On the Science of Changing Sex

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

Tagged with:

Comments Off on Autistic Sunset

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

Tagged with: , ,

Comments Off on Biological Reality! Transsexual Women’s Breasts Are Female Breasts

Transsexual Kids DO Know

Posted in Editorial by Kay Brown on May 5, 2022

Having real data trumps ideological assertions. The “ideology” I speak of is that of transphobic individuals who falsely insist that transkids are too young too “know” – to know who they are, to know their hearts, to know what social gender they best fit in as, to know their minds regarding what constitutes their best chances for future happiness and social success. These ideologist don’t actually say this in true sympathy or empathy with transkids. They say it because they don’t want transkids to grow up to be transsexual adults. They don’t want transkids to grow up to be those people. Data trumps this false assertion, this false empathy.

Over the past decades, data about transkids has been growing. One thing that former transkids (those individuals who had been “early onset”, both gender atypical and gender dysphoric before puberty and are now adult transsexuals, have been saying is that they took to social transition, at whatever age they were able, most as teens or early ’20s in the past, given parental and societal opposition, with great relief and ease. Indeed clinicians have long documented this phenomena. They have also pointed out that they would have benefited from social transition at a far younger age to avoid social difficulties growing up. They actively point out that such social transitions would also differentiate those who would be ‘persisters’ from ‘desisters’, that attempting to socially transition, even before their teens, works as a “Real Life Test”. Those that are likely to desist, are not likely to find social transition all that appealing nor will they remain socially transitioned, if they do. We now have the data to back that up.

Dr. Olson’s latest paper in Pediatrics, “Gender Identity 5 Years After Social Transition” followed a large cohort of transkids starting at age three to twelve as part of an ongoing longitudinal study. The paper is available online, NOT behind a paywall, so it is well worth reading for yourself if you wish to follow-up on my explication of it. But before we dive into the data, I need to deal with an unfortunate misuse of language that the authors have chosen to use.

In the transsexual community, the term “retransition” has a specific meaning that the authors of the paper have turned on its head to the opposite meaning in some cases and its proper meaning in others. Specifically, in the transsexual community, the term means one has once again began living as the opposite of their natal sex after having “detransitioned”, reverted back to living as their natal sex, for a period of time. But the authors of the study use the term “retransition” for BOTH situations. The authors made clear they know that they are making this confusing misuse of the established vernacular, but chose to do it anyway. I will not. So, when I am quoting them, I will substitute the proper term {detransition} for clarity by including it in curly brackets to show when they are misusing the term “retransition” in the original text.

Let’s take a look at the abstract by way of introduction of the study and the data,

Background and Objectives. Concerns about early childhood social transitions amongst
transgender youth include that these youth may later change their gender identification (i.e.,
retransition), a process that could be distressing. The present study aimed to provide the
first estimate of {detransitioning} and to report the current gender identities of youth an
average of 5 years after their initial social transitions.
Methods. The present study examined the rate of {detransition} and current gender identities
of 317 initially-transgender youth (208 transgender girls, 109 transgender boys; M=8.1
years at start of study) participating in a longitudinal study, the Trans Youth Project. Data
were reported by youth and their parents through in-person or online visits or via email or
phone correspondence.
Results. We found that an average of 5 years after their initial social transition, 7.3% of
youth had {detransitioned} at least once. At the end of this period, most youth identified as
binary transgender youth (94%), including 1.3% who {detransitioned} to another identity
before returning to their binary transgender identity. 2.5% of youth identified as cisgender
and 3.5% as nonbinary. Later cisgender identities were more common amongst youth
whose initial social transition occurred before age 6 years; the {detransition} often occurred
before age 10.
Conclusions. These results suggest that {detransitions} are infrequent. More commonly,
transgender youth who socially transitioned at early ages continued to identify that way.
Nonetheless, understanding {detransitions} is crucial for clinicians and families to help make
them as smooth as possible for youth.”

Note that that there are about twice as many MTF transsexual children (“transgender girls”) as FtM transsexuals in the study. This is in keeping with decades of demographic data that show that there are more MTFs than FtM transsexuals. As adults, there are usually so many more “late onset” MTFs than “early onset” such that the ratio is much higher. (Note that I am excluding the recent fad of large numbers of girls and young women falsely claiming a “trans” or “non-binary” identity.)

Note also that of those who detransitioned / desisted, they did so before age 10.

“All but one of the 8 cisgender youth had {detransitioned} by age 9 (the last {detransitioned} at 11)”

This is in keeping with earlier data that showed that desisters always did so before puberty and the age of seven to ten was critical in this process. While persisters reported that the ages of ten to thirteen saw that their gender dysphoria increased and cemented their transsexual (cross-sex) gender identity. Note that of this cohort who had attempted social transition, only 2.5% of them had truly desisted. That is to say, pre-pubertal social transition was overwhelmingly comprised of persisters. The “Real Life Test” works as was predicted years ago, as the study authors also suggest, in a typical “science speak” way,

“It is possible that some youth initially try socially transitioning and then change their minds quickly. Such youth would be unlikely to be enrolled in this study because their eligibility period would have been quite short and therefore the odds of finding the study and completing it would have been low. This means the children in our study may have been especially unlikely, compared to all children who transition, to {detransition} because they had already lived – and presumably been fairly content – with that initial transition for more than a year.”

Further Reading:

Desisting vs Persisting in Gender Atypical Children

Transkids Transition Because They ARE Transkids


Olson, K., et al, “”Gender Identity 5 Years After Social Transition”, Pediatrics (2022), 10.1542/peds.2021-056082

Tagged with: ,

Comments Off on Transsexual Kids DO Know

The Effect Of Socio Economic Status On Transsexuals

Posted in Editorial by Kay Brown on March 27, 2022

There have been many who have commented upon, and even some actual data, to suggest that there is a correlation between Socio Economic Status and etiology found in MTF transsexuals. However, many have made silly and unsupported suppositions as to why this should be. Most mistake the arrow of causation.

For “late onset” (autogynephilic) transwomen, the arrow of causation is very straight forward. Transition is socially, financially, and personally expensive. It often entails loss of career opportunities, loss of income, loss of family connections, divorce, child custody and ensuing child support payment obligations, etc. The very process of transition also entails costly medical and other “gender affirming” procedures (therapy, facial hair removal, hair transplants, etc.) Thus, an individual contemplating transition naturally weighs their ability to “afford” these social and financial costs. This means that the higher ones personal Socio Economic Status, the more likely an autogynephilic male will transition.

Note that is their status AT THE TIME OF TRANSITION !

The arrow of causation is reversed for an HSTS. If she has risen to some level of career success or not, it is an effect of having experienced the visicitudes of being gender atypical, homosexual, and transsexual. It is NOT the cause of her being transsexual and certainly not of having chosen to transition.

For a teenager in transition, an “early onset” Homosexual Transsexual (HSTS), their future SES is an unknown country on the one hand, and likely NOT to become very great, given statistical and cultural realities on the other, especially if their family has already or is very likely to disown them. (I’ve written on this issue before.) If an HSTS works very hard, has a few lucky breaks, and becomes socially and financially stable, even “successful”, this cannot have had a retroactive influence upon her decision to transition. And certainly NOT upon her sexuality.

There have been, and will continue to be, HSTS who achieve some degree of success, even of considerable success in business or industry. Being hungry, cold, and homeless as a teenager and early 20 something often has the effect of driving one’s ambition to never be so again. And if they take advantage of their early education and social connections in a given industry, this cannot be seen as evidence of their sexuality or etiology, only of their “invisible knapsack” of knowledge, packed by their early experiences.

On the other hand, there are many HSTS who never do become financially stable, much less attain notable social, business, or career success, often trapped in a vicious cycle of poverty from an early age. But again, this too is a result, not a cause of their transsexuality.

However, there is a correlation with family of origin’s SES and HSTS, as has been noted by various observers and found in some of the datasets (e.g. Nuttbrock). J. Michael Bailey in his book, The Man Who Would Be Queen, speculated that feminine androphilic males that come from better SES would work harder to “normalize their gender identity”, to be a desister. To be honest, this notion felt wrong somehow.

Consider that desisters always do so BEFORE puberty. This smacks of biology, not sociology. Frankly, I doubt many pre-pubescent children think very deeply about their future careers and their chances of success as gay men vs. HSTS.

One interesting data point is that there are more HSTS transkids raised in middle and upper-middle-class families after adoption than would be expected. Similarly it has been noted that there are more HSTS in foster care than random chance would account. If the issue was low SES in the family that was raising them to persist to become HSTS instead of desisting to become gay men, they should have been desisters per Bailey’s speculation. But they didn’t desist.

We may now have another working hypothesis. It comes from all places, research on 2D:4D ratio of fingers. As I’ve pointed out before, there is some evidence that 2D:4D ratio is both sexually dimorphic and is correlated with both sexual orientation and gender atypicality, including being HSTS. This new data shows a correlation between the mother’s SES during pregnancy and a feminized 2D:4D ratio. That is to say, it suggests that women, without their conscious control, adjust their own hormones to favor masculinity if they are well off, and femininity if they are poor. How one’s SES causes this is as yet unknown, but the data is there.

There is a linear correlation between the 2D:4D ratio and SES as shown in this graph. Poor families have children with more feminized hands due to hormones in the womb. Since the 2D:4D ratio is stable from birth, the effect is only from prenatal exposure to hormones. While this effect is likely not enough on its own, in combination with other factors such as genetics / epigenetics (androphilia and HSTS “running in families”), the Fraternal Birth Order Effect, perinatal hormones, and perhaps other influences yet to be discovered, this maternal SES effect on hormones may be enough to cause the noted statistical finding of more HSTS coming from low SES households.

It is important to note that this SES effect would ONLY be operable prenatally. If the child is adopted, fostered, or if the mother should experience a dramatic increase in SES while she was raising her feminized male child, that child’s then experienced SES would have no bearing on that child’s sexual orientation, gender atypicality, or gender dysphoria. The SES effect would have already done it’s work, causing a locked-in effect. In this case, we would see a SES effected HSTS, but one who grows up in a much more privileged environment and thus much more likely to face the adversities thrown at such teenaged transsexuals and able to overcome them.

These findings have a personal resonance. My own 2D:4D, at 1.06 is literally off the chart feminized, one could describe it as hyperfeminized, not just hypomasculine. Given that we also know that such ratios are found to anti-correlate with sports performance, one would expect that I would be a very poor athlete, which was true. But, as many who know me (or think they do) have no doubt observed, I came from a fairly well off family. But what they don’t realize is that was only true of the second half of my childhood.

My father grew up in Port Arthur, Texas, a dirty, smelly, working class petroleum refining town on the Gulf Coast. He was born in the fall of 1929, right as the economy crashed. He grew up poor as poor can be. He shared stories of how he and his brothers would fish and hunt for crawdads in the Gulf waters to put food on the table. But he and his siblings were very smart and managed to get into college in spite of this lack of funds or legacy, partly on the GI Bill from serving during the Korean War. Even his gay brother climbed out of that poverty through study and hard work, largely because of their father (my grandfather) insisting upon it.

My mother grew up in a tiny farm town in the middle of nowhere on the boarder of Texas and Oklahoma. Her family was a little better off than my father’s, mostly by dint of hard work farming and ranching. (I have childhood memories of collecting eggs from the hen house and of feeding hay to the cows on their farm.) My mother too was very smart, graduated from high school at age 16 to attend college to earn a teacher’s credentials at age 19, graduating as a married woman with a baby in her arms, me. My father worked at a bowling alley, between classes, to support his young wife and child. My siblings came along in rapid succession. Thus, while my mother was carrying me, my parents were dirt poor students from working class families. Things must have been rough for my parents at first. Me? I don’t remember.

My father was proud to have worked his way out of the poverty he grew up in… earning his place in middle and even upper-middle-class professional circles, but always carried a bit of baggage from his childhood, especially around the topic of food. He would become enraged at food waste for example, remembering days of hunger. There was never the entitled expectation in our household that other well off families taught their kids. Instead, my father was constantly exhorting us to study hard, especially math and science, just as his father before him, fearing we would slip down the socio-economic ladder, saying, “You want to be a ditch digger when you grow up?” He not only helped us with homework, but independently tutored us in science, setting up experiments and demonstrations, from basic physics, chemistry, to biology, while our mother pushed us in reading, writing, and arithmetic (she had a teacher’s credential after all). I learned that same lesson about hunger when I was disowned and become a homeless street tranny. But my father’s lessons of hard work and study lifted me out of poverty, just as it had for him.

Further Reading:

2D:4D Evidence Supports Transexual Taxonomy

Stereotypes Are Dangerous


J.T. Manning, et al, “Parental income inequality and children’s digit ratio (2D:4D): a ‘Trivers-Willard’ effect on prenatal androgenization?”, Journal of Biosocial Science, 2021, https://doi.org/10.1017/S0021932021000043

Tagged with:

Comments Off on The Effect Of Socio Economic Status On Transsexuals

Ruth Barrett, Or When An Old Friend Becomes An Enemy

Posted in Autobiographical, Editorial by Kay Brown on June 16, 2021

When J.K. Rowling of Harry Potter fame came out as a major transphobe, many LGB & especially T people felt as though it was a personal betrayal. They had read her books, viewed her movies, responding to the tropes of love and inclusion triumphing over hatefulness… only to learn that Rowling was herself a Death Eater. I was one of those transsexuals who felt betrayed. I had taken my daughter to each of the movies as they came out. She was the same age as the child actors portraying the lead characters. She had all the books. Now, those memories are bitter ashes, tainted by the vile transphobia Rowling has vomited over them.

But there has been an even more bitter betrayal by one that I had admired and emulated, Ruth Barrett.

Ruth Barrett is a musician and Wiccan. She and her musical partner, Cyntia Smith, recorded songs and dulcimer instrumentals. Another Wiccan singer & dulcimer player I admired was Holly Tannen. I was in love with their music, bought all of their recordings.

Note the dulcimer on the wall

I purchased a dulcimer from Folk Roots, the same type that Ruth & Cyntia had learned to play and perform using, taking lessons from Holly. But I struggled to play it. I had studied Individual Voice and Small Group Harmony in high school, but had never learned to play an instrument. I was a klutz. My fingers just didn’t seem to know what to do.

Then, by chance, in the mid’ 80s, I was invited by Z Budapest, feminist author and Wiccan Sage, to help her set up and run the sound system for a conference and concert in Berkeley, as I had learned that skill helping with concerts at the Billy De Frank Gay and Lesbian Community Center in San Jose. It would have been quite churlish of me to have refused. One of the women to perform that day was Holly Tannen, another was Ruth Barrett. Thus, I met and got to know two of my musical idols on the same day.

I engaged Holly as an instructor. I still struggled. My fingers still didn’t seem to know what to do.

By luck, at a pagan event, I met Ruth and Cyntia. They both gave me quick lessons and pointers. Ruth gave me photocopies of her chord charts and tab sheets for several of their songs. Ruth and I talked about how to find one’s own singing and playing style, one’s own authentic voice. I was to see them at several other events over the next few years and was on very friendly terms with both of them. I met Cyntia’s husband, Dale, who was a master luthier, a maker of the finest classical guitars. As a means of courting Cyntia, he had copied the basic design of the Folk Roots dulcimer to make Ruth and Cyntia new dulcimers in the tradition of the finest guitars, with a sound and playability unmatched by any other in the world.

As my playing had vastly improved, thanks to Cyntia and Ruth’s tips, and that I had come into unexpected money from having been granted a patent, which was rewarded by my employer with a cash bonus, I commissioned Dale to make me a custom dulcimer in the same style as Ruth’s and Cyntia’s. As it happened, Cyntia and Ruth were scheduled to perform at the Billy De Frank Center, so it was natural that they stay at my place. Cyntia and I, in the comfort of my condo, spent our time discussing the custom inlay that she herself would design and carve for my dulcimer.

That dulcimer was a wonder. In just a few hours practice, my playing vastly improved. Having a fine instrument is worth everything, both to the performer and their audience. No wonder the greatest musicians pay thousands for them. I began to play the dulcimer, modern full chording/fingerpicking style, mostly British Isles folk tunes, at pagan events to the great appreciation of my audience.  You may listen or download free, should you be interested, to my indie produced cassette tape album of mostly folk music, but a couple Early Music, and even a few of my own composition, on dulcimer, guitar, and flute, I recorded back in ’89.  (Tap on “Side One” or “Side Two” to listen to the MP3 version.)  Please keep in mind, this is my hobby… I don’t pretend to be a professional.

On one of the occassions I was to see and converse with Ruth, at a Wiccan gathering / camping event, she strongly encouraged me to attend The Michigan Wymym’s Music Festival. The irony is not lost on me, as she was to rail loudly against allowing transwomen to attend in the years that followed. She has become a vociferous voice for TERF / GC / Transphobic propaganda, using Wicca / Goddess worship as her authority for her hatred. She edited a book entitled “Female Erasure” whose central theme was that transfolk are a serious threat to women’s existence. She has even led spiritual events for “detrans” female bodied people to “sever” their past “trans” experience.

If learning that the author of Harry Potter is transphobic feels like a betrayal, imagine how I feel about Ruth Barrett spewing the most vile transphobic propaganda after having been a personal musical mentor and friend, a guest in my house, a hero that I emulated.

Tagged with: ,

Comments Off on Ruth Barrett, Or When An Old Friend Becomes An Enemy

Machine Learning Transsexual Brains = Garbage In: Garbage Out

Posted in Brain Sex, Science Criticism by Kay Brown on June 8, 2021

If one spends any time reading science papers about transsexuality, one finds good science, mediocre science, poor science, bad science, and bogus science. But here is an example of garbage science. A paper came out last year that baldy stated that using machine learning and brain imaging, they could, somewhat accurately, determine an individual’s gender identity. This sounded like really exciting results. But after reading the paper, I’m calling BULLSHIT! It’s a harsh characterization, I know. But please follow along to see why I had no other choice.

First, let me state that I’m not an expert on Machine Learning and Deep Neural Net coding. But I have, in my capacity as an engineering executive, managed such experts. I’ve also, in my capacity as a Venture Capitalist (VC) technology advisor, conducted due dilligence research on start-up companies developing ML and NN technology. So I have just enough knowledge to be dangerous… that is to say, I know bullshit when I see it. And I see it here.

The bullshit consists of three elements.

The first is that researchers failed to tell us how many of their subjects were in the training set and how many were in the testing set. But first, let my tell you an anecdote about the time I was in the audience at a technical conference where a young researcher was presenting almost unbelievably high classification accuracy from his new computer vision algorithm. Finally, the first question from the audience during the post-presentation Q&A was how many examples were in the training set and how many in the test set? The young man then acknowledged that he had used the training set to test his algorithm. You could hear the visceral disgust sweep across the room at this basic error. Question is, did the authors make the same mistake? They said that 95% of the DATA was used in training and 5% in the “validation” of the model. Umm…. something is not right. There were less than 25 subjects in each category. Five percent of 25 is one. There was no way they could have used different subjects to have gotten a percentage accuracy of classification without having used the same subjects to provide both training and accuracy tests. So, what was the data split? Different parts of the brain scans of the same subjects? Seriously, something is very wrong here. One cannot do that.

The second garbage element is that they knowingly ignored prior science that there is very clear evidence that there are two separate taxons, at least for the Male-To-Female transsexuals, that have notably different brain phenotypes. We know that they knew because they referenced the Guillamon review paper on that very topic. But, since they didn’t bother to identify and segregate the two taxons for separate analysis, they were knowingly conflating the two, which would dilute the signals of both. The basic rule of thumb is never ascribe to conspiracy what can be explained by incompetence. Given the above issue of questionable Machine Learning validation, incompetence may have been the reason. The second possibility is that they knew this conflation was occuring, but felt, for non-scientific reasons, that they wanted this to occur. (I’ve seen this happen in other papers.)

The third garbage element is actually the most egregious. They claim that they identified nine “cardinal” gender related vectors in their study. But did they? I will argue that no they did not. This is where garbage in, garbage out really applies. They used the Bem Sex Role Inventory and cross correlated it with the brain scan data, claiming that the Bem inventory provides a window to gender. Flat out, it does not. It is an inventory of circa 1970s gender stereotypes! The most enraging thing about this is that the authors KNOW that, fully acknowledge that, but decided to use it anyways.

All in all, the Clemens paper is garbage. So the next question is how could such a paper pass peer review? The answer is where it was published. Cerebral Cortex would have reviewers who were experts in the brain science, but NOT sexology nor in machine learning. They just would have looked at the material that was in their field of expertise and allowed the other material to get a pass, unquestioned.

Further Reading:

Silly Stereotypes: Essay on the BEM inventory

Brainstorm: Essay about the Guillamon brain scan review


Clemens, B. et. al., “Predictive Pattern Classification Can Distinquish Gender Identity Subtypes From Behavior And Brain Imaging”, Cerebral Cortex, (2020), https://doi.org/10.1093/cercor/bhz272

Tagged with: ,

Comments Off on Machine Learning Transsexual Brains = Garbage In: Garbage Out

2D:4D Evidence Supports Transexual Taxonomy

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

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

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

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

Let’s look at the new data they provide:

Table 1

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


Control women


Control men

Left 2D:4D

0.991 (0.034)

0.991 (0.032)

0.981 (0.033)

0.974 (0.029)

n = 104

n = 53

n = 88

n = 56

Right 2D:4D

0.981 (0.030)

0.983 (0.033)

0.972 (0.029)

0.959 (0.033)

n = 104

n = 53

n = 89

n = 56

Table 2

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



Early onset

Late onset

Early onset

Late onset

Left 2D:4D

0.982 (0.034)

0.975 (0.022)

0.988 (0.033)

1.009 (0.031)

n = 80

n = 8

n = 92

n = 12

Right 2D:4D

0.973 (0.029)

0.963 (0.026)

0.977 (0.028)

1.007 (0.027)

n = 81

n = 8

n = 92

n = 12

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

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

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

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

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

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

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

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

Further Reading:

Essay on 2D:4D History

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

Essay on Androphilic Transmen


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)

Tagged with: , ,

Comments Off on 2D:4D Evidence Supports Transexual Taxonomy

Pose: A Look at Transgender Realities

Posted in Autobiographical, Film Review by Kay Brown on June 30, 2018

Kay BrownMy husband and I have been watching a great new drama show on FX, POSE.  I don’t normally watch shows with a transgender theme.  They usually either misrepresent us, make fun of us, or we are the designated tragic losers.  But Pose is different.  As Janet Mock, one of the writers for the show and an important voice in how the show was developed and what issues it covers, said, the show “centers transwomen of color”.  Yes, it does that, and a whole lot more.  It also, by the simple statistical reality that transwomen of color in the US are far more likely to be exclusively androphilic early transitioners, the show centers “homosexual transsexuals” (HSTS).  I love the mix of black, puerto rican, and white transwomen in the show.  This being set in New York, that fits the local demographics.  (Here on the west coast, our mix also includes meso-american hispanic, Filipino, and chinese.)

I haven’t seen a single “late transitioner” being portrayed.  Even better, they don’t make the oft mistake of conflating the two types.  No, we see only one type, as they really are.

This essay is less a review than an educational exposition.  Because the show focuses on HSTS in a realistic way, in a way that I have never seen a TV show actually do before, it offers me an opportunity to connect the science, sociology, psychology, history, to a show that you can watch and connect the dots.

Not all of those dots are flattering.  In the very first episode we see Electra Abundance, a house mother of a collection of trans & gay youth, lead her crew on a caper to steal 18th Century court dress from a museum just so that they could outshine their competition at a Ball.  At least one of the crew, Angel, is a sex worker on the street.  In a later episode, we see a bisexual young man, one of House of Evangelista is a street drug dealer.  Yes, it was like real life, but it still hurts to see stereotypes of street kids, gay and trans alike, as petty criminals.  Electra and Angel have sugar daddies that help get them off the street.  On the other hand, we see Blanca, the mother of the House of Evangelista working a real job at a nail salon.  This too is very realistic.  Very few transwomen who end up on the margins of society when young ever climb very far on their own.

Speaking of throwaways, the show opens with heart wrenching scene of a gay teen being thrown out of his family by homophobic parents.  Blanca and Angel both relate ugly stories of being rejected by their families as kids.  (Been there, done that!)  The show gives us a glimpse of how transwomen form houses and in essence are the social workers that provide group homes for throw away queer kids.  They have been doing this for a very long time.

As the show is set in the late ’80s, there is an ever-present pall hanging over the characters, “the plague”, HIV/AIDS.  At the time, being HIV+ was literally a death sentence.  There is a powerful reminder that though thousands of people were dying, then President Reagan couldn’t even bring himself to mention it.  Homophobes literally saw it as ‘God’s Punishment’ on queer folk.  In the opening scene of the first episode, we meet Blanca as she learns that she is HIV+.  She is a strong woman and decides that knowing that she may get sick and die soon, she is determined to make the world a better place by creating her own house built on love and encouragement for her charges.  She hides that she is HIV+, but works to educate others on safer sex practices.  In another episode, we see AIDS patients in the hospital being treated as pariahs; in one case hospital staff refused to enter the room to deliver their meal.  In another vignette an older gay man cajoles three younger men to get tested at a clinic.  We see three of them joyful that they tested negative, but the older man is first devastated, then puts on a brave face to lie about his own HIV+ status.

Allow me to switch to a few personal anecdotes.  I’m 61 years old now… I lived through all of this.  We first began to suspect something was wrong with the first hints were a rash of young men getting a rare cancer.  I vividly recall reading a cartoon in the gay press, must have been 1980 (?) that read, “I’m glad I’m middle-aged… too young to get old man’s Karposi’s carcinoma and too old to get young man’s Karposi’s.”  I remember standing in line to see a movie at the Castro Theatre and recognizing Karposi’s lesions on a man’s face.  Then, gay men and HSTS transwomen started dying of lots of illnesses that shouldn’t have been killing them.  I remember talking to one of my childhood friends trying to explain all of this, including the various theories, some of them incredibly homophobic such as the notion that gay men were dying because of too much partying, drugs, and of course, sex.  But then it became more obvious that this was an infectious agent that was sexually transmitted.  The fear was palpable.

My own sex life took a very steep nose-dive.  I was then recently post-op, but I had been having unprotected sex with men as an exclusive bottom for years before that.  I had never even seen a condom.  Why should I?  It wasn’t like I was going to get pregnant, more’s the pity.  Sure, there were STDs… but antibiotics could take care if it.  I learned about and how to use a condom at a safer sex house party hosted by members of the Gay & Lesbian Alliance at Stanford.  Like the men in the show, I was too afraid to learn my HIV status when testing became available; but my good friend and sister transactivist, Joy Shaffer, M.D. then a medical resident working with HIV/AIDS patients in the hospital when many others refused, insisted.  Joy and her girlfriend Patricia went with me to the clinic.  They were obviously not in a high risk group, but got tested alongside me to offer encouragement.  I was negative.  I felt relief… but the fear was still there.  My sex life remained much more restrained for a good many years later, until I got married.

Public Service Advertisement:

Practice Safer Sex!  Keep and use condoms.  EVERY TIME!!  Learn about and take PrEP medications to reduce your chances of becoming HIV+.

Now, back to our regularly scheduled show.

Because this show has writers that are themselves early transitioners, we see some intimate details that aren’t usually portrayed.  For instance, we see in one episode that not only are HSTS obligate bottoms, but that they are also “avoidant”.  That is, that they would prefer not to have their pre-op genitalia touched during sex.  Just to make sure the audience understands that this is universal, both Electra and Angel have discussions with their sugar daddy boyfriends about it.  As Electra’s boyfriend puts it, “What?! You didn’t think I noticed you grimace when I touch you there?”  This detail, of course, is almost never discussed or portrayed elsewhere because most of those shows wish to portray young transwomen as sex toys for “chasers”.  In this same show, we learn that Electra’s and Angel’s boyfriends are both chasers, gynandromorphophilic.  That is, they both prefer pre-op transwomen and want to touch their lover’s pre-op genitalia.  Electra is faced with the prospect of losing her man if she has SRS, but decides to go ahead, for her own sake.  Angel, upon learning that her man is a chaser, is repulsed and loudly orders him to leave.

The writers seem to know their history.  In one of the episodes, we see Blanca angered by the blatant transphobia from the ‘straight looking – straight acting’ gay male crowd at a local bar.  She attempts to use civil rights style counter sit-in tactics to force the bar to accept her presence and to serve her.  But that bar uses bouncers and even the police to enforce their ‘no queens’ policy, deliberately insulting and misgendering her.  The gay men at the bar cheer as Blanca is arrested for no real reason.  I see this as a metaphor for the way that much of the larger gay and lesbian community mistreated the transcommunity from the early ’70s through the late ’90s.

The show is singularly refreshing and I look forward to viewing the rest of the season.

Further Reading:

Essay on correlation between non-white ethnicity and HSTS

Essay on HSTS being ‘avoidant’

Essay on gynandromorphophilia

Essay on historic transphobia in the gay and lesbian communities

External Further Reading

‘We’re More Than Capable’: Pose Stars Push Back on Cis Actors Playing Trans Roles by Maiysha Kai

Pose Writer Janet Mock on Making History with Trans Story Telling by Janet Mock

“When Are Trans Actors Allowed to Act?” by Hannah Giorgis in the Atlantic
The FX drama Pose is the rare example of a show that actually gives trans actors top billing—an effort made all the more urgent by a recent controversy that saw Scarlett Johansson cast as a transgender man.


Comments Off on Pose: A Look at Transgender Realities

Baby Hunger…

Posted in Autobiographical, Editorial, Transsexual Theory by Kay Brown on July 9, 2017

female_scientistOr, Rubbing Salt Into the Wound

A couple days ago, a young androphilic transwoman from Portugal, who has been a correspondent for several years, since her late teens, wrote to me asking my opinion of androphilic transwomen’s desire for children.  She, like me, definitely has always desired to be around and to mother children.  She had recently been employed as a caregiver at a children’s group home and had loved it.  She recently entered nursing school and looks forward to someday marrying a loving man and adopting children, preferably babies.  She thought it was be a good idea for me to write an essay on this topic.  So, here it is.

Stoller, in his 1968 book, Sex And Gender, described androphilic transwomen as ardently wanting children including mothering, indeed bearing, infants,

sex-and-gender-the-development-of-masculinity-and-femininityThe ultimate progression for the transsexual … has not yet been reached in our society: he would not only like to have is body appear completely female but he would like to have his internal organs so changed (for example, by transplants) that he would now have is own functioning ovaries and uterus, ultimately to bear a child truly his own.

Stoller described a typical androphilic transwoman and concluded with “The patient is now married and hopes to adopt children.”

When I was first interviewed by Norman Fisk at the Stanford Gender Dysphoria Clinic as a 17 year old in early 1975, I told him of my hopes and dreams of finding a husband and adopting children.  I recall telling him about how much I enjoyed the two summers I had spent as a swimming instructor teaching very young children and of the then previous summer employed as a nanny taking care of two boys, aged four and ten, from early morning to dinner-time.  I had of course, actively sought out babysitting jobs all through Jr. and Sr. high school, with a promise to all of my regular families that I would break any previous engagement for a job.  I don’t remember him making fun of me.

I achieved both of these goals, though it took a lot longer that I had anticipated.  There were many things that had to be achieved first and many pit-falls to avoid along the way.

There are many obstacles for androphilic transwomen to overcome before becoming an adoptive parent.  First, one must have the social stability, an excellent support network, and sufficient family income to afford to raise a child.  Many never reach that goal.  Having a husband with a good income is a dream that is often out of reach.  Second, one has to navigate a system that would much rather find a home for a child with non-LGBT parents, especially for newborns.  Adopting a newborn, even for middle-class non-LGBT families, is difficult as there are always far more prospective families looking to adopt a baby than there are babies available for adoption.  It is becoming easier in some locales for LGBT people to foster-adopt older hard-to-place children, but it still requires surviving an extensive vetting process.  That process will black-ball any who have even the most minor of criminal records.  One also has to have the temperament and above average parenting skills to take in a child who will come with emotional challenges and maladaptive behaviors from early life experiences in a chaotic birth home.  In many locales, in spite of recent legal and social advances for LGBT people, being transsexual will mean not being seriously considered as an ‘appropriate’ placement.


Kay Brown with her adopted daughter Liz

I first became a licenced foster parent in California in 1984, almost by happenstance when Cassandra, a 14-year-old lesbian, needed a supportive home of the sort that I could provide.  Now, 33 years later, she still calls me her Mom.  In the early ’90s while living in Oregon, I sought to become a foster, hopefully adoptive mom of a younger child and carefully researched the possibility.  I put out on the transgender social networks looking for any who had been able to do so.  I found exactly one androphilic transwoman on the east coast who was fostering her sister’s children while her sister was in prison.  (Children’s Services gives priority to relatives for placement whenever possible.)  That was it.  One family.  Special case.  I was breaking new ground when seven-year old Liz was placed in my household.  (There were several women living there.)  Liz was adopted on her ninth birthday.  I have since found one other androphilic transwoman who foster-adopted three siblings sometime after me.

There is always the possibility of surrogacy.  But that takes even more socio-economic status.  I have only one reference that may qualify as surrogacy.  Dawn Langley Simmons, who was white, married a black man then apparently faked pregnancy timed to the delivery of a mixed race baby.  The sire may have been her husband or the baby may have simply been unwanted.  We don’t have the details.

There have also been tales and hints that some androphilic transwomen have been aided by close relatives or friends volunteering to be gestational surrogates.  But those stories are kept very private for good and sufficient reasons.

There was a private effort in the transsexual community to develop ethical  biotechnology that would allow transwomen to carry a child to term in ways not too different from that prophesied by Robert Stoller… but that research did not reach our final goal.  Now, there are new developments regarding uterine transplants that may offer the final key.  Sadly, I’m too old now to participate, but I most certainly would if I were younger.

We have enough evidence here to show that at least some androphilic transwomen do have an intense interest in being mothers of both infants and small children.  But actualizing that desire is extremely difficult for most.

So, we see that though it is difficult for an androphilic transwoman to find a loving husband and build a family through adoption, it is not impossible.  But one wouldn’t know that from reading the literature on transsexuality when they discuss whether transwomen are interested in children, have maternal feelings.

In the 1974 paper describing psychiatric grand rounds at UCSD, “Gloria”, a 20-year-old androphilic pre-op transwoman already in a stable relationship with a straight man reported that she too hoped to adopt a new-born, to which an oh so ‘kindly and understanding’ physician throws shade on her coping skills, her character, and her motives for wanting to raise a child,

No matter which way this goes, Gloria is going to have trouble adjusting. A normal woman has trouble when she bears a child or adopts one; this new woman is going to have many more troubles.  At this point she wants a baby because that is part of her image of being a woman. And yet I do not know whether she really wants a baby or whether this is just the image, just as she stated that she doesn’t feel sexy if she doesn’t have a vagina.

But then we come to the most ugly of all comments coming from John Money in an abstract of a case series paper from 1968 in which we can easily discern that he is lumping together androphilic and autogynephilic transwomen together when he writes,

“All 14 patients desired adoptive motherhood, with a preference for small children, though not newborn babies. In general, the group appeared to possess a feminine gender identity, except for a masculine threshold of erotic arousal in response to visual imagery and an unmotherly disengagement from the helplessness of the newborn.”

Remember how hard it is for a post-transtion transwoman to become a mother, especially of newborns?  Remember how the clinicians made fun of “Gloria” for wanting to be such a mother?  Now, do you think it is possible that transwomen can pick up on that negative attitude, perhaps realize that if they state a desire for what is clearly unlikely to happen that it might be interpreted as having unreasonable life goals?  (One of the selection criteria that clinics used in the ’60s was whether their clients had reasonable expectations for their lives post-op.)  Further, is it in fact a good idea to pine for what can never be?  So… calling them “unmotherly” for looking to adopt hard-to-place children rather than hoping for that one-in-a-million chance to adopt a healthy baby was just rubbing salt into the wound.

So ingrained is our view that interest in children is a measure of womanly virtue it effects how autogynephilic transwomen attempt to portray themselves.  A few years ago, continuing my search for transwomen’s experiences regarding adopting children, I chanced upon an online forum where a number of transwomen were discussing how one could tell the difference between a “transsexual” and a “wannabe” [sic] by whether they noticed small children or not.  Of course, they all congratulated themselves on their interest in small children, telling stories of how they had noticed children in social settings, as did the women, while the men in their company, or even other (presumably “wannabe”) transwomen, had not.  Curious, I traced down each of these transwomen’s identities (people leave a lot of breadcrumbs behind them) and discovered that every one of them was in fact a late transitioner and more than one of them had very masculine occupations and interests.  They had not evinced any notable efforts to pursue being motherly, indeed, some had barely maintained contact with their own children from marriages prior to transition.  Their participation in this discussion was more in line with social desirability bias, impression management, and self-enhancement than in honest self-evaluation.  It fits with the well-known (to cognizant clinicians at least) phenomena of autogynephilic transwomen editing their history, experiences, and desires to more closely approximate those of “classic transsexuals”.

We need to conduct research on whether transsexuals and transgender people of all kinds are interested in being parents.  Interestingly Michael Bailey suggested a great instrument for this task in his book the Man Who Would Be Queen:

1. I greatly enjoy spending time with young children.
2. I get a lot of pleasure from holding babies.
3. I would enjoy taking care of a baby for a friend or relative.
4. I daydream about having a baby of my own.
5. Often when I see babies, I experience warm, positive feelings.
6. When I think about it hard, I have strong doubts whether the
rewards of raising an infant are worth the work and responsibility. (reverse scored)

This could be seven value Likert scored from “Definitely Do NOT Agree” to “Definitely Agree”.  Any interested in conducting the survey?

Further Reading:

Essay on Robert Stoller’s description of a “typical” androphilic transsexual.

New York Times Obituary for Dawn Simmons

Scientific American: How a transgender women could get pregnant


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



Comments Off on Baby Hunger…

It was the best of times…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further Reading:

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


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

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

Tagged with:

Comments Off on It was the best of times…