On the Science of Changing Sex

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.

Another 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.

Candice2

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:

TMWWBQ CoverINTEREST IN CHILDREN
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

References:

Judd, et al., “Male Transsexualism”, (1974) Western Journal of Medicine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1130141/

MONEY, JOHN Ph.D.; PRIMROSE, CLAY, “SEXUAL DIMORPHISM AND DISSOCIATION IN THE PSYCHOLOGY OF MALE TRANSSEXUALS” (1968) The Journal of Mental and Nervous Disease
http://journals.lww.com/jonmd/Abstract/1968/11000/SEXUAL_DIMORPHISM_AND_DISSOCIATION_IN_THE.4.aspx

 

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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.

References:

Pasterski, V., “Fetal Androgens and Human Sexual Orientation: Searching for the Elusive Link”, (2017) Archives of Sexual Behavior
https://link.springer.com/article/10.1007/s10508-017-1021-6

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
http://www.sciencedirect.com/science/article/pii/S0018506X15000033#f0005

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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