On the Science of Changing Sex

Blanchard, Bailey, and Lawrence…

Posted in Editorial by Kay Brown on December 27, 2009

Cloudy… or how to lose friends and not influence people.

Seriously.  Mention anything that sounds like you support any of the science performed by Ray Blanchard, Michael Bailey, or Anne Lawrence and you will instantly be on everyone’s hate list.  Why is that?  Why are the ideas and the replicable experiments that they have performed not been given serious thought?  Even asking this question will generate a firestorm of either invective or derision.

But it shouldn’t be that way.

Many of the ideas explored by these and other researchers, most notably Kurt Freund, seem common sense to anybody who aren’t themselves transsexual or transgender, or what ever new term seems to be in vogue.  Further, the data itself is simply that, data.  We might have a different interpretation of the data, in fact, this is how science works, reinterpretation of the data based on new facts that join the old.  But, we can’t dismiss facts.  And we certainly can’t dismiss the facts or conclusions because they are uncomfortable, or we don’t like who studied them!

OK, to deal with the Elephant in the Room.  I’ve read nearly all of the papers written by these three authors dealing with TS/TG issues.  My opinion.  I couldn’t agree more.  There, I said it.

This is often questioned.  “How can a woman with your history agree with them?”  The answer, simple.  They are right.

Oh, perhaps the fact that I’m 35 years post transition, nearly 30 years post-op, married to a wonderful man, and well past any drama over making tough decisions about my life has something to do with it.  But, quite simply, the real reason is that the science is solid.  The data fits.  In fact, both the data and my own personal observations of literally many hundreds of transfolk for my entire adult life agree.

So what is the conclusion that is so controversial?  Simply put, that there are two types of people who may call themselves “transsexuals” or “transgender”.  They have two different etiologies, two different medical conditions, both equally real and valid, two different life arcs, and two different sets of medical needs.  The only thing they may have in common is that they both may benefit from similar, though not necessarily identical, medical procedures, namely Hormone Replacement Therapy (HRT) and somatic feminization or masculinization surgery, including genital Sex Reassignment Surgery SRS.

Note that here I include both MTF and FtM individuals.  Although most of the science has been conducted on MTF populations, as being more numerous, I will explore FtM types, which show a similar pattern of there being two types.

So, what are these two MTF types?

The first group is obviously feminine from an early age and remain so through puberty. The are primarily interested in men. They have limited, if any, sexual intercourse with women. They transition fairly young, typically before the end of adolescence. They have never experienced autogynephilic ideation.

The second group is typically not obviously feminine (but may not be super butch either) in childhood. They may be primarily interested in women, bisexual, or asexual. (Though, as a group, even the asexual has had more sexual experience with women than the first group). They have had or even continue to have, autogynephilic ideation w/ or w/o erotic cross-dressing. They tend to transition later, often in middle to late-middle-age.

These two types have been observed by clinicians and researchers for decades.  They have been called many different things over the years:

Primary vs. Secondary
True vs. Pseudo
Early vs. Late Onset
Homosexual vs. Autogynephilic

These two types had been noted as early as 1920 or so, described by Magnus Hirschfeld, who was Harry Benjamin’s friend and mentor.   Robert Stoller simply called the first group, “transsexual”, while calling the second group, “Non-transsexual men who seek sex changes”.  So, once upon a time, not long ago, the second group was not considered transsexual.

This led to a myth in the TG/AGP Transsexual community that only the obviously more feminine and androphilic types were accepted by the clinics of North America and Europe in the ’60s and ’70s.  Actually, nothing could be further from the truth.  Most of the clients of these clinics were AGP.  But, these clinics weren’t stupid.  They tended show-case their more socially acceptable clients, the androphilic, feminine type.  Further, it has always been this way; AGP transsexuals have always gotten surgery in larger numbers than the androphilic type, but only the most socially acceptable appearing, of either type, were show-cased in the media, save for shock television, which often sought out the “freaks” of every sort.

In other posts, I will delve into the science and what it might mean.  But, at no time will I pull punches or use euphemism where direct language can serve.

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