On the Science of Changing Sex

It was the best of times…

Posted in Transsexual Field Studies by Kay Brown on June 21, 2017

Kay Brown 2010…It was the worst of times   Or, That ’70s Show

In the May 1974 issue of the Western Journal of Medicine, two back to back articles appeared, one from a number of doctors reporting on a grand rounds at UCSD hospital that included Robert J. Stoller and one from Norman M. Fisk.  Reading them both now is not only a window on the past, but explains where we are now and how we got here.

I can’t write about this period without flashing back on my own life and what was happening at the time.  In May of ’74, I was just about to turn 17, finishing my Junior year in high school.  My favorite class was “Individual Voice”, solo singing but I was also really enjoying one other class, “Cosmology; Stellar and Galactic Evolution” I was taking at a local college, taught by a NASA astronomer.  I got an “A” in the class, of course.  I was also summer job hunting and landed my dream job as a nanny taking care of two boys for a local family for $50 a week (~$250 in today’s money).  I was also desperately searching at the library for any and all information I could find on transsexuality and how I could get HRT and SRS.  That search led me to the Stanford Gender Dysphoria Clinic and Dr. Fisk.

In early ’75, after much drama with my parents, who were separated and soon to be divorced, I finally convinced them to let me go to the clinic (but failed to mention that they performed SRS, etc.), which meant first being evaluated by Dr. Fisk.  During the first interview, I got the very distinct impression that he didn’t believe a word I said, though it was all the absolute truth.  From his article, we can see why,

“The concept of gender dysphoria syndrome grew out of clinical necessity very much in an organic, naturalistic fashion.  This occurred because virtually all patients who initially presented for screening provided us with a totally pat psychobiography which seemed almost to be well rehearsed or prepared, particularly in the salients pertaining to differential diagnoses. It would be accurate to say that of the initial 30 to 40 non-psychotic patients screened, all presented as virtual textbook cases of classical transsexualism.  Remembering the old medical saw that “the last time one sees a textbook case is when one closes the textbook,” it was apparent that this group of patients were so intent upon obtaining sex conversion operations that they had availed themselves of the germane literature and had successfully prepared themselves to pass initial screening.  In some instances they had rehearsed friends, spouses and family members in a similar fashion.”

During a later interview, in the company of my mother, who with obvious disapprobation and the mistaken notion that the clinic was to “cure” me, answered his questions about my early childhood saying,

“He was very different than his brothers.  All of their friends were boys, his were all girls. … He was very prissy.  I could dress him in clean clothes on Monday and they would still be clean on Friday. … I’ve known he wanted to live as a girl for years.  I just felt that was wrong.”

In the next interview, in company with my father, who tried to argue with him about what should be done about me after learning that I had been diagnosed as transsexual, Dr. Fisk replied,

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

That made Dr. Fisk my hero for life!  And he should be a hero to every transsexual who has come after, since it is Dr. Fisk who changed the way transgender people are treated that continues today,

Within the first two to three years of our investigation, it became apparent that when non-fabricated or, more precisely, honest and candid psychobiographies were obtained from our patient population, there was indeed a great deal of diversity and deviance from what had been defined as the symptoms of “classical transsexualism.”  Moreover, the overtly present common denominator was the high level of dysphoria concerning the individual’s gender of assignment or rearing  … employing the diagnostic term gender dysphoria syndrome, our indications for surgical sex conversion therapy have been broadened. Patients now clearly understand that had they been interviewed five or ten or twenty years ago, they would have been diagnosed as not being classical transsexuals. These patients are informed that a diagnosis of transsexualism is not in our view the only valid criterion for deciding who receives surgical sex conversion. Moreover, we practice the rather pragmatic dictum that nothing succeeds quite like success and therefore our criteria for surgical sex reassignment or conversion are more phenomenologically oriented. … Obviously, by liberalizing the indications for sex conversion through conceptualizing patients as having gender dysphoria, we also are committed to provide a program for patients encompassing many factors related to a total overall rehabilitative experience. These include vocational counseling and guidance, psychological and psychiatric supportive therapy, grooming clinics where role-appropriate behaviors are taught, explained and practiced, legal assistance, and, probably of most benefit, an opportunity is afforded to meet and interact with other patients who have successfully negotiated gender reorientation or who are in various phases of reorientation. This program employs some former patients as counselors to persons with gender disorders.

But that’s not to say that my experiences with the clinic were all good.  In fact, personal repercussions of some of what Fisk describes in glowing self-congratulatory fashion were severe.  I’m not alone in experiencing these issues.  While Fisk’s liberalization had eliminated the absolute need for a differential diagnoses for purposes of determining who was to receive services, it has led to a false belief within the trans* communities that there are no differences on the one hand and to the harmful homogenization of treatment protocols on the other.  It is important to note that the Stanford clinic did know that there were in fact two types and organized their services around helping those most in need of “gender reorientation”.

Having seen the best of times… we now turn to the worst of times.

During psychiatric grand rounds at a UCSD hospital, a 20 year old androphilic transwoman is paraded in front of a large group.  The author of the article describing the event uses masculine pronouns to introduce her to his readers and give a bit of her history, then switches to feminine pronouns.  Here’s an excerpt,

“She was told that this interview would be part of a training session on transsexualism so that people in the Department of Psychiatry could learn more about it. She was also told that this session will have no bearing on her treatment, continuing evaluation, or the decision regarding her operation. She understands that coming here is entirely voluntary.  (The patient, whom we shall call Gloria, was escorted into the room. She wore women’s clothing, was heavily made up, and quite attractive.  She was introduced to Dr. Parzen, who interviewed her before a group of approximately 100 staff members and residents. The following are selected excerpts from that interview.)”

Does anyone today believe that “Gloria” didn’t fully understand that her voluntary cooperation was actually mandatory if she was to successfully navigate this clinic’s hoops?  Certainly she did given the times, as Dr. Parzen says,

“These patients become good actors and tend to be paranoid toward anyone who might push them to betray themselves in a way that might jeopardize their surgical treatment.  Gloria had already established a personal relationship with Dr. Millman, and his feelings about her will ultimately determine what will happen to her.”

The doctors had ultimate power of granting or denying services and transfolk knew it!  What’s interesting is that the doctors knew that the they knew it, but saw nothing wrong with this imbalance of power save for complaining about what transsexuals do in the face of such asymmetric power,

Certainly she is quite protective about herself at this point. She is awfully close to getting what she wants, and she isn’t going to tell me anything that might interfere with that. She does not know my orientation, and she isn’t crazy, and therefore isn’t going to present material that might be interpreted wrongly from her point of view.  Transsexual patients classically tend to be very manipulative and very secretive. They tell you what they want you to know, and they have learned through much experience to read and to manipulate medical staff.

I could go on with the odd ideation that these physicians have that relied on classical Freudian psychoanalysis, not to mention the incredibly disrespectful things these doctors said about “Gloria” and transgender people in general, but I don’t need to as the articles have been scanned and available for all to read.

Further Reading:

Essay on differential diagnoses and transsexual taxonomy use in the 1970s.


Fisk, N., “Editorial: Gender dysphoria syndrome–the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen.” (1974) Western Journal of Medicine

Judd, et al., “Male Transsexualism”, (1974) Western Journal of Medicine

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Coming of (r)age in Samoa…

Posted in Science Criticism, Transsexual Field Studies, Transsexual Theory by Kay Brown on June 20, 2017

critical-thinkingOr, The Fa’afafine in Context

It seems to me that research focused on the fa’afafine of Samoa has become all the rage of late, at least for those interested in feminine androphilic males / “homosexual MTF transgender” folk.  The interest has at its heart, the hope that it represents a culture that is closer to what we might have had before large-scale civilizations began, one closer to what humans may have evolved within.

First, Samoan culture is very collectivist.  Although we don’t have a formal Hofstede Individualism Index value for Samoa, most commentators I can find all agree that it would be very low, perhaps lower than just about any other on the planet.  They do everything in groups, traditionally even living together under one roof without walls.  Family and extended family are everything.  Thus, if we were to predict the ratio of androphilic vs. non-androphilic transwomen based upon the relationship between the Hofstede Individualism Index and the percentage of non-androphilic transwomen found by Lawrence, we would expect almost no non-androphilic transwomen.  And indeed, one never sees them mentioned in connection with Samoa.

In Samoa, there is almost no stigma attached to being a feminine male.  Feminine male children are not bullied.  Fa’afafine adults are not discriminated against in employment.  There is little to no stigma attached to masculine men finding Fa’afafine sexually attractive.  This is not to say that there isn’t any problems for them.  Christian missionaries and Western colonization has brought homophobic laws and attitudes.  But because there is little to no stigma attached, androphilic males are free to express as much or as little femininity as they find in themselves with little incentive to attempt to suppress it as occurs in many other cultures.

However, before anyone lauds the Samoan culture as being the transgender (or gay) paradise, consider one other factoid.  I can’t find any reference to any fa’afafine who is in a long-term relationship with a lover.  I’ve never seen any reference to their families celebrating a marriage to a man.  The fa’afafine may be called “in the manner of a woman” (as the term loosely translates), but they aren’t given that social status.  They are granted a status as what many anthropologists would call a “third gender”.  But that gender is not seen as equal to women in status and marital desirability.

fafafineFa’afafine are universally androphilic and have sex with masculine men.  They don’t have sex with each other because they are attracted to masculinity which is not especially abundant in fa’afafine.  But those episodes with masculine men are typically “one night stands”.  I can’t believe that they wouldn’t choose to have long-term romance in a committed relationship.  Although not well publicized, and not nearly as common as we might like, such long term relationships do exist between masculine men and androphilic transwomen in Western cultures.  So I must conclude that it is the Samoan culture that in effect prohibits or discourages such relationships.  I would like to be proven wrong on this… I really would.

An educated reader will perhaps recognize my quip of a title from Margaret Mead’s 1928 book.  They may also know of how she was attacked by Derek Freeman.  Maybe I’m just biased by my friendship with Alice Dreger, since I don’t believe a word Freeman says… but the episode does offer a cautionary tale regarding the potential changes that Christian missionaries have already brought to Samoa.  I’ll leave it at that, since those who are better acquainted with the controversy will know what I mean.

One of the interesting aspects of androphilia in males is the question of evolution, to wit, if genetics play a role, and there is strong evidence it does, than why hasn’t it been selected out of the human population?  How can a trait that confers a significant reproductive disadvantage be maintained in the gene pool, should that allele(s) be under very high anti-selection pressure?  One hypothesis is the “Kin Selection” effect in which androphilic males are indirectly “fit”, reproductively successful, because they increase the resources available for their near relatives.  Paul Vasey has been testing this idea in both Western gay men and fa’afafine.  Interestingly, it doesn’t appear to be true among Western gay men, but does appear to be true among fa’afafine who exhibit strong materterally supportive behaviors toward the children of their siblings.  The speculation is that something about the suppression, the crushing, of the natural femininity of androphilic males in Western nations also suppresses this materteral behavior.  I would suggest that we also look at Western androphilic transwomen, being careful to sort by the quality of familial relationships.

Since the culture is presupposed to be closer to that of our pre-civilization ancestors, the question of who the fa’afafine are sexually attracting may offer other insights into the early evolutionary selection pressures on masculine men, specifically the notion of competition for mating opportunities between women and feminine androphilic males.  Lanna Petterson explored this in a study published as her thesis (also published in journals) in which she presented images of faces, men, women, and very plain emojis on a computer screen, asking her subjects to evaluate and report how sexually attractive they found them.  The images were limited only to the faces.  They were composites that had been digitally modified to enhance their sexual dimorphism.  (Frankly, of the two images she included in the appendix of her thesis, I personally found them disturbing, seeming to be slipping over a cliff into the uncanny valley below.  I can’t but help thinking that the results may have been influenced in part by this.)  Unknown to her subjects, the response time latency was also recorded by the computer.  Earlier studies have shown that people tend to linger over images that they find erotically rewarding.  From this data, she comes to the conclusion that the men who are having sex with fa’afafine are “bisexual”.

Sigh… Looking at the data, as well as what we know from other studies of men who seek out transwomen (chasers), I have to seriously question this conclusion.  First, very much like what androphilic transwomen experience in the West, 65% of the men had never had a sexual encounter with a man and 75% had not within the past year.  As Dr. Richard Green wrote about the men who dated Western androphilic transwomen,

“The men who fall in love with and perhaps marry women who are themselves former males, by and large, have known their partners only as women.  Their prior sexual experiences have been only with females.  They consider themselves heterosexual and their relationships heterosexual.  To varying degrees they are consciously and unconsciously aware of the biologic status of their partners, but it would be simplistic and would furthermore blur generally accepted definitions to call these men homosexual.  Rather they are men who respond to the considerable femininity of male-to-female transsexuals, ignoring the dissonant cues of masculinity.”

For many of the masculine Samoan men in Petterson’s study, I believe would fit this description as well.  Another portion of the men I believe would likely fall into the category of gynandromorphophilic (GAMP).  From a wonderful study by Hsu, we know that such men tend to be autogynephilic as well.  Although Samoan autogynephilic men are not likely to transition to presenting as women, that does not mean that they won’t seek out their prefered external sexual partners, women and feminine males, to wit fa’afafine.

From personal experience and hints from clinician and sexologist comments (e.g. Stoller and Bailey, separately), Western androphilic transwomen avoid gynandromorphophiles. One of the hallmarks of gynandromorphophiles is that they prefer pre-op and “functional”, that is, willing to allow these men to touch their penis, as Stoller remarked, “… she considered anyone who was not interested in her penis as normal…”

From reading between the lines of Petterson’s thesis, it appears that she made the assumption that sexual role “flexibility” denoted greater bisexuality.  I would argue just the opposite, that it is a signifier of potential gynandromorphophilia.  Also, I would predict that such men would have a different and “disturbed” response time when presented with faces to evaluate due to their underlying erotic target location error proneness.  While it is true that people tend to linger over images that they find erotically rewarding, they also tend to have trouble responding quickly to associations that reside further away from each other in their personal experience (e.g. implicit bias testing).  Indeed, this issue is shown in the data… that those who are willing to perform fellatio on fa’afafine had longer response latency, even to the crude emojis.

A minority of the masculine men having sex with fa’afafine are also only having sex with other masculine men, but not women.  This would suggest masculine presentation / identity exclusive androphilia, not bisexuality.  Not all fa’afafine present as extremely feminine as adults – some are fairly conventionally masculine, as average gay men would be in the West.  It would appear to me that not all androphilic males in Samoa developed an identity as fa’afafine as a child and that they are having sex with each other and to at least some of the fa’afafine, perhaps those who are less hypomasculine?

Although Petterson rejected the hypothesis that her masculine male subjects included both primarily androphilic and gynephilic subjects based on statistical tests of her response time data for normal distribution.  I believe that the effect of there being three different populations masked this fact.

Although Samoa and the fa’afafine culture seem so different than that of the West, I believe that the feminine androphilic subcultures in the West, that of feminine gay men, drag, and feminine androphilic transsexuals and our experiences very much parallel each other in important ways and future research will bear this out.

Further Reading:

Essay on relationship between Hofstede Individualism Index and non-androphilic MTF transsexual transitions

Essay on cultural influence on androphilic male presenation

Essay on Gynandromorphophilia


Vasey, P. et al., “What can the Samoan Fa’afafine Teach Us About the Western Concept of Gender Identity Disorder in Childhood?”, (2007) Perspectives on Biology and Medicine,  http://muse.jhu.edu/article/222247

Vasey, P. “The Evolution of Male Androphilia” Personal Website:  http://people.uleth.ca/~paul.vasey/PLV/Evolution_Androphilia.html

Petterson, L. “Male Bisexuality In Samoa” (2012) University of Lethbridge Thesis  https://www.uleth.ca/dspace/bitstream/handle/10133/3745/PETTERSON_LANNA_MSC2015_THESIS.pdf

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Fraternizing with the…

Posted in Transsexual Field Studies by Kay Brown on June 18, 2017

critical-thinking… Allies  Or, The Fraternal Birth Order Effect: Early Onset Transwomen vs. Gay Men

In a very recently published meta-study conducted by Ray Blanchard further exploring the Fraternal Birth Order Effect (FBOE), in which he had earlier noted that androphilic males tend to have more older brothers than sisters, he deals with several concerns and new research questions.  First, there had been some concerns with how best to handle the potential effects of family size.  But what really interests me is that here, for the first time, he carefully considers the effect of transgender (feminine presentation / identity) vs. non-trans androphilic men (masculine presentation / identity i.e. conventional gay men).  The results are striking!

“The pooled Older Brothers Odds Ratio for the feminine groups was 1.85, and the value for the non-feminine groups was 1.27. The corresponding risk ratios were 1.52 and 1.19.  The differences between groups were highly significant.  To sum up the results so far in common language:  Feminine homosexual males have more older brothers than non-feminine homosexual males, and non-feminine homosexual males, in turn, have more older brothers than heterosexual males.”

These results weren’t just “statistically significant”, the effect was very great with the 95% Confidence Levels not even overlapping!

But we should introduce a note of caution here.  The feminine androphilic data was very heterogeneous as can be seen in this plot of the data.  This may be caused by the differences between cultures sampled from all over the world.  Some of this data is from Samoan Fa’afafine, some from Western gender dysphoria clinics in the US, UK, and Spain, some from non-Western cultures like Brazil and Korea.  Blanchard also noted this issue and suggested exploration of this might interest some future researcher as more data becomes available.  But in any case, we are shown some very intriguing data that strongly suggests that we may be seeing a difference in etiology between feminine and masculine androphilic males.

Blanchard discusses possible conclusions regarding this,

“A … possibility is that the neurodevelopmental pathway triggered by older brothers is inherently more feminizing than path ways triggered by other etiologic factors (e.g., ‘‘gay’’ genes or prenatal hormone exposure). Thus, a group of homosexual males selected for generalized femininity is likely to contain a higher proportion of individuals who acquired their sexual orientation via the older brother pathway. Other hypotheses, equally speculative, are also possible. … Blanchard and Bogaert (1996) proposed that the FBOE reflects the progressive immunization of some mothers to male-specific (i.e., Y-linked) antigens by each succeeding male fetus and the concomitantly increasing effects of anti-male antibodies on sexual differentiation of the brain in each succeeding male fetus. According to this maternal immune hypothesis, cells (or cell fragments) from male fetuses enter the maternal circulation during childbirth or perhaps earlier in pregnancy. These cells include substances that occur only on the surfaces of male cells, primarily male brain cells. The mother’s immune system recognizes these male-specific molecules as foreign and produces antibodies to them.  When the mother later becomes pregnant with another male fetus, her antibodies cross the placental barrier and enter the fetal brain. Once in the brain, these antibodies bind to male-specific molecules on the surface of neurons.  This prevents these neurons from ‘‘wiring-up’’ in the male-typical pattern, so that the individual will later be attracted to men rather than women.”

Something not discussed, indeed I’m not sure how it can even be explored – unless the curve in the data shown for the odds of an older brother per other sibling is evidence for the effect of first born males experiencing self-induced maternal immunity creating the same etiological pathway.  I would also expect that some first born males may have this etiology due to previous maternal miscarriages and abortions of male fetuses since they too would be expected to have Y-linked antigen challenges to the maternal immune system.

Still, and all, very exciting paper well worth reading.


Blanchard, R., “Fraternal Birth Order, Family Size, and Male Homosexuality: Meta-Analysis of Studies Spanning 25 Years”, Archives of Sexual Behavior, (2017),

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When the Numbers Add Up…

Posted in Transsexual Field Studies by Kay Brown on June 17, 2017

female_scientistOr, Scientific Numerology

Sometimes, when one spots numbers that seem to be awfully familiar, they cause us to wonder.  Well, I think I spotted either an amazing random coincidence, or a basic connection between the incidence of autogynephilia and autoandrophilia in the general population and the incidence of potential gender dysphoria found in teenagers.  Check out these numbers.

From the Sumia study  0.5% girls compared to 2.2% of the boys had indicated such potentially clinically significant dysphoria.  Note that this is indeed potential, not clinically significant distress.  While in the Langstrom study 2.8% of men and 0.4% of women reported at least one episode of transvestic fetishism.

Again 0.5% vs. 0.4% for natal females and 2.2% vs. 2.8% for natal males.

So, random coincidence?  Or underlying correlation?  We need further study.  But I’m willing to put a high confidence estimate that this reflects that the GIDYQ-A is picking up on the connection between autogynephilia / autoandrophilia and mild gender dysphoria.

Further Reading:

Essay on Autogynephilia causing gender dysphoria in late onset transwomen


Sumia et al., “Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment”, Journal of Adolescence

Langstrom, et al., “Transvestic Fetishism in the General Population”  Journal of Sex & Marital Therapy, (2011) http://dx.doi.org/10.1080/00926230590477934

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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.


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 secretive cross-dressers, “transvestites”, 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 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).

There is another couple names for this behavior, “TransTrender” and “TrendsGender”, as in it is now “trendy” to say that one is transgender, 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 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 an estimated 2.8% to 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 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.


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 5/5/2017:  To reinforce my point that one needs to have an operational definition of “transgender”, we can see in another recent study (Sumia 2017) using the GIDYQ-A that only 1.3% of teenagers had any “potentially clinically significant gender dysphoria”.  Interestingly of the natal female teens, only 0.5% compared to 2.2% of the natal males had indicated such potential dysphoria.  Note that this is indeed potential, not clinically significant distress.  These numbers tally better with the hypothesis that most of these boys are autogynephilic and will likely live as secret cross-dressers.)

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

Essay on the concordance between percentage of erotic cross-dressing adults of both sexes and measures of teenaged sub-clinical gender dysphoria

External Further Reading:

“Tucute: What it is and why its wrong”

The world of cross-dressers is for the most part a world of traditional men, traditional marriages, and truths turned inside out. – From the Atlantic Monthly, April 2002


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

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Did you hear the one about…

Posted in Transsexual Field Studies by Kay Brown on January 29, 2017

female_scientistOr, Silly Objections

I’ve read and heard so many beyond silly objections to the Two Type Taxonomy of transgender etiology that I thought I would start memorializing them.  This will be an ongoing post, with updates occurring as I feel like writing, so I won’t be dating the addenda as is my usual custom.  I will be adding more as I hear or remember more such silliness.  Of course, many of these objections have been thoroughly addressed and laid to rest here in my over one hundred essays to date.  Consider finding them on your own as an easter egg hunt by searching / reading all of my blog essays.

Or, better yet, randomly assign them to squares on a card then each time you see one of these objections mark your card, and be sure to invite your friends to play Silly Objections Bingo!

“Autogynephilia can’t be the reason late transitioners transition because HRT would reduce their libido and they would lose interest in transition.”

“Autogynephilia is just an effect of gender dysphoria.”

“Autogynephilia is just an effect of being transgender and attracted to women while living in a male body.”

“Early transitioners don’t have autogynephilia because they got to transition before their gender dysphoria got so bad like mine did.”

“Early transitioners didn’t express autogynephilia because they started HRT (or puberty blockers) before they developed erections.”

“No one would turn their life upside down for a sexual fetish!”

“Autogynephilia only occurs in cross-dressers, not transsexuals.”

“Autogynephilia doesn’t exist; fetishistic cross-dressers are literally getting off on the clothes themselves.”

“Women are autogynephilic too! It’s just normal female sexuality.”

“Autogynephilia is not a thing. Flat out. Period!”

“Straight (androphilic) transwomen are autogynephilic too!”

“There can’t be two types because sexual orientation and gender identity aren’t related.”

“Straight (androphilic) transwomen just transition earlier because they need to to date men.”

“There’s a part of the brain that proves that (all) transsexuals have female brains.”

“The existence of intersex people proves that transsexuals are ‘real’.”

“I would have transitioned as a teenager too if I had known I could.”

“I would have transitioned early but society wouldn’t let me.”

“All transsexuals are the same.  Some just transition at different times.”

“I was feminine when I was young too but hid it from everyone.”

“I have known I was transgender since I was seven years old… so I can’t be autogynephilic.”

“This theory is wrong because my narrative doesn’t fit your description of either type.”

“Blanchard, Bailey, Lawrence, and everybody else that support this are just transphobic.”

“They (supporters of the two type taxonomy) are just confusing correlation with causation.”

“You can’t use Bradford Hill’s criteria, that’s only for epidemiology, not psychology (ignoring the existence of the psychiatric epidemiology, including a book by that title)”.

“That theory is so out of date.”

“Autogynephilia? Blanchard just made that up.”

“Blanchard is over simplifying.”

“Blanchard and Bailey are full of shit. (without explaining how)”

“There’s no proof.  It’s only a theory.  That data has never been replicated (ignoring the half-dozen referenced peer reviewed papers with data from hundreds of subjects).”

“That essay is just anecdotal (ignoring the half-dozen referenced peer reviewed papers with data from hundreds of subjects).”

“That theory is pseudo-science.”

“Oh, I get it!  You’re just like an anti-vaxxer into fringe theories.”

“Blanchard is calling older transitioners that don’t report arousal to cross-dressing lairs.  That’s unscientific!”

“That theory has been debunked by scientists (without citation).”

“But the Nuttbrock paper said… (ignoring the actual Nuttbrock data).”

“Oh that stuff, that was so ’90s, but there was never any empirical evidence.”

“That paper is fake, Dr. Meltzer is a friend of the community; he would never have given Lawrence access to his patients.”

“Well, I won’t accept it until there is research by someone other than… (fill in the blank, perhaps with Lawrence, Bailey, Cantor, Smith, Nuttbrock, or anybody else who has already done papers that show evidentiary support for the two type taxonomy)”

“Well, I won’t accept it until that paper is peer reviewed by someone other than… (fill in the blank, perhaps with Lawrence, Bailey, Cantor, or anybody else who has already done papers that show evidentiary support for the two type taxonomy)”

“She (me) didn’t cite any references in her FAQ (ignoring the copious citations in the over 100 essays in this blog).”

“Well, I won’t accept it until I see… (impossibly difficult data to get).”

“We shouldn’t do the science because it will hurt the community!”

“This sh!t is just made up to divide the community.”

“Nobody who is transsexual accepts this theory (…ahem…).”

“We shouldn’t talk about this openly until we have won all of our political goals.”

“You only support that because you want people to think you are one of the ‘good kind’ of transsexual.”

“This is just ‘True Transsexual’ bull shit!”

“You just hate older transitioners!”

“You have an agenda!!”

“The tone of your essays…”

“This theory completely ignores the existence of transmen!”

“This theory doesn’t explain all of the other non-binary gender identities (ahem… actually it does).”

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A Voice of Their Own

Posted in Transgender Youth, Transsexual Field Studies by Kay Brown on July 9, 2016

Or, What Do Transkids Think About Puberty Suppression?


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


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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He Loves Me, He Loves Me Not…

Posted in Transsexual Field Studies by Kay Brown on June 8, 2016

female_scientistOr, Are TrannieHawks Gay, Straight, or What?

First, we need to define who we mean.  We are not talking about straight men who fall in love with a woman only later to learn that she is a post-op transwoman.  We are talking about men who specifically seek out transwomen, especially pre-op transwomen.  We use the scientific name for this specific sexual interest, “gynandromorphophilia“.  A common question about these men is, are they straight, gay, or what?

GAMMany insist that those who date and especially marry transwomen are bisexual, or perhaps closeted homosexual.  A recent paper by Hsu et al has conclusive evidence that this is NOT the case.  As shown here, gynandromorphophilic (GAMP) men are much more like heterosexual men in their sexual responses, as measured by a ‘peter-meter’ and by self-reported arousal to pre-op transwomen, here defined as gynandromorphs (GAM).  Note that GAMP genital sexual arousal is slightly, but robustly, higher than their attraction to natal females. Given their much lower response to males, we can rule out describing them as “bisexual” or “homosexual” in any real sense. Also note that for all three groups, gay, straight, and GAMP, their subjective arousal seems to be understating their actual arousal to transwomen relative to male and female stimuli.  This suggests that there may be a bit of social desirability bias in all three groups of men.  That is to say, admitting to finding transwomen “sexy” is ‘not the thing’ to do, even for gynandromorphophiles.

The question that comes up is; what is different about tranniehawks and conventionally straight men?  As has been remarked upon by many, including by me, most of them are also autogynephilic.  In this study, that hypothesis was tested and found to be true.  Using Blanchard’s Core Autogynephilia Scale (0-8), the mean score of the GAMP subjects (N=24) was 2.88 (SD=3.47) compared to the straight subjects (N=21) score of 0.35 (0.99) and that of the gay subjects (N=21) of only 0.06 (0.24).  Even more interesting is that when we further divide the GAMP groups into those who self-identify as “bisexual” and “heterosexual”, we see a difference between their autogynphilia scores of 5.20 (3.46) and 1.21 (2.42) respectively.  This is very much in keeping with other research that shows that autogynephilic (AGP) men often exhibit “pseudo-bisexuality” (aka: psuedo-androphilia) in which their interpersonal autogynephilic sexual ideation includes fantasies of having sex with men, as women.  The data suggests that while most of the GAMP subjects were highly AGP, a few might be only mildly autogynephilic.

It should be noted that most MTF transkids, including myself, do NOT like having relationships with GAMPs, partially due to unconsciously recognizing their essentially autogynephilic sexuality which is self-reflective and partially due to GAMPs’ focus on pre-op genitalia, which given the “avoidant” nature of most MTF transkids, makes them exceedingly uncomfortable.

Further Reading:

Newer Essay on Autogynephilies and Gynandromorphophilia

Previous essay on personal experiences with TrannieHawks

Commentary on the mutual gynandrophmorphophilic relationships between autogynephiles in my essay on transsexual marriages.

Essay on “Avoidant” behavior in MTF transkids

Commentary on MTF transkids (HSTS) not comfortable with gynandromorphophiles in my book review of Bailey’s The Man Who Would Be Queen

Commentary on MTF “true transsexuals” (transkids) not comfortable with gynandromorphophiles by Dr. Robert Stoller and on “avoidant” behavior in his 1968 book, “Sex and Gender”.

Essay on Autogynephilic Psuedo-Androphilia.


K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Who are gynandromorphophilic men? Characterizing men with sexual interest in transgender women”

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A Passing Privilege…

Posted in Editorial, Transsexual Field Studies by Kay Brown on January 1, 2016

Kay BrownOn Privilege and Entitlement in the Transgendered Communities

It’s the first day of a new year, time for another editorial on the transsexual and transgendered communities.  This past year, I’ve noted an increase in discussion on “privilege”, who has it, and who doesn’t.  This is not a new topic in the transgendered forums, or in the so-called, ‘gender critical’ forums.  But, as usual, I find that most of the discussion misses the mark by a very wide margin, largely because of a combination of failing to define what and how privilege is and operates and conflating privilege with advantage and entitlement.

First, among the wider transgendered communities, especially among “older transitioners” and part-time cross-dressers, there is a common lament, a complaint even, of how they are disadvantaged because they don’t “pass”.  They then posit that those who are “lucky” to pass as non-transgendered have a special “privilege”.  I’ve even seen essays that go as far as to criticize those MTF transwomen who do “pass” as expressing a belief that they are somehow “better” than those who don’t.  On one hand, evidence of this is provided by noting that in the (autogynephilic) transgender community, those who pass better are given greater social status.  On the other is that those who don’t pass are exposed to greater transphobic discrimination in the non-transcommunities, even within the LGB communities!

Second, among non-transgendered commenters, especially those with a feminist background and interest in ‘gender crit’, there is much discussion about how transsexuals or part-time transgendered folk do or do not have “male privilege”.

Why, you may ask, is this of interest from the scientific perspective?  Because privilege, accrued advantage, and entitlement lie at the heart of the different social and economic experiences of the different types of transfolk.  It is also key to understanding the response to the growing scientific knowledge and understanding of the etiology and clinical presentations of the two types, by the more socially advantaged, ‘privileged’, of the two MTF types.

So let’s dissagregate (deconstruct, if you prefer post-modernist cant), the terms.

The term “privilege” comes from “private law”, the acknowledgement that some people have legal rights and some don’t.  A king had a special status, a private law, that didn’t apply to his subjects, “rank hath its privileges”.  Until very recently, men had legal rights that women did not in nearly every nation (and still do in far too many).  This is ‘male privilege’ in its most naked and raw form.  But there is another form, that which is given by custom and bias.  It should come as no surprise that, even today, most people, both men and women, still hold irrational biases that grant men more privileges than to women.  That bias is so strong that study after study have shown that women have to be demonstrably more competent and accomplished than men to even hold their own in many domains. (Look up the “Matilda Effect“.)

Privilege of this sort does not lie within the individual.  It lies in those who surround the individual.  It is granted automatically, by law, custom, or bias.  One cannot consciously disown such privilege since it is not within their control to bestow it upon themselves in the first place.

From privilege can, and usually does, come advantage.  It is what allows some people to move forward in their lives in an easier manner.  It also accumulates.  This property of accumulating advantage that comes from privilege is what ‘gender critical’ commenters are usually talking about when they state that MTF transwomen have “privilege”.  When those very same MTF transwomen read the word “privilege” and deny ownership of such, they are only thinking of their current loss of “privilege” due to transphobic bias, or, if they truly pass, of loss of “male privilege” wherein they are now subject to misogynistic bias.  But it is accumulated advantage that is paramount, because, if enough advantage has been accumulated, it can overcome transphobic or misogynistic bias, because advantage leads to further advantages.  (Look up the “Matthew Effect“.)

When someone is accustomed to having privilege and to accumulating advantage, it often engenders ‘entitlement’, the personal belief that such privileges that come from law, custom, or bias are ‘owed’ to them, or that they ‘earned’ them, that they are due to them because of a perceived sense of superiority.  It should come as no surprise that most men, accustomed as they are to socially granted privilege, fail to see their privilege over their female peers until it is painfully lost, as is the case with “late transitioning” MTF transsexuals losing “straight male privilege” as they become subject to homophobic/transphobic bias.  But even then, a substantial number of them fail to adjust to this loss, holding onto their entitlement, especially if they had previously accumulated enough advantage such that the loss of straight male privilege is overcome by compounding socio-economic advantage.

{Great comic strip exploring how socio-economic advantage accumulates and leads to entitlement.}

As an example of how accumulated straight male privilege, internalized bias, entitlement, and the failure to understand its presence, can be found in late transitioning MTF transsexuals, one only has to look at Caitlyn Jenner or Martine Rothblatt who openly touts that she is “the highest paid female CEO”.  Perhaps she can be a role model to the millions of girls who would look to emulate her success?  That is to say, that they should all become straight married men, father children, and climb the corporate ladder, accumulating advantage conferred by straight male privilege?  Or perhaps exclusively androphilic, gender atypical, MTF transkids can do so?   NOT!!!

Well known and respected gender therapist, Dr. Anne Vitale, noted this internalized bias and tightly held sense of entitlement in one of her essays on the phenomena,

“One of the most interesting aspects I have found in my work with genetic males struggling with deep-seated gender dysphoria is ingrained sexism. Although it would seem to be completely out-of-place in this population, the fact that it is present and present almost exclusively in genetic males tells us a great deal about how some men feel about femininity and about aspects of the nature of gender dysphoria. As a general rule, the men I am speaking about present for therapy appearing decidedly male, often to the point of wearing full beards. In addition, they are more often than [Group One transsexuals] to present [as] married, to have children, and to have never considered having a homosexual experience. … There are those that think that what women do — those social behaviors that differentiate them from men — are frivolous and unimportant. Indeed, there are those who take this belief to the point where they feel that women are less than men and are embarrassed over wanting to be like them. Interestingly, these people have no trouble at all with wearing very feminine apparel — as long as they can do it in complete privacy or with the above mentioned male bravado. … Perhaps the most insidious form of sexism resides in the gender dysphoric male who has attained a highly respected position in a male dominated profession. These people routinely tell me that although women are now allowed a certain professional tolerance, the real players are still men.”

Vitale also noted that these late transitioning (universally gynephilic) transsexuals clearly understood that they would be losing their socially conferred straight male privilege should they transition,

“As the number of people who transition on the job grows, they get to see firsthand how public respect between men can quickly turn into private ridicule. Some individuals have even confessed to having participated in sexist jokes as a way to divert even the remotest suspicion from themselves. These people face the very real prospect of becoming outsiders, left to wither on the corporate vine. Given these seemingly unacceptable obstacles, many gender dysphoric males unconsciously accept certain male driven notions about women in an effort to purge the need to be female out of their mind.”

This potential loss of privilege is weighed against the personal benefits of transition, taking into account their already accumulated advantages.  This leads to the phenomena of very advantaged, higher socio-economic status (SES) gender dysphoric autogynephilic MTF transgendered individuals being more likely to transition than those with only moderate SES.  However, heterosexual and male privilege is not the only source of privilege or advantage, others include ethnicity (race/color, etc.), class, and education.  That is to say, that we don’t all start out with the same advantages.  Of course, those with absolutely nothing to lose… those who do not, nor ever did, enjoy straight white male privilege,  or accumulated advantage, poor and homeless “homosexual” transsexuals, both MTF and FtM, of color, whose early gender atypicality is well noted by parents, teachers, and peers alike, do not weigh loss of a privilege that was never theirs.  This is why in the Western countries, we find that most autogynephilic transwomen are white, middle-class, better educated while we find that exclusively androphilic MTF transsexuals (transkids) are more likely black, asian, or hispanic from poor families.

Dr. Vitale, in another essay, contrasted MTF transkids, whom she dubbed “Group One (G1)” type transsexuals, as not exhibiting this presumption of male (straight or otherwise) privilege and entitlement,

“As a psychotherapist I have found female identified males (G1) to be clinically similar to male-identified females (G2). That is, individuals in both groups have little or no compunction against openly presenting themselves as the other sex. Further, they make little or no effort to engage in what they feel for them would be wrong gendered social practices (i.e., the gender role assigned at birth as the basis of authority).”

Gender atypicality, especially notable femininity (disparagingly labeled “effeminacy”) in males, makes most people very uncomfortable, leading to less cooperation and social opportunities.  That is to say, that such individuals are granted less privilege, due to conscious or unconscious bias.  Whether that bias is greater or lesser than the privilege that may or may not be automatically conferred because that individual is male is likely to vary by individual and by the relationship between the individual and their social circle.  But, in many circumstances, this bias against them as feminine persons and gender atypicality/homosexuality far outweighs any potential male privilege, as attested by how many such individuals are disowned by even their own families to become homeless as teenagers.

Thus, for such gender atypical individuals who are contemplating alternatives, the privilegepossibility of passing as a member of the opposite anatomic sex can be very appealing.  But here, the ability to actually pass, really and truly pass, for years on end, with one’s neighbors, co-workers, peers, etc. is carefully evaluated; because, for non-autogynephilically motivated individuals, failing to pass will not grant them part of what they desire, surcease from bias.  Thus, passibility is a necessity for most “homosexual” transsexuals.  While passing as non-transsexual and non-gender-atypical women reduces bias, it does not grant “privilege” in the same sense that being perceived as a gender typical, straight male does.  Thus, attributing “passing privilege” to exclusively androphilic “young transitioners” in the manner that autogynephilic “late transitioners” and part-time cross-dressing transgender males often do, is dubious at best, and an example of autogynephilic projection of a false privilege at worst.  Worse, those who have become accustomed to equating possessing privilege with entitlement, falsely project onto such passable (especially if attractive as well) young transitioning MTF transsexuals the belief that they see themselves as “better than” gynephilic late transitioners, for whom the ability to pass has far less weight on their decisions regarding transition.  As the authors of the transkids.us website put it,

“This kind of perception is very common amongst transsexuals who are motivated by autogynephilia and the desire to acquire femininity and is typical of how hsts issues are re-interpreted within a transsexual context which has meaning to autogynephilic transsexuals and not to homosexual transsexuals.  In the often somewhat oddly “reversed” context of autogynephilic narrative, femininity is redefined in terms of status and hierarchy, as a personal goal and not as a connected social history. Casting transkids as “privileged” because they are defined socially as feminine is a reversal of how things work in the non-transsexual world where femininity grants less social privilege, not more. In a paraphilic value system where femininization is the objective then it can be seen how those who are spontaneously feminine would be considered fortunate but the relationship of homosexual transsexuals to concepts of “passing”, attractiveness and femininity are simply very different from those of autogynephilic transsexuals. Being a member of a very devalued social class from a very young age is not a privilege, it is a huge social liability.”

While femininity in boys is near universally reviled, mild “tomboyishness” in girls is tolerated or even encouraged.  However, extreme masculinity in girls and especially maturing girls and women, is equally disquieting to many.  Here, the ability to pass as straight, gender typical men, may and does confer some privilege, and if one transitions young enough, they may be able to accumulate advantages from it.

Further Reading:

Passibility differences between transsexual types

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

Exploring transsexuals stereotypes and how they reveal differences in privilege, socio-economic status, and transition decision-making

Exploring data regarding ethnicity vs. MTF transsexual types in New York City.

Exploring Dr. Anne Vitale’s clinic descriptions and contrasts between transsexual types.


Anne Vitale, “The Gender Variant Phenomenon–A Developmental Review” http://www.avitale.com/developmentalreview.htm

Vitale, Anne, “Sexism in the Male to Female Transsexual”  1997

Charlotte Alter, What Transmen See That Women Don’t, Time Magazine


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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.


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.


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.

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

Sari R. Fridell, Kenneth J. Zucker, Susan J. Bradley, Dianne M. Maing, “Physical attractiveness of girls with gender identity disorder” Archives of Sexual Behavior

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