picking or leaving out key data points. For instance, lets examine an essay written by Sarah Lewis on “The Brain And Gender Dysphoria”:
“The first study of its kind was conducted by Zhou et al (1995). The study found sex a-typical differences in the stria terminalis of the brain stem when studying transgender subjects. A follow up study by Kruijver et al (2000) confirmed the findings and provided greater insight. The central subdivision of the bed nucleus of the stria terminalis (BSTc) is sexually dimorphic. On average, the BSTc is twice as large in men as in women and contains twice the number of somatostatin neurons. These numbers do not appear to be influenced by sexual orientation or hormone replacement therapy – and both were controlled for by Zhou and Kruijver. A paper by Chung et al (2000) studied how the volume of the BSTc varied with age in both male and female subjects. They found that the dimorphism was only prevalent in adulthood. Suggesting that the differences found by Zhou and Kruijver are not a cause of gender dysphoria but rather a result.”
Ummm… “not a cause but rather a result.” Yes… and not quite. No, the BSTc was influenced by exogenous hormones as a result of treating gender dyshoria, not because of gender dysphoria. Gotta hand it to her, Lewis did a great slight of hand trick there huh? It almost sounded like the BSTc was related to gender dysphoria… but it’s not. Ms. Lewis failed to explain that taking hormones causes changes in the brain toward the target sex. Not quite saying a falsehood… just letting an unwary reader be mislead. Which is what she continues to do in the paper:
“In Luders et al. (2009), 24 trans-women who hadn’t started hormone-replacement therapy were studied via MRI. While regional grey matter concentrations were more similar to men than women, there was a significantly larger volume of grey matter in the right Putamen compared to men. As with many earlier studies, they concluded that gender dysphoria is associated with a distinct cerebral pattern. In contrast, Savic et al (2011) did not find any sex a-typical differences in the Putaman, or other investigated areas of the brain. They did however find differences between their trans-women group and both the male and female controls.”
She didn’t mention that this research, both studies, included only non-exclusively androphilic (i.e. primarily gynephilic) transwomen. In fact, throughout her essay, she fails to make this distinction, which allows data that supports Blanchard’s prediction that exclusively androphilic (transkid) MTF transwomen would show shifts toward a feminized brain, but the non-exclusively androphilic would not, though they would show non-sexually dimorphic differences from both men and women, to be falsely interpreted to suggest that evidence for brain feminization in MTF transkids to apply universally. Actually, in this case the larger volume of grey matter in the right putamen was larger than men AND women, suggestive of a non-sexually-dimorphic brain marker for autogynephilic transwomen, exactly as predicted, as explained in my essay, “And the Beat Goes On”.
Had she compared the Savic (2011) paper to the Simon (2013) paper, especially if she had quoted Simon, she might have had a far different interpretation, as I did in my earlier essay, “Shades of Grey matter”
In that paper, Simon pointed out that their study used the same methods, but found quite different results, and noted that it was because of the issue of the two types of transwomen. Looking at only androphilic MTF transwomen, they did find that they were similar to female controls and not to male controls. But that would not have suited Lewis to have pointed that out. In fact, Lewis failed to note that studies which did find sexually dimorphic shifts, were conducted on exclusively androphilic transwomen,
“Two studies by Rametti et al (2011) looked at white matter differences in both trans-men and trans-women.
In their study of trans-men they found that control males have significantly higher fractional anisotropy values (FA is a measure often used in diffusion imaging where it is thought to reflect fiber density, axonal diameter, and myelination in white matter) than control females “in the medial and posterior parts of the right superior longitudinal fasciculus (SLF), the forceps minor, and the corticospinal tract”.
Compared to control females in the study, trans-men “showed higher FA values in posterior part of the right SLF, the forceps minor and corticospinal tract. Compared to control males, trans-men showed only lower FA values in the corticospinal tract.”
The study concluded that there was evidence for an inherent difference in the brain structure of trans-men.
In their study of trans-women they found that trans-women “differed from both male and female controls bilaterally in the superior longitudinal fasciculus, the right anterior cingulum, the right forceps minor, and the right corticospinal tract.” The nature of these differences suggests that some fasciculi do not complete the masculinization process in trans-women during brain development.”
However, I did point out that this only applies to exclusively androphilic transkids in my essay, “Seeing the world in grey and white”.
Lewis is not a very critical reader of the scientific literature… especially if it suits her thesis. In fact, she accepted at face value one paper, that purported to have shown that MTF transwomen (all non-androphilic, btw) responded to human male pheromones the same as control females. (Which is strange, because if they did respond like straight women, why aren’t they attracted to men?) Problem? Ummmm… nothing…. except that there’s no such thing as human pheromones!! I pointed that out in my essay, “False (Scent) Trail”.
And speaking (er… writing) of not being critical,
“Garcia-Falgueras and Swaab (2008) investigated the hypothalamic uncinate nucleus, which is composed of two subnuclei, namely interstitial nucleus of the anterior hypothalamus (INAH) 3 and 4. They showed for the first time that INAH3 volume and number of neurons of trans-women is similar to that of control females. The study also included analysis of a single trans-man who also had a INAH3 volume and number of neurons within the male control range.”
As I pointed out in my essay, “The Incredible Shrinking Brain”, this too was easily shown to be an effect of hormone therapy, just like Swaab’s earlier report about the BSTc, in fact, these were the same subjects who had been on HRT for years, sigh… Had she read my essay, would Lewis have included my analysis?
She concludes with one paper which suggests a difference between control men and MTF transwomen with respect to the ability to mentally rotate images. Looking at the subject’s ages, average 37, we can see that they are likely mostly non-androphilic. This paper looks interesting, but is this really a sexually dimorphic difference? Or a difference in IQ? The transwomen were about IQ 107-109 and the control men, who performed better, were about IQ 123 (a significant difference at one standard deviation). Me? I’m going with IQ.
This isn’t the only example of cherry picking I’ve commented upon, as I wrote in an earlier essay, “Gender Allusions”.
So, we see that when looking at the scientific evidence and how it is presented, by and within, the transcommunity clearly wants to believe, and leave others with the impression, that it supports the notion that all transwomen have feminized brains and that there is only one kind of transwomen. Sadly for them, neither is true.
On Privilege and Entitlement in the Transgendered Communities
It’s the first day of a new year, time for another editorial on the transsexual and transgendered communities. This past year, I’ve noted an increase in discussion on “privilege”, who has it, and who doesn’t. This is not a new topic in the transgendered forums, or in the so called, ‘gender critical’ forums. But, as usual, I find that most of the discussion misses the mark by a very wide margin, largely because of a combination of failing to define what and how privilege is and operates and conflating privilege with advantage and entitlement.
First, among the wider transgendered communities, especially among “older transitioners”, there is a common lament, a complaint even, of how they are disadvantaged because they don’t “pass”. They then posit that those who are “lucky” to pass as non-transsexuals have a special “privilege”. I’ve even seen essays that go as far as to criticize those MTF transwomen who do “pass” as expressing a belief that they are somehow “better” than those who don’t. On one hand, evidence of this is provided by noting that in the (autogynephilic) transgender community, those who pass better are given greater social status. On the other is that those who don’t pass are exposed to greater transphobic discrimination in the non-transcommunities, even within the LGB communities!
Second, among non-transgendered commenters, especially those with a feminist background and interest in ‘gender crit’, there is much discussion about how transsexuals or transgendered folk do or do not have “male privilege”.
Why, you may ask, is this of interest from the scientific perspective? Because privilege, accrued advantage, and entitlement lie at the heart of the different social and economic experiences of the different types of transfolk. It is also key to understanding the response to the growing scientific knowlege and understanding of the etiology and clinical presentations of the two types, by the more socially advantaged, ‘privileged’, of the two MTF types.
So let’s dissagregate (deconstruct, if you prefer post-modernist cant), the terms.
The term “privilege” comes from “private law”, the acknowledgement that some people have legal rights and some don’t. A king had a special status, a private law, that didn’t apply to his subjects, “rank hath it’s privileges”. Until very recently, men had legal rights that women did not in nearly every nation (and still do in far too many). This is ‘male privilege’ in its most naked and raw form. But there is another form, that which is given by custom and bias. It should come as no surprise that, even today, most people, both men and women, still hold irrational biases that grant men more privileges than to women. That bias is so strong that study after study have shown that women have to be demonstrably more competent and accomplished than men to even hold their own in many domains. (Look up the “Matilda Effect“.)
Privilege of this sort does not lie within the individual. It lies in those who surround the individual. It is granted automatically, by law, custom, or bias. One cannot consciously disown such privilege since it is not within their control to bestow it upon themselves in the first place.
From privilege can, and usually does, come advantage. It is what allows some people to move forward in their lives in an easier manner. It also accumulates. This property of accumulating advantage that comes from privilege is what ‘gender critical’ commenters are usually talking about when they state that MTF transwomen have “privilege”. When those very same MTF transwomen read the word “privilege” and deny ownership of such, they are only thinking of their current loss of “privilege” due to transphobic bias, or, if they truly pass, of loss of “male privilege” wherein they are now subject to misogynistic bias. But it is accumulated advantage that is paramount, because, if enough advantage has been accumulated, it can overcome transphobic or misogynistic bias, because advantage leads to further advantages. (Look up the “Matthew Effect“.)
When someone is accustomed to having privilege and to accumulating advantage, it often engenders ‘entitlement’, the personal belief that such privileges that come from law, custom, or bias are ‘owed’ to them, or that they ‘earned’ them, that they are due to them because of a percieved sense of superiority. It should come as no surprise that most men, accustomed as they are to socially granted privilege, fail to see their privilege over their female peers until it is painfully lost, as is the case with “late transitioning” MTF transsexuals losing “straight male privilege” as they become subject to homophobic/transphobic bias. But even then, a substantial number of them fail to adjust to this loss, holding onto their entitlement, especially if they had previously accumulated enough advantage such that the loss of straight male privilege is overcome by compounding socio-economic advantage.
As an example of how accumulated straight male privilege, internalized bias, and the failure to understand its presence, can be found in late transitioning MTF transsexuals, one only has to look at Martine Rothblatt who openly touts that she is “the highest paid female CEO”. Perhaps she can be a role model to the millions of girls who would look to emulate her success? That is to say, that they should all become straight married men, father children, and climb the corporate ladder, accumulating advantage confered by stright male privilege? Or perhaps exclusively androphilic, gender atypical, MTF transkids can do so? NOT!!!
Well known and respected gender therapist, Dr. Anne Vitale, noted this internalized bias and tightly held sense of entitlement in one of her essays on the phenomena,
“One of the most interesting aspects I have found in my work with genetic males struggling with deep seated gender dysphoria is ingrained sexism. Although it would seem to be completely out of place in this population, the fact that it is present and present almost exclusively in genetic males tells us a great deal about how some men feel about femininity and about aspects of the nature of gender dysphoria. As a general rule, the men I am speaking about present for therapy appearing decidedly male, often to the point of wearing full beards. In addition, they are more often than [Group One transsexuals] to present [as] married, to have children, and to have never considered having a homosexual experience. … There are those that think that what women do — those social behaviors that differentiate them from men — are frivolous and unimportant. Indeed, there are those who take this belief to the point where they feel that women are less than men and are embarrassed over wanting to be like them. Interestingly, these people have no trouble at all with wearing very feminine apparel — as long as they can do it in complete privacy or with the above mentioned male bravado. … Perhaps the most insidious form of sexism resides in the gender dysphoric male who has attained a highly respected position in a male dominated profession. These people routinely tell me that although women are now allowed a certain professional tolerance, the real players are still men.”
Vitale also noted that these late transitioning (universally gynephilic) transsexuals clearly understood that they would be losing their socially confered straight male privilege should they transition,
“As the number of people who transition on the job grows, they get to see firsthand how public respect between men can quickly turn into private ridicule. Some individuals have even confessed to having participated in sexist jokes as a way to divert even the remotest suspicion from themselves. These people face the very real prospect of becoming outsiders, left to wither on the corporate vine. Given these seemingly unacceptable obstacles, many gender dysphoric males unconsciously accept certain male driven notions about women in an effort to purge the need to be female out of their mind.”
This potential loss of privilege is weighed against the personal benefits of transition, taking into account their already accumulated advantages. This leads to the phenomena of very advantaged, higher socio-economic status (SES) gender dysphoric autogynephilic MTF transgendered individuals being more likely to transition than those with only moderate SES. However, heterosexual and male privilege is not the only source of privilege or advantage, others include ethnicity (race/color, etc.), class, and education. That is to say, that we don’t all start out with the same advantages. Of course, those with absolutely nothing to lose… those who do not, nor ever did, enjoy straight white male privilege, or accumulated advantage, poor and homeless “homosexual” transsexuals, both MTF and FtM, of color, whose early gender atypicality is well noted by parents, teachers, and peers alike, do not weigh loss of a privilege that was never theirs. This is why in the Western countries, we find that most autogynephilic transwomen are white, middle-class, better educated while we find that exclusively androphilic MTF transsexuals (transkids) are more likely black, asian, or hispanic from poor families.
Dr. Vitale, in another essay, contrasted MTF transkids, whom she dubbed “Group One (G1)” type transsexuals, as not exhibiting this presumption of male (straight or otherwise) privilege and entitlement,
“As a psychotherapist I have found female identified males (G1) to be clinically similar to male-identified females (G2). That is, individuals in both groups have little or no compunction against openly presenting themselves as the other sex. Further, they make little or no effort to engage in what they feel for them would be wrong gendered social practices (i.e., the gender role assigned at birth as the basis of authority).”
Gender atypicality, especially notable femininity (disparagingly labeled “effeminancy”) in males, makes most people very uncomfortable, leading to less cooperation and social opportunities. That is to say, that such individuals are granted less privilege, due to conscious or unconscious bias. Whether that bias is greater or lesser than the privilege that may or may not be automatically conferered because that individual is male is likely to vary by individual and by the relationship between the individual and their social circle. But, in many circumstances, this bias against them as feminine persons and gender atypicality/homosexuality far outweighs any potential male privilege, as attested by how many such individuals are disowned by even their own families to become homeless as teenagers.
Thus, for such gender atypical individuals who are contemplating alternatives, the possibility of passing as a member of the opposite anotomic sex can be very appealing. But here, the ability to actually pass, really and truly pass, for years on end, with one’s neighbors, co-workers, peers, etc. is carefully evaluated; because, for non-autogynephilically motivated individuals, failing to pass will not grant them part of what they desire, surcease from bias. Thus, passibility is a neccessity for most “homosexual” transsexuals. While passing as non-transsexual and non-gender-atypical women reduces bias, it does not grant “privilege” in the same sense that being percieved as a gender typical, straight male does. Thus, attributing “passing privilege” to exclusively androphilic “young transitioners” in the manner that autogynephilic “late transitioners” often do, is dubious at best, and an example of autogynephilic projection of a false privilege at worst. Worse, those who have become accustomed to equating possessing privilege with entitlement, falsely project onto such passable (especially if attractive as well) young transitioning MTF transsexuals the belief that they see themselves as “better than” gynephilic late transitioners, for whom the ability to pass has far less weight on their decisions regarding transition. As the authors of the transkids.us website put it,
“This kind of perception is very common amongst transsexuals who are motivated by autogynephilia and the desire to acquire femininity and is typical of how hsts issues are re-interpreted within a transsexual context which has meaning to autogynephilic transsexuals and not to homosexual transsexuals. In the often somewhat oddly “reversed” context of autogynephilic narrative, femininity is redefined in terms of status and heirarchy, as a personal goal and not as a connected social history. Casting transkids as “privileged” because they are defined socially as feminine is a reversal of how things work in the non-transsexual world where femininity grants less social privilege, not more. In a paraphilic value system where femininization is the objective then it can be seen how those who are spontaneously feminine would be considered fortunate but the relationship of homosexual transsexuals to concepts of “passing”, attractiveness and femininity are simply very different from those of autogynephilic transsexuals. Being a member of a very devalued social class from a very young age is not a privilege, it is a huge social liability.”
While femininity in boys is near universally reviled, mild “tomboyishness” in girls is tolerated or even encouraged. However, extreme masculinity in girls and especially maturing girls and women, is equally disquieting to many. Here, the ability to pass as straight, gender typical men, may and does confer some privilege, and if one transitions young enough, they may be able to accumulate advantages from it.
Anne Vitale, “The Gender Variant Phenomenon–A Developmental Review” http://www.avitale.com/developmentalreview.htm
Vitale, Anne, “Sexism in the Male to Female Transsexual” 1997
“…I would while away the hours, sniffing all the flowers, if I only had a brain…” — Scarecrow, in the Wizard of Oz musical film.
After years of trying to explain the differences between the two types and the statistical evidence for the two type taxonomy of MTF transwomen, I’m now posting what should be the final clincher; solid biomedical laboratory evidence, “proof” even.
Decades ago, as I was researching our collective history and science (the two often go hand in hand), I came across a reference to studies that showed that gay men had feminized brains while MTF transsexuals did not. SAY WHAT!?!?
Turns out, the study referenced made the false assumption that all MTF transsexuals are the same and had only included gynephilic older transitioners. Other studies, being aware of, and accounting for the differences between the two MTF transsexual types found something quite interesting, as for example, from the Dörner (1983) abstract:
“In male rats, androgen deficiency during a critical period of sexual brain differentiation was shown to give rise to a predominantly female-differentiated brain. Such animals displayed “homosexual behaviour”, i.e., they were sexually attracted preferentially to partners of the same sex. In addition, they exhibited a sex-specific evocability of a positive oestrogen feedback effect. A positive oestrogen feedback effect on LH secretion was also induced in homosexual transsexual men, in contrast to hetero- or bisexual transsexual men. Thus in homosexual transsexual men, an intravenous injection of 20 mg Presomen (Premarin) produced a significant decrease of serum LH levels followed by a significant increase above the initial LH values. In hetero- or bisexual transsexual men, by contrast, intravenous oestrogen administration, while producing a significant decrease of serum LH levels, was not followed by an increase above the initial LH values. A positive oestrogen feedback effect on LH secretion was also found in homosexual non-transsexual men, in contrast to heterosexual men. These findings suggest that transsexual as well as non-transsexual homosexual men possess a predominantly female-differentiated brain which may be based, at least in part, on androgen deficiency during sexual differentiation of the central nervous system. Homosexual transsexual men also showed an increased LH and FSH response to LH-RH as compared to hetero- or bisexual transsexual men.”
Note that non-exclusively-androphilic (“heterosexual or bisexual”) transwomen did NOT have the female like positive estrogen feedback effect on LH serum levels. Of course, according the Blanchard’s work, all “non-homosexual” MTF transsexuals should also be in the same taxon, so we would predict that so-called, asexual transsexuals should also show the lack of this positive feedback, and indeed, this too was found, as discribed in the Dörner’s (1976) earlier paper,
“In transsexual men with homosexual behaviour and intact testicular function, as well as in homosexual men with normal gender identity, following a negative oestrogen feedback effect a delayed positive oestrogen feedback action on LH secretion was evoked. By contrast, in transsexual men with hypo- or asexuality and intact testes or hypergonadotrophic hypo- or agonadism, as well as in heterosexual men with normal gender identity, a negative oestrogen feedback effect was not followed by a positive feedback action on LH release. In transsexual women with homosexual behaviour and oligo- and/or hypomenorrhoea, only a weak or at best moderate positive oestrogen feedback action on LH release was evocable, similarly as in castrated and oestrogen-primed heterosexual men. By contrast, in a transsexual woman with bisexual behaviour and eumenorrhoea, a strong positive oestrogen feedback action on LH secretion was evocable, as well as in heterosexual women with normal gender identity.”
Note that in this paper we see a mirror like difference between FtM “homosexual transsexuals” (gynephilic transmen) who respond more like heterosexual men and bisexual FtM transmen who respond more like heterosexual women. Thus, this data would lend support for there being a taxonic difference between exclusively gynephilic and non-exclusively gynephilic transmen, mirroring the taxonic difference between the two types of transwomen.
These papers, detailing a specific, repeatable, laboratory based test that can differentiate the two types of transsexuals described by Blanchard, “Homosexual” and “Non-Homosexual”, offers both supporting evidence for the two type taxonomy but potentially also a way of independently sorting the two types in future studies. This difference is a classic medical biomarker for the two types. Should anyone one doubt the weight of statistical evidence, we can also point to the biomedical evidence via laboratory tests.
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)
… Or, Who’s the Fairest of them All?
For years, clinicians, therapists, researchers, and transfolk alike have remarked that “younger transitioners”, transkids, “homosexual transsexuals”, “early onset” (whatever label or demarcator in fashion) MTF transsexuals simply ‘pass’ better than “older transitioners”, autogynephilic transsexuals, “late onset” MTF transsexuals. For years, I wanted to conduct a study about this. Well, now we have clinical data to test this observation.
In a study conducted in Europe, by our favorite Netherlands based researchers, they looked at both body image and clinician assessment of gender incongruent physicality. That is to say, how well or poorly they pass. The same single clinician rated them all, so while a different clinician may give folks a different absolute score, the relative scores for all subjects is likely to be very accurate.
In deference to the currently debated question and researching the potential validity of which signifier is the accurate basis for a taxonomic typology of transsexuality, the data was presented for both sexual orientation and age of onset.
Androphilic Non-androphilic Gynephilic Non-gynephilic
Early onset 88 (70%) 102 (43%) 193 (88%) 37 (69%)
Late onset 38 (30%) 139 (57%) 26 (12%) 17 (31%)
The Dutch have long contended that age of onset was the salient signifier, while those in North America contend that it is sexual orientation, specifically “homosexual” vs. “non-homosexual”, which readers of my blog, and those familiar with the literature, know gives a strong signal / correlation with autogynephilia in MTF transsexuals.
In the graphs below, a higher score means more gender incongruent appearance (i.e. ‘readable’), while a lower score means more gender congruent (i.e. ‘passable’).
Now, looking at our earlier observation, do exclusively “homosexual” transsexuals pass better than “non-homosexual”? For transwomen, the answer is a resounding “YES!”, with a large effect size (d=0.7). However, keep in mind that we know that many “late transitioners” misreport their sexual orientation because of Social Desirability Bias and Autogynephilic Pseudo-Androphilia. From several studies we know that perhaps 38% report that their sexual orientation ‘changed’ from exclusively gynephilic to androphilic or bisexual. and that estimates of misreported sexual orientation means that from 20-40% of the androphilic group is in fact, non-androphilic. Even with that possibility, the data still shows that androphilic MTF transwomen pass far better than non-androphilic.
So what of our question about early vs. late onset? Here again, early onset passes better. But look closely at the data, 46% of the early onset group are androphilic. If we hypothesize that the salient signifier is sexual orientation and NOT age of onset, then we would expect that the relative score for early onset would be intermediate between androphilic and both non-androphilic and late-onset (which is predominately non-androphilic at 79%). And that indeed is what we see. Further, one would predict that since late onset is predominately non-androphilic, that they would have the same level of passability… and indeed that is what we see again. The data clearly supports the position that sexual orientation and NOT age of onset is the salient signifier, given the stronger signal. That is to say, variation in the data is explained completely by sexual orientation and that the variation of passability with respect to age of onset is from the correlation between sexual orientation and age of onset.
It is clear that there is a mild correlation with sexual orientation and age of onset, with androphilic MTF transsexual more likely to report early onset (70% vs. 43%). However, given clinical experiences with each, the meaning of age of onset is quite likely different. If 43% of non-androphilic transwomen really did have an early onset… why do they all wait so long to socially transition? The modal age is about 35 years and the average is about 40 years old compared to the 20 years old for androphilic. I contend that retrospective age of onset is time shifted to an earlier age due to Social Desirability Bias AND to having a different internal meaning to the question. For transkids (androphilic transwomen), the age of onset is demarcated by extreme somatic and social dysphoria, while for non-androphilic the demarcator is retrospectively found by their strong but vacillating autogynephilic desire for somatic transformation, but with little as yet stable social or somatic dysphoria. As per Doctor and Prince, it takes considerable time for true gender dysphoria and cross gender identity to develop in non-androphiles / autogynephiles.
We are still left with an open question. Why do androphilic transwomen pass so much better than non-androphilic? Three possible hypotheses exist, 1) Having a truly earlier age of onset and social transition age, they experience less masculinization from endogenous androgens. 2) Self selection for passibility as they are motivated to fit into society better, being both physically and behaviorally extremely gender atypical (and not autogynephilically motivated). 3) Actually being, as a group, intrinsically more physically gender atypical. (That is to say, that the etiological cause for their behavioral gender atypicality causes physical atypicality as well.)
Its also quite possible that any or all of these may be operating. In fact, I strongly believe that all three are, in fact, operating. MTF transkids do transition and obtain HRT at an earlier age. They (we) do care and want to pass to better our lives. And, from research into gender atypical children, it has been noted that gender atypical and dysphoric male children are considered more attractive than their gender typical male peers. This ‘attractiveness’ is caused by hypomasculinity (masculine faces aren’t “pretty”).
Looking at the data for FtM transmen, there seems to be a small signal. I would really like to see a study with more subjects, as this didn’t seem to be as statistically significant as we would like. Even if real, the effect size is small. However, we do have collaborating data from earlier studies that show that FtM transkids are judged to be more physically masculine than non-trans-girls.
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
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
Parental Attitudes Towards Transgender Children
Every now and then, I check the stats on this site. I am gratified by the growing number of readers over the past six years. I also check the search strings that are used to find this site. I am happy that parents of transkids find my site and this much needed information. But I am usually saddened by the search strings. These are the most common, in order of frequency:
“How to cope with transgender children”
“How to deal with a transgender child”
“How to manage a transgender kid”
“My child is transgender”
Do you see the problem? The terms ‘cope’, ‘deal’, and ‘manage’ indicate that these parents see their child as a dissappointent, a burden, a problem. One ‘copes’ with emotional loss and dissappointment. One ‘deals’ with a burden. One ‘manages’ a problem.
I’ve known dozens of other transkids (and former transkids / adults who were transkids). Nearly every one of them spoke of how their parents had been dissappointed by them. Even those whose parents eventually came to support them went through a period where their parents tried to deny that they were transkids. Many were disowned by their parents.
But every now and then, but not nearly as often as I would like, I see this search string:
“How to help a transgender child”
Today, among several like the first three, I saw this gem:
“How to protect a transgender child”
Several years ago, my husband and I hosted a lovely young couple and their two children. Their children were around three years old, fraternal twins. One was ‘all boy’. He wore his favorite T-shirt sporting an image of a bulldozer that read, “I like dirt”. The other child was a sweet natured, feminine girl wearing a yellow flowered sundress. She gave us an impromptu ballet recital in our front parlor. Can you see where this is going? That sweet mannered girl is male.
This young couple loved and celebrated their children. Both of them. They told me that they didn’t like attending support groups for parents of gender atypical / transgender children because the other parents saw their children as dissappointments, problem children, burdens. The other parents would spend most of the time trying to convince everyone, including themselves, that they had done everything they could to cope, deal, and manage their children. They were apolegetic about their child’s behavior and even of their own eventual acceptance of their child’s atypicality, having done everything they could to prevent it.
Which brings me back to the search string that I never see, but would dearly love to:
“How to celebrate my transgender child”
(Addendum 2/4/2016: Banner Day! Today someone used this search string, “loving your transgender child”)
A recent study strongly suggests that for transwomen, being post-op is far more healthy that being pre-op. Reducing testosterone to very low levels by having SRS improves health. We’ve long suspected this to be true. Now we have some preliminary evidence to support it.
Researchers from Cedars-Sinai Medical Center in Los Angeles measured insulin resistance and fat accumulation in the liver of four transgender women who underwent bilateral orchiectomy and were taking female hormones and eight transgender women who were only using female hormones. The researchers found that transgender women only taking hormones exhibited insulin resistance and had greater fat accumulation in the liver. According to lead researcher Michael Nelson, PhD, transgender women with the highest level of testosterone had the poorest metabolic health. The researchers also observed that the amount of fat accumulation in the liver was related to degree of insulin resistance.
“The data suggest that fatty liver and insulin resistance are more prevalent in transgender women taking only female hormones. Transgender women who have undergone bilateral orchiectomy appear protected against these conditions,” Nelson said.
I don’t suppose it would surprise anyone that straight men and women respond differently to men’s and women’s voices. In fact, I think we would be surprised if we didn’t. After all, straight men are attracted to women and their voices, and straight women are attracted to men and men’s voices. But that’s only the obvious part. They also tend to be different in their ability to perceive them, with both sexes responding stronger and faster to opposite sex voices. They also differ in the amount of cognitive resources used in the task, the amount of effort applied. Women use fewer resources than men… they are just better at it.
Now, before one says… OH, a sexually dimorphic difference in the brain! Whoa! Hold on! That may not be true at all. Other research into perception of other signals, ohh… such as emotional expressions have also shown sexually dimorphic difference in ability. But in that case, we also know that wealth and power differences also show up. Rich and/or powerful people are significantly and robustly less able to read emotions on other’s faces than poor and/or less socially privileged people. Further, practice at reading people’s emotional expressions significantly improves this skill. So, is that a built in, sexually dimorphic brain difference between men and women? Or does is simply reflect that women, as a class, have less wealth, power, and privilege than men? I’m betting on the latter.
And so it is with the amount of effort it takes to “read” one’s sex by listening to their voice. Is this built in? Or is it that women NEED to read voices better, just as they NEED to read faces better? I’m betting on the latter.
Now we come to transwomen (MTF transsexuals). In a study conducted in Germany, transsexuals seemed to be unique in some ways, like men in some, and like women in others. One thing that they did find is that during fMRI scanning of the brains of transwomen, they showed that they were using very little effort to determine which sex a given speaker was, similar to women. Interestingly, they analyzed both androphilic and gynephilic transwomen together and separately, though didn’t report them separately, instead they focused on testing pre-HRT and current HRT. They found little difference between the two populations, androphilic vs. gynephilic and pre-HRT and HRT. I’m not surprised by this. In fact, it supports my hypothesis that this is NOT an innate sexually dimorphic trait, nor mediated by hormones, but the result of the social differences in privilege and experience / learning. The two MTF populations have the same basic experiences regarding their own vocal history and needs, as the authors put it,
“Since we found no differences in accuracy between women and MtFs, decreased activation in MtFs might suggest that they need less effort to achieve levels of performance similar to women. This might be due to the fact that MtFs are more attuned to issues related to voice gender perception in everyday life. … In line with the behavioral results, MtFs showed differences (compared to men and women) in neuronal response patterns with respect to male vs. female voices. Presumably, a different strategy is used in MtFs’ voice gender identification due to early processing differences. They also might more intensively examine their own and aspired vocal characteristics during gender alignment, resulting in a certain expertise. In this sense, attentional differences due to automatized processing could lead to less brain activation in MtFs.”
Junger, J., Habel, U., Bröhr, S., Neulen, J., Neuschaefer-Rube, C., Birkholz, P., … Pauly, K. (2014). More than Just Two Sexes: The Neural Correlates of Voice Gender Perception in Gender Dysphoria.(11), e111672. doi:10.1371/journal.pone.0111672
For years, I’ve been using this image on my blog to represent the perception of sex. I’ve long had an intense interest, both personal and professional, in the branch of psychology that deals with perception. In my professional career that area has been mostly focused (yes, pun intended) on early vision processes. But in my own time, I’ve always loved higher level perceptual processes. I’ll bet you, my reader, do too… as in the so called “optical illusions”.
For transfolk, the issue of perception can be of even more practical interest. To wit; how to “pass”. But before we can answer that question, we need to ask another, “What perceptual characteristics do people use to attribute a given sex to an individual?” The image above is one of my favorite “illusions”. Which face is that of a woman? Which face is that of a man? In fact, the two faces are identical. The only difference is the contrast adjustment that was applied by post-processing. Take a moment to view this video:
While contrast is important, so is chromatic cues. Women have greener faces overall, while men have redder (ruddy) faces, due to capillaries carrying red blood closer to the skin surface. Which underscores the use of cosmetics. Women use cosmetics to increase the contrast and color cues that our brains will interpret as gender cues, increasing the sexually dimorphoric cues into super-cues, as people find highly sexually dimorphic characteristics more attractive in both sexes.
But as thousands of transwomen who have had Facial Feminization Surgery (FFS) can confirm, cosmetics alone aren’t sufficient. Other cues feed our perception and attribution of sex. Certain facial shape / feature distances also contribute. Consider the images here. Which is more feminine? Masculine? The one on the left has lower eyebrows than that on the right. This shows why women tweeze their eyebrows from underneath, to increase the distance between the eyes and the brows. But this small difference is not as powerful as the other cues, all things being equal.
So far, science hasn’t really looked at the three dimensional aspects of the face. But given the obvious effects that FFS have on one’s ability to pass, they obviously have a very powerful effect. I look forward to further studies which will include these facial cues.
Dupuis-Roy, N. et al., “Uncovering gender discrimination cues in a realistic setting”
Journal of Vision (2009) doi:10.1167/9.2.10
When transwomen think of transphobic attacks, they often think of Paul McHugh. He was the adminstrator who shut down the John Hopkins Gender Clinic. Of course, looking back, it was just a tiny fraction of a blip in time before it would have been shut down anyways – as all of the clinics in the United States were – a victim of its own success. Yes, success, as their involvement in what was thought to be experimental became routine palliative medicine.
McHugh has long been the darling of the so called “social conservatives”, translation: homophobic bigots. We can see this by how ardently he is admired by the Witherspoon Institute; the same Witherspoon Institute that funded and supported the academically fraudulent Regenerus paper which purported, but in fact did not, show that children of gay and lesbian parents were emotionally harmed. In fact, McHugh has published yet another anti-trans editorial on their website.
In his editorial, he makes some rather amazing claims regarding transsexuality and transgender sexuality, mixing just enough scientific truth to sound credible. But mixed in are some amazing falsehoods, not just mistaken ideas, but outright lies,
“In fact, gender dysphoria—the official psychiatric term for feeling oneself to be of the opposite sex—belongs in the family of similarly disordered assumptions about the body, such as anorexia nervosa and body dysmorphic disorder. Its treatment should not be directed at the body as with surgery and hormones any more than one treats obesity-fearing anorexic patients with liposuction. The treatment should strive to correct the false, problematic nature of the assumption and to resolve the psychosocial conflicts provoking it.”
McHugh correctly identified that there are two types of transwomen, autogynephilic and non-autogynephilic… but then makes the most silly comparison that those with gender dysphoria “belongs in the family of similarly disordered assumptions about the body, such as anorexia nervosa and body dysmorphic disorder” He KNOWS better, or at least, he should. Autogynephilia is NOT related to these two disorders in any way, shape, or form. By making this statement, it is clear, as his final sentence in this quote shows, that he is attempting to mislead his reader into the false understanding that psychotherapy can treat autogynephilia and gender dysphoria. It can’t.
McHugh bemoans the recent movement to outlaw the clearly ineffective and damaging practice of “reparitive therapy”, which he would like to see used to treat transkids. A careful reading of his editorial will show that he fails to acknowledge that transkids are (with respect to their natal sex) “homosexual”. It doesn’t take a super sleuth to know that the reason that he doesn’t mention this is because he would also like to see reparitive therapy used to “treat” homosexual teens under the guise of treating gender atypical / dysphoric youngsters. But he knows this is even more unlikely to be allowed if society understood that the choice for transkids is one of living as a very gender atypical gay man or lesbian, or as gender typical heterosexual transwoman or transman, respectively; but McHugh wants that to be no choice. He wants such youngsters to be “repaired” to be gender typical heterosexual adults, which he knows, but seems incapable of accepting, is an impossibility.
I’ve said it before in a previous essay, but it bears repeating. McHugh, a conservative Catholic, seeks to substitute religious bigotry for palliative medicine… and is quite willing to bend the truth to get it.
Notes: Autogynephilia, while NOT related to anorexia nervosa and body dysmorphic disorder (BDD), is related to Body Integrity Identity Disorder, a member of the family of Erotic Target Identity Disorders. This family is about sexuality and sexual orientations, which like heterosexuality and homosexuality have been shown to be very resistant to change, thus the move to outlaw “reparitive therapy”. Erotic Target Identity Disorders are far more common in men than women.
Anorexia Nervosa is a member of the eating disorders and is far more common in women than men. Interestingly, among the men, it is more common in gay men than straight, suggesting a connection with hypomasculinized brains.
Body Dysmorphic Disorder is a member of the Obsessive-Compulsive disorders.
Note that not only are anorexia and BDD not related to autogynephilia, they aren’t even related to each other!
For the record: No study has EVER shown that therapy can “cure” either type of gender dysphoria, autogynephilic or transkid. One can only come to some accommodation. Among those useful accommodations is social transition, HRT, and SRS, as was fully endorsed by the American Psychiatric Association.
Reference: Paul McHugh, “Transgenderism: A pathogenic Meme”