On the Science of Changing Sex

Getting Lost in the Crowd

Posted in Editorial, Science Criticism, 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

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.  Of course, she was mostly talking about cross-dressers, autogynephilic men, who as we know, are in fact in the same etiological taxon as autogynephilic MTF transsexuals.  In the ’90s, it was possible to ignore this complaint as being specious on the social level, given already rampant socially unwanted and scientifically unwarranted lumping of autogynephilic and exclusively androphilic MTF transwomen.

But what started as merely political embarrassement (for AGP transwomen) has now become a serious scientific and civil rights issue as the term “transgender” has now been stretched to the point where it has little meaning as to actual sexual, social, or gendered behavior.  It is no longer enough for scientists to differentiate between autogynephilic/late onset vs. androphilic/early onset MTF transwomen… nor even between autoandrophilic vs. androphilic FtM transmen… 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 and social scientists 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 “Truscum” (androphilic FtM) for not accepting that they too are just as “trans”, even if they are in no sense gender atypical or 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 so special, she deserves it).

There is another name for this behavior, “TransTrender”, as in it is now “trendy” to be transgender.    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.

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 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 0.03% 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 all that gender dysphoric.  So who are they?  Well, given that 80 to 90% of MTF transsexuals are autogynephilic and that 4.6% of men in the general population are autogynephilic, while only 0.5% of women are autoandrophilic, we can surmise that the vast bulk of those who identify as “transgender” adults are autogynephilic males, otherwise gender typical heterosexual men who cross-dress in the privacy of their homes and perhaps occasionally have a “girls’ night out” with other cross-dressers.

We know that autogynephilic males are gender typical growing up.  They are also gynephilic.  These are, save for their secret cross-dressing and sexual fantasies of being or becoming female, typical, average, run of the mill straight men.  Thus, autogynephilic males who have not transitioned are not socially visible.  Further, we know that the median and average ages of transition for autogynephilic transsexuals (the moment that they become socially visible) is 35 and 40 respectively.  In fact, in the Nuttbrook study, which surveyed 571 transgender women, only one gynephilic (and presumably autogynephilic) individual had begun transition before age 20 and of those who had begun transition before age 20, only 7% said that they were bisexual (of which a number of them are likely to be autogynephilic, as we know from other studies).

Now, compare that to the number of early onset / androphilic transwomen who transition before age 20… that number is half.  HALF.  Further, we know from study after study that such transwomen are very notably gender atypical, as well as gender dysphoric.  THESE are the kids who will be the most socially visible as youth, NOT autogynephilic “transgender”.  On the FtM side, the Autoandrophilic population similarly transition later as adults, not teens.  It will be the rare, very rare (remember, only 0.03% of the total US population transition) exclusively gynephilic, gender dysphoric kids that will be socially visible as youth, not the TuCutes and the TransTrenders.  These are the kids who are socially and personally vulnerable as youth, not the vastly larger number of individuals who will identify as “transgender”.

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 ten times the number of adults who self-identify and three hundred times the number who actually transition.  That’s on the same order as are found to be gay or lesbian.  Are all of the LGB kids claiming to be “transgendered”???  Or is this representative of 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.

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.

Further Reading:

Essay on US Census Estimate of Post-Transition Population

Essay on the Ratio of Gynephilic vs. Androphilic MTF Transsexuals

Essay on the Nature of Autogynephilia

Reference:

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

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Silly Stereotypes

Posted in Editorial, Science Criticism by Kay Brown on November 6, 2016

phrenologyWhen I was being evaluated by the Stanford Gender Dysphoria Clinic, they had me answer a number of questionaires.  Of course, as a naive teenager, not yet having the background in science, especially in psychology, I took them thinking that they might help me get past these evaluations such that I would be OK’ed for SRS.  Only later did I learn that these were not diagnostic but research tools.  Later, I came to recognize them and studied them.  One of them was the Bem Sex Role Inventory.  Interestingly enough, I learned the most damning things about this instrument, not in my psych studies, which I did, but from my U.S. History, Women’s Emphasis Class in 1977.  In that class, I learned about gender stereotypes, their power to shape politics… and as any feminist knows, the personal is political.  Suddenly, for me, my personal experience taking the inventory become political.

Why am I writing about this now?  Because I still see this inventory being touted as though it had any kind of scientific validity as a window into intrisic gender meaning… that it shows any sort of truly sexually dimorphic differences in personality.  It does not.

Then what does it show?  Stereotypes.

The Bem Inventory was developed in 1974 by Sandra Bem, a feminist psychologist.  Bem did not intend it to be, and in fact later bemoaned that it had misused as, a gender identity tool.  It was a tool to explore how individuals hewed, or not, to societal gender stereotypes, period.

I recall, that as I learned about the inventory, how dismayed I was about its use… and how many of the stereotypes made no real sense.  Consider a couple of the terms that were supposed to be “feminine” and “masculine” qualities like “gullible” and “loyal”.  WTF!?!?

In 1974, these were qualities that were considered “feminine” and “masculine”… but not today.  This inventory only helps us understood sexist stereotypes of the mid’70s not who we are today… and certainly does NOT tell us if we are men, women, or transgendered.  It’s far past time to leave the Bem Inventory in the footnotes section of history books.

Further Reading:

“I Took the Bem Sex Role Inventory From 1974 and This Is What Happened”, by Lara Rutherford-Morrison

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Personality, My Dear…

Posted in Science Criticism by Kay Brown on October 6, 2016

phrenology…I Don’t Give a Damn!

or What is the Rate of Co-morbid Personality Disorders in Transsexuals?

I recently came upon a blog that made much of a single paper out of Iran which purported to show that about 80% of transsexuals had a serious personality disorder.  I was shocked at such a result and had to dig deeper.  Well… this paper seems to be an outlier and its use by this blogger (who fits the profile of an angry ex-wife of an autogynephilic transgender-woman turned transphobic crusader) is an example of cherry picking.  Another paper I found was only 24% of the transsexuals had “subthreshold” potential personality disorders compared to 17% of the controls.  (Note, “subthreshold” does NOT mean that they actually had the disorder.)  But why did this first paper get this outrageous percentage of actual disorders when other studies didn’t?

Because they did NOT diagnose anyone, period.  Instead Meybodi used the Millon Clinical Multiaxial Inventory II (MCMI- II), a self-scored inventory and assumed that if they got a high score on any particular scale that they must then have that clinical diagnoses.  This alone is a gross misuse of any instrument; a test score alone is NOT a diagnoses of a disorder.  From the paper, all we know is that their subjects scored higher than a non-reported cut-off, likely the one used by the publishers to indicate the “presence” of a trait.  The researchers fully admit that they did NOT actually interview and determine if the score had any bearing on actual dysfunction.  It is important to note that to have a diagnoses of a disorder, the personality trait must cause significant dysfunction to their lives.  This study failed to evaluate this dimension.  The most common of the purported personality disorders was Narcissistic Personality Disorder at nearly 60%, which given that this paper was from Iran, surprised me greatly.

As Lawrence has shown, the percentage of non-androphilic MTF transfolk is correlated with a given society’s Hofstede Individualism Index, which for Iran is 41, and thus we would expect a very low percentage.  And indeed, anecdotal reports regarding Iran’s MTF population agree.  But we know that from a number of studies and clinical surveys, that exclusively androphilic MTF transsexuals have a LOWER co-morbidity rate.   So what gives?

The answer seems to be that this study failed several basic tenets of science.  First, they failed to provide controls, which had they done so, might have flagged another issue with their methodology, namely that the MCMI-II was written and only validated in ENGLISH and is only valid for those who have at least a 5th Grade literacy level IN ENGLISH.  One assumes that the researchers simply translated the inventory items from English to Farsi and did not conduct a proper re-validation study given the very divergent cultural meanings potentially introduced by this translation?  If so, as Rogers points out, this is a gross abuse,

“Multiscale inventories can be translated into different languages with relatively little effort. The critical issue is that linguistic equivalence (i.e., similar sentences) cannot be equated to clinical equivalence (i.e., similar diagnostic relevance).  Clinical equivalence cannot be assumed, but must be objectively tested. Simple comparisons of vocabulary and syntax (e.g., from English to Spanish) are insufficient to establish clinical validity for translated versions.  An approach to translation validation in which a mere lack of significant group differences between two language or ethnic groups is assumed to mean the tests “work the same way” makes little sense. With depressed patients, for example, the clinician needs to know whether or not depressed persons of different cultures and languages have the appropriate elevations on multiscale inventories. Given our dearth of knowledge regarding translated versions and their cultural differences, psychiatrists and their consultants should be very cautious about using and interpreting translated tests.”

Even if the translation into Farsi was validated, there is the problem of interpretation; a high score on a given scale does NOT necessarily mean that one has a personality disorder.  In fact, emotionally healthy people often have high scores on scales that correlate to Narrissistic Personality Disorder as Stephen Strack explains in his book, Essentials of the Millon Inventories,

“Scale 5 has a research base that suggests that elevated scores indicate either a clinical personality disorder or a healthy adaptional personality style associated with with nonclinical people.  In factor analysis studies, Scale 5 loads positively on items dealing with extroverted traits and behaviors and negatively on items pertaining to maladjustment. … Elevations on Scale 5 are rare in psychiatric samples.  Many nonclinical populations attain elevated scores on Scale 5 including air force pilots in basic training. … Thus the clinical task is to determine whether clinically elevated scales represent a Narcissist Personality Disorder or a narcissistic personality style.  … versions of this scale have not correlated well with structured psychiatric interview schedules.”

Anyone who is familiar with either the literature on, or knows “early onset” / transkids in person knows that they can be quite extroverted, even flamboyantly so, without developing Narcissistic Personality Disorder.  Finally, a study that used structured interviews showed significantly lower co-morbid issues than those studies that used translated personality inventories, from the abstract of the Haraldsen paper,

“Transsexual patients scored significantly lower than Personality Disordered patients on the Global Symptom Index and all SCL-90 subscales. Although the transsexual group generally scored slightly higher than the healthy control group, all scores were within the normal range.  Transsexual patients selected for sex reassignment showed a relatively low level of self-rated psychopathology before and after treatment. This finding casts doubt on the view that transsexualism is a severe mental disorder.”

The conclusion here can only be that we must evaluate the literature on transsexuals and co-morbidity very carefully and critically, not accepting them at face value unless we can determine that they have been conducted with proper methodologies, including proper interview based psychiatric diagnoses, compared against valid controls from both clinically relevant disordered and healthy populations, and shown to be reproducible.  Anything else is just junk science.  {And cherry-picking the worst data you can find to defame transfolk is despicable.}

References:

Maybodi, et Al., “The Frequency of Personality Disorders in Patients with Gender Identity Disorder”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301205/

Bodlund, et Al., “Personality Traits and Disorders in Transsexual” (1993)
https://www.ncbi.nlm.nih.gov/pubmed/8296575

Rogers, R., “Forensic Use and Abuse of Psychological Tests: Multiscale Inventories”
http://www.reidpsychiatry.com/columns/15%20Rogers%2007-03%20pp316-320.pdf

Haraldsen, et. Al., “Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults”
https://www.ncbi.nlm.nih.gov/pubmed/11089727

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Dangerous Thoughts

Posted in Science Criticism by Kay Brown on August 15, 2016

critical-thinkingIt has long been noted by sexologists, and folk in the “kink” scene, that if one has one paraphilic sexual interest, the likelihood that individual will have other paraphilic interests is dramically increased.  Some of these paraphilic sexual interests tend to cluster.  It is these clusters that help sexologist delve into potential underlying common sexual functions that are distorted (hence the the common term “kink”).  One of these clusters is that of Voyeurism, Exhibitionism, Frotteurism, and Paraphilic Rape, that are grouped together as Courtship Disorders.  Another cluster is Autogynephilia & Autoandrophilia (most often found as “transvestic fetishism” = “erotic cross-dressing”),  Autopedophilia, and Apotemnophilia group together as Erotic Target Location Errors.  But there have also been many observations of of clustering of other paraphilias that don’t have obvious connections of an underlying common function (other than sexualility in general).

Given the current political climate and some rather pointed and ugly recriminations and insinuations regarding transgender people and the safety of women & children in sex segregated facilities, it behoves us to seek real data rather than polemical rhetoric.  In a very timely study involving nearly 6,000 subjects chosen because they are members of a twin birth, the incident rates and co-occurances of various paraphilic sexual interests was explored, including “transvestic fetishism” and “sexually coersive behavior”.

As has been known for decades, most people with an Erotic Target Location Error are male.  Males are about nine times more likely to have autogynephilia as females are to have autoandrophilia, with 4.6% of males aroused by cross-dressing and only 0.5% of females.  Please note, the number of females was not zero… only small.  Compare this number to the estimated 3% to 6% of females being exclusive gynephilic.  This ratio also fits the data we have on the relative numbers of gynephilic FTM transmen vs. androphilic/bisexual FTM transmen, adding statitical support to the hypothesis that androphilic/bisexual FTM transmen are autoandrophilic.

First, the good news for transfolk.  There was no independent correlation between transvestic fetishism (both autogynephilia and autoandrophilia) and sexually coersive behavior.  That is to say, that neither autogynephilia nor autoandrophilia alone has any effect on the likelihood, one way or the other, on whether an individual would be sexually coersive.

On the other hand… that’s not the whole story.  As I mentioned above, the likelihood that one will have a co-occuring paraphilic interest is increased with autogynephilia or autoandrophilia, as the data from this paper showed.  And with THAT OTHER paraphilic sexual interest, there WAS a correlation with an interest in sexual coersion.

But, before going deeper into the data, it is important to explain a bit about the study and what constituted interest in sexually coersive behavior in this study.  The question asked whether the thought of persuing a range of behaviors from deliberate deception (not simple dating exageration) to acheive sexual contact, forcing contact, taking advantage of an incapacitated individual, to forcable rape was sexually arousing.  The raw numbers in the population at large were to be honest, more than a little disturbing; They were in fact horrifying.  The number of men who had an interest (not neccessarily actualized / committed such an act) in being sexually coersive was 18.5%.  That’s nearly one in five men indicated that the idea of performing a sexually coersive act was sexually arousing.  The percentage of women who found the thought of performing (not being the victim of) such an act was significantly lower at 3.6%.

Again, while autogynephilia and autoandrophilia alone were not independently correlated with an interest in sexually coersive behavior, when controlling for other paraphilias, this only meant that they were no more likely to have an interest in such coersive acts as the general population.  That is to say, that 18.5% of autogynephilic males without a co-occuring paraphilia is interested in sexual coersive acts.

So the good news isn’t that autogynephilic only males are less likely than other males… only as interested as other males in sexually coersive acts.

The bad news is the fact that paraphilias cluster and that there is an increase in the likelihood of co-occuring paraphilias and that as shown in this paper, sexual interest is some paraphilic behaviors correlates with increased interest in sexually coersive behavior, which in turn would suggest that autogynephilia and autoandrophilic people in general would be more likely to be interested in such acts.  And, sadly for transfolk, this is the case.  The number of autogynephilic and autoandrophilic people (the study lumped male and female “transvestic fetishism” subjects, but given that males are nine time more likely than females to experience transvestic arousal, most of the subjects are male) that are sexually interested in sexually coersive behavior is a disturbingly high 28.3%.  That is to say, that one in four finds the thought of performing a sexually coersive act to be sexually arousing.  Remember, this does not indicate that transfolk are more likely to actually act on such desires, only that they find the thought of it arousing.

Paraphilic Interest          Males          Females           AGP/AAP
Transvestism                     4.6%             0.5%                  100%
Voyeurism                          18.2%             6.3%                 39.8%
Exhibitionism                   4.3%              0.6%                  12.4%
Sadism                                 2.7%             2.3%                   11.5%
Masochism                         4.9%             8.6%                  24.8%
Sexual Coersion               18.5%             3.6%                  28.3%  (AGP/AAP alone: 20%)

What is surprising in this data is that the % of autogynephiles/autoandrophiles that were also interested in voyeurism is so high.  I personally hadn’t seen this suggested in the literature.  We see lots of references to the high co-occurance of sexual masochism.  It may be because of the relative ratios; AGP folks are about twice as likely to be interested in voyeurism as men in general, while they are five times more likely to be interested in masochism as men in general.  Perhaps I shouldn’t be as surprised as I am considering the oft noted intense interest in pornography among AGP transgendered people?  Perhaps pornography could be considered a watered down version of voyeurism?

Going back to risks of paraphilic sexual interests causing actual sexually coersive acts, the authors estimated from this and other data that perhaps one in three sexual assaults may be averted if all paraphilic individuals were identified and provided treatment interventions aimed at keeping them from acting on their sexually coersive interests.  This would, conversely, suggest that two thirds of such assaults are mediated by other factors including Rape Culture in a misogynistic male privileging environment.

Further Reading:

Essay on Erotic Target Location Errors

Essay on Autogynephilia

Essay on Autoandrophilia in Androphilic/Bisexual Transmen

Reference:

Baur, E., et Al, “Paraphilic Sexual Interests & Sexually Coersive Behavior: A Population-Based Twin Study” Archives of Sexual Behavior:  DOI:10.1007/s10508-015-0674-2

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A Voice of Their Own

Posted in Science Criticism, Transsexual Field Studies by Kay Brown on July 9, 2016

Or, What Do Transkids Think About Puberty Suppression?

transkids

Transkids after transition

In the media and especially in social media, we see lots of discussion regarding what is the appropriate standard of care for transkids.  Many adults seem to be horrified by the idea that kids should be treated at all.  Of course, anyone that thinks about it clearly will see that without puberty suppression, one is already making a decision to treat them with hormones, the ones that the body starts to make at puberty.  Thus, the justification for puberty suppression, under the notion that delaying it isn’t really making a hard and fast decision.

But what of transkids themselves?  What do they think about it all?  How about asking them?  Well, a recent paper does just that, as the paper describes them,

“They were between 13 and 18 years of age, with an average age of 16 years and 11 months, and a median age of 17 years and 4 months. All adolescents, except for one, were treated with puberty suppression. The mean age at which the adolescents started treatment with puberty suppression was 15 years and 10 months. The adolescent who was not treated with puberty suppression immediately started treatment with cross-sex hormones because she was above the age of 18 when treatment was indicated, which is in line with the Dutch protocol. Five adolescents were trans girls (natal boys with a female gender identity) and eight were trans boys (natal girls with a male gender identity).”

Note that puberty suppression was their only option until age 18, a state of affairs that I have argued, and will continue to argue, it both unnecessary and cruel, but better than nothing.  This protocol privileges desisters and indeed all non-gender-dysphoric teens in that an active or implicit decision to deliberately use endogenous hormones to masculinize or feminize (as the case may be) their bodies is socially sanctioned, actively encouraged even, but an active decision on the part of gender dysphoric teens is considered suspect and their ability to make such a decision is deemed problematic.  {Can nobody else see the double-standard?  Why, if this is all about not trusting teens to make this decision, are ALL teens not put on puberty blockers until they are adults?}  All evidence points to the age of 14 being an appropriate age to end, not begin, puberty suppression, to be replaced with conventional Hormone Replacement Therapy.  But concerns about transphobic public resistance prevents this evidence based medicine approach.

{On a personal note, I first learned about HRT at age 15, but my pediatrician recommended my mother send me to psychotherapy to “cure” me instead. I began actively requesting feminizing HRT from the Stanford Gender Dysphoria Clinic at age 17 in 1974.  I was denied this.  I had to wait until I was legally of age and began HRT very soon after my 18th birthday in the summer of ’75.  In those days, puberty suppression was not available.  I deeply regret what that delay did to my singing voice.}

So what did these modern teens have to say?  Here’s a typical comment,

“I think it is hard to set an age requirement. On the one hand I think 12 years is a good age minimum, on the other hand I think that a transgender whose puberty started earlier should have the possibility to start treatment with puberty suppression before the age of 12.” (trans girl; age: 13)

You may wish to read the rest of what they had to say at the actual paper at the link below, as it is not behind a paywall, thankfully.

Further Reading:

Essay on evidence for best age to end puberty suppression based on age of desisting gender dysphoria

Essay by Alejandra Velasquez at the transkids.us website on treatment recommendations for MTF transkids. {Note:  Ms. Velasquez was ~20 when she wrote the essay in 2004}

Essay on Advice to Parents of Transkids

References:

Vrouenraets, L. et al. “Perceptions of Sex, Gender, and Puberty Suppression: A Qualitative Analysis of Transgender Youth”
Archives of Sexual Behavior (2016). doi:10.1007/s10508-016-0764-9

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Nature vs. Nurture

Posted in Science Criticism, Transsexual Theory by Kay Brown on May 22, 2016

critical-thinkingGiven the ongoing “culture war” regarding sexual orientation, wherein some elements of society wish to portray homosexuality as “sinful”, “mental illness”, or both it is no surprise that the question of etiology of homosexuality, and indeed of any sexual orientation, has become a political, as well as scientific question.  Into this fray has come some of the best and brightest of the sexologists who are exploring the science.  I know that some transsexuals and transgendered folk won’t like to read the name of the lead author, but in science, it is not important who says something, but what the evidence says.  The lead author is J. Michael Bailey.  Yes, that Prof. Bailey.

Bailey is joined by Lisa Diamond, Paul Vassey, Marc Breedlove, Eric Vilain, and Mark Epprecht in a masterful compliation and exposition on the current science of sexual orientation.  The paper also covers evidence concerning androphilic MTF transgender people and covers some remarkable conjectures regarding the role of culture, nurture if you will, regarding the difference between MTF transkids and conventional gay men.  Fortunately, the paper is NOT behind a paywall, so my reader may follow the link provided in the reference section to read it for oneself, which I highly recommend.

The paper lays out powerful evidence that shows that indeed “nature” has a very strong role to play in the development of sexual orientation.  But as the authors point out, this does NOT mean that morally or politically such evidence, or indeed proof, has any bearing on how society should treat non-heterosexual people,

Ongoing political controversies around the world exemplify a long-standing and widespread preoccupation with the acceptability of homosexuality. Nonheterosexual people have seen dramatic surges both in their rights and in positive public opinion in many Western countries. In contrast, in much of Africa, the Middle East, the Caribbean, Oceania, and parts of Asia, homosexual behavior remains illegal and severely punishable, with some countries retaining the death penalty for it. Political controversies about sexual orientation have often overlapped with scientific controversies. That is, participants on both sides of the sociopolitical debates have tended to believe that scientific findings—and scientific truths—about sexual orientation matter a great deal in making political decisions. The most contentious scientific issues have concerned the causes of sexual orientation—that is, why are some people heterosexual, others bisexual, and others homosexual? The actual relevance of these issues to social, political, and ethical decisions is often poorly justified, however.  … No causal theory of sexual orientation has yet gained widespread support. The most scientifically plausible causal hypotheses are difficult to test. However, there is considerably more evidence supporting nonsocial causes of sexual orientation than social causes. This evidence includes the cross-culturally robust finding that adult homosexuality is strongly related to childhood gender nonconformity; moderate genetic influences demonstrated in well-sampled twin studies; the cross-culturally robust fraternal-birth-order effect on male sexual orientation; and the finding that when infant boys are surgically and socially “changed” into girls, their eventual sexual orientation is unchanged (i.e., they remain sexually attracted to females). In contrast, evidence for the most commonly hypothesized social causes of homosexuality—sexual recruitment by homosexual adults, patterns of disordered parenting, or the influence of homosexual parents—is generally weak in magnitude and distorted by numerous confounding factors.

fafafine

Fa’afafine dancing

Setting aside the issues of policy and etiology, there are still some important issues regarding cultural factors influencing expression of androphilia in males because one of the models of why non-heterosexual orientations may persist is that of kin selection, in which the gender atypicality of androphilic males is evolutionarily selected for and maintained in the population because androphilic males help their near relatives raise their children, thereby increasing the chances of their own genes, shared with those close relatives, to perpetuate.  In this model, gender atypical androphilic males are in effect, an evolutionarily ‘fit’ alternative ‘morph’; far from being a “mistake of nature”, they are in a very real sense, a “third sex” involved in reproduction by proxy through childcare.

Consistent with the predictions of the Kin Selection Hypothesis (KSH), research conducted in Samoa on transgender androphilic males (fa’afafine) has repeatedly demonstrated that they show elevated avuncular (uncle-like) tendencies compared to Samoan women and gynephilic men. (This is measured via a 9-item scale measuring willingness to care for, and to give resources to, nieces and nephews. Furthermore, this finding does not appear to reflect a general tendency to help others, but a specific preference for kin. In contrast, research on cisgender androphilic males in Western populations and non-Western industrialized cultures has garnered virtually no support for the KSH. It is possible that elevated avuncularity is not expressed unless male androphilia takes on the transgender form. More research is needed to ascertain whether other populations of transgender male androphiles exhibit elevated kin-directed altruism or not.  …  Societies in which transgender male androphilia predominates exhibit a significantly greater presence of human ancestral sociocultural conditions compared to societies in which the cisgender form predominates. This suggests that the transgender form of male androphilia was likely the ancestral form. As such, transgender male androphilia likely represents the best model for testing evolutionary hypotheses, given that more derived forms of this trait may reflect recent cultural/historical influences that might obscure the outcome of evolutionary processes. Consequently, the most promising results from tests of both the KSH and SAGH are from studies of Samoan fa’afafine. The evidence would be much stronger if other populations of transgender androphilic males showed similar effects.

Let’s think about this a moment.  If the Western form, conventional gay men, don’t show an interest in their kin, is that because their homophobic siblings won’t let them, or because trying to be gender typical (straight acting) includes disavowing any interests in what would be considered womanly interest in young children?  I know its only anecdotal, but my reader may wish to check out my own history of a very strong interest in children.  Also note that my siblings have forbidden me from having anything to do with their children, due to extreme religious notions and transphobia.  (Note to researchers: Can we please use the more gender identity respectful term materteral if we are speaking of transgendered MTF folk here?)

Here is where things get really interesting.  The authors conjecture here that cultural factors influence the form that male androphilia takes depends upon the culture that androphilic males find themselves in,

Same-sex sexuality between adults typically takes one of two cross-culturally recurrent forms, which are related to gender-role enactment and gender identity. These two forms are cisgender and transgender male androphilia and female gynephilia.

Cisgender male androphiles and female gynephiles occupy the gender role typical of their sex and identify as “men” and “women,” respectively. This is the form of homosexuality that is nearly universal in the contemporary West. In contrast, transgender male androphiles and female gynephiles do not occupy the gender role typical of their sex. Not only do they behave in a highly gender-atypical manner, but they often identify, and are identified by others, as neither “men” nor “women,” but rather, as a member of some alternative gender category. Contemporary examples of transgender male androphiles include the kathoey of Thailand, the xanith of Oman, the muxes of Mexico, and the fa’afafine of Samoa. Some contemporary examples of transgender female gynephiles include the tombois of Sumatra and the mahu of Tahiti.

In some cultures, transgender male androphilia and female gynephilia are linked to particular institutionalized labor practices, which often involve specialized religious activities. This type of transgender male androphilia has been referred to as “profession defined”. For example, on the Indian subcontinent, transgender male androphiles known as hijra bestow blessings from Hindu gods and goddesses for luck and fertility at weddings and at the births of male babies. In Sulawesi, Indonesia, transgender androphilic males known as bissu are shamans who bless people for good health and successful journeys and who play important ritual roles in weddings. These institutionalized religious roles sometimes carry with them the expectation of asceticism, but often this ideal is not realized. In general, same-sex-attracted individuals self-select to fill these roles, probably because they are recognized as socially acceptable niches.

Third Gender

Young Hijra

Here I have to interject a note of caution, nay, derision.  There is a tendency for Western sociologists to romantasize the social status of transgender people.  For example, the hijra are NOT welcome guests at wedding and births.  They come uninvited.  I’ve had a number of occasions to speak at length, careful not to ‘out’ myself, with Hindu expat colleagues from India.  Universally, when speaking of hijra, the tone is one of revulsion and hatred.  The hijra are not revered co-religionists, but feared and dispised “vermin”.  The “blessings” being bestowed are the obverse of a coin, the reverse of which is the obviation of the threat that the children of the marriage or newborn will be “cursed”… the superstitious Hindus believe that the hijra have the power to curse the future childen of a bride or a newborn to become hijra, the lowest of the low, so they pay the unwelcome hijra “guests” money to ensure that they leave without cursing their children.  The hijra also beg on the streets, with the understood threat that if they are not given money, they will lift their skirts to the horror of the onlooking men, to show the scars of their very crude “castration” while being cursed.  From other lengthy conversations I’ve had with an Amercan transsexual who lived for a time among the hijra in India, I learned that many hijra suppliment their begging with prostitution.  Thus, the hijra have wrested for themselves a social position of begging and prostitution… a social position not too much different than poor street transkids in the Western nations.

But, to continue,

Cisgender male androphiles and female gynephiles behave in a relatively gender-typical manner when compared with their transgender counterparts. However, they are relatively gender-atypical when compared to gynephilic cisgender men and androphilic cisgender women. Thus, regardless of the form they take, male androphilia and female gynephilia are associated with gender-atypicality. However, the strength of this association varies with the manner in which same-sex sexuality is publicly expressed.

Both the cisgender and transgender forms of same-sex sexuality may occur within a given culture, but typically one or the other predominates. For example, the cisgender form tends to be much more common in many Western cultures. In contrast, the transgender form appears to be more common in many non-Western cultures. In places where the two forms coexist, their members often consider each other to be part of the same subculture. Margaret Mead observed a meeting in which an Omaha minquga (i.e., a transgender male androphile) and a Japanese homosexual man (i.e., a cisgender male androphile) who visited her field site in 1961 instantly recognized each other. Within an hour of the Japanese man’s arrival, the sole minquga in the tribe turned up and tried to make contact with him. Similarly, sociologist Fredrick Whitam noted that, in São Paulo, travesti (transgender male androphiles) are an especially conspicuous presence in gay clubs and are treated with a high degree of respect.

In contemporary Western cultures, cisgender male androphiles typically engage in sexual interactions with each other; the same is true of cisgender female gynephiles. That is, in the West, homosexual relationships are typically between two homosexual individuals. Such individuals comprise the Western gay and lesbian communities. This type of same-sex sexual relationship has been referred to as “egalitarian” and is characterized by partners who are not markedly different in age or gender-related characteristics. Within such relationships, partners tend not to adopt special social roles, and they treat each other as equals. In contrast, this pattern appears to be relatively uncommon in non-Western cultures and has emerged only recently in certain non-Western urban centers.

Although transgender male androphiles are same-sex attracted, they rarely, if ever, engage in sexual activity with each other; the same is true of transgender female gynephiles. Rather, these individuals engage in sexual activity with same-sex cisgender partners who self-identify, and are identified by others, as “men” or “women.” For example, in Samoa, very feminine natal males called fa’afafine (which means “in the manner of women”) have sex with masculine Samoan men. The fa’afafine would be aghast at the idea of having sex with one another.

Little research has focused on the cisgender sexual partners of same-sex-attracted transgender males and females. Blackwood noted that, in Sumatra, the cisgender female partners (femmes) of tombois “assert an uncomplicated attraction to men, [but] position themselves (if temporarily) under the label ‘lesbi’”—a derivative of “lesbian.” This suggests an episodic pattern of bisexual attraction on the part of femmes. In many cultures, same-sex sexual interactions between transgender and cisgender persons are not considered “homosexual” because they are understood to be hetero-gendered. In other words, if a cisgender androphilic male and a transgender androphilic male engage in sex, the former individual is often understood to be “the male partner” in the interaction, whereas the latter individual is often understood to be “the female partner.” Accordingly, the interaction is understood as male-female rather than male-male. The degree to which cisgender individuals who have sex with transgender persons of their same biological sex (i.e., men who have sex with female-appearing men and women who have sex with male-appearing women) are perceived as different from those whose sexual behavior is only with the other sex (i.e., conventional heterosexuals) remains an open question.

OK, there is one person who has conducted at least limited research on transgendered male androphiles and their non-trans male romantic partners, Dr. Richard Green.  As I explored in another essay, at least in the United States, they are conventionally heterosexual.  I can’t speak for the partners of fa’afafine in Samoa, but I got the impression from reading about them that they too find conventionally heterosexual partners.

For the sake of a thought experiment, let us conceed for the moment that the form that male androphilia takes depends on the culture that they find themselves.  (This will not be a popular notion among either Western Gay men nor autogynephiles who would otherwise wish to identify as androphilic transwomen.)  Let us further assume that the Kinship Selection Hypothesis is correct.  This would support not only the notion that androphilic males are a special morph, but that of neccessity, the transgender form is the evolutionarily selected form.  In which case, transkids are not “failed gay men”… but Western Gay Men are “failed transkids” !!!  This also reads upon efforts to “help” gender atypical children to be “more gender fluid”, less gender atypical, less.. well… less likely to be transgender, is in fact an attempt to fight an evolutionarilty selected and natural role, and as such is a “crime against nature”.

I would be tempted to close this with “just say’n”, but I’ve always found that expression to be irratating.

Further Reading:

Essay on the male romantic partners of transwomen

Essay on evidence that MTF transkids and gay men have the same etiology

References:

Bailey, et al., “Sexual Orientation, Controversy, and Science”, Psychological Science in the Public Interest, doi: 10.1177/1529100616637616

Vanderlaan, et al., “Elevated Kin-Directed Altruism Emerges in Childhood and Is Linked to Feminine Gender Expression in Samoan Fa’afafine: A Retrospective Study” Archives of Sexual Behavior
DOI: 10.1007/s10508-016-0884-2

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Ripe Cherries…

Posted in Brain Sex, Science Criticism by Kay Brown on January 16, 2016

phrenology… or How the Science of Changing Sex is Distorted by the Transsexual Community
Funny how I have been carefully writing about the science regarding transsexuality and transgender sexuality and trying to be very careful about NOT cherry picking or distorting the evidence by either misstating or omitting key points?  Well… now I seem to have competition at The TransScience Project.  Of course, it appears that they are cherry picking or leaving out key data points.  For instance, lets examine an essay written by Sarah Lewis on “The Brain And Gender Dysphoria”:

“The first study of its kind was conducted by Zhou et al (1995). The study found sex a-typical differences in the stria terminalis of the brain stem when studying transgender subjects. A follow up study by Kruijver et al (2000) confirmed the findings and provided greater insight. The central subdivision of the bed nucleus of the stria terminalis (BSTc) is sexually dimorphic. On average, the BSTc is twice as large in men as in women and contains twice the number of somatostatin neurons. These numbers do not appear to be influenced by sexual orientation or hormone replacement therapy – and both were controlled for by Zhou and Kruijver. A paper by Chung et al (2000) studied how the volume of the BSTc varied with age in both male and female subjects. They found that the dimorphism was only prevalent in adulthood. Suggesting that the differences found by Zhou and Kruijver are not a cause of gender dysphoria but rather a result.”

Ummm… “not a cause but rather a result.”  Yes… and not quite.  No, the BSTc was influenced by exogenous hormones as a result of treating gender dyshoria, not because of gender dysphoria.  Gotta hand it to her, Lewis did a great slight of hand trick there huh?  It almost sounded like the BSTc was related to gender dysphoria… but it’s not.  Ms. Lewis failed to explain that taking hormones causes changes in the brain toward the target sex.  Not quite saying a falsehood… just letting an unwary reader be mislead.  Which is what she continues to do in the paper:

“In Luders et al. (2009), 24 trans-women who hadn’t started hormone-replacement therapy were studied via MRI. While regional grey matter concentrations were more similar to men than women, there was a significantly larger volume of grey matter in the right Putamen compared to men. As with many earlier studies, they concluded that gender dysphoria is associated with a distinct cerebral pattern.  In contrast, Savic et al (2011) did not find any sex a-typical differences in the Putaman, or other investigated areas of the brain. They did however find differences between their trans-women group and both the male and female controls.”

She didn’t mention that this research, both studies, included only non-exclusively  androphilic (i.e. primarily gynephilic) transwomen.  In fact, throughout her essay, she fails to make this distinction, which allows data that supports Blanchard’s prediction that exclusively androphilic (transkid) MTF transwomen would show shifts toward a feminized brain, but the non-exclusively androphilic would not, though they would show non-sexually dimorphic differences from both men and women, to be falsely interpreted to suggest that evidence for brain feminization in MTF transkids to apply universally.  Actually, in this case the larger volume of grey matter in the right putamen was larger than men AND women, suggestive of a non-sexually-dimorphic brain marker for autogynephilic transwomen, exactly as predicted, as explained in my essay, “And the Beat Goes On”.

Had she compared the Savic (2011) paper to the Simon (2013) paper, especially if she had quoted Simon, she might have had a far different interpretation, as I did in my earlier essay, “Shades of Grey matter”

In that paper, Simon pointed out that their study used the same methods, but found quite different results, and noted that it was because of the issue of the two types of transwomen.  Looking at only androphilic MTF transwomen, they did find that they were similar to female controls and not to male controls.  But that would not have suited Lewis to have pointed that out.  In fact, Lewis failed to note that studies which did find sexually dimorphic shifts, were conducted on exclusively androphilic transwomen,

“Two studies by Rametti et al (2011) looked at white matter differences in both trans-men and trans-women.

In their study of trans-men they found that control males have significantly higher fractional anisotropy values (FA is a measure often used in diffusion imaging where it is thought to reflect fiber density, axonal diameter, and myelination in white matter) than control females “in the medial and posterior parts of the right superior longitudinal fasciculus (SLF), the forceps minor, and the corticospinal tract”.

Compared to control females in the study, trans-men “showed higher FA values in posterior part of the right SLF, the forceps minor and corticospinal tract. Compared to control males, trans-men showed only lower FA values in the corticospinal tract.”

The study concluded that there was evidence for an inherent difference in the brain structure of trans-men.

In their study of trans-women they found that trans-women “differed from both male and female controls bilaterally in the superior longitudinal fasciculus, the right anterior cingulum, the right forceps minor, and the right corticospinal tract.” The nature of these differences suggests that some fasciculi do not complete the masculinization process in trans-women during brain development.”

However, I did point out that this only applies to exclusively androphilic transkids in my essay, “Seeing the world in grey and white”.

Lewis is not a very critical reader of the scientific literature… especially if it suits her thesis.  In fact, she accepted at face value one paper, that purported to have shown that MTF transwomen (all non-androphilic, btw) responded to human male pheromones the same as control females.  (Which is strange, because if they did respond like straight women, why aren’t they attracted to men?)  Problem?  Ummmm… nothing…. except that there’s no such thing as human pheromones!!  I pointed that out in my essay, “False (Scent) Trail”.

And speaking (er… writing) of not being critical,

“Garcia-Falgueras and Swaab (2008) investigated the hypothalamic uncinate nucleus, which is composed of two subnuclei, namely interstitial nucleus of the anterior hypothalamus (INAH) 3 and 4. They showed for the first time that INAH3 volume and number of neurons of trans-women is similar to that of control females. The study also included analysis of a single trans-man who also had a INAH3 volume and number of neurons within the male control range.”

As I pointed out in my essay, “The Incredible Shrinking Brain”, this too was easily shown to be an effect of hormone therapy, just like Swaab’s earlier report about the BSTc, in fact, these were the same subjects who had been on HRT for years, sigh…  Had she read my essay, would Lewis have included my analysis?

She concludes with one paper which suggests a difference between control men and MTF transwomen with respect to the ability to mentally rotate images.  Looking at the subject’s ages, average 37, we can see that they are likely mostly non-androphilic.  This paper looks interesting, but is this really a sexually dimorphic difference?  Or a difference in IQ?  The transwomen were about IQ 107-109 and the control men, who performed better, were about IQ 123 (a significant difference at one standard deviation).  Me?  I’m going with IQ.

This isn’t the only example of cherry picking I’ve commented upon, as I wrote in an earlier essay, “Gender Allusions”.

So, we see that when looking at the scientific evidence and how it is presented, by and within, the transcommunity clearly wants to believe, and leave others with the impression, that it supports the notion that all transwomen have feminized brains and that there is only one kind of transwomen.  Sadly for them, neither is true.

Further Reading:

Essays on Brain Sex

Cherry Picking at Scientific American {Author uses only papers w/ exclusively androphilic subjects.}

 

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A Passing Moment…

Posted in Female-to-Male, Science Criticism, Transsexual Field Studies by Kay Brown on December 13, 2015

critical-thinking… Or, Who’s the Fairest of them All?

For years, clinicians, therapists, researchers, and transfolk alike have remarked that “younger transitioners”, transkids, “homosexual transsexuals”, “early onset” (whatever label or demarcator in fashion) MTF transsexuals simply ‘pass’ better than “older transitioners”, autogynephilic transsexuals, “late onset” MTF transsexuals.  For years, I wanted to conduct a study about this.  Well, now we have clinical data to test this observation.

In a study conducted in Europe, by our favorite Netherlands based researchers, they looked at both body image and clinician assessment of gender incongruent physicality.  That is to say, how well or poorly they pass.  The same single clinician rated them all, so while a different clinician may give folks a different absolute score, the relative scores for all subjects is likely to be very accurate.

In deference to the currently debated question and researching the potential validity of which signifier is the accurate basis for a taxonomic typology of transsexuality, the data was presented for both sexual orientation and age of onset.

MtF                                                                 FtM
Androphilic      Non-androphilic           Gynephilic Non-gynephilic
Early onset 88 (70%) 102 (43%)                   193 (88%)   37 (69%)
Late onset  38 (30%)   139 (57%)                   26 (12%)     17 (31%)

The Dutch have long contended that age of onset was the salient signifier, while those in North America contend that it is sexual orientation, specifically “homosexual” vs. “non-homosexual”, which readers of my blog, and those familiar with the literature, know gives a strong signal / correlation with autogynephilia in MTF transsexuals.

In the graphs below, a higher score means more gender incongruent appearance (i.e. ‘readable’), while a lower score means more gender congruent (i.e. ‘passable’).

passingtransNow, looking at our earlier observation, do exclusively “homosexual” transsexuals pass better than “non-homosexual”?  For transwomen, the answer is a resounding “YES!”, with a large effect size (d=0.7).  Putting this into everday language, this is to say that the most passible of the non-androphilic transwomen are just barely comparable to the average androphilic transwoman.  Or another way of putting it, nearly half the androphilic transwoman pass better than nearly all non-androphilic.  Or yet another way of putting is that the least passible androphilic is the same as the average non-androphilic transwoman.

However, keep in mind that we know that many “late transitioners” misreport their sexual orientation because of Social Desirability Bias and Autogynephilic Pseudo-Androphilia.  From several studies we know that perhaps 38% report that their sexual orientation ‘changed’ from exclusively gynephilic to androphilic or bisexual. and that estimates of misreported sexual orientation means that from 20-40% of the self-reported androphilic group is in fact, non-androphilic, which would tend to pull the data toward the non-androphilic value.  Even with that possibility, the data still shows that androphilic MTF transwomen pass far better than non-androphilic.  The data also shows a greater range, standard deviation, which we would expect if 20-40% of the self-reported androphilic were in fact a mixture of the two populations.

Joy_Candice

Dr. Joy Shaffer and Kay Brown at ages 27 & 26.  Joy is non-androphilic, transitioned at age 21/22. Kay is androphilic, transitioned at age 17/18.

So what of our question about early vs. late onset?  Here again, early onset passes better.  But look closely at the data, 46% of the early onset group are androphilic.  If we hypothesize that the salient signifier is sexual orientation and NOT age of onset, then we would expect that the relative score for early onset would be intermediate between androphilic and both non-androphilic and late-onset (which is predominately non-androphilic at 79%).  And that indeed is what we see.  Further, one would predict that since late onset is predominately non-androphilic, that they would have the same level of passability… and indeed that is what we see again.  The data clearly supports the position that sexual orientation and NOT age of onset is the salient signifier, given the stronger signal.  That is to say, variation in the data is explained completely by sexual orientation and that the variation of passability with respect to age of onset is from the correlation between sexual orientation and age of onset.

It is clear that there is a mild correlation with sexual orientation and age of onset, with androphilic MTF transsexual more likely to report early onset (70% vs. 43%).  However, given clinical experiences with each, the meaning of age of onset is quite likely different.  If 43% of non-androphilic transwomen really did have an early onset… why do they all wait so long to socially transition?  The modal age is about 35 years and the average is about 40 years old compared to the 20 years old for androphilic.  I contend that retrospective age of onset is time shifted to an earlier age due to Social Desirability Bias AND to having a different internal meaning to the question.  For transkids (androphilic transwomen), the age of onset is demarcated by extreme somatic and social dysphoria, while for non-androphilic the demarcator is retrospectively found by their strong but vacillating autogynephilic desire for somatic transformation, but with little as yet stable social or somatic dysphoria.  As per Doctor and Prince, it takes considerable time for true gender dysphoria and cross gender identity to develop in non-androphiles / autogynephiles.

We are still left with an open question.  Why do androphilic transwomen pass so much better than non-androphilic?  Three possible hypotheses exist, 1) Having a truly earlier age of onset and social transition age, they experience less masculinization from endogenous androgens. 2) Self selection for passibility as they are motivated to fit into society better, being both physically and behaviorally extremely gender atypical (and not autogynephilically motivated). 3) Actually being, as a group, intrinsically more physically gender atypical.  (That is to say, that the etiological cause for their behavioral gender atypicality causes physical atypicality as well.)

Its also quite possible that any or all of these may be operating.  In fact, I strongly believe that all three are, in fact, operating.  MTF transkids do transition and obtain HRT at an earlier age.  They (we) do care and want to pass to better our lives.  And, from research into gender atypical children, it has been noted that gender atypical and dysphoric male children are considered more attractive than their gender typical male peers.  This ‘attractiveness’ is caused by hypomasculinity (masculine faces aren’t “pretty”).

Looking at the data for FtM transmen, there seems to be a small signal.  I would really like to see a study with more subjects, as this didn’t seem to be as statistically significant as we would like.  Even if real, the effect size is small.  However, we do have collaborating data from earlier studies that show that FtM transkids are judged to be more physically masculine than non-trans-girls.

Further Reading:

Differences between androphilic vs. non-androphilic transwomen, passing, and transition decision making.

References:

Tim C. van de Grift, Peggy T. Cohen-Kettenis, Thomas D. Steensma, Griet De Cuypere, Hertha Richter-Appelt, Ira R. H. Haraldsen, Rieky E. G. Dikmans, Susanne C. Cerwenka, , Baudewijntje P. C. Kreukels, “Body Satisfaction and Physical Appearance in Gender Dysphoria” Archives of Sexual Behavior
DOI: 10.1007/s10508-015-0614-1

Zucker KJ\, Wild J, Bradley SJ, Lowry CB., “Physical attractiveness of boys with gender identity disorder.” Archives of Sexual Behavior. 1993 Feb;22(1):23-36.
http://link.springer.com/article/10.1007/BF01552910

Stephanie A. Mcdermid, Kenneth J. Zucker, Susan J. Bradley, Dianne M. Maing, “Effects of Physical Appearance on Masculine Trait Ratings of Boys and Girls with Gender Identity Disorder” Archives of Sexual Behavior
http://link.springer.com/article/10.1023/A%3A1018650401386

Sari R. Fridell, Kenneth J. Zucker, Susan J. Bradley, Dianne M. Maing, “Physical attractiveness of girls with gender identity disorder” Archives of Sexual Behavior
http://link.springer.com/article/10.1007/BF02437905

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Audio Sex Perception

Posted in Science Criticism by Kay Brown on August 29, 2015

critical-thinkingI don’t suppose it would surprise anyone that straight men and women respond differently to men’s and women’s voices.  In fact, I think we would be surprised if we didn’t.  After all, straight men are attracted to women and their voices, and straight women are attracted to men and men’s voices.  But that’s only the obvious part.  They also tend to be different in their ability to perceive them, with both sexes responding stronger and faster to opposite sex voices.  They also differ in the amount of cognitive resources used in the task, the amount of effort applied.  Women use fewer resources than men… they are just better at it.

Now, before one says… OH, a sexually dimorphic difference in the brain!  Whoa!  Hold on!  That may not be true at all.  Other research into perception of other signals, ohh… such as emotional expressions have also shown sexually dimorphic difference in ability.  But in that case, we also know that wealth and power differences also show up.  Rich and/or powerful people are significantly and robustly less able to read emotions on other’s faces than poor and/or less socially privileged people.  Further, practice at reading people’s emotional expressions significantly improves this skill.  So, is that a built in, sexually dimorphic brain difference between men and women?  Or does is simply reflect that women, as a class, have less wealth, power, and privilege than men?  I’m betting on the latter.

And so it is with the amount of effort it takes to “read” one’s sex by listening to their voice.  Is this built in?  Or is it that women NEED to read voices better, just as they NEED to read faces better?  I’m betting on the latter.

Now we come to transwomen (MTF transsexuals).  In a study conducted in Germany, transsexuals seemed to be unique in some ways, like men in some, and like women in others.  One thing that they did find is that during fMRI scanning of the brains of transwomen, they showed that they were using very little effort to determine which sex a given speaker was, similar to women.  Interestingly, they analyzed both androphilic and gynephilic transwomen together and separately, though didn’t report them separately, instead they focused on testing pre-HRT and current HRT.  They found little difference between the two populations, androphilic vs. gynephilic and pre-HRT and HRT.  I’m not surprised by this.  In fact, it supports my hypothesis that this is NOT an innate sexually dimorphic trait, nor mediated by hormones, but the result of the social differences in privilege and experience / learning.  The two MTF populations have the same basic experiences regarding their own vocal history and needs, as the authors put it,

“Since we found no differences in accuracy between women and MtFs, decreased activation in MtFs might suggest that they need less effort to achieve levels of performance similar to women. This might be due to the fact that MtFs are more attuned to issues related to voice gender perception in everyday life.  … In line with the behavioral results, MtFs showed differences (compared to men and women) in neuronal response patterns with respect to male vs. female voices. Presumably, a different strategy is used in MtFs’ voice gender identification due to early processing differences. They also might more intensively examine their own and aspired vocal characteristics during gender alignment, resulting in a certain expertise. In this sense, attentional differences due to automatized processing could lead to less brain activation in MtFs.”

Reference:

Junger, J., Habel, U., Bröhr, S., Neulen, J., Neuschaefer-Rube, C., Birkholz, P., … Pauly, K. (2014). More than Just Two Sexes: The Neural Correlates of Voice Gender Perception in Gender Dysphoria.(11), e111672. doi:10.1371/journal.pone.0111672

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Gender Allusions

Posted in Brain Sex, Science Criticism by Kay Brown on February 24, 2015

critical-thinkingIs “Gender Identity” biological?  For most people, the answer is intuitively obvious, “duh!”.  Of course, for these people, they usually also insist that the markers for such identity is some privileged and testable characteristic, like genitalia, which is easy to observe, or karyotype (sex chromosome configuration) which requires a microscope.  But for people with Disorders of Sexual Development (DSD), these markers may not be all that clear.  Further, what are we to make of the gender identities of transsexual and transgendered people, people whose experienced / stated gender identity is at odds with all currently known sex markers?  IS there a biological etiology?  And is that etiology the same as that that gives rise to the gender identity of non-trans people? A recent review article attempts to answer these very questions.  Sadly, I believe that it falls far short of a conclusive answer.  In fact, as I will show, it invokes conclusions from several papers as evidence that are quite questionable.  Further, the authors failed to note the very probable multiple etiologies for Gender Dysphoria and their associated gender identity resolutions suggested by the Freund/Blanchard two type taxonomy of MTF transsexuality. First, they reviewed evidence for a biological basis for the phenomenological existence of “gender identity” in non-transfolk which comes from those with certain DSDs,

A seminal study by Meyer-Bahlburg et al involving outcomes of XY individuals raised as females due to severe non-hormonal, anatomic abnormalities of sex development has provided the most convincing evidence that gender identity is fixed. These congenital abnormalities include penile agenesis, cloacal exstrophy, and penile ablation. For many years, female gender assignment along with surgical feminization was the dominant approach for these patients. In this study, it was observed that 78% of all female-assigned 46 XY patients were living as females. While the majority of these patients did not initiate a gender change to male, none of the 15 male raised 46 XY patients initiated a gender change to female. Thus, risk of questioning gender identity was higher in those patients raised as females than in those raised as males among 46 XY subjects with one of these conditions. A study by the same group that examined the degree of satisfaction with surgical intervention reported by patients with 46 XY genotype also found that those subjects raised as boys were considerably more comfortable with their gender identity. – Another seminal study relevant to this topic was by Reiner and Gearhart in their review of 16 XY genotype subjects with cloacal exstrophy who underwent female gender reassignment surgery. Out of the 14 individuals raised as girls, 4 announced they were male and 4 later chose to live as boys when they became aware of their genotype. The 2 individuals who were raised as males identified as males throughout life. The sexual behavior and attitudes of all 16 subjects ultimately reflected strong masculine characteristics regardless of gender assignment. Thus, children who were born genetically and hormonally male identified as males despite being raised as females and undergoing feminizing genitoplasty at birth. Although cohort size in these studies is small, these data provide the strongest evidence for biological underpinnings of gender identity.  …  In a study of affected subjects, gender role changes were reported in 56-63% of cases with 5 alpha-reductase-2 and 39-64% of cases with 17-beta-hydroxy-steroid dehydrogenase-3 who were raised as girls (6). These data support the concept that gender identity might be attributed to hormone milieu during intrauterine development on some occasions.

These studies are indeed very strong evidence.  Looking at the data, we see that of those raised as girls, 22% of of these subjects in the first study and 57% in the second study, while in the third study, those with hormonal abnormalities, 56-63%, chose to socially transition from female-to-male.  Compare that to the very, very small number of 46XX individuals in the general population who experience severe gender dysphoria and choose to transition.  As an aside, the fact that not all chose to transition should not be taken as proof that gender identity is all that malleable, but should probably be taken as a demonstration that social transition has very high social costs and is not undertaken lightly. Strangely, this paper did not explicitly mention that the majority of these individuals, whether they experienced gender dysphoria or not, were exclusively gynephilic, but they did allude to it.  Also puzzling was their failure to include the converse situation of individuals with 46XY and complete androgen insensitivity syndrome (CAIS), all raised as female, who are extremely unlikely to experience gender dysphoria or sex reassignment, and are universally exclusively androphilic.  Or the even more interesting case of 46XX progestin influenced females raised as male, 50% of whom transitioned from male to female and all are exclusively androphilic.

Thus, they failed to explicitly show the very high correlation of brain sex with gender identity, gendered behavior, and sexual orientation. Having shown that there is indeed very strong evidence that “gender identity might be attributed to hormone milieu during intrauterine development on some occasions”, which supports the notion that gender identity has a basis in biology (as opposed to being purely a social construct overlain on observable sex differences), it is tempting to say that transsexuality, all transsexuality and transgender identity, is also the result of mismatched hormonal milieu.  In fact, many transsexuals hold to just such a position.

But they would be dead wrong.

The logical leap that all transsexuals have such an etiology is not supported by the above evidence.  In fact, given the very probable differing etiologies for Gender Dysphoria and their associated gender identity resolutions suggested by the Freund/Blanchard two type taxonomy of MTF transsexuality, at least one of these types must NOT have been caused by such.  Blanchard went on to predict that this would be born out by studies of the sexually dimorphic structures in the brain, predicting that the exclusively androphilic MTF transsexual would show shifts toward the female morphology, while the other type would not. It is here that this recent paper has its biggest failings, in that not only did they not discuss this issue, but included very problematic studies by Swaab that purported to have shown female like shifts in non-exclusively androphilic transwomen.  These papers did show the shifts in the BSTc and INAH3, but incorrectly concluded that they had existed prior to exogenous HRT and incorrectly concluded that these features in the brain were organization effects of endogenous hormones in utero, when the data clearly demonstrated the opposite, that these shifts were purely activational effects from exogenous estrogenic and anti-androgenic HRT.  To be fair, they did mention that the BSTc was potentially questionable, but completely failed with regards to the INAH3, which demonstrably is not evidence for a biological basis of gender identity.

In reviewing the recent grey and white matter studies, they failed to note that it fits and supports Blanchard’s prediction, which had they done so, would have strengthened their argument for a biological basis for a conventional gender identity in exclusively androphilic MTF transsexuals.  That is to say, that they experience the same feminine “gender identity” as females because their brains are female like.  Conversely, they would also have evidence for a biological underpinning to autogynephiles sexuality, a non-sexually-dimporphic one, which lead to an epiphenomically generated “female gender identity” later in adulthood.  (See my essay on the different origins of cross-gender identity in transsexuals.)

The authors reviewed the literature on possible genetic factors that could lead to transsexuality, noting that they were inconclusive. Totally absent in this paper was any mention of the papers that document the fraternal birth order effect found in exclusively androphilic MTF transsexuals. All in all, I was disappointed in this paper.

I found it shallow, lacking in both depth and breadth, and literally out of step with much of the literature on the cutting edge of the science.

(Addendum 7/7/2015:  I got suspicious of this paper as it reads like a cherry-picked list of papers that support the brain sex hypothesis for all transsexuals, including “late onset” transwomen, so I checked into the background of the authors.  Sure enough, one of the authors is transgendered.  While that alone is NOT damning (after all, so am I), it does explain why this paper only referenced the studies it did, and did not include those studies that when considered as a whole, would show that while one subset of the larger transsexual population could possibly be explained by the brain sex hypothesis, most transwomen could not.  This paper then can and should be considered part of the ongoing effort by some in the transgender community to deny the evidence of the two type taxonomy.)

Reference:

Aruna Saraswat, MD, Jamie D. Weinand, BA, BS; Joshua D. Safer, MD, “Evidence Supporting the Biological Basis of Gender Identity” (2015) DOI:10.4158/EP14351.RA

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