On the Science of Changing Sex

“Sherman, set the WayBack Machine to 1978”

Posted in Transsexual Field Studies by Kay Brown on December 18, 2011

female_scientist“Sure Mr. Peabody!”

In the late summer of 1977, at the tender age of 20, the folks at Stanford made it known to me that I was then eligible for SRS, having been living full time as a young woman for two years, etc.  Those two years had been great.  I was happy.  I was getting along with people.  Folks treated me well.  I had boyfriends.  But two years of dating with a proscribed, ‘no fly zone’ was growing very old.  I really looked forward to being post-op.  All I really needed was the money.  But as a young secretary, the cost of SRS was greater than a year’s gross salary!  I got a better paying job as an electronics assembler, but I was still barely making ends meet.  For months I had been trying to save up money…  Saving more than 10% of my take-home pay would be difficult.  How could I ever afford it?  It would take more than a decade!  So in early 1978, I turned to my folks, hoping that they had changed their minds and were now ready to help me.  My mother was totally unmoved.  My Dad had another proposal.

My Dad instead proposed that I should seek psychotherapy for my “problem” from a certain Dr. Stoller in Los Angeles, for which he would pay.  My Dad hadn’t liked Dr. Fisk, the shrink at Stanford, who three years previously had told him that he should be supportive, not obstructive, “You will win a few battles, but lose the war.”  So, my father had asked around for someone else and Stoller had been recommended.  I had also heard of Stoller, of course.  I understood that he was a psychiatrist.  I blew off the suggestion, with extreme prejudice.

But now, as I have been researching our history and the science for this blog, I realize I missed out on meeting a very interesting man.  I have a feeling we would have got on swimmingly.  That’s not to say that we would have agreed.  Oh no!  Stoller, along with many psychiatrists of the mid-20th Century, was suckered into Freud’s pseudo-science cult of psychoanalysis.  Stoller’s works are redolent of the type of confirmation bias and untested, and often untestable, assertions built upon assertions, like sand castles on quicksand, all accepted as true, and precious little of it actually so, found in non-scientific texts.  (Resolutions of Oedipal Conflicts; Seriously?)  A modern reader, educated in experimental psychology, neurology, and rigorous scientific method, must wade through a morass of useless psychobabble to find the occasional gem of insight.  But still Stoller had a keen mind and was very observant.  When he stuck to direct observation, leaving behind for a moment any superfluous psychodynamic formulations, he was brilliant.

Green, writing of and quoting Stoller, said,

Sex research published in science journals typically reports extensive samples, assessed by questionnaire, and analyzed statistically. To this, Stoller complained, ‘‘Sex research is camouflaged by large samples, hidden in tabulated columns, and dissected beyond significance by statistical packages. Although statistical techniques may enable us to corroborate or deny a hypothesis, they do not produce one’’

I couldn’t agree more.  One needs to get to know the populations one is studying to gain insights that may lead to hypotheses.  Although, I trust the insight only after the statistics prove out the hypothesis.

One hypothesis from Stoller that needed (still needs?) testing is that his “true transsexuals”, which he later called “primary transsexuals”*, avoid using, or allowing their male partners to touch, their penis in sexual encounters.

*(Likely to tweek Oversey and Person who were using that term for asexual transsexuals, which they mistakenly thought were not autogynephilic, but that is a subject for another essay).

It would be instructive to read a description of Stoller’s “true” or “primary” transsexual to learn just who he meant by these terms.  From his 1968 book, Sex and Gender, starting on page 190:

Let us briefly describe a typical male transsexual.  The patient is twenty-five years old. She is dyed-blonde, well-rounded “woman” who in none of the ordinary mannerisms of life (smoking cigarettes, walking, crossing her legs, blowing her nose, gesticulating, etc.) in any way reaveals she was ever a male.  She points out that she had the same mannerisms when living as a male, when she seemed bizarre.  She recalls no time in life of not wanting to be a girl, of not feeling extremely feminine, of not having intersets and daydreams that seemed to her the same as those of normal girls.  Her earliest memories, starting around the age of three, already show this very feminine attitude.  As a boy, she was treated with ridicule by the other boys, despite which she maintained her same feminine behavior.  …  her daydreams from the start were that she was a woman being made love to by a man. … She hated to masturbate and says she did so only once a year or less, not because of conscious guilt but because it so concretely demonstrated her anatomical maleness.  …  She began going out with men and having sexual relations.  However, she never permitted a man to touch or see her genitalia, since they were such a source of shame; she defined as normal any man who made no such attempts.  …  Some months before I first met her, she made contact with an operated transsexual, who suggested that they live together (not sexually, of course).  She did so, and at the point for the first time she went through the preparations that were so lead to her being able to pass successfully as a female.  …  She was so successful that she very shortly found herself a job, being hired unsuspectingly as a woman.  …  The patient has now married and hopes to adopt children.

I sincerely hope that this young woman did succeed in adopting, as I did, and found it as rewarding.  I hope she has grandchildren.  She should be in her late sixties or early seventies by now?  This description is totally in keeping with what I understand as the feminine androphilic MTF transkid “homosexual transsexual” (HSTS).

Note the characteristics that Stoller attributes to this typical “true” or “nuclear” transsexual: Atypical gendered behavior since very early childhood, consciously gender dysphoric from childhood (early onset), exclusively androphilic, interested in children and being a mother, and emotionally stable, mature, and nurturing.  Stoller insisted that the “true” or “primary” transsexual universally avoided, did not allow, contact or visual notice, of her genitals.  Person and Oversey flatly rejected this claim.  Stoller and Person&Oversey duked it out in their respective books and papers, relying on reference to psychoanalytic theory and psychodynamic formulations, citing counter examples.  Sigh…

I could regale my reader with an anecdote of my own avoidant behavior… but adding one more anecdote does not help.  The plural of anecdote is not data.

Hypothesis were meant to be tested.

Fast forward to 1990 when Leavitt and Berger attempted to do just that.  I wrote about this before, but let’s review.  The authors used Blanchard’s Modified Androphilia Scale in an attempt to identify and segregate exclusively androphilic MTF transsexuals from the larger pool of SRS candidates.  But, as the authors admit, this was inadequate.  Not only did they not separate the HSTS from the bisexual group, but they also caught up heterosexual and asexual types as well.  As we’ve seen, pseudo-androphila and social desirability bias both lead many AGP transsexual SRS candidates to overstate any sexual interest in men, downplay any interest in women, and strongly downplay a history of erotic arousal to cross-dressing. But, when L&B separated by actual sexual behavior, they separated the types quite well as evidenced by the data.

Type:             Avoidant            Pleasure     Inactive

Number                 n=15              n=30         n=36
Age                          29.9                32.8          34.5
SD                              4.2                 7.5             9.6

time:                         4.9                 3.1           0.73
Transition:             25               29.7            33.7   (mean age – mean time post transition)
Married:                    0%            23%             47%
Penis “OK”             6.7%           83.3%         33%
Fetishistic              6.7%           33.3%         50%
Sex w/ female:       0%             33.3%         58%
Attraction to
females:                     0%             33.3%        70%
Male toys               16%              46%            50%
Male playmates   16%              37%           47%

Rorschach sex#   0.7               6.4             5.7    (high score indicates “disturbed” sexuality)
F+%                          70.5             57.8          51.1   (score below 70.0  indicates poor reality testing)

MMPI Scales:
Pd                              61.1            70.4          68.3  (high scores indicate anti-social tendency)
Sc                               57.7           70.1          68.3  (high scores indicate “odd” thinking and social alienation)

The Avoidant group fits Stoller’s profile of the “true” transsexual to a T.

(Addendum 12/24/2011: It appears that there may be one (or two) autogynephilic individual out of the fifteen who also states that she is comfortable with her penis, who was sorted into the “avoidant” group.  This may be an artifact of the rules by which the sorting was performed; To be in the avoidant group, one had to have had at least five sexual encounters with a man and no more than five of those times have allowed that man to touch ones penis.  Thus, an individual with relatively few sexual encounters may have actually had a high percentage of them wherein that individual allowed penile contact, up to 5/5 = 100% in fact.  In the future, if this study is replicated, I recommend using an additional rule wherein there is a low percentage cut-off as well as a fixed numerical cut-off.)

The Inactive group is clearly heterosexual, with some of them possibly being the so called asexual (actually automonosexual). While L&B remarked from the strong similarity of the MMPI and Rorschach tests that the Pleasure group was essentially the same as the Inactive. As the pleasure group includes individuals who admit to being sexually attracted to women, including some who have been married, they, as a group, represent a bisexual group. Is it possible that the pleasure group also included etiologically HSTS individuals? The data can’t be used to rule this out, but I personally don’t believe so. Why would an exclusively androphilic, non-autogynephilic male who is very comfortable with having sex using their penis want to be rid of it? The data bears out Blanchard’s typology of exclusive homosexual (non-autogynephilic) vs. non-homosexual (and thus autogynephilic) transsexual etiologies.

(Addendum 2/21/2012:  Actually, we can use the data to rule out the possibility that etiologically HSTS individuals were in included in the pleasure group.  If the pleasure group was a mixture of HSTS and autogynephilic bisexuals, then we would expect the scores on the Rorschach and MMPI scores to be intermediate between the avoidant and inactive groups.  Instead, they are nearly the same as the inactive, if anything, these scores are further away from the avoidant group’s scores.)

In Leavitt and Berger’s own words,

Transsexuals who are sexually active with males but do not allow their penis to be involved in sexual activity share a constellation of traits and experiences that generally conform to characteristics of the nuclear transsexual (Buhrich and McConaghy, 1977). The picture of the nuclear transsexual conveyed by the literature is that of sustained, nonfluctuating femininity, developmental patterns involving a preference for girls’ games and company, aversion to rough-and-tumble activity in early childhood, later patterns involving a desire to posses a woman’s body, to live in society as a woman, and to attract heterosexual male partners. The nuclear transexuals experience intense disgust and aversion for their penis and deny a history of heterosexual orientation or fetish arousal. If patients in the Avoidant group are accepted as nuclear transsexuals, then only 18.5% of our sample meet those criteria. This implies that most of our sample seeking reassigment are not nuclear transsexuals (Newman and Stoller, 1974).

Thus, Stoller’s hypothesis that HSTS transkids universally are “avoidant” has been born out by this study. We should not be surprised by this observation, because it forms a natural truism; A male bodied person who was not motivated by autogynephilia and felt comfortable with their genitalia, would not be likely to actively seek out its removal.

Addendum 8/1/2014:  I added another essay on this topic, using a very recent paper that adds evidence to the above hypothesis.


Richard Green, “Robert Stoller’s Sex and Gender: 40 Years On”

Robert Stoller, “Sex and Gender, On the development of masculinity and femininity” (1968)

Frank Leavitt and Jack C. Berger, “Clinical patterns among male transsexual candidates with erotic interest in males”

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