On the Science of Changing Sex

…She Loves Me.

Posted in Transsexual Theory by Kay Brown on November 16, 2016

female_scientistAre Autogynephiles also Gynandromorphophiles?

Are cross-dressers also tranny-chasers?  We had already seen a study that clearly demonstrated that transfans are more like straight men than like gay or bisexual men and that they are also at least somewhat autogynephilic.  But we have to ask, are all autogynephilic males also gynandromorphophilic?

In my personal experience, yes, both cross-dressers and “late transitioning” / “late onset” transwomen were in fact avid transfans.  I can’t tell you how often I saw that sexually admiring look from such transwomen, especially when I was decades younger than I am now.  There have also been a few who were hopelessly in love with me who sadly pined for what I could not return.  But that is all anecdotal; we need data.

Well, now we have that data.

In a recent paper following up on their earlier paper, Hsu, et Al., tested the sexual response of 27 known autogynephilic males, cross-dressers specifically recruited for this study, of whom 74.1% reported cross-dressing at least once a week, on average (M=5.26, SD=1.40). They also reported a high average degree of transvestic fetishism (M=4.11, SD=1.19). Consistent with their transvestic fetishism, these men reported a high average degree of autogynephilia (M=6.44, SD=2.47) on the 8-item, sum-scored Core Autogynephilia Scale, although two denied any autogynephilia on this measure despite reporting arousal from cross-dressing.

Using this same Core Autogynephilia Scale (0-8), the mean score of the gynandromorphilic (GAMP) subjects, recruited for their strong interest in transwomen (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 autogynephilia 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) transwomen often exhibit “pseudo-bisexuality” (aka: pseudo-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.

gampAgain, our question is are all autogynephiles also gynandromorphophiles?  From the data we can see that, why yes, yes they are.  Note that the relative sexual response, using a ‘peter-meter’ is identical between the GAMP and Autogynephilic (cross-dresser) groups.  Both groups show higher sexual response to gynandromorphs (GAM – pre-op feminized MTF transwomen) than to females.  Interestingly, the cross-dresser group has a lower response overall.  This is very much in keeping with earlier work from Blanchard that showed that autogynephilia competes with gynephilia.  In this case, we now have data that shows that it also competes with their co-existing (greater) gynandromorphophilia.

Also, thanks to Veale, who showed that gynandromorphophilia is common in autogynephilic transwomen, we have yet more evidence that AGP transwomen are in the same etiological taxon as non-gender-dysphoric cross-dressers, further supporting the Two Type Transsexual Taxonomy.

Further Reading:

Essay on Sexual Response of Gynandromorphophiles

Previous essay on personal experiences with TrannieHawks

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

References:

K. J. Hsu, A. M. Rosenthal, D. I. Miller and J. M. Bailey, “Sexual Arousal Patterns of Autogynephilic Cross-dressing Men”
https://www.researchgate.net/publication/308036975_Sexual_Arousal_Patterns_of_Autogynephilic_Male_Cross-Dressers

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”
http://d-miller.github.io/assets/HsuEtAl2015.pdf

Jaimie F. Veale, Dave E. Clarke and Terri C. Lomax, “Sexuality of Male-to-Female Transsexuals”
http://www.springerlink.com/content/bp2235t8261q23u3/

Anne A. Lawrence and J. Michael Bailey
Transsexual Groups in Veale et al. (2008) are “Autogynephilic” and “Even More Autogynephilic”
http://www.springerlink.com/content/u473w370g11vx758/

Jaimie F. Veale, David E. Clarke and Terri C. Lomax
Reply to Lawrence and Bailey (2008)
http://www.springerlink.com/content/cm2531l3m3148377/

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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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Four Out of Five…

Posted in Transsexual Theory by Kay Brown on February 2, 2016

female_scientistWhich Came First?  Chicken Or Egg?

Not too long ago, I got an email from a transwoman, and ‘older transitioner’ who acknowledged without reservation that there was a “correlation” between later transition / gynephilia (non-exclusive androphilic) transwomen and autogynephilia, while tacitly acknowleging that exclusively androphilic early transitioners do not.  This was great, but not too surprising, since four out of five such transwomen acknowledge experiencing autogynephilia either currently, or in the past.  But she asked, does it mean causation?  That is to say, is autogynephilia the prime mover in causing gynephilic (and bisexual / asexual) transwomen to become gender dysphoric and develop a ‘female identity’?

I would have thought it was obvious that it does, and that we don’t need to explicate why.  But, no, Sillyolme, nothing in science is self-evident.  One really does need to explore the question fairly, making the assumption, the null hypothesis, that it does not, then look to see if the evidence supports that null hypothesis.  Only if the data fails to support the null hypothesis should we state that it does.

Let’s start at the begining shall we?  First, does autogynephilia exist?  Yes, we need to ask this first, as it can’t be a cause of gender dysphoria if it doesn’t exist.  And, indeed, many ‘older transitioners’ insist that autogynephilia does not exist.  Well, that one is easily answered, because we have at least 100 years of sexologist observations of a minority of males who definately become sexually aroused when wearing women’s clothing and/or when thinking of themselves being or becoming female.  Consider this typical description of a teenaged male experiencing an autogynephilic episode from Richard Ekins book Male Femaling – A grounded theory approach to cross-dressing and sex-changing,

“… I was 13 when I stepped, quivering with excitement into a pair of French knickers belonging to my sister.  I ejaculated almost immediately… The feeling was glorious and yet quite alarming and I felt as though I was leaking urine. … Some three days after this first ‘event’ I got home from school to find my mother out.  I went upstairs to do my homework and through the half-opened door of my mother’s bedroom I saw, hanging over a chair, a pair of her pink directoire knickers, obviously discarded in a hurry as she changed before going out.  That soft gleaming bundle turned my whole body and senses into a jelly-like state of desire and longing.  I had to wear them, to try and see if I was all right.  Would it happen again?  My answer was there almost immediately in my swift gathering erection as I struggled out of my clothes.  …”

We can find hundreds of such examples, very often showing that this behavior is most noted in early adolescence, but continues into adulthood. In fact, we have an entire genre of erotic fiction and images (still and motion picture porn) dedicated to the tastes of autogynephilic adult male individuals.  These examples and the males that experience it are common enough that they also form organizations to join together to support each other emotionally and even politically.  So, no, we can’t say that autogynephilia does not exist.  The null hypothesis is easily proven wrong.  Autogynephilia in some males exists.

OK, now that we know that autogynephilia exists in some males, we can take a known group of autogynphilic males, conduct in depth interviews into just what sorts of things they erotically respond to that the majority non-autogynephilic males don’t.  From that we can construct trial psychometric inventories, test items (questions), for an autogynephilia scale, so that we can measure the degree of and autogynephilic factors (types) present in, autogynephilic males.  Then carefully test and validate it against known autogynephilic males and a set of control males.

However, some transwomen insist that autogynephilia can’t be the cause of their trans identity, because autogynephilia is common, perhaps near universal, in females.  Thus, that would demonstrate that autogynephilia is just part of normal female sexuality.

Does autogynephilia exist in females?  Now, remember, we START with the null hypthesis.  So, assuming it does NOT exist, can we find (credible) evidence that would disprove the null hypothesis?  First, how many sexologists have observed, documented, and remarked on autogynephilic sexual arousal in females?

Wow… I’m hearing an empty, hollow echo in that department.  Not one observation, study, or anything… oh wait, I hear some tiny voices outside the hall?  Could it be?  Why there ARE some folks saying that females do experience autogynephilia… but… what?  Oh, yeah… that… ALL of them are autogynephilic males who are claiming that their autogynephilia is the same as what women feel when they wear women’s clothing… after all, wearing “sexy” panties gets them all going, so it must get women going too?  Right?  Ummmm no.

Seriously, where in the many thousands of diaries, autobiographies, and now online social media blogs published, is there ANY (credible, not catphishing by an AGP male) female individual accounts of anything remotely like the autogynephilia so easily found in a minority of males?  Seriously?  Where are the copious accounts of how, when they were pre and early teens, that they became intensely sexually aroused upon trying on their big sister’s bra and panties?  Or looking in the mirror at their blossoming breasts and become intensely sexually aroused?  Or examining their genitals and finding them so arousing that that they masturbate while examining them… cause being female is just so sexy?  No?  Again that hollow echo.

Oh, but wait, I hear a rising chorus (of autogynephilic males) saying that a Dr. Charles Moser created an autogynphilic inventory for females and tested a group of women.  So we ask, as we must assume the null hypothesis, where did he find the known autogynephilic females to interview to create a valid test?  How did he validate it? What are the psychometric properties of the instrument?  What?  No?  He did none of that?  Well, then what did he do?  He carefully rewrote questions from an instrument intended for and validated only for males in a gender clinic setting?  Well, looking carefully at the rewrite, they don’t seem to have even a passing bearing on what autogynephilia would theoretically look like in women, or even in androphilic transsexuals. The questions were very carefully written to get positive answers from heterosexual females, as that was the intended (political) goal, to “prove” that straight women were also autogynphilic… but they have no meaning.  They don’t measure autogynephilia, they measure mostly anticipatory arousal before dates with men.  Well that was dissappointing.  One and only one demonstrably invalid study.  We still have no evidence to disprove the null hypothesis.  So, for now, we must accept that females do NOT experience autogynephilia.

OK, so now we know that autogynephilia exists in males, but there’s no (credible) evidence that it exists in females.  But are there really two types of MTF transsexual?  Does autogynephilia exist equally as much in exclusively androphilic transwomen?  Let’s assume the null hypothesis, that there is only one type, not two.  We can use the previously developed and validated, instruments to measure any putative autogynphilia in both exclusively androphilic and non-exclusively-androphilic transwomen and see if there is a difference.  Here, we have a number of studies done over the years, Buhrich (1977), Freund (1982), Blanchard (1985), Doorn (1994), Smith (2005),  Lawrence (2005), and Nuttbrock (2009).

These studies all clearly indicate a strong correlation with non-exclusively androphilic reporting a high, nearly universal, percentage of individuals acknowleging autogynephilic arousal, either currently, or in early adolescence, and a strong anti-correlation with exclusive androphilia.  Diving deeper, consider that in the largest and most recent of these studies by Nuttbrock (N=571), the grouping that had the highest percentage reporting sexual arousal to crossdressing was the gynephilic at 82%, while the group with the least non-exclusively androphilic was those who had begun Hormone Replacement Therapy (HRT) as teenagers, who had the lowest percentage reporting sexual arousal to cross-dressing at 14%.

To support the null hypothesis, there should have been no correlation with sexual orientation.  The null hypothesis is NOT supported, there is NOT one group, but two.  Futher, the null hypothesis regarding autogynphilia not being correlated with gynephilic/bisexual/asexual transwomen, and only these transwomen, is not supported.  Androphilic transwomen and natal female women do not experience autogynephilia.

But this only brings us back to where we started, with my correspondent fully conceding to the above.  But she still has a valid question, does this mean causation?  After all, we all know that correlation does not imply causation.  But here we need to bring up a point, actually, it doesn’t imply it… but causation does require correlation.  So, we have our first step toward answering the question.  With correlation, we may have causation.  But we need to explore further.

One of the most accepted methods of deducing whether there is a cause and effect relationship is found in Bradford Hill’s Criteria.

The list of the criteria is as follows:

  1. Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.
  2. Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.
  3. Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.
  4. Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
  5. Biological gradient: Greater exposure (dosage or intensity of cause) should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence (as found in vitamin deficiencies).
  6. Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).
  7. Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that “… lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations”.
  8. Experiment: “Occasionally it is possible to appeal to experimental evidence”.
  9. Analogy: The effect of similar factors may be considered.

Taking each in turn:

  1. Strength of the correlation is very high.  Four out of five gynephilic transwomen acknowlege experiencing, currently or in the past, autogynephilia.  Considering that autogynphilia is very rare in the general male population and non-existent in the female population, this correlation is very, very high.  But it gets even higher when considering the experimental results of phallometry of those cross-dressers experiencing gender dysphoria who claim that they did not experience sexual arousal to cross-dressing, did in fact demonstrate mild sexual arousal to cross-dressing narration (autogynephilic erotic fiction) compared to control males.
  2. Consistency of the correlation is easily shown by looking at the literature referenced above, in which study after study, over four decades, involving around a thousand transwomen, consistently shows the same data, even using different measures of sexual orientation and autogynephilia.
  3. Specificity is shown in that it is only non-exclusively-androphilic males who experience autogynephilia and that a subset of those males develop gender dysphoria.
  4. Temporality is demonstrated in that the majority of non-exclusively-androphilic males who become gender dysphoric and come to identify as women report autogynephilia in adolescence which seems to mellow even as their need to cross-dress and their gender dysphoria increases, reaching a threshold, a crisis point, most commonly in their mid-30’s.  As Prince (herself an autogynephile) and Doctor documented, “Among our subjects, 79% did not appear in public cross dressed prior to age 20; at that time, most of the subjects had already had several years of experience with cross dressing. The average number of years of practice with cross dressing prior to owning a full feminine outfit was 15. The average number of years of practice with cross dressing prior to adoption of a feminine name was 21. Again, we have factual evidence indicative of the considerable time required for the development of the cross-gender identity.”
  5. A gradient effect is easily found in autogynephilia in that men who have only very mild autogynephilia typically are content to cross-dress in private, never developing severe gender dysphoria or a female gender identity.  There are individuals with partial autogynephilia who only wish to have breasts, who are content with mildly feminizing HRT, cross-dressing in public only occasionally.  There are those who come to identify as “Bi-Gendered” or “Gender Fluid” who go back and forth.  And finally, there are those whose autogynephilic ideation was intensely focused on being completely female and develop intense and all consuming gender dysphoria who go on to live full time as women, obtain HRT, and SRS.  A number of studies have found that intensity and the specific nature of their autogynephilia correlates with these differential outcomes.  Further, these effects seem to indicate both a continuum and a progression (criterion #4).  There is another dosage effect that though subtle, is of high importance to the question of causation and the nature of autogynephilia itself found by Blanchard in “Nonmonotonic relation of autogynephilia and heterosexual attraction”, from the abstract, “the highest levels of autogynephilia were observed at intermediate rather than high levels of heterosexual interest; that is, the function relating these variables took the form of an inverted U. This finding supports the hypothesis that autogynephilia is a misdirected type of heterosexual impulse, which arises in association with normal heterosexuality but also competes with it”.  This non-monotonic relationship was questioned in the Nuttbrock study, as they hypothosized that autogynephilia was a classic conditioned sexual fetish that had arisen as a consequence of cross-dressing and gender dysphoria, and not the cause.  But Lawrence easily demonstrated that Nutbrook missed the relationship due to improper mathmatical treatment of the data… and thus the dosage relationship evidence remains valid.
  6. Plausability.  This is almost self-evident.  If one’s sexual ideation is exclusively autogynephilic, if each time such an individual sees herself as obligatorially female during sex, that would be strong drive towards gender dysphoria and an incentive to adopt a female gender identity, over time.
  7. Coherence with laboratory tests are found by looking at brain sex research which shows that non-exclusively-androphilic transwomen are different than exclusively androphilic transwomen AND females, as expected by the theory that autogynephilia is the cause, not the result, of gender dysphoria and a female gender identity.
  8. Experiments with animals are not possible as we have no animal models of autogynephilia.
  9. Analogy is found in the amazing similarity of autogynephilia and its effects are found in males with apotemnophilia, the sexual desire for limb amputation, and autopedophilia, the sexual desire to be a child.  In fact, a very high percentage of heterosexual apotemnophiliacs are also autogynephilic, experiencing an Erotic Target Location Error in which they wish to become female amputees.

So, we can see that we meet nearly all, saving only experimental evidence, to support the conclusion that autogynephilia is the cause, and not the result or merely a co-occuring factor, of gender dysporia and female gender identity in non-exclusively-androphilic transwomen.

Additional Reading:

Essay on the development of an Autogynphilia Instrument in Males

Essay on the Non-Validity of Moser’s “Autogynephilia in Women”

Essays on evidence to support the two type taxonomy of MTF transsexuality

Essay on the Origins of Cross-Gender Identity in Transsexuals

Essays on Brain Sex in Transsexuals

Essay on analogy between autogynphilia and apotemnophilia

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A Novel Argument

Posted in Transsexual Theory by Kay Brown on January 1, 2015

Science vs nonsenseA new argument was presented to me just yesterday involving the well documented fact that among those who transitioned as teenagers, far fewer report having experienced autogynephilia.  What made the line of argument ironic was that the proponent had started out in absolute denial of any of the science and most especially of the the notion that autogynephilia existed in some transsexuals, “autogynephilia my ass!”  However as the debate developed, she presented a novel take on the Nuttbrock data that I presented, to wit that in that study, 82% of self-reported exclusive gynephiles reported sexual arousal to cross-dressing, while only 14% of those who had begun HRT as adolescents (defined in the Nuttbrock study as before one’s 20th birthday) reported such arousal.

Here’s where it gets interesting: In an effort to win ANY point she could, she took the position that I was twisting the data to suit my position… yet in so doing she had to take the position, for her arguments’ logic to work, that autogynephilia is a UNIVERSAL phenomena among MTF transsexuals.  I had to laugh privately, since this reversal of her position would obviate all of her previous positions and support some (but not all) of mine.  Interestingly, this argument of universal autogynephilia mirrors the argument proposed by another contingent of autogynephilic transwomen, that autogynephilia is also normal and expected in natal women.  I find it doubly ironic that there is such an extreme reaction to the two type taxonomy, but from two camps, those that deny any autogynephilia in transwomen, and those who insist that their autogynephilia is just part of being a woman, and thus, all transwomen must also be autogynephilic.

Her argument also starts with several assumptions that are not supported by the data, nor by community observation.  She assumed first that HRT in these teens meant “puberty blockers” and that such blockers would preclude an individual from experiencing any sexual arousal.  It wasn’t made explicit, but she may also have been making the false assumption that even traditional HRT precludes any sexual arousal.  (I’ve heard several “late transitioning” transwomen make this statement, likely due to their own personal experience, while real for these individuals, is neither universal nor inevitable.  From casual observation, it seems to occur more frequently in more senior transwomen than younger “late transitioning” transwomen.  And from personal conversations with a fair number of transkids, not one had experienced this phenomena.)

So, she explains the significant difference between these adolescents (of whom only one had identified as gynephilic and 7% as bisexual, with the remaining 93% identifying as exclusively androphilic) and the gynephilic (all but one of whom had begun HRT as adults or had never had HRT, and yes, that one individual is in both groups… I couldn’t back her out of the data), as the adolescents not experiencing sexual arousal to cross-dressing due to them not experiencing sexual arousal in general.

So, having convinced herself that she had won her point… she began to crow that I was the one who was not willing to look at reality!!!

Ummm…  Not so fast.

Hypothesis were meant to be tested.

I’ve already pointed out the canard that HRT stops sexual arousal in all transwomen.  If it did, would we be having sex as often as we do post HRT and SRS, especially transkids?  It simply isn’t true.  Second, it is extremely unlikely that these youngsters were all on puberty blockers (e.g. Lupron) as it is still a fairly rare protocol.  It is typically initiated by well meaning parents bringing their extremely gender dysphoric pre-adolescent children to specialists.  While I would wish that all parents were so willing to medically intervene and save their transkid from the damaging effects of endogenous hormones, it is still a rare parent who does so.  Most transkids have to fight to get medical help… and many never get parental support, either waiting until they are legally of age, running away early, or getting HRT “on the street” surreptitiously.

Although the Nuttbrock study did not give us the fine detail I would have liked regarding the exact ages which folks started HRT, we know that half of those who identified as androphilic and had started HRT did so before the age of 20.  That also means that half did NOT.  From other studies, we know that the age of 20 is the median and the mode, that most androphilic transwomen start HRT, not right at puberty, but nearer age 20, showing a Gaussian distribution centered on age 20, with the bulk having started HRT between the ages of 17 and 23 inclusive.  This is enough after puberty to have allowed them to experience that first flush of sexual awakening that accompanies the onset of puberty and adolescence.

We know from countless personal narritives of autogynephilia that those early years of adolescence are typically when sexual arousal to autogynephilic imagery, most especially to cross-dressing, stereotypically in women’s lingerie, is the most obvious and intense.  Thus, IF these youngsters who began HRT as teens were universally autogynephilic, they would have had ample time to experience it in all of its intensity, before begining HRT, even if, as was argued, HRT would preclude experiencing it!

Looking further at the Nuttbrock study, only 40% of the self identified exclusively androphilic population had started HRT before age 20.  If this argument that HRT in adolescence explains the reduced number reporting autogynephilic arousal to cross-dressing, we would expect that those who did NOT start HRT as an adolescent to report at the same rate as the other sexual orientations.  Of those who self-identified as androphilic, all of those, including adolescent onset HRT, adult onset HRT (40%), and not on HRT (20%), the combined population had 23% report autogynephilic arousal to cross-dressing.  A little algebra and a calculator will show that those who were NOT adolescent onset HRT were reporting at the rate of 29%, far lower than the 82% of gynephilic transwomen, and even lower than the bisexually identified transwomen who reported at 67%, and the asexual at 66%.

Thus, even if HRT did what my erstwhile debating partner claimed… the data STILL would NOT show that self-reported exclusive androphiles report less than half the incidence of autogynephilic arousal to cross-dressing.  We would instead expect the later onset HRT androphiles to report at rates that were at least similar to the bisexual population.

OH… and a note on why I keep using the term “self-reported”:  There is, unfortunately for our research purposes, a well documented phenomena of “late transitioning” transwomen misreporting their sexual orientation.  It is quite possible, even probable, that the 29% rate of adult onset HRT and no HRT, is from a number of such misreporting older transitioners.

Thus, I’ve outlined my theoretical and evidence based reasons why this novel hypothesis is not supported by the data.  Instead, the data supports the two type taxonomy for MTF transsexuality, namely “exclusively androphilic vs. autogynephilic”.

To those who understand the limitations and implications of sociological and psychological studies, I’m sure that the above explication of the data is sufficient.  I’m equally certain that to those who are in denial of this research and of the Fruend/Blanchard transsexual taxonomy, what I’ve outlined above will only back them further into their denial.

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I Know What Boys Like…

Posted in Transsexual Theory by Kay Brown on June 29, 2014

♫♫I know what guys want…
They want to touch me,
But I won’t let them.♫♫
-The Waitresses

androgynous faceA while back, I explored one of the very few studies that tested Stoller’s observation that “true” MTF transsexuals, which we now recognize as exclusively androphilic MTF transkids, are “avoidant”.  That is, that though they have intimate relations with their boyfriends before SRS, they refuse to use or allow contact with their pre-operative genitalia.  Stoller (and others) held that non-exclusive androphilic women would not be “avoidant”, but would find pleasure in the use of their male genitals prior to SRS.  Now a new study explores this behavior.  But sadly, since it comes out of Europe, where they believe that age of onset of gender dysphoria, early or late, is the most important typology, the study failed to explicitly report avoidant behavior by sexual orientation.  However, I hypothesize that Stoller is correct, and that even though we don’t have explicit data in this new study, we will see a direct correlation with the percentage of exclusively androphilic transwomen in the two onset age categories and avoidant behavior.  Data is reported in the number of transwomen for each category except for that reported as percentage:

Sexual Orientation vs. Age of Onset
Onset                                                 Early         Late
Androphilic      N=                             54               20
Non-exclusively Androphilic         53               78
Percentage Androphilic:                51%            20%

Avoidant vs. Age of Onset
Onset                                                Early           Late
Avoidant           N=                            38                15
Pleasure                                             34                47
Percentage Avoidant:                     53%             24%

Note the essentially identical percentages of exclusively androphilic transwomen in each onset category and the percentages of avoidant behavior?  Thus the data supports the hypothesis perfectly.  This of course is not definitive, since we would really like to have seen the direct comparason, but if the numbers had been wildly different between them, it would have supported the null hypothesis.  The null hypothesis still cannot be ruled out… but seriously?  Seriously?

It has been my personal observation, from talking to MTFs, during my entire lifetime, that “avoidant” behavior is near universal in transkids, but very rare in “late transitioning” transwomen.  Such late transitioning transwomen have very often been sexually active with women, married to women, and have had children.  Obviously, the easiest way to have sired children is to have had vaginal intercourse (penile penetration).

Reference:

S. Cerwenka, et al., “Sexual Behavior of Gender Dysphoric Individuals Before Gender-Confirming Interventions: A European Multicenter Study” (2014)

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Etiological Conjectures, Part 3

Posted in Transsexual Theory by Kay Brown on February 14, 2013

androgynous faceAs I related in Part 1 and Part 2 of my discussion regarding etiological conjectures, there are still more questions than answers about how early onset gender atypicality and dysphoria develops.  However, there are some very intriguing clues from the biodemographics of transkids.  As I discussed in an earlier essay on how MTF transkids may be a subset population of the larger exclusively androphilic, gender atypical, but not gender dysphoric children who grow up to be conventional gay men, the biodemographics of MTF transkids seems to be very similar, if not identical, to that of at least some gay men.

Simply put, MTF transkids have more brothers than sisters, far more than one would expect comparing them to the general population.  They tend to have more older brothers than would be expected, showing that for each older brother, the likelihood that a given male would be an MTF transkid is increased by 40%.  Note that the absolute likelihood of being an MTF transkid is still very, very tiny, but the more older brothers that one’s mother had given birth to, the more likely this tiny chance is increased.  This effect is also found in conventional gay men, but only those who were feminine as children.

From this statistical anomaly, Blanchard suggested that at least some gay men and MTF transkids have an etiological cause that is effected by their mother’s prior pregnancy experiences.  His conjecture is that prior male pregnancies challenged their mother’s immune system such that they developed anti-bodies to “maleness” in some, as yet to be discovered, fashion.

I would offer a different conjecture.  It is fairly well established that placentas from each fetus a women bears releases cells that migrate to all parts of her body.  In effect, she becomes a genetic chimera, carrying the DNA of each of her children (including those who miscarried).  This means that she also carries cells in her body which are genetically “male”, that have a Y chromosome and have supposedly been epigenetically tagged as being “male” during gestastion, prior to escaping via the placenta and migrating into her own body.  I conjecture that the mother’s own epigenetic gene regulation mechanisms are invoked to bring these “male” cells in line with her female body.  If these mechanisms become especially strong, they may tag her own germ cell line prior to oogenesis with epigenetic tags that push the later born male children toward neurological femininity.

Perhaps someday, we will see which, if either, of us guessed right.

References:

Sebastian E. E. Schagen, Henriette A. Delemarre-van de Waal, Ray Blanchard, Peggy T. Cohen-Kettenis, (2012) “Sibling Sex Ratio and Birth Order in Early-Onset Gender Dysphoric Adolescents”
http://link.springer.com/article/10.1007%2Fs10508-011-9777-6

Blanchard, R., & Sheridan, P. M. (1992). Sibship size, sibling sex ratio, birth order, and parental age in homosexual and nonhomosexual gender dysphorics. Journal of Nervous and Mental Diseases, 180, 40–47.
http://www.ncbi.nlm.nih.gov/pubmed/1538206

Blanchard, Bogaert, “Homosexuality in men and number of older brothers”
http://ajp.psychiatryonline.org/cgi/content/abstract/153/1/27?ijkey=e186877631aa1c47de8fd859310668c21bcd25ef&keytype2=tf_ipsecsha

Anthony F. Bogaert, “Biological versus nonbiological older brothers and men’s sexual orientation”
http://www.pnas.org/content/103/28/10771.full

Green, R. (2000). Birth order and ratio of brothers to sisters in transsexuals. Psychological Medicine, 30, 789–795.
http://www.ncbi.nlm.nih.gov/pubmed/11037086

Blanchard, R., Zucker, K., Cohen-Kettenis, P., Gooren, L., & Bailey, J. (1996) “Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males” Archives of Sexual Behavior, 25, 495–514.
http://link.springer.com/article/10.1007%2FBF02437544?LI=true

Johannes Bohacek, Katharina Gapp, Bechara J. Saab, Isabelle M. Mansuy, “Transgenerational Epigenetic Effects on Brain Functions”
http://www.biologicalpsychiatryjournal.com/article/PIIS0006322312007299/abstract

Miranda P. Dierselhuis, Els Goulmy, “We are all born as microchimera”
https://www.landesbioscience.com/journals/chimerism/article/23348/

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Etiological Conjectures, Part 2

Posted in Science Criticism, Transsexual Theory by Kay Brown on December 25, 2012

androgynous faceAs I alluded in my previous post, scientists also like to speculate and generate conjectures regarding the etiology of transsexuals. In this post, I will explore and comment on some of them.

Many of the earlier conjectures were highly influenced by psychoanalysis, shoehorning observations into existing, yet completely untested, models of psycho-sexual development.  These were largely psychogenic theories, that is to say, that mental process create the condition, either transsexuality or homosexuality.  More specifically, they theorized that family constellations, usually an overly involved mother and a distant father create the conditions whereby a male child gets the erroneous idea that they must be female, as they can’t separate themselves as individuals from their mothers.  Or, the theory might be that fear of losing their precious penis causes them to overly-identify with their mother so that losing it doesn’t  seem such a bad alternative.  (Yes, I’m over simplifying, deliberately, sarcastically.)

Before we completely laugh at the idea of psychogenic illness, we should remember that there are several very real psychiatric illnesses which have been identified and shown, using modern science, to be of such psychogenic origin.  The most heart breaking is Reactive Attachment Disorder, which is common among institutionalized children who as babies and toddlers were literally not cuddled.  The lack of physical / emotional contact with caregivers literally creates a condition whereby these children have severe emotional and behavioral problems as they grow up (but not autism).  Another illness that has a psychogenic origin is post-traumatic stress disorder.  Although traumatic events as adults act as the proximate trigger, horrific events in childhood have been identified as leaving these individuals without the emotional resilience to weather such events.  A history of physical abuse as a child is one of the more commonly identified preconditions for later post-traumatic stress syndrome, likely due to down-regulation of cortisol production.

But, during the early to mid-twentieth century, psychoanalysis claimed illnesses were psychogenic that we now have clearly established as neurological defects including schizophrenia and autism spectrum disorders.  Typically, the quality of mothering was blamed.  (Sound familiar?)  Mothers were blamed for nearly every sort of bad outcome in their children, without ANY corroborating statistics or evidence.  The ugliest of these was calling the mothers of autistic children, “refrigerator mothers” and the mothers of schizophrenic young adults, “schizogenic mothers”.

So, in a similar vein, I call the theories that invoke parenting styles, especially those that blame mothers, for MTF transkids, the “smother mother” hypothesis.  Without ANY corroborating statistics or evidence, many psychoanalysts and their medical colleagues, accepted many of these theories as “true”.  Although it is true that many parents become emotionally distant from a transkid, this is far more likely a result, not a cause, of the child’s gender atypical behavior.  These theories, although largely abandoned by scientists, still seem to have currency with a number of therapists that I’ve talked to.  In one odd conversation I had about two decades ago, an elderly therapist acknowledged that it didn’t seem to be true of her “early transitioners”, but she was convinced that her “late transitioners and transvestites” had come from such families with smothering mothers and distant fathers.  During the conversation, I began to suspect that she was guilty of confirmation bias and of  subtly “coaching” her clients in what she expected them to say, so that they could obtain their “letters”.

To a modern scientifically based intellect, the creation and wide scale acceptance of psychodynamic theories about the origins of both typical and atypical gender and sexual behavior seems incomprehensible.  How could they ever even entertain such odd notions?  But, if we understand that the ideas have at their core, the pre-Darwinian notion that humans are a special creation, unlike any other species on the planet, it starts to make some sense.  While to us, the thought that gendered and sexual behavior comes from a mental process that, if we translated to our rodent cousins, would make it sound, and be, ludicrous:  Baby rat sees Daddy rat’s penis and notices she doesn’t have one… and envies Daddy rat’s penis… so she starts acting like Mommy rat to get Daddy rat’s affectional attention, etc.   But, if humans are special creation, the theory doesn’t have to work for our rodent, or even, or maybe especially (?) our primate cousins.  These notions had their genesis in Late-Victorian Europe, which was then struggling with the implications of Darwin’s theory of natural selection and evolution and spread to North America which is still struggling (!) .

Another hypothesis is that an anomalous hormonal environment causes cross-sex neurological development.  This is bolstered by experimental research in various animal models, usually rodents, in which exogenous hormonal intervention at certain critical times in neurological development induces cross-sex behaviors.  When coupled with the discovery of cross-sex neurological features in the brain, this would seem to clinch the matter.  Yet… and yet… it doesn’t explain how or why these events occur in otherwise phenotypically normal individuals.  Further, phenotypical markers of prenatal hormone exposure, such as the 2D:4D finger ratio have failed to provide consistent, reproducible, results.

Thus was born the “gay gene” hypothesis.  Studies of gay men and MTF transkids consistently show evidence of consanguinity, that male homosexuality and exclusive androphilic MTF transsexuality both run in families.  However, the idea of a “gay gene” caused problems with evolutionary theory, since how could such a genetic allele continue to exist against the obvious reproductive disadvantage that being gay (or transkid) naturally presented.  Researchers have spent the past two decades searching for an evolutionary advantage that the relatives of gay men and transkids might enjoy as a “carrier” of the putative “gay gene”.  But years of searching have failed to find such a gene(s).  Perhaps that’s because, there isn’t one?

Finally, we have our new variant on the “gay gene”, the “gay epigene”.  An epigenetic model is based on the recognition that genes are controlled and regulated by other genes using chemical tags, dangling links, attached to the DNA in each and every cell in the body.  These marks are like the conditional branch points, the “flags” or variables, of a computer program.  The interesting thing about such epi-marks is that though it is believed that they should all be erased between generations, many of them are not always fully erased.  This might be a mistake… or it might even be an evolved ability for a crude form of transgenerational gene regulation “memory”.  For example, if an organism needs to adjust it’s metabolism to lean times, like not enough food, by becoming careful about not burning off fat too quickly, it might be advantageous to their progeny to have that adjustment already turned on.  Just such a behavior has been seen in humans, where grandchildren of individuals who knew starvation have slower metabolisms than individuals whose grandparents and parents never knew such lean times.

One of the earliest models to include an epigenetic explanation was from Richard Green M.D., ( a stalwart friend of the transsexual community) and E.B. Keverne, a noted geneticist.  This model suggests that the failure to erase/modify epigenetic markers on the X chromosome that are supposed to be passed down to only one generation, but when passed down past that generation, are theorized to cause severe harm:

A significant skewing in the sex ratio in favour of females has been reported for the families of homosexual men such that there are fewer maternal uncles than aunts. This finding is repeated for a large series of transsexual families in this study. Four hundred and seventeen male-to-female transsexuals and 96 female-to-male transsexuals were assessed. Male-to-female transsexuals have a significant excess of maternal aunts vs. uncles. No differences from the expected parity were found for female-to-male transsexuals or on the paternal side. A posited explanation for these findings invokes X inactivation and genes on the X chromosome that escape inactivation but may be imprinted. Our hypothesis incorporates the known familial traits in the families of homosexuals and transsexuals by way of retention of the grand parental epigenotype on the X chromosome. Generation one would be characterized by a failure to erase the paternal imprints on the paternal X chromosome. Daughters of this second generation would produce sons that are XpY and XmY. Since XpY expresses Xist, the X chromosome is silenced and half of the sons are lost at the earliest stages of pregnancy because of the normal requirement for paternal X expression in extra-embryonic tissues. Females survive by virtue of inheriting two X chromosomes, and therefore the possibility of X chromosome counting and choice during embryonic development. In generation three, sons inheriting the paternal X after its second passage through the female germline survive, but half would inherit the feminizing Xp imprinted genes. These genes could pre-dispose the sons to feminization and subsequent development of either homosexuality or transsexualism.

The latest attempt to explain the presence of homosexuality goes into greater detail of how epigenetic markers canalize (channel) the sex hormone influenced masculinization in males or protect against such masculization in females.  This model assumes that all of the epimarkers should have been erased between generations, but the ones from the cross-sex parent were not fully erased:

It is well established that fetal androgen signaling strongly influences sexual development. We show that an unappreciated feature of this process is reduced androgen sensitivity in XX fetuses and enhanced sensitivity in XY fetuses, and that this difference is most feasibly caused by numerous sex-specific epigenetic modifications (“epi-marks”) originating in embryonic stem cells. These epi-marks buffer XX fetuses from masculinization due to excess fetal androgen exposure and similarly buffer XY fetuses from androgen underexposure. Extant data indicates that individual epi-marks influence some but not other sexually dimorphic traits, vary in strength across individuals, and are produced during ontogeny and erased between generations. Those that escape erasure will steer development of the sexual phenotypes they influence in a gonad-discordant direction in opposite sex offspring, mosaically feminizing XY offspring and masculinizing XX offspring. Such sex-specific epi-marks are sexually antagonistic (SA-epi-marks) because they canalize sexual development in the parent that produced them, but contribute to gonad-trait discordances in opposite-sex offspring when unerased. In this model, homosexuality occurs when stronger-than-average SA-epi-marks (influencing sexual preference) from an opposite-sex parent escape erasure and are then paired with a weaker-than-average de novo sex-specific epi-marks produced in opposite-sex offspring. Our model predicts that homosexuality is part of a wider phenomenon in which recently evolved androgen-influenced traits commonly display gonad-trait discordances at substantial frequency, and that the molecular feature underlying most homosexuality is not DNA polymorphism(s), but epi-marks that evolved to canalize sexual dimorphic development that sometimes carryover across generations and contribute to gonad-trait discordances in opposite-sex descendants.

This model has much to recommend it.  For instance, it would fit with the conjecture I made in my last post regarding the possibility of multiple semi-independent genes controlling sexually dimorphic behavior being involved. Yet,the odd thing about this recently published paper is that the authors seem to have no understanding of the nature of homosexuality and the close relationship it has with transkids, childhood gender atypicality, childhood gender dysphoria in desisting pre-homosexuals, and persisting transkids.  Incredibly, they actually predict that such epigenetic marking will have no correspondence with “gender identity”:

We describe our hypothesis for an epigenetic cause of homosexuality as a series of statements (see Figure 3 for a graphical summary):

a) Empirical studies demonstrate that XX fetuses are canalized to blunt androgen signaling (lower sensitivity to T) and XY fetuses are canalized to boost androgen signaling (higher sensitivity to T).

b) Empirical studies demonstrate the production of XX- and XY-induced epi-marks in embryonic stem cells and extensive sex-specific differences in gene expression at this time. Epi-marks laid down during the embryonic stem cell stage are also established to influence gene expression later in development. This stem cell period is the most plausible candidate time point for the production of epi-marks influencing sensitivity to androgens later in development (canalization of fetal androgen signaling).

c) Epi-marks produced in embryonic stem cells are mitotically transmitted to cell lineages leading to both the soma and the germline, and hence can contribute to pseudo-heritability when they escape erasure across generations (nonerasure in the primordial germ cells and in the zygote and first few cell divisions of the next generation). Animal models as well as human data unambiguously demonstrate that such a multistep escape from erasure does occur at nontrivial frequency.

d) Epi-marks blunting (in XX fetuses) or boosting (in XY fetuses) androgen signaling will be sexually antagonistic (SA-epi-marks) when they have a nonzero probability of carryover across generations and are expressed in oppose sex descendants. Such carryover will contribute to discordance between the gonad and one or more sexually dimorphic traits.

e) Our modeling work shows that SA-epi-marks are favored by natural selection over a broad span of parameter space because there is a net benefit to the carrier (due to canalization of sexually dimorphic development) that is not offset sufficiently by transmission (and fitness reduction) to opposite sex descendants.

f) Genetic mutations causing SA-epi-marks are expected to fix in populations and are therefore not expected to be polymorphic except transiently during their initial spread within a population. Therefore, no association between genotype and homosexuality is predicted.

g) Because the androgen signaling pathways differ among organs and tissues (e.g., use of different AR cofactors), the same inherited SA-epi-mark can affect only a subset of sexually dimorphic traits, e.g., no effect on the genitalia, but a large effect on a sexually dimorphic region of the brain.

h) Shared, gonad-discordant SA-epi-marks that carryover across generations would contribute to the observed realized heritability of homosexuality, e.g., monozygotic twins share the same SA-epi-marks coinherited from a parent.

i) Unshared, gonad-concordant SA-epi-marks, produced during fetal development, would contribute to the low proband concordance of homosexuality observed between monozygotic twins, i.e., they need not share SA-epi-marks generated during development that occurs after the twins have separated.

j) Homosexuality occurs when an individual inherits one or more gonad-discordant SA-epi-marks that are not masked nor erased by the production of de novo gonad-concordant SA-epi-marks that accrue during ontogeny. The SA-epi-mark(s) influence androgen signaling in the part of the brain controlling sexual orientation, but not the genitalia nor the brain region(s) controlling gender identity.

Perhaps they are referring not to the existence of transkids “gender identity” but of the “gender identity” of autogynephilic transsexuals? If so, I would TOTALLY agree with them. But, somehow, I believe that they are simply basing this odd assertion on the mistaken acceptance of our late 20th Century adoption of the separation of sexual orientation and gender identity as being unrelated phenomena, without having read the scientific literature dispelling it.

Thus, we see that cultural biases have and continue to distort scientific discourse into the etiology of homosexual transsexuality.

References:

David E. Simpson, J.J. Hanley, Gordon Quinn, Documentary film: “Refrigerator Mothers”
http://www.pbs.org/pov/refrigeratormothers/#.UNntP6xLnkY

Green, R., Keverne, EB., The disparate maternal aunt-uncle ratio in male transsexuals: an explanation invoking genomic imprinting.
http://www.ncbi.nlm.nih.gov/pubmed/10623499

Rice, et al.  “Homosexuality as a Consequence of Epigenetically Canalized Sexual Development”
http://www.jstor.org/stable/10.1086/668167

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Etiological Conjectures, Part 1

Posted in Transsexual Theory by Kay Brown on December 22, 2012

androgynous faceWe all love to speculate on what made us the way we are.  We all love to generate models for how the transgendered world came to be.  I’m certainly not immune to those speculations, and neither are many of the scientists who conduct research on the trans-phenomena.  About two decades ago, I formulated a model of how MTF transkids (HSTS) and conventional gay men were similar and dissimilar.  At the time, it was purely based on personal observation and conjecture.  Imagine my surprise and delight when I read a recent paper based on genetic manipulation (gene “knock-out”) on sexual dimorphic behaviors in mice that would support part of my conjecture.

Many animals who are bisexual (i.e. that come in two and only two sexes) also often have sexually dimorphic behaviors.  Typically, they involve reproductive behavior, sexual uniting of gametes, mating, and rearing or protection of their young.  The range of such behaviors found in the animal world are so diverse, that I would fill up an entire multi-volume set of books just to list them all.  However, for mammals, many of these behaviors are similar enough that we can use some animals as stand-ins for researching what is likely to be also true for humans, especially in the evolutionarily close relatives in primates and rodents.  The most useful, due to their short lifespans, small size, and ease of maintaining, are mice and rats.

My personal model has been that many sexually dimorphic behaviors are independently evolved and genetically encoded.  They are developmentally controlled by similar mechanisms such as sex hormone receptors on neurons.  This implied that masculinity and femininity (to be defined below) are not a “one shot deal” nor a simple one dimensional, nor even a two dimensional behavioral space.  That is to say, that many of the sexually dimorphic behaviors may be “switched on or off” independently.  In fact, when describing this model to others, I often asked my listener to imagine a long row of switches, which may be up or down.  Some of these switches control masculine behaviors and some feminine.  In theory, they could be in any combination, but during development, processes come into play such that the vast majority of people have all of one type, masculine or feminine in the on, while the opposite type are in the off positions.  However, in a small number of individuals some of the switches are flipped to the “wrong” state.  In an even smaller number of individuals, quite a few of the switches are flipped to the wrong state.  Some of those switches have only small effects.  But some of the switches have rather dramatic effects.

To say that a given behavior is masculine or feminine is to say that that behavior is more likely to be produced by one sex than the other.  For example, in common rabbits, a female is far more likely to pull hair from its belly to line an underground nest in preparation for caring for kits (newborn rabbits).  Thus, in rabbits, nest lining would be a “feminine” behavior.  In rodents, females are far more likely than males to exhibit lordosis, arching of the spine to tilt and raise the pelvis, than males, usually in the presence of adult male.  So we can describe lordosis as also being “feminine” behavior.  Conversely, mounting behavior is usually only seen in males, and thus may be described as a “masculine” trait.

Now, at least in mice, we have confirmation that it is possible to switch “off” individual genes that are associated with such behaviors, both masculine and feminine.  This study did not demonstrate turning “on” a cross-sex behavior, but that has been demonstrated repeatedly, if crudely, by administering cross-sex hormones to neonatal rats.   Further, in sheep, we have seen that a mix of masculine and feminine traits can coexist in that one finds male sheep who preferentially mount (masculine) other male sheep for sex (feminine).  (I needn’t provide references, given that these are well known in the literature.)

In humans, there are a range of behaviors that show varying levels of sexual dimorphism.  Simple observation would suggest that the single most sexually dimorphic trait in humans is the propensity for sexual attraction to men.  In women, approximately 98% exhibit sexual attraction to men, while in men perhaps only 5-10% are attracted to other men, and only 3% are exclusively so.  Thus, sexual attraction to men would, by our definition, be a “feminine” trait.  Interestingly, there appears to be analogs to “mounting behavior” and “lordosis” in humans.   Men who are sexually attracted to other men, also exhibit a preference for mounting (active or “top”) or lordosis (passive or “bottom”).  It is my thesis here that in gay men, independent sexually dimorphic behaviors have been feminized while others have not, and that this independent switching has occurred in varying combinations in individual men.  That is to say, that a gay man could be quite feminized in at least one behavior (androphilia) but show a range of other behaviors that may or may not also be feminine.

Which brings us to MTF transkids.

Transkids are universally attracted to men.  They are also universally obligate “bottoms”.  In fact, they are also universally “avoidant” as well.  That is to say, that they refuse to allow a partner to take notice of, or touch, their pre-op genitalia.  Transkids are also, by definition, persistors, while most gay men were at least somewhat gender atypical as young children and may or may not have also been gender dysphoric, yet they desisted being so by the time they were eleven or twelve.  Transkids remain behaviorally feminine in voice production, motor movements, etc.  I’ve often noted that many transkids are especially interested in small children and babies.  As a speculative conjecture, might the difference between conventional gay men and transkids be the number, or a key subset, of the sexually dimorphic behaviors that are possible?  That it is not so much that they are “more feminine” than most gay men, but that they are “feminine in more ways”?  So much so, that they find it far more comfortable and advantageous to transition?

Etiological Conjectures, Part 2

Etiological Conjectures, Part 3

References:

X. Xu et al. “Modular Genetic Control of Sexually Dimorphic Behaviors”
http://dx.doi.org/10.1016/j.cell.2011.12.018

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New World Order…

Posted in Transsexual Theory by Kay Brown on November 25, 2012

… at the New Women’s Conference.

androgynous faceIn the late ’90s,  a transactivist friend (the same friend with whom I had dinner in in the City just last year) cajoled me into attending the very last of the “New Womens’ Conference” events.  I was extremely reluctant to go for several reasons.  First, I had no emotional desire nor need to attend a gathering I knew would likely be comprised of only “older transitioners”, with whom I, save political interests, have nothing in common.  In addition, one of the suggested activities was to bring dildos and share a group masturbatory session together.  Fortunately, that was universally disapproved by all the rest of the conferees!  I went because of my friendship, and the fact that she worked on my interest in trans-history research, and my love of being witness to such historic events.

During one of the sessions, Dr. Anne Lawrence, gathering research material, asked a forced choice question, “Would you rather be very beautiful, but unable to pass; Or be plain but pass perfectly.”  Anne seemed very surprised at my very impassioned exposition on why I would chose passing.  “One needs to pass to have a normal life.  One does not need to be beautiful to find love.  Lots of plain women find loving husbands.”  Looking around the room at the rest of the transwomen gathered there, all of whom were lesbian identified, I found no nodding of agreement, only uncomfortable silence.  I don’t want to sound narcissistic… and you can confirm for yourself by viewing my photograph, that I both passed and am reasonably attractive… while the rest varied from ‘could pass at the grocery store’ to ‘couldn’t pass in the dark’.  I very much doubted if any of the others was living as “stealth” as I was.

This difference is generalizable to all transkids and AGP transwomen.  In my years of talking to other transkids, they universally would prefer to be 100% passable, even to being beautiful.  Most of them were passible.  Some were also beautiful.  The need to be passible, and to actually pass, to live as stealthily as one can, is likely to be so important, as to be a major factor in the “transition/don’t transition” decision making process for transkids.  Bailey, in his book, The Man Who Would Be Queen, commented on this process, noting that it was indicative of a rational decision process whereby transkids made go/no go choices on which direction would lead to the greatest social success. But for AGP transwomen, the ability to pass doesn’t seem to enter into their decisions in the slightest.

The definition of “passing” seems to me to be different for transkids and older transitioners as well.  “Passing” for a large number of AGPs seems to me to consist of the ability to go shopping or to a restaurant without receiving rude comments.  For the majority it does not seem to mean the ability to live in society for years, going to work, school, participating in civic affairs, visiting neighbors, all without any of them being aware, or even suspecting, of her transsexual status or history.  Yet, for most transkids, this is passing.  As one transkid wrote on her own blog, passing for her is going out into the street at three a.m. due to a fire in the apartment building, no make-up, no padding, in a overly large T-shirt, and the firemen calling her “Miss”.  Anything less is not “passing”.

Having stressed the importance of the ability to pass in MTF transkids, I now have to explain that not all transkids do this well.  One may view my video field guide and note that a couple of the transkids there don’t meet this standard.  Kiira, in several of our lengthy correspondences, noted that socio-economic status (SES) seemed to be correlated with passability.  She advanced the hypothesis that as SES increased, the requirement that one be able to truly pass increased.  She felt that transkids weighed their opportunities as girls against their opportunities as femmie gay boys.

As SES increases, the opportunities as femmie gay boys/men increase.   One can go to college, study the arts, get a job in fields where being gay is less of a problem, and might even be a benefit, etc.  While for low SES transkids, there are far fewer opportunities for them as femmie gay men… and many more opportunities and less social disapproval, and even the chance for a normal and fullfilling life, as a woman.  Further, in the lower classes, those individuals who are on the edge of being transkids vs. drag queen / femmie gay may be better off as a transkids.  Thus explaining why we find more “in-betweenies” as Kiira called them, on the street.  Kiira quiped that if one wanted to see a truly pure example of a transkid, one needed to look to the upper-middle-class.  (I should note, that I myself was raised as upper-middle-class, and after some difficulty in my early adult years, rose back to that level in my mid-20s.)

Thus, we see opposite effects of socio-economic status in transkids vs AGP populations in that higher SES means fewer transkids and more AGPs.

Although there is limited statistical and anecdotal published data to support the above hypothesis, no one has, to my knowledge, done a proper study to develop a path model for transkid decision making.  <Hint to grad students>  I look forward to such a study.

Further Reading:

Passibility differences between transsexual types

On Privilege and Entitlement in the Transgendered Communities

 

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We’re freakin at the freakers ball…

Posted in Editorial, Transsexual Theory by Kay Brown on March 24, 2012

Kay BrownWhere all the fags and the dykes, they’re boogyin’ together
The leather freaks are dressed in all kinds of leather
The greatest of the sadists and the masochists too
Screaming “Please hit me, and I’ll hit you”

-Dr. Hook and the Medicine Show

Last summer, I had dinner at a restaurant in the City with a transactivist friend of mine that I hadn’t seen in nearly a decade.  It was pleasant enough, until she started on a rant about Anne Lawrence, with whom we have both been acquainted for many years.  My friend wanted me to agree with her that Anne was doing the “community” a horrible disservice, “She’s trying to turn us all into paraphiliacs!”  I replied, quite honestly and ironically, “No, she isn’t…”  But left the rest of my thought unsaid: “… she can’t make you be what you already are.”  But, although I didn’t voice my real opinions, she kept up her rant.  She argued that Anne was wrong because it would harm the community. She never asked me about this blog, nor did I volunteer that I was writing it.  She seemed to take it for granted that I, as a long time transactivist, would agree with her that we should all fight against Dr. Lawrence’s work, ignoring my personal history, and what that might mean regarding my personal views on the subject.  What struck me later about the evening’s discussion, that while always friendly, despite our not agreeing, was that my friend, though a biological scientist herself, never once tried to argue her point based on the science, but rather on the politics.  That it was wrong to do the science, if the science itself would lead to certain knowledge that most transwomen were autogynephilic, and that autogynephilia was the cause of their gender dysphoria and cross-gender identity, as that would lead to the public no longer seeing MTF transsexuals as “women in men’s bodies”.    I countered that science is what it is, and the truth is what it is.  I made it clear that I support science, and that the truth is always a good thing to know.  I came away with the certain knowledge that among the transactivist community, it was very well understood that the science did, and would continue, to support the Freund / Blanchard two type taxonomy of MTF transsexuality.

There are several elements to this story.  First, is Anne Lawrence really demonstrating that non-homosexual transsexuality is a manifestation of a paraphilia, to wit, autogynephilia?  Second, is autogynephilia a “mental disorder”?  Third, is that really so bad?

First, is Lawrence demonstrating that non-homosexual transsexuals are autogynephilic?  Yes, but her work is largely redundant to the science that has been so meticulously done by Freund, Blanchard, and even, if unintentionally, Nuttbrock.  Further, one of the best documentations that autogynephilia is the root cause of non-homosexual transsexuality was done by Doctor and Prince, who showed that cross-gender identification was most commonly preceded by years of autogynephilic cross-dressing, that transvestism and non-homosexual transsexuality are both a continuum and a progression.

Among our subjects, 79% did not appear in public cross dressed prior to age 20; at that time, most of the subjects had already had several years of experience with cross dressing. The average number of years of practice with cross dressing prior to owning a full feminine outfit was 15. The average number of years of practice with cross dressing prior to adoption of a feminine name was 21. Again, we have factual evidence indicative of the considerable time required for the development of the cross-gender identity.

So, MTF transactivists can hardly blame Lawrence for merely adding to what has already been very convincingly demonstrated.  The real value of her work has been to expand on the theme, adding weight to the need for compassionate therapeutic and surgical intervention to allow AGP transsexual women to live fulfilling lives.

Does Lawrence consider autogynephilia, and by extension, autogynephilic transsexuality a paraphilia?  Again, Yes, as her 2004 paper states that explicitly in its title, “Autogynephilia: A Paraphilic Model of Gender Identity Disorder”, and in the text,

…Blanchard’s autogynephilia theory helps explain why transvestism and transsexualism are often associated with other unusual erotic interests. Sexual scientists have observed for decades that unusual sexual interests— sadomasochism, bondage, autoerotic asphyxia, interest in leather and rubber, exhibitionism, voyeurism, infantilism, pedophilia—frequently do not occur in isolation, but instead tend to co-occur. Males who have one unusual sexual interest are far more likely to have one or more other unusual sexual interests than would be expected simply by chance (Abel & Osborn, 1992; Wilson & Gosselin, 1980). And other unusual erotic interests are very common among transvestites and some MtF transsexuals. Wilson and Gosselin (1980) found that 63% of their sample of transvestites and transsexuals also described fetishistic or sadomasochistic interests. Blanchard and Hucker (1991) reported that transvestism accompanied many cases of autoerotic asphyxia. Abel and Osborn (1992) documented the co-occurrence of transvestism and transsexualism with other paraphilias. If transsexualism and transvestism are purely gender-identity-based phenomena, then these associations makes no sense. But if transsexualism and transvestism sometimes represent unusual sexual interests—as Blanchard’s autogynephilia theory proposes—then their association with other uncommon sexual interests does make sense.

So, I believe that Lawrence convincingly demonstrates, from prior studies, that autogynephilic transsexuality is most definitely a paraphilia.  But is it a “mental disorder”?  Again, from another, more recent paper from Lawrence,

Does the desire for sex reassignment in autogynephilic MtF transsexuals represent a mental disorder? I contend that it does. To meaningfully address the question, one must attempt to define the term mental disorder, an obligation that writers who discuss this topic — including Meyer-Bahlburg (2010) — too often neglect. For purposes of discussion, I will use the definition proposed by Wakefield and First (2003), in an article cited by Meyer-Bahlburg; similar definitions have recently been proposed by Stein et al. (2010) and First and Wakefield (2010). According to Wakefield and First, a mental disorder is “a ‘harmful mental dysfunction,’ with harm being determined by social values and the word dysfunction referring to the failure of a mental mechanism to perform its natural (i.e., evolutionarily selected) function” (p. 28). Wakefield and First recognized that an evolutionary analysis created potential epistemological challenges but argued that often “one can judge with some plausibility the functions and dysfunctions of a [mental] mechanism (or at least that a function or dysfunction likely exists), with no need for detailed direct knowledge of the evolution of the mechanism.” (p. 39). They added that, in many cases, “one can make such inferences without knowing anything about the actual mechanisms. . . . Indeed, many of the DSM’s categories (e.g., sleep disorders, sexual and gender identity disorders) clearly correspond to types of inferred designed mechanisms that have gone wrong.” (p. 36). Wakefield and First considered a dysfunction to be harmful if it carried significant “negative implications for the individual’s overall well-being” (p. 34), or perhaps sometimes for the well-being of others (p. 41). They also emphasized that the dysfunction must be “in the individual” (p. 34) and “cannot be due only to social deviance, disapproval by others, or conflict with society or others” (p. 34). Although Wakefield and First’s definition may not be perfect, it provides a starting point for discussion, and the analysis that follows is not highly dependent on its specific details.

In autogynephilic MtF transsexuals, it is reasonable to infer that the mental mechanism responsible for accurately “locating erotic targets in the environment” (Freund & Blanchard, 1993, p. 558) has failed to perform its natural function: Specifically, there has been a partial or complete failure of the evolutionarily selected mechanism that keeps heterosexual erotic interest (i.e., gynephilia) directed toward erotic targets external to the self. Autogynephilic MtF transsexuals experience a powerful erotic interest in turning their own bodies into facsimiles of their preferred erotic targets (females), an interest that competes with and sometimes completely overshadows erotic interest directed toward external female partners (Blanchard, 1992). It is easy to understand why evolutionary selection might favor the development of a mental mechanism that would keep gynephilic men’s erotic interest focused on external female partners. When a gynephilic man’s erotic interest is instead directed primarily toward his own feminized body, one can reasonably infer that this putative mental mechanism has wholly or partly failed. If the foregoing analysis is correct, then the desire for sex reassignment in autogynephilic MtF transsexuals — that is, in many or most nonhomosexual MtF transsexuals — represents a genuine mental dysfunction.

Again, Lawrence convincingly argues that autogynphilic transsexuality is a “mental disorder”?  But is this a “bad thing” in and of itself?  That is to say, it it morally reprehensible?  Who is harmed?  No one.  As Cantor poignantly states regarding all human beings with paraphilic sexualities,

It is here that I must draw an important, but usually unmarked, distinction: I personally agree wholeheartedly that everyone with atypical sexual interests deserves respect and full recognition of all their civil rights; however, I disagree that answers to scientific questions can be identified by presuming the desired outcome and then backwards-engineering one’s interpretation of the research data to guarantee arrival at that outcome. Moreover, and perhaps more importantly, questions of rights fall outside the purview of science. People deserve respect and civil rights regardless of the scientific classification of their sexual interests.

Herein lies an important point, an atypical sexuality, per se, should never be the cause of unreasoning stigma or discrimination.  But, it often does.  In point of fact, homosexuality itself, though generally not thought of as either a paraphilia nor a mental disorder, has still a very negative stigma and even legal sanctions against it.  So, whether a phenomena is officially, or unofficially, recognized as a paraphilia has no bearing on whether it will or will not be stigmatized.  Transsexuality, like homosexuality, is stigmatized regardless of whether it is understood to be a paraphilia or a mental disorder.

Anne Lawrence, and all of the scientists and clinicians working to better understand the transsexual phenomena, are not responsible for the stigma and discrimination.  But, hopefully, with better understanding of our two, separate, conditions, both autogynephilic and homosexual transsexuals will each be better off, with appropriate and compassionate medical care.

Further Reading:

Essay on Co-occurance of Paraphilias

References:

Lawrence, A., “Autogynephilia: A Paraphilic Model of Gender Identity Disorder”
http://www.annelawrence.com/autogynephilia,_a_paraphilic_model_of_GID.pdf

Lawrence, A., “Do Some Men Who Desire Sex Reassignment Have a Mental Disorder? Comment on Meyer-Bahlburg (2010)”, Archives of Sexual Behavior (in press)
http://www.annelawrence.com/desire_for_sr_a_mental_disorder.html

Cantor, J., “Is Homosexuality a Paraphilia? The Evidence For and Against”
http://www.springerlink.com/content/00311501070l6321/fulltext.pdf

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