On the Science of Changing Sex

Straight Men Viewing Nudes Of Pre-Op Transsexuals

Posted in Transsexual Field Studies by Kay Brown on February 23, 2023

In a very recently published paper by a graduate student in Vasey’s team, Heatlie added to our knowledge that straight men can and do find pre-op transsexuals sexually arousing to a small degree when viewing static images. This adds support for Hsu’s earlier work. The paper is available online so I highly recommend reading it. However, I do have some comments about it to share.

The study used pupillary dilation response while viewing to measure arousal and compared that to subjective responses while viewing nudes of four different stimuli sets, men, women, and two types of gynenadromorphs (GAM).

Heatlie used two “types” of gynadromorphic stimuli, one “with breasts” and one “without breasts”. Surprise surprise, straight men found those with breasts more arousing. Sadly, we do not have examples of the stimuli. This is a serious deficit in evaluating the paper in that we don’t really know just how “feminine” those without breasts are. Those with breasts most likely have been on feminizing Hormone Replacement Therapy (HRT) for some time, even if they had elected to have breast implants. We simply do not know whether those “w/o breasts” have had any HRT. Thus, these stimuli subjects may look rather phenotypically male in other respects, not just genitally. They may just look like normal boys in the nude!

Note that the straight subject’s pupils actually contracted upon seeing the nude men, indicating that they found these images aversive. But the GAMs with no breasts were not aversive, but not very arousing either. A bit of a side comment here: The paper said the difference was “not significant”. This is NOT a measure of the meaning or size of the difference, but rather a comment on the statistical strength of the evidence, the measurement being somewhat noisy and the number of subjects being measured rather limited (N=65).

Some of the comments in the paper suggest that the authors do not understand the difference between control men and “chasers”, men who specifically seek out gynandromorphs, even though they cite Hsu’s work on this very subject, “Many men who seek out gynandromorphs as sexual partners cite the femininity of such individuals as being a key motivator (e.g., Kulick,1997Mitsuhashi, 2006Operario et al., 2008Reback & Larkins, 2006Rosenthal et al., 2017). Some studies have characterized the femininity of gynandromorphs as more accentuated than the average cisgender female (Gerico, 2015Operario et al., 2008Reback and Larkins, 2006). These findings could be viewed as at odds with our results, given that participants were more sexually aroused to cisgender females than to gynandromorphs, with or without breasts.” They fail to note that most (perhaps all) such men are also autogynephilic, experiencing a paraphilic interest, not a conventional interest, in gynandromorphs.

The study also used nude static stimuli, which the authors recognize may not capture the salient factors that conventionally heterosexual men may find attractive that overcomes their aversion to gynandromorphs, their genitalia, “Consequently, our nude stimuli may have failed to capture many of the qualities (e.g., clothing, voice, and body movements) that communicate femininity, or accentuated femininity, and elicit sexual interest from gynephilic males in naturalistic contexts. Conversely, given that our stimuli were nude, the obvious presence of gynandromorphs’ penises may have negatively influenced participants’ subjective ratings of sexual arousal and their pupil dilation.” My response is “No shit, Sherlock”

Further, there is a classic behavior in such gynandromorphic individuals being “avoidant”, disliking letting their partners touch or view their genitalia. This widely shared behavior reduces straight men’s aversion. The use of nude photos of gynandromorphs unnaturally circumvents this, distorting the data.

The paper makes a claim that I just can NOT agree with, “These data are consistent with the conclusion that the capacity for some, albeit low level of sexual interest in gynandromorphs is an invariant capacity of male gynephiles, even in cultures such as Canada where sexual interactions between gynandromorphs and gynephilic men are relatively rare…” These interactions are only “rare” because GAMs, pre-op androphilic MTF transsexuals are rare. If they had surveyed such they would learn that we have no trouble finding straight men who find us sexually desirable.

Update 2/23/2023: The lead author responded:

Hi Candice, thank you very much for your thoughtful essay. I had some thoughts as I read it: 1.The feminine males were characterized as such on the basis of having traditionally feminine hairstyles, make up, and poses. However, we do address the limitations inherent to this approach in our limitations section. Because we will likely be reusing this stimulus set for another study (in order to triangulate our findings using another measure), I am unable to share the images online. 2.Participants’ pupils did not constrict in response to images of males. Pupil change was standardized (i.e., converted to z-scores), and negative values simply suggest that most measurements fell below the mean. The difference between cisgender males and gynandromorphs without breasts was both non-significant and small (d = .37). In general, psychologically relevant stimuli do not elicit constriction. 3.I feel it is important to note that when we say that sexual interactions between gynandromorphs and heterosexual men are relatively rare, we are simply referring to the prevalence of such relationships. As compared to many other cultures such interactions are reported less frequently by Canadian men. We are not making a statement about the attractiveness of gynandromorphs.

Further Reading:

Essay on attraction to gynandromorphs

Essay on pre-op MTF transsexuals being “avoidant”


Heatlie, L, et al, “Heterosexual men’s pupillary responses to stimuli depicting cisgender males, cisgender females, and gynandromorphs”, Biological Psychology (2023), https://doi.org/10.1016/j.biopsycho.2023.108518

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

Posted in Transsexual Field Studies by Kay Brown on February 14, 2023

Social fads tend to have rapid rises and rapid fades. They begin with just a few people, early adopters, then grow exponentially when highly influential celebrities or “trend-setters” adopt it. They begin to fade when the novelty factors no longer operate and the celebrities and trend-setters abandon it. One of the factors that begins the fade phase of the fad is when a growing number of people point out how silly or nonsensical the fad is.

Such may be what is happening with non-gender dysphoric / gender typical / straight people, mostly teenaged girls and young women claiming to be “trans” and/or “non-binary”.

This concept probably originated in the autogynephilic male cross-dressing (i.e. transvestite) community. Decades ago, they would often describe their cross-dressing as “exploring their feminine side”. There was an organization called the Society for the Second Self, often simply called “Tri-Ess” for short. Many such men would sometimes describe themselves as “Bi-Gendered” in a direct reference to the term “Bi-Sexual”, having both a male and female gender and expression.

But sometime in the early 2010’s, a number of women started claiming first to be “trans” when they clearly were not, to be “cool”. Why? Hard to sort out the beginnings of any social fad, but I strongly suspect it had to do with the unfortunate practice of Hollywood using non-trans actors to portray transsexuals.

The use of non-trans folk as transsexuals has the unfortunate effect of misleading people about the nature and expression of transsexuality. It was bad enough when young transitioning, naturally feminine, exclusively androphilic, Male-To-Female transsexuals were represented in film and television by masculine straight men, trying to act “feminine / gay”, giving the distinct impression of such transsexuals as being more like overly dramatic drag queens. But when young, feminine heterosexual women are cast as Female-To-Male transsexuals, especially if the actor is popular and admired, portrays transmen as “cool”, as was happening in some shows and movies (e.g. Hillary Swank), it misleads teenaged girls to falsely believe that they too could be “cool” and trans.

But then, actual transmen pushed back, pointing out that claiming to be transsexual when they were clearly not gender dysphoric (the definition of “transsexual”) was “uncool”. These young women likely picked up and modified the original “Bi-Gender” concept, making a reference to “asexual” to be “agender” and then “non-binary”. The value of claiming to be “non-binary” was that one didn’t need to be gender dysphoric, nor even gender atypical. It was the perfect way to claim to be “trans” without actually being “trans” anything.

Sometime in the 2010’s, the fad took off when such celebrities as Demi Lovato declared herself to “non-binary”. Here was a very feminine, heterosexual woman, who could be emulated by teenaged girls and young women, without the cognitive dissonance of knowing that they were NOT actually “trans”.

Looking at some data in a relatively small study by Katiala-Heino, et al, comparing 2012-13 scores to 2017,

“The aim of this study was to explore whether there has been an increase in prevalence and changes in sex ratio in feelings of gender dysphoria (GD) in an adolescent population in Northern Europe, and to study the impact of invalid responding on this topic. We replicated an earlier survey among junior high school students in Tampere, Finland. All first and second year students, aged 16–18, in the participating schools were invited to respond to an anonymous classroom survey on gender experience during the 2012–2013 school year and in the spring and autumn terms of 2017. Gender identity/GD was measured using the GIDYQ-A. A total of 318 male and 401 female youth participated in 2012–2013, and 326 male and 701 female youth in 2017. In the earlier survey, the GIDYQ-A scores, both among males and females, were strongly skewed toward a cis-gender experience with very narrow interquartile ranges. Of males, 2.2%, and of females, 0.5% nevertheless reported possibly clinically significant GD. The 2017 GIDYQ-A distribution was similarly skewed. The proportion of those reporting potentially clinically significant GD was 3.6% among males and 2.3% among females. Validity screening proved to have a considerable impact on conclusions. GD seems to have increased in prevalence in the adolescent population.”

The authors noted that testing for dishonesty was highly correlated with positive answers to GD questions, especially among males. But note that the number of girls claiming to be “trans” jumped nearly five fold, from 0.5% to 2.3%, from 2012 to 2017.

This caused the exponential growth of the fad though “social contagion”. Such ridiculously high percentage of teenagers and young people, mostly female, claimed to be “trans” and “non-binary” (the two were very often lumped together as “gender diverse”) in polls that soon headlines with claims that transfolk were common in young people. It also lead to the false notion that there was an epidemic of actual gender dysphoria, because of the use of superficial trappings of FtM transsexuals to become known as “Rapid Onset Gender Dysphoria”. This became weaponized in the current culture and legislative war against transkids and their medical care.

To be sure, the number of female teenagers referred to therapists and clinics because they claimed to be “trans” increased, but the numbers were not really out of line with the small number historically expected based on the number of adult transmen transitioning in past. Though, it was obvious that some of the increase was caused by non-gender dysphoric girls mistakenly referred to the clinics.

As I said, fads eventually fade. When will this one fade? Could it be that it already is? Demi Lovato went back to “she/her” pronouns last year, indicative of the “influencer” effect fading.

Consider that in Turbin, et al, they used a very large poll from two different years. They found 2.4% (similar to the 2.3% from Finland that same year) and 1.6% respectively. If the numbers can be trusted, the drop over the two year period from 2017 to 2019 of 50% would indicate that the fad is fading. Another researcher with extreme numbers, Kidd, found in her survey that it had dropped from 10% a few years ago to 7% in 2022, a 30% drop, also indicating that the fad is fading. What of the numbers being referred to clinics?

Our favorite Netherlands clinic recently published a paper on 20 years of treating transkids. This is a graph from that paper showing the number referred to the clinic each year.

Note that the number of those older than ten years old (pre-teens and teens) peaked in 2017 and then dramatically dropped (nearly 45%) in 2018. We don’t have more recent data, but this does agree with the other data points we have.

It looks like the fad may have peaked in 2017. I shall be keeping an eye on this to see if the apparent fade continues.

Further Reading:


Butterfly Effect

Lost In The Crowd

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

ROGD Redux

External Reading:

Wikipedia Entry on Fads


Katiala-Heino, R., et al, “Gender dysphoria in adolescent population: A 5-year replication study” Clinical Child Psychology and Psychiatry (2019)

Turbin, et al., “Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents In The United States”, Pediatrics (2022), https://doi.org/10.1542/peds.2022-056567

Kidd, K. et al., “The Prevalence of Gender-Diverse Youth in a Rural Appalachian Region”, JAMA Pediatrics (2022), DOI:10.1001/jamapediatrics.2022.2768

van der Loos, et al., “Children and adolescents in the Amsterdam Cohort of Gender Dysphoria: trends in diagnostic- and treatment trajectories during the first 20 years of the Dutch Protocol”, The Journal of Sexual Medicine, 2023;, qdac029, https://doi.org/10.1093/jsxmed/qdac029

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Is Ehlers–Danlos Syndrome Really Associated With Gender Dysphoria?

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

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

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

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

But why should a connective tissue problem cause gender dysphoria?

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

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

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

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

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


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

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

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One’s Job or Education Do NOT Define Either HSTS Nor AGP Transwomen

Posted in Autobiographical, Transsexual Field Studies by Kay Brown on January 17, 2023

— Just as one’s job or education do NOT define men nor women.

For over a decade, I’ve been writing on the Science of Changing Sex, explaining how the science supports the Two Type Taxonomy. This after spending years researching, teaching, and writing about our history. (Trivia: many of the current texts on our history have borrowed rather heavily from that earlier work. No, I’m not upset by that, but pleased it has become so well known.) That after having worked as an early transsexual rights activist, including joining with several other transsexuals to form the ACLU Transsexual Rights Committee in 1980. This early work almost certainly set the stage for later activists to join in that work.) Sadly, while there has been progress in understanding the nature of the Two Type Taxonomy, there is a continuing denialist opposition to it. That opposition has not restricted itself to respectful scientific arguments, but often descends into personal attacks, calumny, and character assassination.

Please Read “What The Next Wave of Transgender Activists Need To Know”

One of the silliest of these is based on mistaken sexist stereotypes about the differences between the two types, sadly started by several of the top sexologists that researched the taxonomy and support further research and education, to wit, that Autogynephilic (AGP) transwomen are very likely to be “geeky” and become scientists, engineers, and technologists while Homosexual (HSTS) transwomen are not. This is based on the totally erroneous idea that straight men are more interested in these careers than either women or gay men, by nature. The other false stereotype is that HSTS are too stupid to have such careers, having lower IQ than average. This too was started by an offhand personal obsersation by a sexologist.

Please Read “Stereotypes Are Dangerous” and “The Right Stuff”

The reality is that women are just as likely to be interested in such educations and careers as men, when given the chance and not discouraged from doing so. And HSTS show the same average IQ as the general population, though very rare, there are HSTS with very high IQs.

Please Read “Tech Bros and Silicon Valley’s Misogyny Problem”

From the graph, we can see how women, when the sexist limits on their enrollment in the physical sciences, legal, and medical fields were reduced, the percentage of women seeking degrees in those fields climbed and now has reached near parity with men. Computer Science is the only field where the enrollment initially climbed, then fell off. It was NOT that women didn’t like the field. It was and remains a problem of a toxic culture in computer programming where immature, misogynistic, young men make studying and working in the field a hostile environment for women.

Women have long wanted to be scientists and technologists. Consider these women: Ada Lovelace who worked with Babbage on the concepts of computer programming before computers existed; Maria Sklowdowska Curie who was awarded, not one, but two Nobel prizes in physics and chemistry; her daughter Irène Joliet-Curie who also won a Nobel prize in chemistry; Lise Meitner, who should have won the Nobel Prize for the discovery of atomic fission that led to nuclear power. The list is long. Although these are extraordinary women for their accomplishments, they are not unusual for being interested in science.

I would argue that gay men are also just as likely to be interested in these fields, though we don’t have as much documentation to prove it. But consider Alan Turing, one of the most celebrated mathematicians and computer pioneers of the 20th Century, was gay. Today, we have Tim Cook, CEO of Apple, Inc., one of the most successful Silicon Valley companies. The most amazingly brilliant technologist who ever reported to me was an undergraduate summer intern from MIT in the early ’80s. When he later came out, he asked me if I knew he was gay before. “I knew the day I hired you!”. He later earned a Ph.D., published a textbook on robotics, and became a Silicon Valley executive.

The stereotype of autogynephilic transwomen being geeky also fails to hold water when we look at them and note how many have careers that are not at all “geeky”, but are stereotypically male/masculine coded like law enforcement, military, construction, transportation, etc. Then there are the number who are living in poverty and squalor because they have no marketable skills acceptable to (accepting of) women post-transition.

Thus, women and gay men like and pursue education and careers in the physical sciences and technology just as much as straight men. But straight men will avoid fields that are coded as “women’s work” or feminine/”gay”. Autogynephilic transwomen notoriously have the same aversion pre-transition. So, while we can NOT use pursuing an education in the sciences or working in technology as a useful marker for autogynephilia, nor as exclusionary of being homosexual (transsexual or not); we can use female coded careers and jobs, especially those pursued before transition, as likely exclusionary of being autogynephilic and also increasing the odds that such an individual is homosexual (transsexual or not).

Back to the issue of what does define and differentiate the two types of transwomen. Very simply, their sexuality. One is gynephilic and autogynephilic, the other is androphilic (homosexual w/ respect to their natal sex). Nothing else defines the two types.

However, there are indicia that highly correlate with the two types. In my years of examining the science literature I have found seventeen independent lines of evidence that correlate and supports the two type taxonomy. None of them are educational / career interests. Some of these correlates can only be used at the population level, but several can be used at the individual level: gender atypical behavior as a pre-adolescent, age of onset of gender dysphoria, age of social transition, and of course, definitionally, sexual history (showing actual sexual orientation).

Please Read the first few entries in the “FAQ on the Science of Changing Sex”

The Personal Is Political

Back to the problem of the denialism and of the calumnious attacks, specifically, those attacks on me. In an ironically revealing, one might even say, self-own, they simultaneously claim that there is no two type taxonomy and nearly in the same breath tell me to shut up because I must be AGP as well because of my interest in the sciences and my long career in Silicon Valley! But as I showed above, that does NOT define nor differentiate the two types. But if one examines my bio, one can find all the indicia needed to determine which etiological type I fall into.

Please Read “About”

Consider this section to be an expansion of my bio, focused on those indicia. As I said in my bio, the only honorable defense against lies is the truth.

My mother, during an interview with Dr. Fisk at the Stanford Gender Dysphoria Clinic, complained bitterly about my early gender atypical behavior, under the false impression that he would be attempting to “cure” me. I was but 17 years old at the time.

“I have known for years that he wanted to be a girl.  But I thought that was [morally] wrong.  He was very different than his brothers.  All their friends were boys.  His were always girls,” naming several of my friends over the years, starting with those when I was five and six years old, but couldn’t remember my friend who had been my only guest on my tenth birthday.  “Marian,” I interjected for the only time during the whole interview.  “He was always very prissy.  He would walk clear around even the shallowest puddles.  When he was little, I would put him in clean clothes on Monday and on Friday they would still be clean.”  She confirmed that I had been sent to a therapist about my behavior when I was ten years old and again when I was 15/16.

When I was nine years old, at the end of 4th grade, our elementary school was planning one of those embarrassing shows where students perform for their parents and friends. I’m sure you know the type I’m talking about. I was cast for a part but when told the details of the part, I had a total emotional melt-down, tears, loud drama, refusing to take a male role. It set off a chain of interviews and behind the scene discussions with my parents that I only learned about years later. The next school year, I was required, by the school district psychologist, to be sent to a very special therapist some miles from our home, to “play” and talk with Dr. Peters every Friday afternoon. Interesting thing about the playroom. It had only boy’s toys, which held zero interest for me. Sometimes, we played chess, but otherwise, we only talked. Why?

Please Read, “Shameful History of Reparative Therapy of Transsexual and Gay Children”

I’ve already disclosed a few details about how in Jr. High, I spent my time at the library reading about girl’s fashion, make-up, etc. I also practiced putting on make-up, borrowing my mother’s, given that we had the same coloring, etc. I was always careful to put everything back exactly as I found it and to wash my face carefully, but she knew I was doing it. She just couldn’t catch me at it.

One of the stories my mother would tell other mothers, often in my presence to try to embarrass me, was about the day she was sitting out on the lawn pulling weeds when she saw me at a distance walking home from school. When I saw her, I discretely adjusted the stack of books I was carrying (female style, books against my chest, if you must know), sadly not discretely enough. She would tell her listeners that she was convinced that I must be bringing home and attempting to hide, pornography, so she later searched my room. What she found instead was a book on manners and etiquette for teenagers, mostly for girls.

When I was fourteen, my freshman year in high school, Debra asked me to the Sadie Hawkins dance. I loved dancing and she was one of my friends so I agreed. A couple weeks after the dance, she invited me over to her house. Her mother wasn’t home as I had expected her to be. Debra went into her bedroom and changed out of school clothes and into a very revealing, slinky dress. She literally draped herself across me as I sat on the front room couch. Disturbed, I pushed her off of me and jumped up off the couch. She tried to cajole me into rejoining her on the couch but I refused, as I paced the floor. She gave up and changed back into more modest jeans and top. The next day, as school ended, she again invited me over to her house, but I turned her down. Debra broke into tears and ran away. We never spoke again.

During the next summer, just after I turned 15, I took square dancing classes with one of my female friends. I paid special attention to the girl’s part, intending to attend square dances as a girl, and dance with the cute boys. My friend supported this plan and lent me one of her square dancing outfits. My mother discovered the plot and forbid me to attend any more lessons and forced the return of the outfit.

Another girl, who was in the square dancing crowd freaked out and cut me off when I came out to her. Thank goodness we didn’t go to the same school. But I hated losing friends.

We moved to a new house in a nearby suburb a couple months after that and I transferred to the local high school. I joined up with a crowd of kids that included a boy, Greg, I had known in Jr. High. He now lived with his mother and new stepdad, while his brother Jeff (Not my husband Jeff) lived with his dad and attended my old high school. Thus, my circle of friends doubled as I kept in touch and occasionally met with my old friends. One of those old friends, Dennis, would meet me half-way, at Cassie’s house. Dennis was very comfortable being affection with me, often letting me massage his back or just sitting close. One day, at Cassie’s, the two of them started making out hot and heavy right in front of me. The green eyed monster joined us and took over. I stormed out, slamming the door as hard as I could. For the next week, Dennis tried calling me several times a day. I just hung up on him as soon as I heard his voice. After a week, Cassie called. I wasn’t mad at her. She could make out with any boy she wanted as far as I was concerned. Cassie said to me, “You have punished him enough.”

So, with that we agreed that I would go to Cassie’s and talk to Dennis, to patch things up. But I had a plan. Cassie agreed to let me come early and borrow her clothes. She was two inches taller and a bit bigger, but her dress size was close enough to mine. I met Dennis wearing a cute blouse with a jumper dress over it, panty-hose and nice shoes. Dennis and I talked pleasantly, never once making any reference to how I was dressed. I was trying to let him see that I was attracted to him, etc. He didn’t reject me, but wasn’t going to be dating me either. Oh well… I tried. Skipping forward three years for just a moment. Dennis visited me right around graduation. During a walk around the block, away from other’s ears, he asked, “You going for that sex change?” I answered simply, “Yes.” Upon which he said, “Good luck.” and hugged me.

That same year, aged 15, my mother decided it was time she dealt with me and my “homosexuality”. She first took me to our family doctor for a physical and a consult about it. There didn’t seem to be anything physically wrong, save that I was “underdeveloped” (and stayed that way, thank the Blessed Goddess… At 15 I was perhaps at Tanner stage 3, I never reached stage 5). He recommended a therapist, Dr. Kanski, who I had to see once a week to “talk about my problem”. I would talk very pleasantly about almost any subject, but my sexual orientation and gender dysphoria / identity. Dr. Kanski later told my mother that I was “uncooperative”.

Around this time Jeff introduced me to his best friend Kevin. I had a huge crush on him for the rest of my time in high school. Jeff and Kevin occasionally came over to our house. My mother would notice that I got excited each time they did this, but thought it was Jeff that I had a crush on.

Later that year, as I was helping Cassie with her homework (I was often asked to help others and gladly did so), she reached under the table and grabbed my genitalia, saying in coquettish voice, “My mother won’t be home for hours.” I was horrified! I pulled her hand away from me and pretended nothing had happened. She started to slide her hand to my crotch again but I grabbed it and held it tight against her leg, while continuing to explain the homework problem. I was hurt and angry. She knew about my transsexuality. Why would she should do this?

The summer, just after I turned 17, I got a job as a full-time nanny taking care of two boys, ages ten, and four. Their mom later wrote a letter of introduction and recommendation using my new name and gender. The family also gave me some of her older, but stylishly appropriate for a teenager, clothes that would fit me.

Our house was next door to our community pool. We often had friends over for a swim, including Cassie and Barby, among others. One day, I picked up Barby from her house in our family’s spare car to go for a swim. She was wearing a skimpy bikini and nothing else. As we were going down the street, she grabbed my hand and pulled my hand to her crotch. (You just know that a straight boy would have loved it and also be having ‘trouble’ with his own.) I was never more grateful that I was driving a car with a manual transmission as I removed my hand back to the gear shift knob.

It was past time I came out to Barby.

My senior year I called our family doctor and asked for female hormones. His reply was, “You can do anything you want with your life, but I won’t be any part of it.” Soon after that I found a reference to the Stanford Gender Dysphoria Clinic. On the phone, they said I needed to have my parents make the appointments, etc. After some serious family drama, my Dad did. After the intake interviews with Dr. Fisk, I filled out their required paperwork at school, with friends looking over my shoulders, offering comments. Both of my parents tried to talk me out of transition.

Please Read “Cognitive Dissonance…”

A few months before graduation rolled around, I was out to all my close friends and word was getting around. Of course, the fact that I was often seen around town or at the mall with friends dressed as a girl helped that. But, I still had to present as a boy in class. I openly hung up my new wardrobe in my closet, earning silent glares of disapproval from my mother, but gave her a ‘I dare you’ look back. But after graduation, I was living full time as a girl.

At one point my father strongly suggested, “Have sex with a girl.  I’m sure that will change you.  What about one of your friends, Barby, or Cassie?  Wouldn’t they do it to help you?”  I replied angrily,  “I’m sure they would.  But that won’t change me and I DON’T want to have sex with them!”

I turned eighteen a week before graduation. My dad came over to wish me happy birthday and give me a present, the only one I got from anyone, a nice clock radio. I would need it as he also told me I was being evicted from my mother’s house and not allowed to move in with him.

I won’t go into details, that’s not anyone’s business; I dated several boys/young men from my circle of high school friends starting then and for the next few years. But one of my boyfriends, Jordan, from that time, later introduced me to his wife as his “first girlfriend”. Think about that, a straight man was proudly telling his wife that his first relationship was with a pre-op transwoman! Of the others, my mother had accused Jeff of being my lover. Wrong, he had rebuffed me… his brother Greg on the other hand… The one that really created family drama was Don, my brother’s best friend.

Barby complained, bitterly and unkindly, that I was “boy crazy”.

Bob at Jeff’s and my wedding in 1999

The relationship that lasted the longest was Bob. His mother was an engineer, president of the Silicon Valley chapter of the Society for Women Engineers. I was a welcome guest at their family dinners. She strongly encouraged me to study engineering. When he was away at Rensselaer, back east, we handwrote letters often and occasionally talked long distance on the phone. I learned from one of his housemates on the phone that when Bob was lonely, he would open the drawer where he kept my letters, just for the waft of my perfume I scented them with. When he was home… we dated on and off like that for several years. in the end though, he married my best friend Jan and raised two girls with her. But we remained friends. In fact, Bob attended my wedding to Jeff.

I remained friends with several female friends, most especially Jan and Robyne, occasionally sleeping over in their bedrooms. Think about that for a moment. Their families had known me for years…Robyne’s since Jr. High, do you think for one moment that they would let me be alone, in their teenaged daughter’s bedrooms over night, if they thought I might be interested or capable of having sex with them?

As to choice of careers. I love teaching and have been an instructor/tutor in several schools in several subjects, from teaching little kids swimming to teaching teens and adults flying. I started my career in Silicon Valley as a secretary / administrative assistant. I worked as an electronic assembler (a female coded job) and proceeded up the ranks of supervisor and management, all while earning a degree by examination after self-study. That’s not the career arc of a typical AGP.

So, remembering the definitions and indicia of sexual history & orientation, childhood gender atypicality (as reported by my mother), age of gender dysphoria onset, age of transition, etc. What type am I?

I have no doubt the AGPs in denial, haters, disappointed chasers, and TERF/GC folk will all still tell lies. But I know who and what I am.

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Sex Reassignment Surgery Demographics in the Netherlands

Posted in Confirming Two Type Taxonomy, Transsexual Field Studies by Kay Brown on January 5, 2023

Our favorite folks in Amsterdam have provided data set on MTF transsexuals receiving SRS in their clinic covering 40 years. The paper is openly available online, not behind a paywall, so you may read it for yourself. But I have a few observations and comments regarding the data and the authors’ comments.

First, let’s look at the data, reorganized into putatively HSTS vs. AGP. (Yes, given all we know about MTF transwomen, I will assume that all non-exclusively androphilic transwomen are AGP.)

Table 1

Demographics of transgender women undergoing primary genital gender-affirming surgery at the authors’ institution between January 1980 and January 2020

Age at surgery (SD=1)33 (25–44) 33 (24–44) 32 (26–45) 54 (45–60) 
Sexual orientation (self report) n=699 6454212
HSTS n= (%)372 (53) 357 (55) 13 (31) 2 (17) 

As the authors noted, “Individuals who opted for GCV (vulvaplasty only, no vaginoplasty) were generally older, had no history of puberty suppression, and were more frequently sexually oriented towards women.” The same could be said for orchiectomy as well. HSTS are must more likely to want/need vaginoplasty over other possible choices as one would expect, so as to be able to have vaginal intercourse with men.

The authors made a comment that I found ahistorical. They believe that GCV is a relatively new procedure. It is not. In fact, Christine Jorgensen had GCV only in 1952, as reported by her surgeon, Dr. Christian Hamburger, as neither of them desired to facilitate sex with men. Similarly, “orchies”, as we called them back in the 1970s, was common for both HSTS and AGP in the early 20th through the mid- to late-20th Century due to greater ease of obtaining them. (Some of this was due to the Eugenics Movement, which was only too happy to sterilize “perverts”.)

Finally, the authors wrote about encouraging “fertility preservation” but seem to lament that it isn’t possible for those who begin puberty blockers early, “The increase in individuals starting puberty suppression at early pubertal stages, when serum testosterone concentrations are insufficient for spermatogenesis, may lead to an increase in individuals without options for preservation of fertility.” This strikes me as “unclear on the the concept” as why would such MTF early transitioners, who are all HSTS (as even this clinic’s own data attests), want or need to cryostore sperm. Just who will they impregnate, their future husbands?


Van der Sluis, et al., “Surgical and demographic trends in genital gender-affirming surgery in transgender women: 40 years of experience in Amsterdam”, British Journal of Surgery, Volume 109, Issue 1, January 2022, Pages 8–11, https://doi.org/10.1093/bjs/znab213

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More Proof That Transsexual Teens Persist

Posted in Transgender Youth by Kay Brown on October 21, 2022

We have another paper looking at the number of transsexual teens that began puberty blockers and/or HRT who continue to take them into adulthood. That is to say, that they ‘persisted’. This is important because transphobic activists keep pushing a propaganda lie that most gender dysphoric youth ‘desist’ being such and detransition, to become “detrans”.

From the study,

“720 people were included, of whom 220 (31%) were assigned male at birth and 500 (69%) were assigned female at birth. At the start of GnRHa treatment, the median age was 14·1 (IQR 13·0–16·3) years for people assigned male at birth and 16·0 (14·1–16·9) years for people assigned female at birth. Median age at end of data collection was 20·2 (17·9–24·8) years for people assigned male at birth and 19·2 (17·8–22·0) years for those assigned female at birth. 704 (98%) people who had started gender-affirming medical treatment in adolescence continued to use gender-affirming hormones at follow-up. Age at first visit, year of first visit, age and puberty stage at start of GnRHa treatment, age at start of gender-affirming hormone treatment, year of start of gender-affirming hormone treatment, and gonadectomy were not associated with discontinuing gender-affirming hormones.”

The latest paper adds another 720 subjects from the Netherlands to the 1,057 in the UK [Butler] study earlier this year for a total of 1,777 teens who began medical transition treatment. In the UK study showed that 94.5% of the teens persisted into adulthood while the Netherland study showed that 98% did so. Combined, the number is 95.8%. Round it off to 96%.

In this study, age at beginning treatment did not correlate with ‘desistance’, which is not the case with the UK study which showed that those that did desist, had been on the younger side. This is in keeping with earlier studies from the Netherlands and Canada that showed that those that desisted, did so BEFORE puberty, and thus never began medical treatment.

Once again, we have solid, reproducible evidence that transsexual teens are unlikely to detransition, to stop medical transition. Any who say otherwise are either misinformed or are willfully lying.

Further Reading:

Transsexual Teens In UK Gender Dysphoria Treatment

Age of Innocence (Desistence)


van der Loos, M. et al., “Continuation of gender affirming hormones in transgender people starting puberty suppression in adolescence: a cohort study in the Netherlands”, Lancet (2022), https://doi.org/10.1016/S2352-4642(22)00254-1

Butler G, Adu-Gyamfi K, Clarkson K, et al., “Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021” Archives of Disease in Childhood (2022) doi: 10.1136/archdischild-2022-324302

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Transsexual Teens In UK Gender Dysphora Treatment

Posted in Editorial, Transgender Youth by Kay Brown on August 20, 2022

In a spate of recent UK media there was a wild accusation that a “thousand” youths were suing the National Health Service for wrongly pushing them into transsexual medical treatments. But there is a serious problem with this statement. That number, a thousand, is roughly the TOTAL number of transsexual teens that have been treated in the UK from 2008 through 2021. Are ALL of them suing the NHS? No, the story is disinformation generated by a transphobic propagandists under the rubric of the “Big Lie” theory, that the bigger the lie, the more believable it is. In truth, very few teens would be unhappy with receiving treatment and most would be very grateful. (Though they may grumble about aspects of the hoops they had to clear to get it.)

I’m a US citizen living in California, so I have zero direct experience with the UK NHS and their gender dysphoria treatment system. But as I understand it, to get treatment, one must jump through multiple hoops, first convincing a (potentially transphobic) skeptical General Practitioner (GP) to provide a referral to the Gender Identity Service (GIDS). The GIDS does a psych and history evaluation and may or may not provide a referral to the Endocrine Service which may or may not then provide puberty blockers (PB) or cross-sex Hormone Replacement Therapy (HRT).

If you were to believe the propaganda, you would be think that the NHS hands out HRT like candy on Halloween. They do not. Further, the real numbers from these clinics show that the number of teens treated is NOT indicative of an “epidemic” of gender dysphoria. Far from it.

We need to review some stats. The current population of the entire UK is a bit over 67 million people. The long time historical estimate of actual transsexuals, those who experience gender dysphoria, seek medical treatment, and live full time as the opposite sex is known to be less than one in ten thousand (<1:10,000). That includes those that seek treatment as adults. So, the maximum number of people we expect in the NHS system receiving HRT and later Sex Reassignment Surgery for gender dysphoria would be less than 7,000 people TOTAL. So, we expect, that the number of transsexual teens would be some lower number. And that is exactly what we see.

Consider the recent paper published in the British Medical Journals by Butler, et al. In it we learn that the NHS Gender Identity Services referred only 1,151 teens for evaluation between 2008 and 2021 inclusive. Of that only 1089 had known outcomes. Of those, 32 did NOT receive hormonal medical treatment, likely realizing that they weren’t actually gender dysphoric when confronted with the reality of what that really meant. (That is, they were likely falsely claiming to be “trans”, which has become a very popular fad among teens and young people such that there are likely over 500 people falsely claiming to be “trans” or “non-binary” for every actual transsexual.) Of the remaining 1,057 teens, 58 (5.5%) later elected to cease medical treatments leaving 999 that continued into adulthood.

Again, this is NOT indicative of a sudden epidemic of gender dysphoria among teens. In fact, it is perfectly in keeping with the number we expect from decades of clinical experience. Most especially, these numbers put the lie to the assertion that a thousand youths are planning to sue the NHS for medical malpractice. It also gives us an insight into the relative stability of gender dysphoria and of transsexual identities in teenagers, that so called “desistence” occurs before puberty onset.

Further Reading:

More Proof That Transsexual Teens Persist

How Many Transfolk Are There, Really?

Lost In The Crowd – The recent phenomena of young people falsely claiming to be “trans” or “non-binary”

Age Of Innocence – Clinical evidence that “desistence” occurs before puberty onset.


Butler G, Adu-Gyamfi K, Clarkson K, et al., “Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021” Archives of Disease in Childhood (2022) doi: 10.1136/archdischild-2022-324302

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No. Iran Does NOT “Force” Gay Men & Lesbians To Be Transsexuals

Posted in Editorial by Kay Brown on July 28, 2022

For several decades now, I’ve seen the same claim made, usually from transphobic elements in the Gay & Lesbian communities, but increasingly in right wing heterosexual circles, that gay men and women, especially gay men, are “forced” to have sex reassignment surgery in Iran. They rarely have any actual data to back up their claims, only nebulous references to anecdotes that they heard from somewhere else. Occasionally this story shows up on a newspaper or magazine, usually of the tabloid / yellow “journalism” type.

It’s long past time to carefully examine these stories, where they come from, why they persist, and what the real facts are.

First, one must know that the idea of gays and lesbians being “forced”, or in modern transphobic parlance, “transed” is many decades old. The story is usually told that a “gender non-conforming” (read: gender atypical) gay boy or tomboyish girl / lesbian, is pushed to be transsexual by their homophobic parents. This is itself a strange notion, that homophobic parents wouldn’t be just as transphobic. It also stretches credulity in that it pre-supposes that transsexuals will successfully avoid public scrutiny when they transition such that homophobic parents can, as though by magic, suddenly introduce their “straight” daughter or son that their other relatives, neighbors, and co-workers, had never heard of before… and my oh my… don’t they remind everyone about their obviously gay / lesbian child that they had met before?

This also goes against the actual experience of both homosexuals and transsexuals, in that such ‘phobic parents would MUCH rather have a CLOSETED homosexual child than an out transsexual child. Many transsexuals with such ‘phobic parents have experienced entreaties from parents that “couldn’t they just be closeted homosexual instead?”

So why does the idea that transsexuals are pushed into being transsexuals occur at all? Because it is the corollary of that other false narrative popular within the transphobic elements of the gay and lesbian community that transsexuals are homophobic themselves and having internalized this homophobia, seek to live as heterosexuals by changing their sex. Never mind that such Homosexual Transsexuals (HSTS) were nearly all extremely gender dysphoric as young children and had long desired, indeed, made up their minds, that they would grow up to be the opposite sex, long before coming to understand what their sexual orientation might be. Only as they matured, did they realize it would take medical interventions for this to occur. They (we) do not hold homophobic views, internalized or not.

Back to the Iran myth. What is true is that Iran, like many other nations, both Islamic and Christian, have a history of social and legal persecution of homosexual people. Slowly very slowly, some Christian nations changed their laws in fits and starts, sometimes becoming better for gays and lesbians, sometimes becoming better for transsexuals. Did you know that transsexuals are still being legally harassed by police in the United States? We call it “trans while walking”. Look it up. Today, half of the US States are working to pass bills that specifically target transsexuals, our families, and access to medical services. There are similar issues occurring in other Western, mostly Christian, nations. But in Iran, an odd thing occurred after the Islamic Revolution. While homosexuality, or rather it’s direct practice, remained criminalized as it had been earlier, in 1987, a transsexual, a pre-op transwoman who had been able to obtain HRT, reached their top cleric and reminded him that in the Hadith (stories of the Prophet Mohammed’s life and sayings that were not included in the Quran) included details of Mohammed’s friendships and acceptance of what would clearly be recognized today as “homosexual transsexuals”. She begged him to explore this history. The result was a fatwa that specifically sanctioned the existence and medical treatment of transsexuals in Islam.

So, jump back to the West and know that some transphobic elements in the gay and lesbian communities saw this as being unfair. Why should non-gender-dysphoric gays and lesbians continue to be legally and socially discriminated against (and indeed, why should they?) in Iran while transsexuals have a free pass, a “get out of jail free card”? This anger, combined with the earlier angry myths of parents forcing their homosexual children to be transsexuals and the myth that transsexuals are just self-hating homosexuals transitioning to escape homophobic (and in the case of transmen, sexist) discrimination, naturally lead to the false narrative that Iran is “forcing” gays and lesbians to have sex reassignment surgery. They don’t actually need evidence, certainly not of the kind that involves data, to prove it’s happening. Just the horror at the thought of being forced to “change sex” vs. being jailed for being gay is enough to let others who hear the myth believe it unskeptically.

But, we do require such evidence! Because the data, the numbers, just didn’t fit that narrative.

But let us say for the moment that it’s true, that Iran is rounding up homosexuals and forcing them to have sex changes. What would the data look like? What it should look like is that there would be far more people having sex reassignment surgeries in Iran, per capita, especially per homosexual population, than in the West. But is this true?

Consider that it is now well known that homosexuality is universal, occurring in all societies, throughout history, and at about the same rates. It’s public expression may vary, due to repressive legal and social circumstances, but the actual sexual orientation and desire remain constant at about three percent (give or take depending upon definitions, etc.).

Now compare that the number of actual transsexuals in the United States at around ~6/100,000 people. So, 3% G&L = 3,000/100,000 against 6. Thus, in the United State, one of the most transsexual and homosexual friendly nations in the world (not the best, but near the top) the ratio of homosexuals to transsexuals seeking social and medical transition is 500 to 1.

Back to Iran. How many transsexuals are seeking medical transition? It is only 1.46/100,000. So, in Iran that ratio of homosexuals to transsexuals is a whopping 2055 to 1.

Let’s turn our attention to the data on who is getting medical transition services. Here we see something interesting in that multiple separate papers both show that the average age for SRS for both natal sexes is around 25 years old. Further, the data for MTF transsexuals shows that 90% report being “early onset”. This is what we would expect given Iran’s culture and the correlation between a given culture’s level of individualism vs. the number of “late onset” transwomen transitioning. The numbers add up with what we would expect for those receiving transition services to be naturally occurring gender dysphoric people, freely choosing it.

The numbers do NOT support the allegation that gays and lesbians are being “forced” to undergo an unwanted “sex change”, the data would in fact, suggest the opposite, that transsexuals in Iran are exactly the people we expect to find. Neither the government, “society”, nor transsexuals’ families are “forcing” transsexuality upon unwilling gays and lesbians.

Instead of spreading the myth of unwanted, forced, “sex changes”, the LGBT community should be decrying the recent vicious propaganda against transsexual people in Iran (and elsewhere).

Further Reading:

Transphobic Propaganda Aimed at Parents of Transsexual Kids

Stolen History: False Narratives of Transsexuals Transitioning Because of Homophobia & Sexism

Data On Transsexual SubTypes In Iran


Talaei, et al, “The Epidemiology of Gender Dysphoria In Iran: The First Nation Wide Study”, Archives of Sexual Behavior (2022), https://doi.org/10.1007/s10508-021-02250-y

Ahmadzad-asl, et al., “The Epidemiology of Transsexualism In Iran”, Journal of Gay & Lesbian Mental Health (2010), https://doi.org/10.1080/19359705.2011.530580

Sadr, M., Khorashad, B.S., Talaei, A. et al. “2D:4D Suggests a Role of Prenatal Testosterone in Gender Dysphoria” Archives of Sexual Behavior (2020)

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Autistic Sunset

Posted in Editorial by Kay Brown on July 1, 2022

As noted before, gynephilic transmen are not only “butch” but somewhat “hypermasculine” in some respects. This shows up in being more likely to be somewhere on the autistic spectrum. We now have another study that confirms this observation and some other observations regarding transwomen as I will explore in this essay.

The new study is out of the UK, which will be an important point, so keep in mind given that we know that the UK, like the US, has a very “individualist” culture and that in such cultures, autogynephilic transwomen significantly out number homosexual transwomen. Thus, this data for transwomen is very, very likely ONLY from autogynephilic transwomen. I point this out because the data clearly shows that transwomen in the study are nearly identical to control men and very different than control women; that autogynephilic transwomen has been shown before by Jones, et al. as the data documents.

Group:               Men                  Women       FTM                 Non-Androphilic           Androphilic
.                                                                                                     MTF  N=129                   MTF N=69

Score (SD):       17.8 (6.8)        15.4 (5.7)     23.2 (9.1)         17.4 (7.4)                         15.0 (5.6)

In this new study, the trend that transmen have high Autistic Quotient scores compared to everyone else remains, and thus can be considered to have been replicated.

Control women2119.439.931921.0510.821913.749.68
Control men1818.117.611820.8310.001818.946.82
Transwomen (AGP)1820.179.061822.069.011721.249.54

The table shows the data for the mean Autism Quotient (AQ), the Emotional Quotient (EQ), and the Systematizing Quotient (SQ) scores and their standard deviations from the new Hendriks, et al. study.

As well the AQ scores being substantially different, the EQ and SQ scores for transmen are different than control women, but only slightly higher than for both the control men and notably, the transwomen. At this point, it might be well to ask, “how different” by calculating Cohen’s d for some of these population differences. The difference between control men and the transmen for AQ is d = 0.86, a fairly large, but not super large difference. It certainly does show that transmen are as a population, likely to be “on the spectrum”. But more importantly, it shows that the brains of exclusively gynephilic (as all these subjects were) are masculinized, even hypermasculinized, as one would expect them to be.

The other interesting point is how different the control women and transwomen are in their Systematizing Quotient with d = 0.77, reasonably large effect size indicating that women and (likely to be autogynephilic) transwomen are very different in this regard. How different are they from control men? First note that their score for transwomen is even more “masculine” than control men with d = 0.28, small but detectable. Again, as with the Jones study, this shows that autogynephilic transwomen are NOT very different than control men in these important, sexually dimorphic phenomena, and thus NOT feminized, nor even hypomasculine.

Further Reading:

Autistic Sky


Jones, et al, “Female-To-Male Transsexual People and Autistic Traits”, J. Autism Dev. Discord. DOI: 10.1007/s10803-011-1227-8

Hendriks, et al, “Autist Traits, Empathizing-Systematizing, and Gender Diversity”, Archives of Sexual Behavior (2022), https://doi.org/10.1007/s10508-021-02251-x

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Biological Reality! Transsexual Women’s Breasts Are Female Breasts

Posted in Transsexual Field Studies by Kay Brown on May 19, 2022
Kay Brown with her adopted daughter Liz

Yesterday, a post about a transwoman breastfeeding a baby went viral. As one could imagine, transphobic commentators had many nasty, ugly comments to make. However, it also became clear that they were under the misapprehension that transwomen couldn’t breastfeed, “Your male body can’t produce milk!” “You don’t have female breasts.” “Where is the colostrum?” “Where are the lobules?” Why do they object to this knowledge and go into deep denial? Could it be because of their reliance on an ugly propaganda slogan of “biological reality” which they say transsexuals are in denial of… yet, here is something that they claim can’t be done, a true female biological function that can only be performed by women, by only natal female women, that is being done by transwomen. Learning that transwomen can and do perform this uniquely female, womanly function of sharing life giving milk with a baby upsets their world view and their propaganda.

So, sad as the need to explain such basics of mammalian biology to the world is, it must be done, as these ignorant and false assertions from these transphobes proves.

First, it important to understand that each and every gene that a woman has is also found in males. Females have two copies of the X chromosome while males have only one. But they still have that one. Further, many of the genes needed to express female phenotype aren’t even on the X chromosome, they are spread over the various autosomal chromosomes. To get a male, one need the genes on the Y chromosome, most particularly the SRY gene that first tells the proto-gonads to become a testes instead of the default ovary. But after that, nearly all the rest of sexual development is under the control of hormones produced by the testes.

If the body lacks the usual androgen (testosterone) receptor gene(s), even if that body has all the other typical genes and chromosomes for a male, that body develops in a rather typical female pattern. This condition is called 46XY CAIS, complete androgen insensitivity syndrome. They have typical testes in a seemingly typical female body phenotype, and most importantly for our discussion, women’s breasts at puberty.

Breast tissue does not care if there are XX vs. XY chromosomes. Breast tissue, like all secondary sexual characteristics that develop at puberty, are under the influence of sex hormones. Sex hormones can and should be viewed as specialized growth hormones. Various tissues express different sensitivities to the various sex hormones and will grow or not grow depending upon the presence and balance of these specialized growth hormones. In particular, breast tissue responds to estrogen and progesterone and are somewhat suppressed by androgens.

Circling back to transwomen, we note that Hormone Replacement Therapy (HRT) uses the very same hormones that induce breast tissue development in women. Transwomen have all the genes and breast tissue stem cells needed to develop fully functional FEMALE breast tissue. When a transwoman begins HRT, her breasts respond and begin to develop. After sufficient time, her breasts are histologically identical to adult natal female breasts. That includes the potential for lactation.

A woman does NOT have to have given birth or even have been pregnant to lactate. It certainly helps, given that certain hormones automatically are produced in amounts that prepare the breasts to produce first colostrum then milk, but isn’t an absolute requirement. The key requirement is that of tactile stimulation that a baby’s suckling produces and that once a flow of colostrum is present, that it be drawn out, either by a baby suckling or by manual expression / pump.

If a woman is adopting or working with a gestational surrogate, she may elect to breastfeed her baby by following a regimen of stimulation, expression, and pumping. In some cases, medication may aid in this process.

Many transwomen have produced colostrum due to HRT which in some cases, primes the breasts in the same manner as being pregnant. (I myself have produced colostrum.) If a transwoman is adopting, working with a gestational surrogate, or has a female partner who is expecting a baby, she too may elect to breastfeed her baby in the same manner as would any other non-birthing woman.

The milk produced by a transwoman is identical to milk produced by a natal female. Transwomen have been quietly, successfully, and safely breastfeeding babies for decades. They will continue to do so.

Biological Reality.

Further Reading:

Baby Hunger


de Blok, et al, “Frequency and outcomes of benign breast biopsies in trans women: A nationwide cohort study” The Breast: Official Journal of the European Society of Mastology, (2021) https://doi.org/10.1016/j.breast.2021.03.007

Wambolt, R. et al, “Lactation Induction In A Transgender Woman Wanting To Breastfeed: Case Report”, Journal of Clinical Endocrinology & Metabolism, (2021), https://doi.org/10.1210/clinem/dgaa976

Kulski, J., et al, “Composition of breast fluid of a man with galactorrhea and hyperprolactinaemia”, Journal of Clinical Endocrinology & Metabolism, (1981), https://doi.org/10.1210/jcem-52-3-581

Breastfeeding Without Giving Birth

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