Or, How Do We REALLY Know That There Are Two Types of Transwomen?
One would think that with years of both clinical and scientific evidence to support the Two Type Taxonomy of MTF transexuality, we would no longer have need of essays that explain how we know this to be true, but no… sillyolme, nothing is so obvious as to be truly self-evident. So, once again, it’s time to write a clear, concise, yet also complete explication of how we know that there are two and only two types of transwomen.
First, we need to know a bit about epidemiological research into etiology. In medical science we often recognize that a given medical entity exists because of its pattern of symptoms that collectively we call a syndrome. After recognizing a syndrome, science then attempts to determine an etiology, if it can. Here it is important to recognize that the existence of a given symptom in itself does not define a syndrome. Consider fever as a symptom. Today, after much research, we know that it is caused by our immune system attempting to fight off an infection. But that infection may be from any of literally millions of different entities, from eukaryotic parasites, bacteria, to viruses. One would not say that just because two individuals both have fevers, or that a given medicine helps reduce both individual’s fevers, that they have the same etiology. Yet, when it comes to transsexuals, this seems to be the assumption by both transexuals and the public at large. As I will show, this is just not the case.
We also need to know a bit about statistics, most critically, about the concept of “effect size” and what it means. Effect size is a measure of how different two populations are from one another when comparing their mean (average) and their variance (how much spread in a given measure exists within a given population). If two populations have the same average, they have by definition an effect size between them of exactly zero, no matter the variance within the populations. But even if they do not have the same average, if the variance in each is so large that it dwarfs the difference in average, it has a small and not very important effect size. But if two populations have a difference in their average and no overlap in their variance, than there is a large effect size. We calculate the effect size using a standard formula called “Cohen’s d”.
Why is this important? Because to determine if there are in fact two (and only two) types, we must show that the Null Hypothesis, the assumption that there is only one type, is wrong by demonstrating that we consistently find that there is a large enough effect size in a number of measures that consistently cluster together. In science we never “prove” an hypothesis… we only disprove one. If the null hypothesis holds, there should be no such effect sizes. So, in this essay, I’m going to review some of the evidence, demonstrating that there are respectable effect sizes and that they consistently cluster together. Here’s the key, we DON’T have to show that that there are characteristics that give 100% vs. 0%… only that there ARE differences, respectfully large effect sizes, in order to disprove the null hypothesis.
Further Reading on Effect Size
Having prefaced our discussion, let’s describe our hypothetical two types, as described by experienced clinicians:
One group is exclusively attracted to men, transitions quite young, passed as girls/women with relative ease, were noted to be feminine (sissy boys) by parents and teachers as children, preferred female playmates, avoided rough’n’tumble play, and were unlikely to report finding wearing women’s clothing to be sexually arousing.
The other grouping was sexually attracted to women (as evidenced by extensive sexual experience with women, marriage, and siring children) but may identify as bisexual or asexual, transitioned later in life, rarely passed successfully as women, were considered to have been typical boys (“boyish”) by their parents and teachers, and were very likely to report finding wearing women’s clothes to be, or once had been, sexually arousing.
But what is the evidence and how large are the effect sizes?
Let’s look at some data. In a study by Lawrence, conducted in 2005 among those who had had SRS by Toby Meltzer, she has three groups, those who had always been exclusively into men (androphilic), those who had always been exclusively into women (gynephilic), and those who claimed that their sexuality has switched from women to men (bisexual).
|Attraction before SRS/Attraction after SRS:||F/M||F/F||M/M|
|Participant characteristic||(n = 30)||(n = 50)||(n = 17)|
|Mean age at SRS (SD)||45 (8.4)||44 (9.1)||34 (9.2)|
|Mean age at living full-time in female role (SD)||42 (11.3)||42 (9.6)||28 (8.8)|
|Very or somewhat feminine as a child, in own opinion||41%||45%||76%|
|Very or somewhat feminine as a child, in others’ probable opinion||21%||24%||76%|
|Autogynephilic arousal hundred of times or more before SRS||52%||58%||18%|
So, let’s look at the effect size ages of SRS and of social transition. When we compare those who had been consistently gynephilic to those who would best be described as bisexual (having claimed sexual attraction to both men and women) we see that Cohen’s d for age of SRS is only 0.11, so tiny as to be essentially zero. For age of social transition Cohen’s d is 0.0000 = zero. Thus, we would have to say, for this characteristic and these two populations the null hypothesis is not disproven. Again, this does not mean that the null hypothesis is proven… only that it is not disproven. Gynephilic and bisexual transwomen could be the same underlying etiology… or not.
Oh… but let’s look at the androphilic group compared to these other two groups, shall we? Comparing age of SRS between the bisexual and androphilic Cohen’s d = 1.25, a very large effect size. Comparing their ages of social transition Cohen’s d = 1.48, also a very large difference. Finally, looking at the ages of SRS and ages of social transition between the gynephilic and androphilic groups Cohen’s d = 1.09 and 1.44 respectively. This very powerfully disproves the null hypothesis. Sexual orientation is definitely important and supports the two type hypothesis.
Lest you think this result is from only one study, consider the even larger Nuttbrock study in which we see that of those who have started HRT, fully one half of the androphilic had done so before they turned age 20, while only one gynephilic individual had done so.
Our description of the two types also mentioned other characteristics, such as gender atypicality and autogynephilia. Now here, we have a small problem in that we don’t have measures that have a continuous value nor a variance. These were bivalued. However, interestingly, because people don’t always answer perfectly, we can use the number of people who answer a given way as a pseudo continuous measure of the real continuous value. That is to say, if only a small number say yes to a question, it’s likely that the real value is very small. If a large number answer yes to a question, it’s likely that the real value is very large. So, let’s look at the values for self image and likely impression to others of being gender atypical. Oh look, consistent with our earlier conclusion that the gynephilic and bisexual groups were in fact not really different groups, their answers are very similar at 41% vs. 45% and 21% vs. 24%. These are so close, that we might as well agree that they are identical. And once again, we see that the androphilic group scores are quite different at 76%. So, consistent with our earlier conclusion, the null hypothesis that there is only one group is very much disproven.
Before we leave Lawrence’s study, lets look at the issue of autogynephilia. Again, we have a bivalued question whether one had experienced hundreds (or more) episodes of autogynephilic arousal to wearing women’s clothing. As before, we see that the gynephilic and bisexual groups are very similar at 52% vs. 58%, while the androphilic group had only 18%. So, once again, consistent with our earlier conclusion, the null hypothesis that there is only one group is very very much disproven.
Again, lest you think this result is restricted to only this study, we have seen this replicated by Buhrich (1977), Freund (1982), Blanchard (1985), Doorn (1994), Smith (2005), and Nuttbrock (2009), in separate studies spanning four decades, collectively involving over a thousand transsexuals to date. In fact, this is one of the most repeated and reconfirmed scientific finding regarding transsexuality.
Another characteristic difference mentioned about the two types was passability. Fortunately, we have a clinical study from the Netherlands which showed a robust effect size d = 0.7 difference between androphilic and non-androphilic transwomen. The graph above shows the data. The higher the score, the more ‘readable’ (less passable) the individual. From the graph, we see that the most passable non-androphilic (gynephilic and bisexual) is just average for the androphilic population.
When we add in the growing evidence that there is a distinct difference between the brains of androphilic vs. gynephilic & bisexual, the null hypothesis that there is only one type is not just merely dead, but most sincerely dead.
A new review paper has just been published on the current status of brain structure research in transsexuality. Interestingly, it was submitted to the Archives of Sexual Behavior two full years ago. This suggests that it went through a rather thorough peer review. For myself, the first thing I do when reading a review paper is to see that the reference list is comprehensive to ensure that the authors aren’t cherry-picking. In this case, they are not. The paper looks to be very complete and scientifically honest. You may wish to read it yourself, as it is not behind a paywall, thankfully.
The paper is written rather densely, with a great deal of information and discussion; so much in fact, that I will likely be writing several essays covering a number of topics from it. At the high level, my regular readers will not be surprised at the primary conclusions drawn from the review, as I had already written about a fair number of the brain research papers. The authors offer this chief conclusion at the end of the paper,
“The review of the available data seems to support two existing hypotheses: (1) a brain-restricted intersexuality in homosexual MtFs and FtMs and (2) Blanchard’s insight on the existence of two brain phenotypes that differentiate “homosexual” and “nonhomosexual” MtFs”
The review of all of the available brain structure research fully supports the Two Type Taxonomy. In light of this, the authors recommend that future researchers take care to distinguish between the two types, lamenting that some studies in the review had not made this distinction, and further, that it is important that the control groups also be concordant with sexual orientation,
“The study of mixed samples implicitly assumes that transsexuals are a homogeneous group. This is far from the truth with respect to the onset of GD and sexual orientation. … These observations signify that control groups in studies of the transsexual brain must be homogeneous in regards to sexual orientation.”
The authors did find separate studies of androphilic “homosexual” MTFs and non-gender dysphoric gay men that used the same methods, such that a tentative comparison could be made,
“The only study on the CTh [cortical thickness] of homosexual persons that do not present gender dysphoria is by the Savic group (Abé et al.). If we compare this study with that of Zubiaurre-Elorza et al. on the CTh of homosexual MtFs, we see both studies report sex differences showing an F > M pattern in similar structures of the right hemisphere. But there is only one region, the pars triangularis, in which homosexuals and homosexual MtFs both present differences. However, these changes are in opposite directions. The pars triangularis of homosexual MtFs is thicker than in heterosexual male controls, while for homosexuals it is thinner than in heterosexual males. Thus, it seems that for transsexuals this region is feminized but demasculinized [i.e.: “different that straight men, but not in the heterosexual female direction” – K. Brown] in homosexual individuals. Interestingly, in both studies, the affected pars triangularis is in the right hemisphere. Nevertheless, confirming Blanchard’s prediction still needs a specifically designed comparison of homosexual MtF, homosexual male, and heterosexual male and female people.”
This is interesting, that there is a difference between gay men and androphilic transwomen? But the right hemisphere pars triangularis of all things? For left hemisphere dominant people, this region of the brain is believed to be involved in the understanding and production of prosody, emotionally nuanced speech modulation. We know this because individuals who have serious lesions in this area have trouble with prosody.
For more information, read the Wikipedia page on prosody.
Before anyone gets too excited about the possible implications for a neurological marker for androphilic transsexuality that differentiates them from gay men, we need to note that the brain exhibits neuroplasticity. That is to say, that like a muscle, exercise of particular skills causes the brain to increase in volume and neuron number in those regions used to supply that skill. If this is about language and more particularly, about language production that imparts an emotional / sexual identity / gender identity through one’s voice, the difference in this part of the brain may be caused by experience and practice.
On the other hand, it just might represent a real difference. We need more studies.
Guillamon, A et al., “A Review of the Status of Brain Structure Research in Transsexualism” Arch Sex Behav (2016). doi:10.1007/s10508-016-0768-5
“…I would while away the hours, confir’in with 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)
We live in exciting times – At least scientifically. We can now peer into the heads of transsexuals to see if their brains exhibit sexually dimorphic features that match their natal sex or their preferred gender. Years ago, Ray Blanchard made a prediction, based on early evidence that there was a taxonic difference between “homosexual” and “non-homosexual” transwomen in sexuality, natural gendered mannerisms, age of transition, etc, that the former would show sexually dimorphic features in the brain that were shifted in the female direction while the latter would not, but would show features that were different than controls, but that they would not be sexually dimorphic features, and definitely not shifted in the female direction. We now have yet more evidence that that prediction is correct, giving more weight to the two type taxonomy of MTF transsexuality, namely exclusively androphilic vs. autogynephilic.
The best evidence would be to use two populations of transwomen, one known to be exclusively androphilic and the other not, and test them for the same features, using the same type of measurement. We now have that data for grey matter distribution in the brains of both types of transsexual.
In the earlier Savic and Arver paper, they compared grey matter distribution of 24 gynephilic transwomen, before HRT to that of heterosexual men and women. (Remember, HRT itself causes a shift in sexually dimorphic features due to activational effects of sex hormones, and the lack of such hormones.) The conclusion?
“The present data do not support the notion that brains of (gynephilic) MtF-TR are feminized.”
In the later Simon paper, they compared grey matter distribution of 10 exclusively androphilic transwomen, and 7 exclusively gynephilic FtM transmen, before HRT to that of heterosexual men and women. The conclusion?
“Our findings support the notion that structural differences exist between subjects with GID and controls from the same biological gender. We found that transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender in their regional GM volume of several brain areas, including the left and right precentral gyri, the left postcentral gyrus (including the somatosensory cortex and the primary motor cortex), the left posterior cingulate, precueneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri. Additionaly, we also found areas in the cerebellum and in the left angular gyrus and left inferior parietal lobule that showed significant structural difference between transgender subjects and controls, independent from their biological gender.”
The choice to explore only “homosexual” transsexuals in this study was informed by the researchers’ knowledge of the Freund/Blanchard taxonomy and of Blanchard’s prediction, as they explained,
“Both MTF and FTM patients were eligible for the study, but only those with homosexual orientation. The rationale for this choice was based on the Blanchard typology which considers two fundamentally different types of transsexualism: homosexual and nonhomosexual. Homosexual transsexual individuals are sexually attracted to the same biological gender, while nonhomosexual transsexual individuals are attracted to either the opposite gender or show no sexual orientation/attraction at all. According to Blanchard, homosexual transsexuals are usually younger at initial presentation of gender identity disorder and show more pronounced and frequent childhood femininity, as well as different anthropometric data. One might argue that mixing individuals from both transsexual groups in one study targeting the neurobiological background of transsexualism might bias the results by introducing heterogeneity in the sample. Thus, in our study, only homosexual transsexual individuals were included preventing our findings from the aforementioned bias.”
This points to growing recognition within the scientific community that the two type taxonomy is correct. They went further, indirectly referring to the taxonomy and Blanchard’s prediction,
“In another study also limited to MTF transsexuals Savic and Arver, reported no “feminization” of any brain region with regard to structure. Nonetheless, certain brain areas (clusters ≥100 voxels) showed characteristic structural features in the transsexual group compared with both male and female control groups. Specifically, they found reduced thalamus and putamen volumes and increased GM volumes in the insular and inferior frontal cortex and in the right temporo-parietal junction (angular gyrus and superior temporal gyrus) in the transsexual group compared with both control groups. In our study, however only the angular gyrus (but in the left hemisphere) was affected among these areas, showing lower regional GM concentration in both FTM and MTF transgender subjects compared to controls, independent of their biological gender. When comparing the results reported by Savic and Arver to either our study or to other imaging studies in the literature of transsexualism, it has to be taken into consideration that their reported results were obtained from a solely nonhomosexual transsexual group of patients. The lack of real overlap between our and Savic and Arvers’ findings, despite the very similar methodology used, might at least in part be explained by the difference of the sexual orientation of the two samples.”
Truly, exiting times.
Ivanka Savic, Stefan Arver, “Sex Dimorphism of the Brain in Male-to-Female Transsexuals”
Lajos Simon, Lajos R. Kozák, Viktória Simon, Pál Czobor, Zsolt Unoka, Ádám Szabó, Gábor Csukly, “Regional Grey Matter Structure Differences between Transsexuals and Healthy Controls—A Voxel Based Morphometry Study”
For the past several years, evidence has been accumulating that there is a fairly high comorbitity between transsexuality / transgenderism and the autism spectrum. Interestingly, and perhaps not totally surprisingly, among MTF transwomen, it appears to be exclusively found in the non-exclusively androphilic population. This fits the Freund/Blanchard taxonomy and more importantly, Blanchard’s prediction that “non-homosexual” (with respect to natal sex) MTF transwomen would exhibit neurological / brain differences from control males but these differences would NOT be a shift toward female like brains.
Autism and autism spectrum disorders are found in four to five times as many men as women. There are a number of theories as to why this happens, including the rather intriguing “hypermasculine brain hypothesis”, in which a link between the slight differences between men and women, as groups, having different cognitive and social behaviors and the apparent similarity, or rather, exaggeration of these differences between men and women, found in those on the autism spectrum. If autism is a form of hypermasculinization, it would not surprise us to learn that FTM transmen were more autistic-like than most women… and that is what one group of researchers found.
Using a 50 item, Likert scored, instrument called the Autism Spectrum Quotient (AQ), Jones, et Al., found that FTM transmen as a group, scored 23.2, higher than control women AND men! This puts about half of the FTM onto the high functioning autism spectrum!! (The lower AQ cut-off for ASD is 23.) Non-exclusively-androphilic transwomen scored essentially the same as the control men, while exclusively androphilic transwomen scored essentially the same as the control women, and definitely (statistically significant: p<0.03 ) below both the control men and non-androphilic transwomen.
Group: Men Women FTM Non-Androphilic Androphilic
. MTF N=129 MTF N=69
Score (SD): 17.8 (6.8) 15.4 (5.7) 23.2 (9.1) 17.4 (7.4) 15.0 (5.6)
The implication is clear, FTM’s are masculine, perhaps even hypermasculine, while the data also supports the Freund/Blanchard two type taxonomy for MTF transwomen. In the discussion section of the paper, the authors remarked,
“Interestingly, with the 198 transwomen group, there were 6 individuals (i.e. 3%) with a diagnosis of AS. This rate is about 3 times as many as in the general population.”
These authors didn’t state what the sexuality of the six AS individuals were; but if they conform to the greater likelihood that they were non-androphilic, found in other papers, the incidence rate for such non-androphilic transwomen would be closer to five times the rate found in the general population, however, that is only about twice as high as that found in the male population.
(Addendum: 1/21/2017: Looking at the data again, this time from the perspective of effect sizes with respect to men vs. women and non-androphilic vs. androphilic aids us in understanding how important this difference is. First, the effect size between men and women is 0.38 a modest but still very noticable difference in the populations. Now, let’s look at the diffence between non-androphilic and androphilic at 0.37, nearly identical to the difference between men and women. So, lets compare the difference between men and non-androphilic tranwomen at 0.06 which is tiny. And similarly, when we compare between women and androphilic transwomen it is only 0.07 which again is very tiny. That is to say, these statistical tests shows that the difference between men and women is the same size as between non-androphilic and androphilic transwomen, while there is effectly no difference between men & non-androphilic and women & androphilic transwomen respectively. That is to say, that non-androphilic transwomen are identical to men in general, while androphilic transwomen are essentially the same as women in general. Further the difference between the two types of transwomen exactly matches the difference between men and women, which strongly supports the Two Type Taxonomy.)
Jones, et Al, “Female-To-Male Transsexual People and Autistic Traits”, J. Autism Dev. Discord. DOI: 10.1007/s10803-011-1227-8
I have heard and read a number of “late transitioning” transsexuals state that the two type taxonomy is not accepted in the “real world” of today’s gender therapists, the people most intimately knowledgeable of the transsexual population, thus proving that Blanchard’s theory is “wrong”. Although I have met, during my prior research on our collective history, a few therapists who were completely unaware of Blanchard’s theory, most therapists are VERY well versed in the scientific literature. Further, as I will show here, those who have been in the field the longest, have a strong psychology background, and have kept up with the literature, have come to understand and write about the two types. But, many therapists who are fully aware of the issue, choose not to publicize that fact, or they may attempt to smooth over the issue, avoid directly using the word “autogynephilia“, using euphemistic and obscurantist terms instead. After all, their lively-hood depends on autogynephilic transgendered people coming for help.
One of the most experienced gender therapists is Dr. Anne Vitale, having entered the field in 1978. In a paper she wrote in 2001, she clearly describes the two types of MTF transsexuals and compares them to FtMs,
“Group One (G1) is best described as those natal males who have a high degree of cross-sexed gender identity. In these individuals, we can hypothesize that the prenatal androgenization process–if there was any at all–was minimal, leaving the default female identity intact. Furthermore, the expression of female identity of those individuals appears impossible or very difficult for them to conceal.
Group Two (G2) is composed of natal females who almost universally report a life- long history of rejecting female dress conventions along with, girls’ toys and activities, and have a strong distaste for their female secondary sex characteristics. These individuals typically take full advantage of the social permissiveness allowed women in many societies to wear their hair short and dress in loose, gender-neutral clothing. These individuals rarely marry, preferring instead to partner with women who may or may not identify as lesbian. Group Two is the mirror image of Group One.
Group Three (G3) is composed of natal males who identify as female but who act and appear normally male. … They tend to live secretive lives, often making increasingly stronger attempts to convince themselves and others that they are male.
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). Although I have seen some notable exceptions, especially in male-identified females, these individuals–at the time of presentation for treatment–are rarely married or have children, are rarely involved in the corporate or academic culture and are typically involved in the service industry at a blue- or pink-collar level. With little investment in trying to live as their assigned birth sex and with a lot of practice in living as closely as possible to their desired sex, these individuals report relatively low levels of anxiety about their dilemma. For those who decide transition is in their best interest, they accomplish the change with relatively little difficulty, particularly compared to G3, female-identified males.
The story is very different for Group Three. In the hope of ridding themselves of their dysphoria they tend to invest heavily in typical male activities. Being largely heterosexual, they marry and have children, hold advanced educational degrees and are involved at high levels of corporate and academic cultures. These are the invisible or cloistered gender dysphorics. They develop an aura of deep secrecy based on shame and risk of ridicule and their secret desire to be female is protected at all costs. The risk of being found out adds to the psychological and physiological pressures they experience. Transitioning from this deeply entrenched defensive position is very difficult. The irony here is that gender dysphoric symptoms appear to worsen in direct proportion to their self-enforced entrenchment in the male world. The further an individual gets from believing he can ever live as a female, the more acute and disruptive his dysphoria becomes”
As I’ve noted before, the social consequences for the two types of MTF transsexuals is quite dissimilar. Before transition, Vitale’s “Group One”, is very visible, but becomes invisible after transition, while the opposite is true for her “Group Three”. This brings up the matter of ‘Identity Politics’ in the larger ‘Transgender’ world. Language is important. For these essays, I’ve often, “held my nose” as I used terminology in the papers I’m citing, so as not to confuse my reader. Here, Vitale has side-stepped the issue, by inventing de novo, just for the purposes of her paper, totally neutral language that is also completely non-descriptive and had it not been for her carefully describing the characteristics that define and contrast each type, we might not be able to compare her types with other authors. But here, I can provide that map. Her “Group One”, as Vitale makes clear, consists of MTF transkids. Other names have been “core”, “true”, “early onset”, “ego syntonic”, and most controversially, “homosexual”.
“G1 boys, who have a strong feminine core identity, typically develop a sexual interest in other boys during adolescence and prefer girls as peer friends. Although they still desire to be girls, they appear to have significantly less anxiety over not being female then that reported by the boys in G3. I believe this is due to the relatively uninhibited open expression of their femininity. For example Monica was 19 years old when she reported to my office accompanied by her mother. She wore gender-neutral clothing but otherwise presented as female in voice inflection and mannerisms. The problem, of course, was that Monica was genetically male. Monica’s mother related to me that Monica had been more like a girl then a boy all her life. Her and her husband loved her dearly but thought of her more as a daughter then a son. Over the course of treating Monica, it became clear that although she was distressed over her male physiology, she was otherwise emotionally stable and very aware of the seriousness of her situation. Once it became clear that she was her own person and ready to undergo transition, a course of hormone replacement therapy was introduced. With the exception of having to face some extreme religious issues brought up by her much older brother, she accomplished an almost effortless transition from male to female. The presence of family support and little or no investment by the family or Monica in her being male made this transition straight forward.”
Vitale’s use of the phrase “feminine core identity” harks back to earlier work showing that this type of transsexual has developed a female gender identity as a young child, while the other type, had not. She remarks that this type is very comfortable with their femininity and naturally find the idea of living as a girl to be agreeable. This is called “ego syntonic” behavior, as opposed to Group Three’s “ego dystonic” behavior, where their desire to be female is unwelcome and out of step with their core identity as male. Note also the reference to Group One being “emotionally stable”, making a tacit comparison to “Group Three”, who, as Smith put it,
“Homosexual transsexuals were found to be younger when applying for sex reassignment, reported a stronger cross-gender identity in childhood, had a more convincing cross-gender appearance, and functioned psychologically better than nonhomosexual transsexuals. … The more vulnerable nonhomosexual transsexuals may particularly benefit from additional professional guidance before and/or during treatment.”
Compare Vitale’s description of her “Group One” to the one I gave of transkids in a previous essay.
“The prototypical feminine androphilic transsexual was called a “sissy” by her peers growing up. She avoided rough & tumble activities. Her primary social circle consisted of one or two girls. She actively participated in girls games and imaginary play. … As a young teen, she became interested in girls fashion and make-up, often exploring how she might look as a girl by dressing up and experimenting with make-up, with occasional trips out shopping or hanging out with her friends. This did not, of course, involve erotic cross-dressing. She had crushes on boys at school. … She was hassled, perhaps even bullied, by homophobic boys, but otherwise was reasonably popular in her chosen circle. She was considered very neat and well dressed in boy’s clothes. … As she approached adulthood, looking at her own nature, her potential future, both romantic and economic, made a rational decision to transition to living as a girl so as to grow up to be a woman socially. Her family may or may not have disowned her in late adolescence. As she is naturally feminine and passes quite well, she found that she was socially and romantically more successful as a woman.”
Vitale goes on to describe her “Group Three”,
“To add to their confusion, and counter to behavior typically reported in openly gender dysphoric boys, many cloistered boys actually preferred solo play with boys’ toys and had little or no interest in girls’ toys. For example I have heard more than one long-time post-op male-to-female transsexual speak fondly of having spent countless hours playing with an Erector Set or a Lionel model train set-up that their father had helped them build. Others described of designing and making detailed model airplanes, race cars and sailing ships. The more academic of this group report little or no interest in sports and rough and tumble play. To avoid castigation from their peers, they report spending a lot of time reading and studying. However, although these children appeared to be normal boys doing what most people would consider some normal boy activities, they may very well have been doing so while secretly wearing their mother’s or sister’s underwear, fantasizing about being a girl or both if they could manage it.
As sexual maturity advances, Group Three, cloistered gender dysphoric boys, often combine excessive masturbation (one individual reported masturbating up to 5 and even 6 times a day) with an increase in secret cross-dressing activity to release anxiety. In a post-op group I facilitated, Jenna (age 43) spoke fondly of the delight she experienced as a boy when she would find something of her mom’s in the dirty clothes’ hamper in the bathroom. Two others in the group laughingly agreed that they too took many a trip to the bathroom for the same reason. At the same time, in their public life, these boys report employing overtly stereotypical efforts to draw attention from their secret desires to be female by affecting appearances of being normally male. This includes dating girls, participating in individual sports activities such as swimming, running, golf, tennis, and for some, even body building.
Cloistered (G3) gender dysphoric boys appear to others and even to themselves to be heterosexual. Although as a group they are not especially active daters, they clearly prefer to date girls when they do date. Significantly, unlike other boys, their dating motives are markedly different. For these boys, being on a date with a girl is a chance to spend time with a girl in a way not generally allowed under other circumstances. Dating serves two purposes for these boys. The first is social, as it gives them the all-important appearance of being normal. The second is therapeutic. Being close to a girl’s softness, and even her female smell, has a mitigating effect on gender expression deprivation anxiety. The fantasy is not to make love to her but to actually be her.”
Note the rather direct description of use of female clothing as an aid to sexual arousal during masturbation. We have another name for this behavior, “autogynephilic erotic cross-dressing”. Note also the reference to dating girls. Though she calls it “therapeutic”, I believe that she is describing the phenomena of autogynephilia being simultaneously dependent upon and in competition with conventional gynephilia. Being with a girl has “mitigating effect” on experiencing autogynephilia, which Vitale euphemistically refers to as “gender expression deprivation anxiety”. I’ve remarked on Vitale’s seeming obtuseness on the issue of recognizing autogynephilic sexuality when she sees it in a previous essay. This is remarkable, in that even in her own words, she clearly describes autogynephilia, “The fantasy is not to make love to her but to actually be her”.
Very tellingly, as Vitale continues to describe older gender dysphoric individuals, her “Group One” simply disappear from her essay. This is because, by that age, they have either transitioned and become invisible, or they don’t ever transition. Simply put, there is no “late transitioning” “Group One” transsexual, while “Group Three” digs in and clings to their socially formed (core) male identity, while trying to ignore the cognitive dissonance created by their growing awareness of their autogynephilically enforced erotic ideal, their “desires to be female”,
“As more information about transition to one’s felt gender identity becomes available to the general public, we are seeing genetic males with strong core female identities and genetic females with strong core male gender identities present in their early twenties with the clear objective to being sexually reassigned.
The cloistered, natal males, on the other hand typically start to realize the seriousness of their dilemma at this age. It is common to hear reports of these individuals increasing the intensity with which they try to rid themselves of the ever-increasing gender-related anxiety. Many individuals paradoxically adopt homophobic, transphobic, and overtly sexist attitudes in the hope that they will override their desires to be female.”
As she describes her “Group Three” as adults, we clearly see the pattern of late transitioning MTF transsexuals,
“For those who continue to struggle inwardly with their gender issues into mid-life, new issues come to the fore. As a time when most people realize that about half of life has been lived and feel the need to make an accounting of who they are and what they have done with their lives, this period can be especially anxiety provoking for the gender-dysphoric individual. Decades of trying to overcome an increasing gender expression deprivation anxiety begin to weigh heavily on the individual. Family and career are now as deeply rooted as they will ever be. The idea of starting over as a member of a different sex has become seemingly impossible. The fact that the need to change sex has increased rather than diminished, despite Herculean efforts, is now undeniable.”
Thus, we see clearly two mutually exclusive clinical patterns described by a veteran gender therapist. It is painfully obvious that there are two distinctly different types, with two different etiologies and life arcs. Blanchard’s model of “homosexual” (yes, holding my nose) vs. autogynephilic transsexuality completely explains the clinical experience.
(Addendum 3/17/2017: I noted on some fora that people have critiqued this essay and have objected that my mapping of Type 1 and Type 3 to Blanchard’s “homosexual” (androphilic) and autogynephilic is unwarranted and wrong. However, in an essay written three years before, Vitale wrote,
“…Primary/Secondary terminology has largely been dropped from the literature. It has instead been replaced with sex researcher Ray Blanchard’s more descriptive and non-hierarchical Autogynephilic and Androphilic transsexualism. (More on these classifications in a future work.)”
The above essay was that “future work”. Vitale, as my analysis shows, fully agrees that the two type taxonomy is correct and has merely substituted terms to make it more palatable to late transitioners.)
Its important to know that the American Psychiatric Association also recognizes the two types and recommends that they need different case management.
Book Review of The Praeger Handbook of Transsexuality which discusses Vitale’s typology, showing them to be identical to several others.
Anne Vitale, “The Gender Variant Phenomenon–A Developmental Review” http://www.avitale.com/developmentalreview.htm
Anne Vitale, “Primary and Secondary Transsexualism: Myths & Facts”
Yolanda L.S. Smith, Stephanie H.M. van Goozen, A.J. Kuiper, Peggy T. Cohen-Kettenis, “Transsexual subtypes: Clinical and theoretical significance”
Dragana Duišin, Jasmina Barišić & Gordana Nikolić-Balkoski, “CASE REPORT OF AUTOGYNOPHILLIA – FAMILY, ETHICAL AND SURGICAL IMPLICATIONS
I hadn’t covered this earlier, and perhaps I should have, but, never too late. In 2005, Dr. Anne Lawrence published a study in which she canvased a significant number of MTF transwomen that had had SRS from Dr. Toby Meltzer. This paper is a true treasure trove of data, only a smattering of which I will explore here:
Characteristics of Participants by Reported Pattern of Sexual Attraction
Attraction before SRS/Attraction after SRS: F/M F/F M/M
Participant characteristic (n = 30) (n = 50) (n = 17)
Mean age at SRS (SD) 45 (8.4) 44 (9.1) 34 (9.2)
Mean age at living full-time in female role (SD) 42 (11.3) 42 (9.6) 28 (8.8)
Mean duration of real-life experience before SRS, in months (SD) 21 (18) 21 (18) 63 (63)
Mean number of female sexual partners before SRS (SD) 12 (16) 15 (21) 0.3 (0.8)
Mean number of male sexual partners before SRS (SD) 0.7 (1.3) 0.8 (1.8) 6.6 (8.8)
Very or somewhat feminine as a child, in own opinion 41% 45% 76%
Very or somewhat feminine as a child, in others’ probable opinion 21% 24% 76%
Autogynephilic arousal hundred of times or more before SRS 52% 58% 18%
Married to a woman before SRS 70% 74% 12%
Biologic parent before SRS 53% 42% 6%
Mean number of female sexual partners after SRS (SD) 0 (0) 1.5 (2.6) 0.4 (0.9)
Mean number of female sexual partners after SRS 0 (0) 1.0 (1.7) 0.3 (0.8)
in last year (SD)
Mean episodes of sexual behavior with female partners after SRS 0 (0) 21 (48) 0.1 (0.5)
in last year (SD)
Mean number of male sexual partners after SRS (SD) 2.9 (3.1) 0.7 (1.6) 6.9 (10.7)
Mean number of male sexual partners after SRS in last year (SD) 1.9 (2.3) 0.4 (1.5) 2.9 (3.9)
Mean episodes of sexual behavior with male partners after SRS 30 (63) 1 (4) 67 (128)
in last year (SD)
More than one male sexual partner after SRS 60% 16% 65%
In stable partnered relationship after SRS, at any time 40% 74% 71%
In stable partnered relationship after SRS, at time of survey 27% 62% 29%
F/M = Exclusively or almost exclusively attracted to females before SRS, exclusively or almost exclusively attracted to males after SRS.
F/F = Exclusively or almost exclusively attracted to females before and after SRS.
M/M = Exclusively or almost exclusively attracted to males before and after SRS.
This paper has clearly documented the phenomena of autogynephilic pseudo-androphilic shift in sexual behavior after SRS, showing it is fairly common.
Looking at the data for autogynephila, we note that the stably “exclusively” androphilic included 18% that reported extensive autogynephilic arousal. This would seem to contradict Blanchard’s taxonomy that exclusively androphilic MTF transsexuals do not experience autogynephilia. However, there is strong evidence that a number of these individuals inaccurately reported their actual sexual orientation as Lawrence dug deeper,
“six participants classified as homosexual based on their pattern of sexual partnering before SRS reported experiencing autogynephilic arousal before SRS. Two of these participants, both of whom reported “hundreds of episodes or more” of autogynephilic arousal before SRS, had been married to women and had been biologic parents before SRS, suggesting that their reports of no female sexual partners before SRS were inaccurate. Two other homosexual participants, both of whom also reported “hundreds of episodes or more” of autogynephilic arousal, had not been married and had not been biologic parents; one, age 33 at time of SRS, reported only one male partner before SRS; the other, age 44 at time of SRS, reported multiple male partners before SRS. The remaining 2 homosexual participants, both ages 38, reported autogynephilic arousal only “once or twice” before SRS; both reported multiple male partners before SRS and one also reported MtF transgendered partners. Seven other participants who were classified as homosexual based on their self-reported pattern of sexual attraction before SRS but not on the basis of their pattern of sexual partnering before SRS also reported autogynephilic sexual arousal before SRS. Four of these 7 participants had been married, and 2 of these 4 had been biologic parents; only 1 reported any male sexual partners before SRS. Of the remaining 3 participants, 2 reported no sexual partners before SRS, and 1 reported multiple male, female, and MtF transgendered partners before SRS.”
Some of these self-identified androphilic individuals who were clearly having sex with female partners before SRS, are just as clearly STILL having sex with female partners after SRS. Notice also the odd data regarding sex with women, that they reported more female sexual partners than number of sexual encounters? Someone is not being honest here. This would suggest that they were in fact bisexual in behavior and sexual orientation, which as Blanchard demonstrated, are autogynphilic. Thus, we don’t really see any exclusively androphilic transwomen reporting autogynephilia and thus the Freund/Blanchard two type taxonomy hypothesis is supported by this data.
Note that even with these older transitioning AGP transsexuals inadvertently included in the stably androphilic group, the mean age of transition is still significantly younger than the originally (and in truth, still) gynephilic transwomen. Unfortunately, I don’t have the raw data that would allow me to back these individuals out to determine a better value of the mean age of transition, but it is certainly less than the 28 years old found here. The data also supports an assertion I have long made, that AGP transwomen usually have greater access to capital which allows them to move quickly from full time transition to SRS, while transkids often remain “pre-op” for far longer; a little more than five years on average compared to less than two for AGPs. (Again, likely to be longer if we backed out the bisexuals.) Also note that sizable difference between the childhood femininity between the stably androphilic and the originally and stably gynephilic groups. I’m personally amused that when asked what others might have perceived, that some in the gynephilic groups seem to have sheepishly admitted that others would not have considered them to have been feminine as young children.
On a sad note, the data shows that truly androphilic transwomen have trouble keeping long term partners. What this data doesn’t show is why. From personal experience and from having spoken to many others, I can attest that it is due to straight men having difficulty accepting our transsexual medical history. Straight men fall in love with transkids readily enough… but after the blush of infatuation passes, the fear of friends and family discovering their lover’s transsexual status far too often over-rides their pair bond.
When reviewing this data, we should always keep in mind that we are looking for trends in the data, since people don’t always accurately report their sexual behavior, especially autogynephilic transwomen. But still, the data clearly supports the Freund/Blanchard two type taxonomy hypothesis.
(Addendum 12/20/2013: Using a technique I successfully used before, we might be able to make an estimate/SWAG at the age of transition for the exclusively androphilic transwomen in this sample by estimating the number of AGP transwomen from their reported erotic cross-dressing (18%), assuming that they report it at the same rate as those transwomen who reported that their orientation had changed from gynephilic to androphilic (52%) who they most resemble… 0.18/0.52 x 17 = ~6 So, our estimate is that six non-exclusively-androphilic transwomen incorrectly identified themselves as exclusively androphilic. Thus, of 17 transwomen who collectively averaged 28 years old at full time transition, only 11 were likely to have been actually exclusively androphilic. So we need to subtract six individuals who likely were 42 years old on average, when they transitioned. So, ((28×17)-(42×6))/11 = ~20 years old. This is more in keeping with other studies that show that the median and average is 20 years old. )
(Addendum 1/21/2017: I think it is instructive to calculate the effect size (Cohen’s d) for age of transition between the the putatively exclusively androphilic and the non-androphilic transwomen, ignoring our suspicion that a number of non-androphilic transwomen have been accidentally included: d=1.5 which is quite extraordinarily high, while there is no difference in age of transition between the stabily gynephilic and those who later developed sexual interest in men (“bisexual”) transwomen, strongly supporting the Two Type Taxonomy.)
Anne A. Lawrence, “Sexuality Before and After Male-to-Female Sex Reassignment Surgery”
I mentioned this in passing before, that Anne Lawrence had shown in 2010 that there was a very strong correlation with the Hofstede Individualism Index of a country and the percentage of “non-homosexual” (AGP) transsexuals vs. “homosexual”. Using seven new studies, she has shown that the correlation continues to hold in a paper published just this month. Now, you may be thinking, “ho hum, wasn’t this shown earlier”. Well, yes. But science is all about repeatability. It could have been that the first study she did was just a fluke, that she had found a coincidence. But when later data becomes available with exactly the same correlation, it shows it wasn’t a fluke.
But what does it mean? I believe that she has expressed it fairly well,
As I suggested previously, the observed relationship between IDV and %NHS probably reflects the combined operation of at least two distinct factors. First, non-homosexual persons probably constitute larger apparent percentages of MtF transsexuals and gender gender dysphoric persons in more individualist societies because these societies place a higher value on individual self-expression (including cross-gender expression), despite the possible socially disruptive consequences of gender transition in men who are typically middle-aged, are often married, and have usually pursued traditionally masculine occupations. Second, homosexual persons probably constitute larger apparent percentages of MtF transsexuals and gender dysphoric persons in less individualistic (or collectivistic) societies because these societies place a higher value on inclusion and often provide socially approved transgender roles for pervasively feminine, androphilic gender dysphoric men.
I couldn’t resist playing with the numbers a little. Combining both papers’ data, the correlation between the Hofstede Individualism Index and the percentage non-homosexual orientation is r=0.866 which is very high. (For those that don’t love statistics and math, a perfect correlation would be 1.000 and no correlation at all would be 0.000 or “zero”.) It would be very surprising if the correlation were perfect, since nothing in real life is, but this is really quite high.
I got curious about the scatter plot shown in the second paper… and my intuitive mathematical sense tells me that the function between the Index and %NHS is not linear. So I graphed what I think the function is, reproduced here:
Individualism vs. Percentage Non-Homosexual
There is one outlier if we use my suggested non-linear relationship, the one dead center in the graph. This represents Japan with an IDV of 46 and 60% non-homosexual orientation among MTF transwomen. How do I explain this? I believe that we need to look at the Hofstede Center’s own description of this index score and note that it may not reflect exactly what societal characteristic is usually captured by the IDV,
Japan scores 46 on the Individualism dimension. Certainly Japanese society shows many of the characteristics of a collectivistic society: such as putting harmony of group above the expression of individual opinions and people have a strong sense of shame for losing face. However, it is not as collectivistic as most of her Asian neighbours. The most popular explanation for this is that Japanese society does not have extended family system which forms a base of more collectivistic societies such as China and Korea. Japan has been a paternalistic society and the family name and asset was inherited from father to the eldest son. The younger siblings had to leave home and make their own living with their core families.
Thus, while Japan is more collectivist, that collectivism differs from other Eastern societies as being focused on non-family groups, e.g. companies and schools,
One seemingly paradoxical example is that Japanese are famous for their loyalty to their companies, while Chinese seem to job hop more easily. However, company loyalty is something which people have chosen for themselves, which is an individualistic thing to do. You could say that the Japanese in-group is situational. While in more collectivistic culture, people are loyal to their inner group by birth, such as their extended family and their local community. Japanese are experienced as collectivistic by Western standards and experienced as individualistic by Asian standards. They are more private and reserved than most other Asians.
My hypothesis is that it is from the impact on family structures that this high correlation stems.
Anne A. Lawrence (2010), “Societal Individualism Predicts Prevalence of Nonhomosexual Orientation in Male-to-Female Transsexualism”
Anne A. Lawrence (2013), “More Evidence that Societal Individualism Predicts Prevalence of Nonhomosexual Orientation in Male-to-Female Transsexualism”
The Hofstede Centre
The consanguinity of both homosexuality and autogynephilia appears to be very high. So one would not be surprised to find that the consanguinity of transsexuality would also be very high. That is to say, that transsexuality runs in families. But not the same families.
I have to wonder about my own family.
I always wondered why I never met my paternal uncle, until the day, when I was 16 years old, he showed up at our doorstep, unannounced, with his boyfriend/partner. My father desperately, but quietly, tried to shuttle my three siblings and I to our respective bedrooms, but I obstinately refused to understand my father’s not so subtle hint. My uncle gave me a present that day of a beautiful butterfly mounted as though still alive, in a plastic cube. I never saw him again. But I asked my grandmother about him when I was 22. I simply asked if he had ever married. “He’s not gay!” was her vehement reply. “That wasn’t what I asked, but now I know, thanks.”
I also wondered about one of my brothers. One brother was very, very obviously straight. He was always mooning after some girl or other in high school. But, our younger brother? The tall, handsome blond, star athlete? No girlfriends, not even a hint of one. When our mother suggested that an appointment with a girl was a “date”, he testily replied, “Its not a date, Mother! She’s just a friend.” But, as a kid, he used to dress up in mock drag and imitate drag comedians, especially Flip Wilson, “My boyfriend’s name is Killer!”, said in grating falseto. I used to cringe and want to hide when he did that. When he was a ‘tween’, he had a poster of the teen-girls heart-throb of the day, Bobby Sherman, on his door. On one particular occasion, when I was 17 and he was 15, we were driving down a back road behind Stanford University, past a known gay cruising spot, when up ahead we saw a handsome young man with cut-off jeans and his shirt off, bare chested, thumbing a ride. My brother nonchalantly rolled down the passenger side window, stuck out his head as we passed by the obviously gay young man and called out teasingly, “Sorry guy. Not cute enough!” Many of my gay friends over the years said that their gaydar went off when ever he was around… but… perhaps after seeing how our family and most of our social set disowned me as a teenager, he slammed the closet door so shut that even he didn’t recognize it? He’s now married with two children, a very successful cardiologist and hospital administrator.
There have been lots of reports of transsexuals having transsexual or transvestite siblings, fathers, or sons. The press just eats up these stories. But what of the clinical experience?
From Green’s paper on the subject:
Familial cases of gender identity disorder were reviewed by Freund (1985)
and categorized as concordant or discordant for sexual orientation. No instances of
a mixed heterosexual and homosexual pattern in the same family were found. The
interpretation was that the two groups of gender-identity disorder have different
etiologies. In the 10 family series reported here, only Case Five contains a mixed
heterosexual/homosexual family pair.
Green’s ten cases came from a pool of only 1,500. This would suggest that one in one hundred fifty transsexuals has a transsexual or transvestite sibling, but not of the other type? Is this random chance? Not likely.
Richard Green, M.D., “Family Cooccurrence of “Gender Dysphoria”:Ten Sibling or Parent–Child Pairs”
Esther Go´mez-Gil et al. “Familiality of Gender Identity Disorder in Non-Twin Siblings”
Robert J. Stoller and Howard J. Baker, “Two male transsexuals in one family”
♫…Drum keeps pounding rhythm to the brain… ♫ La di da di dee…♫
James Cantor recently published a letter to the editor in the Archives of Sexual Behavior pointing out nearly the same point that I had made earlier, that recent MRI scans of transsexual brains show clear evidence that Blanchard’s two type hypotheses is supported. One of the papers he referenced is one that I had earlier referenced; The Rametti study in Spain, which showed that MTF transkids have partially feminized brain structures. The other paper is new to me; The Savic paper clearly adds yet another confirming MRI study that when combined with the Luders MRI study, shows that gynephilic MTF transsexuals do not have feminized brains. On top of it, true to another speculative prediction that Blanchard made, the new study confirms the other paper’s finding that gynephilic (AGP) MTF transsexuals show other, non-sexually dimorphic structures, are different from both non-transsexual men and women!
These two papers both noted that the putamen of gynephilic MTF transsexual are different from both non-TS men and women. This may be the main area to research in the future?
For more essays on trans-brains see Brain Sex
Cantor, James, “New MRI Studies Support the Blanchard Typology of Male-to-Female Transsexualism”
Reply to Italiano’s (2012) Comment on Cantor (2011)
JamesM. Cantor http://link.springer.com/content/pdf/10.1007%2Fs10508-012-0011-y
Rametti G, Carrillo B, Gómez-Gil E, Junque C, Zubiarre-Elorza L, Segovia S, Gomez A, Guillamon A., “The microstructure of white matter in male to female transsexuals before cross-sex hormonal treatment. A DTI study.”
Ivanka Savic, Stefan Arver, “Sex Dimorphism of the Brain in Male-to-Female Transsexuals”
Luders E, Sánchez FJ, Gaser C, Toga AW, Narr KL, Hamilton LS, Vilain E., “Regional gray matter variation in male-to-female transsexualism.”