On the Science of Changing Sex

Is Ehlers–Danlos Syndrome Really Associated With Gender Dysphoria?

Posted in Female-to-Male, Transgender Youth, Transsexual Field Studies by Kay Brown on February 12, 2023

A couple years ago, I got an email from someone who felt that I was failing in my exploration of the science by not writing about how Ehlers-Danlos Syndrome causes one to be transgender. I was confused. I had never seen any paper to suggest such a connection. Plus, something about the way this correspondent wrote about it set off several red flags of someone seeking confirmation and affirmation, not information.

Now there is a paper that purports to provide evidence of a connection. But how and why this should be so opens up more questions than answers as I will explain.

First, one must understand that Ehlers-Danlos is one of those syndromes that is both rare and not easy to diagnose. It has been associated with several genetic variants that deal with connective tissue development. The syndrome is defined as causing very loose, “mobile” joints. Something most people call “double jointed”. It’s also said to cause “stretchy” “smooth” skin. Doesn’t sound very bad until one learns that this hypermobility is associated with disabling, even crippling, dislocations of hip and other joints.

But why should a connective tissue problem cause gender dysphoria?

In Jones, et al, he reports that among his TEENAGED patients, 17% reported gender dysphoria. Had this been published in the 1970s, I would have been astounded and would be strongly urging further research into the connection. But this was published in December of 2022. This suggests a far simpler explanation: teenagers falsely claiming to be “trans” and “non-binary”.

We already know that in some other studies up to 10% of teenagers making such a claim. Add to that number the idea of being diagnosed with a rare genetic variant and a social network of teens with said variant, all feeling “special” and told that there is an association with being “trans”, we get a perfect storm for a classic fad. A super majority of 89% of these patients claiming to be “trans” and “non-binary” were female, which fits the recent trend of “tucutes”.

But the ultimate suspicious hint that this is a social imitation phenomena among teens is this statement from the researchers, “To date, there have been no reports of prevalence of TGD youth in pediatric patients with EDS.”

But now we need to look at other data, from the other direction. We must never be blinded by confirmation bias or cherry picking. What of those who are adults receiving medical transition services? Here we find another paper, published in 2022, that reported that of over a thousand patients being treated for gender dysphoria, 2.6% had a diagnoses of Ehlers-Danlos Syndrome, which is ~136 times more than is found in the general population. Further, 67% of them were female.

So we are left with a conundrum. How is it that a connective tissue syndrome is associated with gender dysphoria?

References:

Jones JT, Black WR, Moser CN, Rush ET, Malloy Walton L. Gender dysphoria in adolescents with Ehlers–Danlos syndrome. SAGE Open Medicine. 2022;10. doi:10.1177/20503121221146074

Najafian, A.; Cylinder I.; Jedrzejewski B.; Sineath C.; Sikora Z.; Martin LH.; Dugi D.; Dy GW.; Berli JU. Ehlers-Danlos syndrome: prevalence and outcomes in gender affirming surgery – a single institution experience. Plast. Aesthet. Res. 20229, 35. http://dx.doi.org/10.20517/2347-9264.2021.89

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Where Are All These “Detransitioners” Coming From?

Posted in Editorial, Female-to-Male, Transsexual Theory by Kay Brown on June 1, 2021

Perhaps, as we begin Pride Month, we should talk about both the psychology and the politics of non-gender dysphoric / non-gender atypical people , mostly teenaged girls and young women, claiming a “trans” and especially now days, a “non-binary” identity.  It must be hard on lonely straight folks seeing LGBT Pride celebrations and wishing that they too could be part of something larger than themselves, where they can be accepted and feel ‘loved’ by so many others, all at once.  Who wouldn’t want to be part of that?  Oh, and add into the mix the frisson of being a rebel, joining a cause, resisting homophobia and transphobia?  It’s every teen’s dream; They aren’t just some dissaffected youth, they are special and have a right to be angry with the world.

But, here’s the rub.  If they claim to be lesbian, they can’t be with the cute guys w/o looking silly.  If they claim to be bisexual and aren’t… well then they might have to fend off girls, and that might be akward, though it might be easier than claiming to be lesbian.  If they claim to be “trans”… well… you don’t have to like girls to be “trans” right?  Lot’s of transmen are into men, right?  Then the awkward issue of people pointing out that they aren’t actually gender dysphoric nor all that masculine.  One might get labeled (correctly) as being “tucute” to be FtM transman.  No problem, just wear unisex clothes and chest bind on occasion at LGB and especially T events and support groups.

But wait, there’s this new category of “trans” where one doesn’t have to actually be “trans”; one can claim to be “non-binary”.  One can still date boys and still dress as femininely as one wishes, when one wishes; because to be non-binary doesn’t require one to be butch in any way.

So, we get more and more feminine heterosexual girls and young women “coming out” as “trans” and  “non-binary” to be one with the LGBT community.  Some LGBT, in an effort to be accepting and inclusive, openly accept and even celebrate these non-LGBT people as though they were.  After all, they aren’t hurting us, and the more that come to the political fight, the better, right?

Except, there is a danger for the transsexual community lurking just underneath.  These non-gender dysphoric “trans” are telling people that “trans” people don’t need or want medical interventions. They get used to “prove” that medical interventions like HRT and SRS aren’t needed by “trans” people! And what happens when these young women tire of LARPing as “trans” and “non-binary”?  Some will quietly stop.  But some will connect with “ex-trans” types, just like “ex-gay”, and claim a new identity, in another community that love bombs them, offering a new group identity that supports and assuages their loneliness: “desister” or “de-transitioner” (even if they never actually transitioned).  We are already seeing this coming about.

And as they become “detrans”, they become the darlings of transphobic political efforts, weaponized as “proof” that “transgender ideology” is “seducing” girls into believing that they are trans.

But actual transsexuals are NOT the villains here.  It is the young people who falsely claim these identities that are.

Consider that a recent claim was made that there are 28,000 “detranstioners” from the US on a single subreddit. How can that be when we know from solid data that there are only ~100,000 actual transitioners in the United States, and that detrans post-op regret is rare at less than 0.15%. That’s around 150 people in the US total, most of whom are “older transitioners”, MTF transsexuals who return to living as men as they find it too difficult to pass as women in a transphobic society. So where did these 28,000 people come from? Simple, only a tiny handful were ever trans to begin with. The rest were those described above, falsely claiming to be “trans” or “non-binary”, now falsely claiming to be “detrans”.

Further Reading:

Is The “Non-Binary” Fad Ready To Fade?

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2D:4D Evidence Supports Transexual Taxonomy

Posted in Brain Sex, Confirming Two Type Taxonomy, Female-to-Male by Kay Brown on January 30, 2020

handA new paper provided both new direct evidence and a meta-analysis of measurements of 2D:4D finger ratios in transsexuals, both FtM and MTF.  Such measurements are interesting because it is known to be influenced by testosterone levels in utero and thus an indirect measure of testosterone exposure that might influence brain sexual dimorphism.

What is doubly exciting about this paper is that the authors fully comprehend the overwhelming evidence for the two type taxonomy and of the (mild) scientific controversy regarding sexual orientation vs. age of onset as the best clinical markers for the two taxons.  The study is open access so I highly recommend following the link to it and reading it for yourself.  The study is also interesting because of where it was conducted; Iran.

Iran is a Muslim country which while being extremely homophobic, both culturally and legally, treats transsexuals fairly well, at least legally and medically.  Make no mistake, culturally, it is far from truly accepting.  Further, Iran is considered a “Collectivist Society” according to the Hofstede Individualism vs. Collectivism Index.  Lawrence has shown that this index highly correlates with the percentage of non-androphilic (and thus likely autogynephilic / late onset) transwomen transitioning in a given culture.  Thus, we would expect that there were fewer such transwomen in the study and the reported data bear this out.

Let’s look at the new data they provide:

Table 1

Means (and SD) for 2D:4D in the left and right hand for transmen, transwomen, control women, and control men

Transmen

Control women

Transwomen

Control men

Left 2D:4D

0.991 (0.034)

0.991 (0.032)

0.981 (0.033)

0.974 (0.029)

n = 104

n = 53

n = 88

n = 56

Right 2D:4D

0.981 (0.030)

0.983 (0.033)

0.972 (0.029)

0.959 (0.033)

n = 104

n = 53

n = 89

n = 56

Table 2

Means (and SD) for 2D:4D in transsexuals’ left and right hand as a function of early or late onset of gender dysphoria

Transwomen

Transmen

Early onset

Late onset

Early onset

Late onset

Left 2D:4D

0.982 (0.034)

0.975 (0.022)

0.988 (0.033)

1.009 (0.031)

n = 80

n = 8

n = 92

n = 12

Right 2D:4D

0.973 (0.029)

0.963 (0.026)

0.977 (0.028)

1.007 (0.027)

n = 81

n = 8

n = 92

n = 12

Before the analysis of transfolk, it would be a good idea to scale the effect by looking at the effect size between the controls.  The difference between control women and men is d= 0.56 for the left hand and d= 0.76 for the right. This is only a moderate effect size.

Although the number of late onset is small, and thus must be viewed with caution, the analysis is still very interesting and would seem to confirm (agree) with the two type hypothesis.  Consider that the two MTF types have a small but distinct difference of d= 0.24 for the left hand and d= 0.22 for the right.  When we compare early onset type to the male controls we get d= 0.25 and d= 0.45 for the right.   When we compare early onset to female controls we get d= -0.27 for the left and d= -0.32 on the right.  This shows that early onset transwomen are roughly halfway between the controls, and if anything a bit closer to the female controls.

But even more intriguing, and the reason for trusting this interpretation is that when we compare the late onset population to the male controls we see that it exactly agrees with the hypothesis that the late onset type is essentially like the majority heterosexual male population and not at all feminized, with effect sizes that are, statistically speaking, non-existent at d= 0.04 and d= 0.12 for the left and right hands respectively.

This shows that early onset MTF type has notably hypomasculine (feminized) hands while the late onset MTF type does not, and thus in agreement with other data that supports the two type MTF taxonomy.

But what about the FtM transmen?  Here we see an even more intriguing set of data.

The two FtM types have a moderate to substantial, very notable, difference of d= -0.66 for the left hand and d = -1.07 for the right, indicating that early onset transmen are far more masculine than late onset.  When we compare the early onset FtM to female controls we find effect sizes of d= -0.09 for the left hand and d= -0.20 for the right indicating a non-existent to small masculinization signal.

However when we compare the late onset FtM to female controls we see a very different pattern with effect sizes of d= 0.57 for the left and d= 0.80 for the right.  The positive sign indicates that late onset transmen have a more feminine 2D:4D ratio than control women (!!).  And the effect size difference between early and late onset transmen is far greater than the difference between control men and women (!!!).

This, if replicated, is very big news.  It would support the notion that transmen also exhibit two taxons as has long been suspected, one that is masculinized in both behavior, sexual orientation, and very mildly in appearance, the other that is very feminine, androphilic, and autoandrophilic, the mirror image of late onset transwomen.

Further Reading:

Essay on 2D:4D History

Essay on Cultural Difference in Percentage of HSTS vs. AGP Transwomen

Essay on Androphilic Transmen

Reference:

Sadr, M., Khorashad, B.S., Talaei, A. et al. “2D:4D Suggests a Role of Prenatal Testosterone in Gender Dysphoria” Archives of Sexual Behavior (2020)
https://doi.org/10.1007/s10508-020-01630-0

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Autoandrophilia vs. Autohomoerotic Sexuality

Posted in Editorial, Female-to-Male by Kay Brown on May 15, 2019

female_scientistIf you are paying attention to the latest discussions regarding sexology of female bodied gender dysphoria you may have come across a debate in which some of the old time sexologists have quibbles about the concept of autoandrophilic transgender sexuality.  Oh, let’s spell it out, Ray Blanchard had once upon a time flat out denied that autoandrophilia exists, largely because he, as many other sexologists asserted, believed women never have paraphilias…. but then evidence poured in… OK… he says so some women have paraphilias (masochism being the most common)… but that still doesn’t mean that gay or bisexual identified transmen are autoandrophilic… they just have autohomoerotic fantasies of themselves as gay men.

Sigh… I say tomato, you say tahmahto…

Seriously, recent research has shown that autogynephilic males can experience essentially the same thing as Interpersonal Autogynephilia, in fact, many of them do, having fantasies in which they are lesbian.  And no, one can’t say that they aren’t the same thing.  Frankly, if males can experience autogynephilia as the result of an erotic target location error, by simple symmetry, we would expect that females can also experience autoandrophilia as a result of an erotic target location error.

Need proof that women experience an erotic target location errors?  Consider amputee “devotees” and “wannabees”, people who are both sexually attracted to amputees and want to become an amputee.  While most are men, there are women.  Are we to say that female wannabees experience a different phenomena just because they are female?  Seriously?  I prefer to use Occam’s Razor and avoid unnecessary sexist ideology.

Back to autoandrophilia in androphilic transmen, we see the same sex ratio, very few such transmen compared to autogynephilic transwomen.  And again, by Occam’s Razor, if we know that female bodied individuals can experience an erotic target location error as rare as amputee wannabee, then we fully expect to find it in simple androphilia as autoandrophilia.  It might “look” different than what we find in males, but it’s still there.

Further Reading:

Essay on Androphilic Transmen being Autoandrophilic

Essay on Amputee Wannabees and Erotic Target Location Errors

Further External Reading:

https://meduza.io/en/feature/2017/08/02/lose-a-leg-find-yourself

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Rapid Onset Gender Dysphoria

Posted in Autobiographical, Female-to-Male, Transgender Youth by Kay Brown on June 6, 2018

Kay BrownIs this a newly emerging etiology?

Unless you’ve been under a rock the past few years, you will have heard of what many are describing as a new phenomena affecting natal female teens, “Rapid Onset Gender Dysphoria” (ROGD) to join the old duopoly of “Early Onset” and “Late Onset” gender dysphoria seen in natal males.  The description of the putative phenomena is that gender TYPICAL and not at all previously gender dysphoric girls learn through the internet and perhaps from friends at school about transgender issues and then suddenly, because of ‘social contagion’, seemingly out of the blue, declare that they are trans.  There have been a number of speculative hypothesis regarding the putative phenomena which I will explore here.

One hypothesis with a lot of weight of evidence is that this is merely the outsider’s term for “Tucutes” / “TransTrender” / “TrendsGender” in which teenaged girls with no real gender dysphoria take on the social position of “transgender”, from identifying as a pre-transition transman to more recently as “non-binary”, a social position that doesn’t require one to actually have to socially, and certainly not medically, transition.  Without doubt, this is happening.  I first met such an individual in 1980.  Their numbers have grown in the intervening years.  But this phenomena, annoying as it may be for some gender dysphoric transmen, is not a major cause of concern to medical professionals in that they rarely seek medical intervention.

Some within the transcommunity have argued that these young people, including those labeled “Tucutes” are in fact the female equivalent of “Late Onset” natal males in that they are autoandrophilic.  This too certainly exists.  While some sexologists and therapists will deny that autoandrophilia exists, I know for a fact that it does, as I had a very close friend since high school who clearly experiences it.  Absolute proof of existence N=1.  We have more evidence than just my one anecdotal one from the years of reports on the sexuality of androphilic transmen.  Such individuals do experience gender dysphoria, but of a notably different character and developmental arc than autogynephilic transwomen.  But just as with autogynephilia, not everyone with autoandrophilia will develop extreme gender dysphoria and thus a range of accommodations occur.

Of course, there is another hypothesis coming from the gay and lesbian community in which they claim that these teens are simply gender atypical lesbians who have been falsely convinced by “Transgender Ideology” that they must be transgender.  At the heart of this is a misunderstanding or deliberate disinformation about the nature of transgender etiology and experience.  Either there are true transsexuals and true lesbians and they shouldn’t be confused… or there are only lesbians and transgender ideology gives them a false sense of gender dysphoria.  The evidence suggests that neither is wholly the case. Gynephilic natal female people exhibit a range of gender atypicality and gender dysphoria.  How they accommodate these within a given culture is variable.  However, when extreme gender atypicality and dysphoria are accommodated by social and medical transition, these are typically labeled “early onset” even if they transition in their 30’s.  If with changing attitudes more such individuals are seeking to address their gender dysphoria at an earlier age, we would expect to see just what we are seeing today.

The question is, are all of those who are labeled with ROGD actually either tucutes or autoandrophilic?  Are some actually gynephilic gender atypical and dysphoric natal females who were simply not recognized or acknowledged as such?  I’ve come to suspect that many may be.

Consider that pre-adolescent tomboys have always been given greater latitude than sissy boys.  In today’s climate of empowering girls to pursue sports and allowed to wear jeans and t-shirts… just like boys, but over scheduled and constantly under parental supervision, with little time for personal choices and expression by privileged helicopter parents, the type that are active on social media, these girls may not have been acknowledged as being gender dysphoric… until the social pressures of adolescence to be heterosexual and feminine.

TransSupportConsider also that nearly half of these parents acknowledged that they knew that their daughter was attracted to girls BEFORE they had confided being gender dysphoric.  (Gynephilia is a key co-presenting factor in transmen.)  These parents also point to their children having other emotional problems, which for them mean that their gender dysphoria is just another symptom, failing to note that gender dysphoric youth living in transphobic households typically experience such problems.  One out of seven of these parents state homophobic attitudes while the rest say that they support LGBT people.  (Really?  Recall that support for same-sex marriage hovers at only 50%… yet 85% of these parents say that they support LGBT rights?  Anyone remember the 60’s cliche “We’re not racist… but our daughter will never marry a black man.” ?!?)

In recent interactions via social media that I’ve had with parents of teens who they claim have ROGD and further claim that means that they are “not really transgender” and they should NOT be encouraged, acknowledged, nor affirmed, I’ve had an extreme sense of deja vu.  What I sense is not that these teens are tucutes or ‘non-binaries’… as most of them have very laid back parents who allow their children to explore their place in the world, knowing that kids do that.  No, I sense both angry denial, genuine concern for their child’s welfare, combined with homo- and trans- phobia, saying “my child is not one of those people“.

Deja Vu

About that deja vu.  At this point I have to switch from academic exposition to personal anecdotal mode:

In very early ’75, at the age of 17, I had “come out” to my father about being transsexual (the word “transgender” did exist at the time, but it was reserved for heterosexual lifestyle cross-dressers = autogynephilic men and specifically excluded androphilic gender atypical MTF transkids).  The time and place had NOT been my choice, having been forced to do so by my mother.  (That’s a whole other story.  My parents were divorced and my mother had custody, as was usual back in the ’70s.)  He seemed calm and concerned, no anger or lamentation.  Instead, he suggested that we should seek professional advice and help.  I recognized an opening.

I had for some months been in contact with the Stanford University Gender Dysphoria Clinic.  I literally had in my possession, in my pocket, the contact information for them.  I gave it to my Dad who said that he would be contacting them.  I was astounded.  The clinic had told me that they would love to help me but that I had to have my parents make the arrangements.  But my mother had made it abundantly clear that she would never help me transition.  Now my Dad was opening the door for me!

I had several intake interviews with Dr. Norman Fisk, the man I would later learn had coined the term “gender dysphoria”.  At the time, I had no idea how influential and expert he was in the field.  He was just a guy who might be able to help me get medical help.  He asked about my sexuality.  I told him about the boy I had a crush on.  He asked me about my dreams for the future.  I told him about how I hoped to find a husband and adopt children.  I told him about my summer job as a nanny and of the two summers I volunteered teaching little kids to swim.  And sadly, I told him about how unhappy my parents were about my behavior and how I had been sent to therapists (who had been anything but affirming).

Then I had a joint interview with my mother and a week later another with my father.

During the interview, my father made it abundantly clear that he thought transsexuals were sick perverts.  Dr. Fisk assured my Dad that transsexuals were NOT mentally ill and that social and medical transition was the typical course of treatment.  My father then became very agitated, objecting, “My son is NOT transsexual.  I’ve never seen anything feminine about him.  This is just a phase!  It will blow over!”  Dr. Fisk knew better, having talked to me and more importantly talked to my mother.

My father focused on the fact that he and I had over the years gone fishing and hunting together (ignoring that during their courtship, so had he and my then teenaged mother).  That we spent hours working together on projects (that he usually chose).  That I was a Boy Scout (ignoring that he had insisted I and my two brothers join since he had been a Scout as a boy… and the deeply mortifying incident in which I had been kicked out of the first Troop though I had done nothing objectively wrong in any sense… but none of the boys wanted the “faggot” around… and that the Scout Master declared to my Dad with a sneer that I was “not Eagle Scout material”… and that my Dad had to find another troop for me to join that accepted queers).  At the end of the interview, my Dad stormed out making homophobic references to Dr. Fisk to me in the parking lot.  (Dr. Fisk was straight, married, and had a son near my age.  I learned that they lived only blocks from my mother’s house.)

The interview with my mother the week before was quite different.  Far from being in denial, she was petulantly resentful that she had such a child.  “I have known for years that he wanted to be a girl.  But I thought that was [morally] wrong.  He was very different than his brothers.  All their friends were boys.  His were always girls,” naming several of my friends over the years, but couldn’t remember my friend who had been my only guest on my tenth birthday.  “Marian,” I interjected for the only time during the whole interview.  “He was always very prissy.  He would walk clear around even the shallowest puddles.  When he was little, I would put him in clean clothes on Monday and on Friday they would still be clean.”  She confirmed that I had been sent to a therapist about my behavior when I was ten years old… and again when I was 15/16.  She came away under the impression that she had spelled out all of the things about me that needed to be fixed, that Dr. Fisk and the clinic would endeavor to make me a normal, healthy, masculine heterosexual man and had shared that impression with my father.

So, it was a shock to my Dad that Dr. Fisk was recommending to him that my family accept that I was never going to be a masculine straight man.  That I was going to transition.  And when my Dad objected, offered this bit of advice,

“Denial will not serve.  You will win a few battles but lose the war.”

At home my mother began sharing comments such as sweetly asking, dripping with obvious false concern, “What will your friends think of you when they find out?”

“They already know,” I replied honestly, having grown used to the twisting knife within her tone.

“I could understand it if you were petite like your sister (at 12 years old, not yet fully grown she was 5’2″ – our mother was 5’5″ –  I’m 5’7″ – our brothers were closer to 6′).”

“That’s funny, Cassie (school friend) is 5’9″ and she has no problems,” I demurred.

“No man will ever love you,” she taunted.  I couldn’t answer back, it hurt too much, but I could feel my eyes smouldering with suppressed anger.

My father came over to see me and begged me not to transition, “You’ll be throwing away a chance for a career.  No one will hire you.”  I couldn’t answer him, having the same fears.  He also tried to shame me, telling me that I was embarrassing the family, that we all have our “cross to bear” and that I should think of my siblings and how they might be treated at school and by friends.  I replied that it was unfair that they should ask that I be extremely unhappy my entire life so that they could avoid some mild embarrassment.  In that same conversation he begged me to live as a closeted gay man, promising that the family would look the other way when I had boyfriends.  My thoughts on this were bitter, as that would put me in the same position as his gay brother, the one we weren’t allowed to meet or talk about.  He then tried to sweeten the deal by offering to pay for vacations in which I could dress up as a woman (!).

I lost my temper at that and loudly replied, “I am NOT a part-time woman!”

Conclusion

I hear that same combination of denial, anger, embarrassment, resentment, desperation, and socially & religiously motivated transphobia in those parents who now describe their teens as having ROGD. Which to them indicates that they are “not really transgender” and should not be allowed to socially transition nor allowed to use puberty blockers much less actual HRT.  These parents sound suspiciously like my parents.

Epilog

I think it worth describing how things went down after the events above, as a sincere warning.

Candice_Caltech

Kay Brown in college

I had already been in the process of social transition, presenting as a girl after school but continued to dress as a boy at school until graduation day.  But had already made arrangements for my high school records to be changed to my new name, female gender, and even to have it say that I attended girls P.E.  It became very apparent that my family, led by mother, was going to do everything they legally could to stop me from successfully transitioning.  Although I had been accepted at a four-year college, I was made to understand that I would not be supported if I continued to present as a girl, so was unable to attend.  I was kicked out of the house by mother and my father was not to take me in.  I started HRT right after I turned 18, forgoing food to buy them.  Using documents from the clinic, I was able to have my driver’s licence and social security ID changed to my new name and gender that summer.  I was given a meagre allowance for about a year with the proviso that I was NOT to show my face anywhere near home.  I attended community college part-time, as they were nearly free the next few years.  I became, in the modern vernacular, a housing and food insecure student.  It took me a few years, having no financial or social support or capital.  But I managed to climb back out of the hole that being effectively disowned had thrown me.  I established a career in Silicon Valley, first as a secretary at age 19, then working my way up.  At the age of 23, I had saved and borrowed enough for SRS.

After SRS, it was perhaps ‘barn doors’ and all… but slowly my folks then began to extend more social and financial capital to me… perhaps also in embarrassment when comparing how they had treated me compared to my siblings.  One had gone to Stanford as an undergraduate and was then attending Baylor Medical School while living in a condo provided by my mother’s family money.  Another was working as an engineer in Silicon Valley, living in a condo also provided by her money.  My sister was going to a small private college… oh… you get the picture.  I had earned a BS soon after SRS, on my own resources, combining credits from four different community colleges and all of my upper division credits earned entirely by examination.  I was then admitted to Stanford Graduate School.  At that point, my father began offering emotional and logistical support and a couple of years later, my mother’s family provided the down payment on a condo for me.

family

Kay, Jeff, Liz, & Reese

Over the years, my mother never really accepted me and we haven’t spoken in decades now, just as I haven’t spoken with any of my siblings.  Oh… and she was wrong.  One man does love me… and we’ve been married these past two decades and I did become an adoptive mom.

And my father was wrong.  My career took off.  I rose to executive rank and even founded and raised venture capital for a start-up which I sold to Samsung.  My father and I speak often… and he makes it clear that he loves and is proud of me.

So, if you are a parent of a transkid or a so called “ROGD” teen.  Please recall Dr. Fisk’s advice to my Dad.

“Denial will not serve.  You will win a few battles but lose the war.”

Addendum 9/3/2018:  The past week and some has seen renewed publicity regarding this putative phenomena of ROGD since the Littman paper was published.  I have been following this issue for much longer.  I chalked it up to standard parental denialism which I have written about for a decade now.  But I became disturbed by it when champions of MTF transkids approached me urging me to in effect throw FtM “ROGD” transkids under the bus.  They had been bamboozled by these parents in denial and what I now see as growing anti-transkid propaganda. The Littman paper does NOT document a new phenomena of social contagion among teens… it documents parental denial and rationalizations.  If there is any new social contagion phenomena occuring it is that the internet allows transphobic parents a means to create memes that can be used to bolster their denial and obtain social approval among their “transgender critical” peers for obstructing their teens.

Further Reading:

ROGD As An Expression of Parental Greiving

ROGD Redux

Essay on TransTrenders & Tucutes

Essay on Androphilic Transmen being Autoandrophilic

Advice to Parents of Transkids

Essay on Transphobic Propaganda Aimed at Parents of Transkids

References:

Lisa Littman, “Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports” (2018)
https://doi.org/10.1371/journal.pone.0202330

External Further Reading:

Brown University Statement regarding the Littman study controversy

https://thinkprogress.org/conservatives-complain-people-have-noticed-their-anti-trans-junk-science-is-in-fact-junk-ab9ee965b865/amp/

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Autism and Transgender

Posted in Brain Sex, Female-to-Male by Kay Brown on May 24, 2018

critical-thinkingCo-Morbidity of Gender Dysphoria and Autism Spectrum

More studies show that there is a higher than expected by random chance of co-morbidity of gender dysphoria and autism spectrum disorders.  It’s seems to be true for both MTF and FtM.  There are hints that it may be more likely in “nonhomosexual” individuals.  The question not yet answered is whether this is an independent path to gender dysphoria in adults or is co-morbid with autogynephilia and autoandrophilia, though we have seen adolescents with and without autogynephilia in earlier studies.

From the Shumer study abstract:

“There is evolving evidence that children and adolescents with gender dysphoria have higher-than-expected rates of autism spectrum disorder (ASD)… We conducted a retrospective review of patient chart data from 39 consecutive youth ages 8 to 20 years (mean age 15.8 years, natal male: n = 22, natal female: n = 17) presenting for evaluation at a multidisciplinary gender clinic in a large U.S. pediatric hospital from 2007 to 2011 to evaluate the prevalence of ASD in this patient population. … Overall, 23.1% of patients (9/39) presenting with gender dysphoria had possible, likely, or very likely Asperger syndrome as measured by the Asperger Syndrome Diagnostic Scale.”

From the Pasterski study abstract:

“The current study examined this co-occurrence of GD and autistic traits in an adult population, to see whether this heightened prevalence persisted from childhood as well as to provide further comparison of MtF versus FtM transsexuals and homosexual versus nonhomosexual individuals. Using the Autistic Spectrum Quotient (AQ), 91 GD adults (63 male-to-female [MtF] and 28 female-to-male [FtM]) undertaking treatment at a gender clinic completed the AQ. The prevalence of autistic traits consistent with a clinical diagnosis for an autism spectrum disorder (ASD) was 5.5 % (n = 3 MtF and n = 2 FtM) compared to reports of clinical diagnoses of 0.5–2.0 % in the general population. In contrast to the single previous report in adults, there was no significant difference between MtF and FtM on AQ scores; however, all of those who scored above the clinical cut-off were classified as nonhomosexual with respect to natal sex. Results were considered in the context of emerging theories for the observed co-occurrence of GD and autistic traits.”

This was not a very large enough sample size given the small number of individuals found on the spectrum, but note that all five were nonhomosexual.

Further Reading:

Autistic Sky

Further External Reading:

Why we need to respect sexual orientation, gender diversity in autism by John Strang

Large study finds significant overlap between “transgender” identity and autism

References:

Pasterski, et al., “Traits of Autism Spectrum Disorders in Adults with Gender Dysphoria”, Archives of Sexual Behavior (2013)
https://doi.org/10.1007/s10508-013-0154-5

Shumer et al., “Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic”, LGBT Health (2016)
https://doi.org/10.1089/lgbt.2015.0070

van der Meisen, et al., “Prevalence of the Wish to be the Opposite Gender in Adolescents and Adults with Autism Sprectrum Disorder”, Archives of Sexual Behavior (2018)
https://doi.org/10.1007/s10508-018-1218-3

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Presented with no comments:

Posted in Female-to-Male by Kay Brown on November 1, 2017

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Testosterone Poisoning Real?

Posted in Female-to-Male by Kay Brown on April 30, 2017

critical-thinkingHow T Makes Men Dysrational

Back in the early ’90s when I was staying home from work because of some bug, I recall watching daytime reruns of really dumb shows. I chanced upon a silly sitcom for ‘tweens where one of the plot elements was a math problem which was supposed to be challenging for the middle school students. It was a classic dual rate problem: How long it would take two boys washing cars if they did the next car together instead of separately.  As I was bored, I set up and solved the simple (to me) algebra problem during the next commercial break. I looked forward to seeing that I was correct.  As the show progressed, the kids were becoming more and more agitated that no one could solve it, not even the stereotypical “brain” of the class.  Only the stereotypical airhead girl (obnoxious portrayals) seemed to be immune.  At the climax of the show, no one has solved it, but the airhead… who states, “It can’t be solved.”  “Right!” the math teacher concurs.  WTF!?!?!  I think.  The “brain’s” head explodes.

I was dumbfounded.  I checked my work.  No, I could easily solve it.  No, it didn’t take a genius.  It was a very straight forward bit of algebra any first year high school algebra student could solve.   How could the writers, producers, stage crew, and actors not know this?  What the &^%$#@! were they doing telling their young audience; that it couldn’t be solved?

This episode (pun intended) stuck in my mind.  I couldn’t understand it until I learned of the phenomena of Dysrationalia, researched by Keith Stanovich.  It was a revelation.  But I never thought this topic would find it’s way to my blog here, not being related to trans issues (save perhaps as one possible explanation for the irrational denial of the two type taxonomy).  But, here it is…

High testosterone levels increase dysrationality.  Seriously.

In a recent study, healthy men were randomly given T gel or placebo gel to apply to their skin.  Hours later, their plasma T levels had doubled.  They then took on a series of cognitive tests buried within them were three “trick questions” that measure “Cognitive Reflection”, a subset of the Stanovich’s original seven dysrationality questions.  These three questions, mathematical in nature, are extremely easy, deceptively easy, in that unless one slows down and thinks, one will all too easily try to use irrational mental shortcuts that get the wrong answers.  The key to being rational is that another part of the brain double checks one’s thinking to spot this and says to one’s self, “hey, hold on, that type of thinking is flawed.”

The results were dramatic.  Those who had been given T got 20% more wrong answers than those given the placebo.  The difference was quite robust ( Cohen’s d=0.41 ).  High T levels seem to reduce the ability of the brain to spot irrational thinking processes.

This has implications for transmen as they begin and continue hormone replacement therapy (HRT) using testosterone, as transient high levels of T occur.  Transmen should be counseled on this phenomena and given cognitive tools to compensate.

Researchers should also look at the effects of androgen suppression in transwomen.  Does this effect go in reverse?  Does low T make one less prone to cognitive reflection errors?

Further External Reading:

Rational and Irrational Thought: The Thinking That IQ Tests Miss

Reference:

Nave, Gideon and Nadler, Amos and Zava, David and Camerer, Colin (2017) Single dose testosterone administration impairs cognitive reflection in men. Psychological Science . ISSN 0956-7976 .   http://resolver.caltech.edu/CaltechAUTHORS:20170428-091020875

 

 

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Getting Lost in the Crowd

Posted in Female-to-Male, Science Criticism, Transgender Youth, Transsexual Field Studies by Kay Brown on April 16, 2017

Kay Brown

Or, How the Big Tent Transgender Movement Distorts Science and Holds Back Civil Rights for Transsexuals

The word “transgender” was originally coined and used by Dr. Virginia Prince, a full time autogynephilic cross-dresser, in the early ’70s, to denote those like her/him as opposed to “transsexuals” who took hormones and had “sex change” surgery and also opposed to secretive “transvestites” who only occasionally cross-dressed, usually in private.  The term was meant to be exclusive of any other group, like drag artists or gender atypical gays or lesbians.

But…

In the early ’90s, Beth Elliott, using her nom de plume Mustang Sally, wrote an essay entitled, “The Incredible Shrinking Identity” in which she decried the social effects of subsuming transsexual people into the larger umbrella of “transgender”, which with each passing year seemed to be growing at its margins to include more and more people who just a few years before, would never have been considered to be in the same grouping.  Now we must differentiate between an ever growing host of self-defined “other” gender categories and underlying behaviors, identities that are lumped under “transgender” to the point of making the term meaningless to sexologists, social scientists, and the public alike.

Flashback, 1980:  Hanging out in the L.A. transsexual community, as it gained a political self awareness, was a teenager; let’s call her “Lee”.  Lee would tell anyone who asked that she was “transsexual”… yet caused great confusion to all who met her.  She was natal female, short even for a woman, pleasantly plump, and decidedly feminine in both appearance and manner.  She was in no sense gender atypical.  And during the time that I knew her, over 18 months, she never made any attempt to present as a man, nor even as butch.  She was always on the femmy side of androgenous to the point of being decidedly “cute” as she hung out, mostly with younger MTF transwomen whom she seemed to admire.  Had she been hanging out in this same manner in the gay male scene, they would have likely labeled her a “Fag Hag”.  The transsexual community, while leery of non-trans males who would have acted this way, affectionately accepted Lee’s non-threatening presence, while secretly rolling their eyes when she declared that she was “FtM”.

Thinking back on Lee, I’m fairly certain that she never transitioned and I’m willing to place fairly high odds that she married and had kids, probably now has grandchildren, none of which have any idea that she once hung out in the trans-scene.  At the time, we had no label for her.  Today, on the internet, the FtM transsexual community does have a label that would have applied, “tucute”, as in “Too Cute” to be trans.  If you visit the FtM pages on Tumbler, you are sure to run into a few… and will also note that they in turn, grumble about the negative feedback they get from those they call “Truscum” (“true” masculine gynephilic FtM transsexuals) for not accepting that they too are just as “trans”, even if they are in no sense gender atypical nor gender dysphoric.

Recent Events:  A couple years ago, via her facebook page, a very socially liberal, rather prominent (and wealthy) venture capitalist in my professional circle proudly announced that her teenaged child was “transgender”.  I’ve been living “mostly stealth” in that most of my professional contacts do not know of my medical history (yes, I “pass”).  But in a move to be supportive and perhaps even help her with the emotional issues that almost always come with a child’s transition I came out to her.  BAD MOVE!  Nope, upon learning more about her child, it became very clear that her daughter had always been very gender typical as a girl, was not the least bit gender dysphoric, and had no intention of legally, socially, nor medically transitioning.  No, she just wanted to be recognized as “transgender” and have everyone around her use gender neutral pronouns (cause she is they are so special, she they deserves it).

tucuteThere is another couple names for this behavior, “TransTrender” and “TrendsGender”, as in it is now “trendy” to say that one is transgender, or “non-binary”, in the right circles.    Back in my college years, hanging around Stanford University, I would often hear complaints from actual gynephilic women, real lesbians, about the phenomena of primarily androphilic women taking social positions as “Political Lesbians” and “Lesbians Until Graduation”.  The “transgender” community now has the same phenomena.  It seems to have become “cool” in some comfortably well off, very socially liberal teenaged and young adult circles to be associated with the LGB and now T community, as though being associated with a marginalized group made up for their obvious social privilege.

One could well imagine the growing resentment felt by those of us who have experienced familial rejection, social disapprobation, economic deprivation, and psychic pain from a lifetime of gender atypicality and dysphoria towards those who misappropriate an identity from the protective cocoon of indulgent family, liberal universities, and the anonymity of the internet.

As one young transman put it,

“Dysphoria is the defining factor of a transgender person. It’s why they want to TRANSition. It’s why they’re called TRANS in the first place, fuckwits. It doesn’t have to be crippling “I hate my body ugh I can’t look at myself naked” (And I do know some trans people whose dysphoria is that bad). On a 10 is an “I can’t see myself naked” to 1 is a “I don’t feel right in this body”, I’m probably a 5-7. I can see myself naked but it just doesn’t feel right. Specially with my chest. That’s dysphoria. Not “omg I don’t want to be human I want to be a rabbit/sunflower/magical girl” or whatever these tucutes are on I don’t even know.   …

The more I look at it, the more I see tucutes acting like being transgender is a cute little accessory they can put on. You’re comfy with your body but you like girls even if you’re a girl yourself? Congratulations, you could be a lesbian. You like boys but you’re a boy? Good on you, you might be a homosexual man. You like the opposite gender? That makes you a terrible hetero person and that’s bad because all hetero people are transphobic and evil. 😦 Be trans instead. That’s cooler.

Except… it’s not.

It’s not cool to be trans. It’s not cool to wake up and see these parts of you that you feel so uncomfortable with having that you would wish cancer on yourself just to have them taken away. It’s not cool to have to struggle with the longing to tell your parents that you’re not the right gender because you want to trust them and want to open up to them but you’re afraid it’ll just add to the laundry list of things you’ve already disappointed them with. It’s not cool to have known you were one thing from birth but everyone else and your own body telling you you’re not and that you were supposed to be a certain way because that’s what you looked like from the outside.

It’s not cool to be trans.

If I had a choice, if being trans WAS a choice I would choose to be cis.”

If these issues had stayed on the pages of tumbler and facebook, it wouldn’t be a problem for science or those seeking better civil rights for transitioning transfolk.  But it hasn’t.

Consider a recent paper published in the Journal of Youth and Adolescence in which the authors very laudably explore the issues of safety and bathroom access for “transgender” youth.  Ah… you are probably anticipating some of the problems that this might entail and you would be right.  But let’s explore each of them carefully.

The authors cite the now popular William’s estimate of 0.7% of the population in the US as “transgendered”.  The problem with that study is that is the number who identify as “transgendered” because William’s did not apply any operational definition beyond asking if they were “transgendered”. Yet we know that only 0.01% of the U.S. population has actually socially transitioned, according to US Census study that cross-correlated with name/sex status changes to Social Security cards (arguably the absolute best estimate we will ever get to the number of individuals who actually transitioned).  This means that less than 5% of those who identify as “transgender” ever transition.  Thus, by definition, more than 95% of those who identify as “transgender” never transition, that in fact, they aren’t at all gender dysphoric.  So who are they?

Most of them are young women who for various reasons want to sit at what they perceive to be the ‘cool kids lunch table’, as being “trans” or “non-binary” gives them a feeling of being special.  We should talk about both the psychology and the politics of non-gender dysphoric / non-gender atypical people , mostly teenaged girls and young women, claiming a “trans” and especially now days, a “non-binary” identity.  It must be hard on lonely straight folks seeing LGBT Pride celebrations and wishing that they too could be part of something larger than themselves, where they can be accepted and feel ‘loved’ by so many others, all at once.  Who wouldn’t want to be part of that?  Oh, and add into the mix the frisson of being a rebel, joining a cause, resisting homophobia and transphobia?  It’s every teen’s dream; They aren’t just some dissaffected youth, they are special and have a right to be angry with the world.

How badly off are the numbers?  In the Wernick study they found 86 individuals who self-identified as transgendered out of 935 students.  Seriously, 9%?  NINE &^%$#@ percent?!?  That’s more than three hundred times the number who actually transition.  That’s higher than the number of teens who grow up to be gay or lesbian.  Are all of the LGB kids claiming to be “transgendered”???  Or is this representative of all LGB plus all of the secretly cross-dressing and cross-dreaming boys plus the TuCutes and the TransTrenders, all balled into one?  Because, if the schools were statistically representative of the population as a whole, with only a thousand or so students, we could only expect a one in three chance of finding an actual transsexual among them, most likely an autogynephile who will transition as an adult and only one in fifteen chance of finding a transkid.

The design of this study was flawed from inception, as the numbers surveyed were never enough to find any statistically valid number of transkids, while using self report of being “transgendered” without a valid operational definition lead only to a measure of the trendiness of the label in the teenaged population combined with “mischievous responders”, kids saying ‘shit’ to mess with the study.

transkids

Transkids after transition

So we see, that truly gender atypical and gender dysphoric individuals will be a very small percentage of youth who will self-identify as “transgender”.  These are the kids who social scientists and policy makers should be concerned with, not those who have yet to transition or never will.  These are the kids who, while finding more and more visibility in the press as they transition, are the ones who are getting lost in the crowd in social science studies and policy making because of the failure to apply appropriate operational definitions.

Addendum September 2020:  Here is THE poster child for a young, clearly feminine white woman falsely claiming to be both a Person Of Color AND to being trans / non-binary, demonstrating the problem discussed above.  Note that she did this at a liberal university to take on the mantle of being a doubly under-privileged individual.  Vitolo-Haddad was outed on the ethnic impersonation.  Here I am outing her on her trans impersonation.  She needs to stop doing it and apologize for it.

https://amp.cnn.com/cnn/2020/09/17/us/wisconsin-grad-student-race-trnd/index.html

Further Reading:

Essay on “How Many Transfolk Are There, Really?”

Essay on US Census Estimate of Post-Transition Population

Falsely Claiming To Be “Trans” is Cool (NOT!)

Is The Non-Binary Fad Ready To Fade?

External Further Reading:

“Tucute: What it is and why its wrong”

Research on “Mischievous Responders” causing over-estimate of transgender in teenagers

References:

Wernick, et Al, “Gender Identity Disparities in Bathroom Safety and Wellbeing in High School Students”, Journal of Youth and Adolescence
DOI: 10.1007/s10964-017-0652-1

Sumia et Al, “Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment”, Journal of Adolescence
http://www.sciencedirect.com/science/article/pii/S0140197117300155

Joseph R. Cimpian, Jennifer D. Timmer, Michelle A. Birkett, Rachel L. Marro, Blair C. Turner, Gregory L. Phillips II, “Bias From Potentially Mischievous Responders on Large-Scale Estimates of Lesbian, Gay, Bisexual, or Questioning (LGBQ)–Heterosexual Youth Health Disparities”, American Journal of Public Health 108, no. S4 (November 1, 2018): pp. S258-S265. DOI: 10.2105/AJPH.2018.304407

Goodman, M. et al., “Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review” (2016) The Journal of Sexual Medicine
https://doi.org/10.1016/j.jsxm.2016.02.001

Reisner, S., Hughto, J., “Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample” PLOSOne, https://doi.org/10.1371/journal.pone.0221583

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Brainstorm

Posted in Brain Sex, Confirming Two Type Taxonomy, Female-to-Male by Kay Brown on July 2, 2016

critical-thinkingA 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.

For more information, read my essays on feminine speech production and on voice recognition.

On the other hand, it just might represent a real difference.  We need more studies.

References:

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

 

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