On the Science of Changing Sex

Personality, My Dear…

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

phrenology…I Don’t Give a Damn!

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

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

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

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

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

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

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

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

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

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

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

References:

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

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

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

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

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Four Out of Five…

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

female_scientistWhich Came First?  Chicken Or Egg?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The list of the criteria is as follows:

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

Taking each in turn:

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

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

Additional Reading:

Essay on the development of an Autogynphilia Instrument in Males

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

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

Essay on the Origins of Cross-Gender Identity in Transsexuals

Essays on Brain Sex in Transsexuals

Essay on analogy between autogynphilia and apotemnophilia

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Brain Power…

Posted in Brain Sex, Confirming Two Type Taxonomy by Kay Brown on December 28, 2015

Teenage-brain

…I would while away the hours, confir’in with the flowers…. if I only had a brain…”  — Scarecrow, in the Wizard of Oz musical film.

After years of trying to explain the differences between the two types and the statistical evidence for the two type taxonomy of MTF transwomen, I’m now posting what should be the final clincher; solid biomedical laboratory evidence, “proof” even.

Decades ago, as I was researching our collective history and science (the two often go hand in hand), I came across a reference to studies that showed that gay men had feminized brains while MTF transsexuals did not.  SAY WHAT!?!?

Turns out, the study referenced made the false assumption that all MTF transsexuals are the same and had only included gynephilic older transitioners.  Other studies, being aware of, and accounting for the differences between the two MTF transsexual types found something quite interesting, as for example, from the Dörner (1983) abstract:

“In male rats, androgen deficiency during a critical period of sexual brain differentiation was shown to give rise to a predominantly female-differentiated brain. Such animals displayed “homosexual behaviour”, i.e., they were sexually attracted preferentially to partners of the same sex. In addition, they exhibited a sex-specific evocability of a positive oestrogen feedback effect. A positive oestrogen feedback effect on LH secretion was also induced in homosexual transsexual men, in contrast to hetero- or bisexual transsexual men. Thus in homosexual transsexual men, an intravenous injection of 20 mg Presomen (Premarin) produced a significant decrease of serum LH levels followed by a significant increase above the initial LH values. In hetero- or bisexual transsexual men, by contrast, intravenous oestrogen administration, while producing a significant decrease of serum LH levels, was not followed by an increase above the initial LH values. A positive oestrogen feedback effect on LH secretion was also found in homosexual non-transsexual men, in contrast to heterosexual men. These findings suggest that transsexual as well as non-transsexual homosexual men possess a predominantly female-differentiated brain which may be based, at least in part, on androgen deficiency during sexual differentiation of the central nervous system. Homosexual transsexual men also showed an increased LH and FSH response to LH-RH as compared to hetero- or bisexual transsexual men.”

Note that non-exclusively-androphilic (“heterosexual or bisexual”) transwomen did NOT have the female like positive estrogen feedback effect on LH serum levels.  Of course, according the Blanchard’s work, all “non-homosexual” MTF transsexuals should also be in the same taxon, so we would predict that so-called, asexual transsexuals should also show the lack of this positive feedback, and indeed, this too was found, as discribed in the Dörner’s (1976) earlier paper,

“In transsexual men with homosexual behaviour and intact testicular function, as well as in homosexual men with normal gender identity, following a negative oestrogen feedback effect a delayed positive oestrogen feedback action on LH secretion was evoked. By contrast, in transsexual men with hypo- or asexuality and intact testes or hypergonadotrophic hypo- or agonadism, as well as in heterosexual men with normal gender identity, a negative oestrogen feedback effect was not followed by a positive feedback action on LH release. In transsexual women with homosexual behaviour and oligo- and/or hypomenorrhoea, only a weak or at best moderate positive oestrogen feedback action on LH release was evocable, similarly as in castrated and oestrogen-primed heterosexual men. By contrast, in a transsexual woman with bisexual behaviour and eumenorrhoea, a strong positive oestrogen feedback action on LH secretion was evocable, as well as in heterosexual women with normal gender identity.”

Note that in this paper we see a mirror like difference between FtM “homosexual transsexuals” (gynephilic transmen) who respond more like heterosexual men and bisexual FtM transmen who respond more like heterosexual women.  Thus, this data would lend support for there being a taxonic difference between exclusively gynephilic and non-exclusively gynephilic transmen, mirroring the taxonic difference between the two types of transwomen.

Conclusion:

These papers, detailing a specific, repeatable, laboratory based test that can differentiate the two types of transsexuals described by Blanchard, “Homosexual” and “Non-Homosexual”, offers both supporting evidence for the two type taxonomy but potentially also a way of independently sorting the two types in future studies.  This difference is a classic medical biomarker for the two types.  Should anyone one doubt the weight of statistical evidence, we can also point to the biomedical evidence via laboratory tests.

References:

Dörner G, Rohde W, Schott G, Schnabl C., “On the LH response to oestrogen and LH-RH in transsexual men.” Experimental Clinical Endrocrinology (1983)
http://www.ncbi.nlm.nih.gov/pubmed/6317420

Dörner G., “Neuroendocrine response to estrogen and brain differentiation in heterosexuals, homosexuals, and transsexuals.” Archives of Sexual Behavior (1988)
http://www.ncbi.nlm.nih.gov/pubmed/3282489?dopt=Abstract

Dörner G, Rohde W, Seidel K, Haas W, Schott GS.”On the evocability of a positive oestrogen feedback action on LH secretion in transsexual men and women.” Endokrinology (1976)
http://www.ncbi.nlm.nih.gov/pubmed/1244197

 

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Raising Children is a Sacred Trust…

Posted in Editorial by Kay Brown on December 8, 2015

Kay BrownParental Attitudes Towards Transgender Children

Every now and then, I check the stats on this site.  I am gratified by the growing number of readers over the past six years.  I also check the search strings that are used to find this site.  I am happy that parents of transkids find my site and this much needed information.  But I am usually saddened by the search strings.  These are the most common, in order of frequency:

“How to cope with transgender children”

“How to deal with a transgender child”

“How to manage a transgender kid”

“My child is transgender”

Do you see the problem?  The terms ‘cope’, ‘deal’, and ‘manage’ indicate that these parents see their child as a dissappointent, a burden, a problem.  One ‘copes’ with emotional loss and dissappointment.  One ‘deals’ with a burden.  One ‘manages’ a problem.

I’ve known dozens of other transkids (and former transkids / adults who were transkids).  Nearly every one of them spoke of how their parents had been dissappointed by them.  Even those whose parents eventually came to support them went through a period where their parents tried to deny that they were transkids.  Many were disowned by their parents.

But every now and then, but not nearly as often as I would like, I see this search string:

“How to help a transgender child”

Today, among several like the first three, I saw this gem:

“How to protect a transgender child”

Several years ago, my husband and I hosted a lovely young couple and their two children.  Their children were around three years old, fraternal twins.  One was ‘all boy’.  He wore his favorite T-shirt sporting an image of a bulldozer that read, “I like dirt”.  The other child was a sweet natured, feminine girl wearing a yellow flowered sundress.  She gave us an impromptu ballet recital in our front parlor.  Can you see where this is going?  That sweet mannered girl is male.

This young couple loved and celebrated their children.  Both of them.  They told me that they didn’t like attending support groups for parents of gender atypical / transgender children because the other parents saw their children as dissappointments, problem children, burdens.  The other parents would spend most of the time trying to convince everyone, including themselves, that they had done everything they could to cope, deal, and manage their children.  They were apolegetic about their child’s behavior and even of their own eventual acceptance of their child’s atypicality, having done everything they could to prevent it.

Which brings me back to the search string that I never see, but would dearly love to:

“How to celebrate my transgender child”

(Addendum 2/4/2016:  Banner Day!  Today someone used this search string, “loving your transgender child”)

(3/26/2016:  UGLY DAY!  Today someone used this search string, “things to say to comfort parents of a transgender”, as though having a trans-child were a terrible tragedy.

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Flipping the Bird

Posted in Book Reviews by Kay Brown on March 22, 2015

Flip_the_birdBook Review:  Galileo’s Middle Finger – Heretics, Activists, And The Search For Justice In Science, by Alice Dreger

Dr. Dreger’s latest book could be described as a coming of age story as it chronicles her journey from naive graduate student to a world class activist historian, seeker of Truth, Justice, and the American Way.  She truly is a super-hero, if any real, live human being can be.  Hers is a journey into social justice activism, only to find that many of the self-styled activists were searching for anything but social justice.

Dreger’s introduction to activism was the result of meeting modern examples of the very injustice that she had previously documented had occurred to people in the 19th Century when their bodies didn’t conform to the expected norms for males and females, the so called “Hermaphrodites”, which today we called “intersexed” or “people with Disorders of Sexual Development” (DSD).  Writing about her academic work on 19th Century treatment of intersexed people,

“…It ended up pushing me into two unfamiliar and intense worlds: contemporary sex politics and contemporary medical activism.  That’s because, thanks to the Internet, by the time I came to this topic, in the mid-1990s, something was going on that the Victorian doctors would never have imagined: People who had been born with various sex anomoalies had started to find each other, and they had started to organize as an identity movement.  Labeling themselves intersex, many gather under the leadership of Bo Laurent, the founder of the Intersex Society of North America, and after reading my Victorian Studies article, some of these intersex activists, including Bo, contacted me.  A couple wrote me simply to complain that they found some of my language offensive, apparently not realizing I was relaying Victorian rhetoric in my article.  By contrast, Bo got my work.  And she asked for my help in changing the way children born intersex were treated in modern medicine. … I hastened to tell Bo, “I’m a historian; I study dead people.”  However, once I understood what was really going on at pediatric hospitals all over the nation – once I understood that Bo’s clitoris had been amputated in the name of sex “normalcy” and that this practice was still going on – I felt I had to assist in her efforts.”

Dreger rose to that challenge, taking on a leadership role in the fight to end medically unnecessary surgeries on children with ambigous genitalia.  This entailed taking on the medical establishment, confronting them, insisting that they re-examine their protocols in the light of real damage to real people.  It took a while, years, but the work of these activists with whom Dreger worked, began to seriously effect the desired change.  While the work is not truly complete, it is well on the way.  In her book, she details the long hours, the difficulties encountered, but most importantly, the need for such evidence based activism, that the work of these activists was based on demonstrating the real outcomes of these surgeries, which diverged greatly from the view previously held, that these surgeries helped.  If the book went no further, it would be worth buying it.

But Dreger’s work, and her life, as she took a new position at Northwestern University would take another turn,

“It was shortly after this time that I took on a new scholarly project, one that without warning forced me to question my politics and my political loyalties … This was a project that suddenly changed me from an activist going after establishment scientists into an aide-de-camp to scientists who found themselves the target of activists like me.  Indeed, this project soon put me in a position I would never have imagined for myself; vilified by gender activists at the National Women’s Studies Association meeting and then celebrated at the Human Behavior and Evolution Society by the enemies of my childhood hero, Stephen Jay Gould.”

In 2003, J. Michael Bailey had published his book on femininity in males, The Man Who Would Be Queen.   This had set off a firestorm among a group of autogyenphilic transwomen who took exception to Bailey’s effort to popularize Ray Blanchard’s research which had shown that there were two etiologies leading to gender dysphoria, that there were two (and only two) types of transwomen, as different as night and day, one that was gynephilic, autogynephilic, and gender typical until they announced their intention to transition –  and the other that was exclusively androphilic and gender atypical since birth.  This led to a number of serious accusations of wrongdoing by Bailey, to which Dreger was asked by her friend Paul Vasey to investigate.  As Dreger expresses her initial reluctance,

“Still, I thought I knew from my background in science studies and a decade of intersex work how to navigate an identity politics minefield, so I wasn’t that worried when in 2006 I set out to investigate the history of what had really happened with Bailey and his critics.  My investigation ballooned into a year of intensive research and a fifty-thousand word peer-reviewed scholarly account of the controversy.  And the results shocked me.  Letting the data lead me, I uncovered a story that upended the simple narrative of power and oppression to which we leftist science studies scholars had become accustomed. – I found that, in the Bailey case, a small group had tried to bury a politically challenging scientific theory by killing the messenger.  In the process of doing so, these critics, rather than restrict themselves to argument over the ideas, had charged Bailey with a whole host of serious crimes, including abusing the rights of subjects, having sex with a transsexual research subject, and making up data.  The individuals making these charges – a trio of powerful transgender women, two of them situated in the safe house of liberal academia – had nearly ruined Bailey’s reputation and his life.  To do so, they had used some of the tactics we had used in the intersex rights movement. … but there was one crucial difference: What they claimed about Bailey simply wasn’t true.”

Here, I have to break from the usual traditional book review to share my own experiences in this story.  I personally know most of the players.  I was an active participant in Bo Laurent’s work, meeting with her on several occasions, donating money, and helping her in a minor way to raise funds from the transsexual community.  One of those transwomen who donated was at the time, also a friendly acquaintance of mine, Lynn Conway, one of the “trio of powerful transsexual women”.  The other two were Andrea James, who I had never heard of before, and Deirdre McCloskey, who my good friend (and college roommate) Dr. Joy Shaffer, had spoken of highly.  It was reading Dreger’s lengthy paper on the Bailey affair that upended MY life, led me to become friends with Kiira Trea and eventually to write this blog at her encouragement.  This blog is the direct result of Dreger’s history of the Bailey affair.  I can think of no greater testament to the power of a scholar’s work, than that it should inspire others to action.

But Dreger’s story is only just beginning,

“You can probably guess what happens when you expose the unseemly deeds of the people who fight dirty … Certainly I should have known what was coming – after all, I had literally written what amounted to a book on what this small group of activists had done to Bailey.  But it was still pretty uncomfortable when I became the new target of their precise and unrelenting attacks.  The online story soon morphed into “Alice Dreger versus the rights of sexual minorities,”  and no matter how hard I tried to point people back to documentation of the truth, facts just didn’t seem to matter.”

I must share, that I too was vilified by these same transwomen, when I openly supported Dreger, Bailey, Blanchard, and Lawrence.

Because of her experiences, Dreger set out on a new scholarly journey,

“Troubled and confused by this ordeal, in 2008 I purposefully set out on a journey – or rather a series of journeys – that ended up lasting six years.  During this time, I moved back and forth between camps of activists and camps of scientists, to try to understand what happens – and to figure out what should happen – when activists and scholars find themselves in conflict over critical matters of human identity.”

The result of those journeys is her new book.  It explores intersex, transgender, indigenous peoples of the South American rainforest, back to intersexed people again.  Its quite a journey, of which I can only barely touch upon in this review.  While I read the entire book with great pleasure, here I chose to focus on the section dealing with transgender and Bailey’s book and its aftermath.

In delving further into the book, one finds gems like this,

“When people ask me how transgender is different from intersex, I usually start by saying that intersex and transgender people have historically suffered from opposite problems for the same reason.  Whereas intersex people have historically been subjected to sex “normalizing” hormones and surgeries they have not wanted, transgender people have had a hard time getting the sex-changing hormones and surgeries they have wanted.  Both problems arise from a single cause: a heterosexist medical establishment determined to retain control over who gets to be what sex.”

She even has a very insightful explanation of why the “trio”, and many others in the autogynephilic transwomen’s community, went to war against Bailey,

“To understand the vehemence of the backlash against Bailey’s book, you have to understand one more thing.  There’s a critical difference between autogynephilia and most other sexual orientations; Most other orientations aren’t erotically disrupted simply by being labeled.  When you call a typical gay man homosexual, you’re not disturbing his sexual hopes and desires.  By contrast, autogynephilia is perhaps best understood as a love that would really rather we didn’t speak its name.  The ultimate eroticism of autogynephilia lies in the idea of really becoming or being a woman, not in being a natal male who desires to be a woman. … The erotic fantasy is to really be a woman.  Indeed, according to a vision of transsexualism common among those transitioning from lives as privileged straight men to trans women, sex reassignment procedures are restorative rather than transformative… For Bailey or anyone else to call someone with armour de soi en femme an autogynephile or even a transgender woman – rather than simply a woman – is at some level to interfere with her core sexual desire.  Such naming also risks questioning her core self-identity … When they felt that Bailey was fundamentally threatening their selves and their social identities as women – well, it’s because he was.  That’s what talking openly about autogynephilia necessarily does.”

There’s a wonderful bon mot moment in the movie, Desert Hearts, when a lesbian scholar vows that she will have her revenge on a homophobe when she writes her memoirs.  In this book, one could say that Dreger takes her revenge on McCloskey, Conway, and especially James by revealing evidence that they are not only autogynephilic, but knowingly so, as Dreger reprints text from an email from Andrea James to Anne Lawrence in 1998,

“A definition is inherently inclusive or exclusive, and there’s always going to be someone who doesn’t feel they belong in or out of a definition.  I got body slammed by the usual suspects in 1996 for recommending a Blanchard book.  Sure, he’s pretty much the Antichrist to the surgery-on-demand folks, and I’ve heard some horror stories about the institute he runs that justify the nickname “Jurassic Clarke.”  However, I found many of his observations to be quite valid, even brilliant, especially in distinguishing early and late-transitioning TS patterns of thought and behavior.  I’ve noticed in most TSs, and in “surgery addicts” especially, a certain sort of self-loathing, a drive to efface every shred of masculinity.  While I readily admit to my own autogynephilia, I would contend that my drives towards feminization seem to have a component pushing me from the opposite direction as well.”

Dreger goes on,

“OK, THIS WAS FASCINATING.  A prior admission to autogynephilia from James and what seemed to amount to the same from McCloskey – plus something very much like an ongoing tacit admission from Conway? – lying behind the attempts to bury Bailey.  All that spoke to motivation on the part of Conway et al.”

Personally, I find this damning, as James has made a special point of defaming a number of individuals in the transcommunity for supporting Anne Lawrence, Bailey, or Blanchard.  She writes scurrilous material on her website against Dreger, Bailey, Blanchard, Lawrence, and many other notable transwomen, including myself; all for writing about a phenomena of which she admits she experiences.

Dreger recounts her year of research on the Bailey affair, detailing the ways in which Conway and James attack Bailey and how she was able to discover the truth of the matter, setting the record straight.  She also recounts how these two transwomen then turned on her, attempting to blacken her name with the same tar filled brush.  In the end, it becomes clear, that though the experience was unpleasant, it lead her to connect with a number of other scholars who have wrongfully been attacked and vilified by other groups, in other fields.

At the end of the book, Dreger lays out recommendations for society and especially for social justice advocates, to follow an evidence based approach.  I would like to think that I would qualify as an exemplar of her recommendations, in my conduct of this affair and of my previous, and definitely of my future, activism.

I highly recommend purchasing and carefully reading this book:

http://www.amazon.com/Galileos-Middle-Finger-Heretics-Activists/dp/1594206082

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Triumph for Whom?

Posted in Editorial by Kay Brown on March 1, 2015

CloudyIn a recent popular magazine article, intellectual essayist, Charlotte Allen wrote an extensive and deep exposition on the events of the past 15 years of the increase in visibility of the Transgender community.  Encouragingly, it was unflinching in its exploration of not only the pop-psychology, but also the REAL psychology and politics.  Of neccessity, this also means that she explained about the two type taxonomy, Blanchard’s role in researching it, Bailey’s role in popularizing it… and of the disgraceful behavior of the autogynephilic transwomen who attempted to shout down those who, in their research, came to support the scientific recognition that “late transitioning” transwomen are on the same continuum as transvestites / cross-dressers.  Ms. Allen writes,

“Blanchard’s theory is that transgenders fall into two distinct categories whose sexual orientations, interests, choice of careers, and even, to a large extent, social class are violently different from each other. One of those categories he calls “homosexual” transgenders, whose sexual attraction, from childhood to death, is strictly toward members of their own genetic sex. Among males, they’re the extremely effeminate boys who identify as girls in early childhood, play with dolls and other girls’ toys, and shun the rough-and-tumble play typical of boys their age. Studies at Vanderbilt and the University of London have shown that 70 to 80 percent of those trans-children grow out of their trans-identity at puberty and become, simply, gay adolescents and, later, gay adult men. The 20 to 30 percent who do take formal steps toward transitioning, Blanchard believes, are a self-selected group who, thanks to their more delicate looks, can function fairly successfully as women. “They’re people who might be unsuccessful as men,” Blanchard said.  —  Homosexual transgender men transition early in adulthood, typically during their twenties, Blanchard observed. They account for the vast majority of transgenders in the non-Western world: from the “two-spirits” of indigenous North American tribes, to the fa’afafine of Samoa, to the kathoeys of Thailand who can easily fool Western sex tourists into misidentifying them as women. In those societies there is typically a recognized and thoroughly integrated social niche for men who identify and dress as women. The fa’afafine typically work as secretaries, nannies, and housekeepers​—​stereotypically female occupations. In that respect, they’re not unlike the flamboyant gay men of Western culture who carved out a recognized social niche for themselves in such occupations as hairdresser, dancer, makeup artist, interior decorator, couturier, and fashion consultant (Queer Eye for the Straight Guy). Boys and men in drag played women’s roles on stage from classical times to the 17th century, and they continue to be popular entertainers for both gays and heterosexuals to this day, as the demographics of the Kit Kat Lounge attest.  — By contrast, Blanchard discovered that the predominant form that trangenderism takes in the West today involves men who, as men, have never identified as homosexual in their erotic attractions, but rather as heterosexual, bisexual, or asexual. Those men, his research revealed, tended to make their transitions in their mid-to-late thirties, or even later​—​at least a full decade on average after the homosexual transgenders did. Furthermore, many of those men were married and fathers before they came out. The paradigm might be travel writer Jan Morris, now 88, who spent the first 46 years of her life as James Morris, the journalist who covered Edmund Hillary’s ascent of Mt. Everest and who fathered five children before undergoing transition surgery in 1972. And many in this heterosexual population​—​in contrast to the homosexual transgenders on the drag scene​—​worked in stereotypically hypermasculine professions: They’d been parachutists, Navy SEALs, engineers, policemen, firemen, and high school football coaches. The billionaire philanthropist James Pritzker, who became Jennifer Natalya Pritzker in 2013, in his early sixties, is a retired much-decorated U.S. Army lieutenant colonel with three children by his former wife. “They’ll say that they chose those professions in order to suppress their feelings as females,” Blanchard said. “But no one put a gun to their heads to choose those jobs.” Many late-transitioning transgenders (Jennifer Finney Boylan, for example) insist, contra Blanchard, that they were aware from early childhood that they were born into the wrong body—​but Blanchard thinks they aren’t being honest with themselves.”

Ms. Allen then goes on to explain how certain members of the autogynephilic tranwomen’s community took umbridge with Bailey’s attempt at popularizing Blanchard’s work,

The Man Who Would Be Queen inflamed transgender activists. It did have certain inflammatory aspects. There was the jacket photo of the man in high heels. Blanchard’s coinage “autogynephilia” (extensively used by Bailey in the book), with its connotations of fetishism, deviance, and mental disorder, has never sat well with transgenders. Bailey was even more adamant than Blanchard that autogynephilic transgenders often lied about their erotic fascination with cross-dressing. Furthermore, Bailey observed, drawing on his previous studies, that homosexual transgenders tended to come from lower socioeconomic classes than autogynephiles, and that they tended to have short time-horizons that often led them into streetwalking, shoplifting, and other petty crimes. “Prostitution is the single most common occupation,” Bailey wrote. His book also, perhaps inadvertently, included details about “Cher” that made her real identity quickly discoverable to those in the know: Anjelica Kieltyka, a Chicago transgender woman who, although disagreeing with Bailey about his characterization of her as autogynephilic, had made frequent guest appearances in his classes and had introduced him to other figures in the city’s transgender scene.  —  Bailey’s book caught the immediate​—​and hostile—​attention of Lynn Conway, now 77, a pioneer of computer-chip design during the 1970s, a longtime engineering professor at the University of Michigan, and a leading transgender activist who figured as one of Time’s “21 Transgender People Who Influenced American Culture” in its May 2014 cover story. Conway was close to Andrea James (both had been patients of Dr. Ousterhout and touted his facial-feminization techniques on their websites). James, best-known for counseling Felicity Huffman, the star of the film Transamerica (2005), on transgender voice and mannerisms, underwent transition surgery in 1996. She and Conway teamed up with Kieltyka, and with Deirdre McCloskey, to make sure that The Man Who Would Be Queen would not receive a respectable academic hearing. McCloskey’s participation in this enterprise seems odd. For one thing, her memoir, Crossing, describes her pre-transition self as having been “sexually aroused” as a young man by accounts of cross-dressing​—​a classic Blanchard-esque theme.”

She also notes that the science does not support the contention that “late transitioners” have female brains,

“The medical evidence for a mismatch between brains and bodies is ambiguous. The two studies cited most frequently by transgender activists, published in 1995 and 2000, examined the brains of a total of seven male-to-female transgenders and found that a region of the hypothalamus, an almond-shaped area of the brain that controls the release of hormones by the pituitary gland, was female-typical in those brains. But those studies have been criticized for not controlling for the estrogen​—​which affects the size of the hypothalamus​—​that most male-to-female transgenders take daily in order to maintain their feminine appearance.”

If I had any serious criticism of her essay, it would be in the way that she hews to the stereotype that transkids, “homosexual transsexuals”, are stereotyped as being prone to becoming petty criminals, prostitutes, and drag performers.  I also found her take on the recent improvments in medicine and law regarding the treament of transchildren and teens to be unsympathetic.  She gives one the impression that too many gender variant pre-teens are being pushed into iatrogenic trauma via puberty blockers, etc.  While it may be true that autogynephiles may overvalue transition, most transkids and our caregivers are careful not to push children who are more likely to become gay and lesbian adults into wrong paths.

It may be uncomfortable reading, but I highly recommend that you do.

Reference:

http://m.weeklystandard.com/articles/transgender-triumph_859614.html?page=3

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Gender Allusions

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

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

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

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

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

But they would be dead wrong.

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

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

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

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

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

Reference:

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

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Child’s Play

Posted in Female-to-Male, Science Criticism by Kay Brown on February 9, 2015

critical-thinkingFor years, critics of transkids’ identities have made claims that transkids are either “confused”, “delayed”, or “pretending”.  Many papers describing feminine boys from the 1960’s would describe them as being “talented mimics”, explicitely taking the position that men and women, boys and girls, do in fact have in-born differences in behavior, mannerisms, and motor-movements, but that these feminine boys were NOT exhibiting natural behavior, but were consciously, or “subconsciously”, observing girls and women, and learning to “mimic” these behaviors.  Of course, those of us who were such and grew up to transition, have long begged to differ!

Today, we have a published paper that demolishes these notions.  At the core of the paper is the ability to determine implicit associations between concepts.  If you are not familiar with this tool, it may be useful to review the Wiki page on Implicit Association Testing .  One of it strengths is that it cannot be “faked”.  It is impervious to Social Desirability Bias or other impression management distortions.  It is also impossible for someone to be “pretending”, as the cognitive load to evaluate the test set-up, determine the “right” answer, etc. would create an obvious delay in the test.  Further, if a child were “confused” as to the meaning of sex and gender, there would be an obvious anomalous signature in the test results.

ImplicitThe study involved 32 transkids, ages 5-12, 12 FtM, 20 MTF, who have already transitioned full time, with the full support of their families.  This would obviously include “early onset” transkids.  However, and this is critical, we know, or at least suspect, that some of these kids will “desist” being gender dysphoric before puberty, if they follow the trend already seen in other studies, most especially the Steensma study from the Netherlands.  Yet, for all of that, the results of the study show that these kids are completely consistent in their implicit gender identity and preferences as their opposite sex, non-trans, controls and siblings.  They are NOT pretending, nor confused.

The folks who conducted this recent study are continuing their work, looking at these kids as they grow up.  They are looking for additional transkids to join the study.

Study on Gender Nonconformity in Children

Hi from the TransYouth Project at the University of Washington! We are researchers interested in gender development in children and have a new research project we are currently recruiting families for. The project aims to better understand gender development in gender nonconforming and transgender children.  Our new study takes 30-60 minutes and includes children ages 3-12. We are running the study all over the U.S. and Canada so please let us know if you are interested and we can let you know when we’ll be in your area. We are hoping to recruit gender nonconforming children as well as their siblings (where applicable). All data collected as part of this study are confidential. Payment is $10 per parent and $10 plus a small toy per child. There is an optional longitudinal component that we can tell you more about as well if you are interested. To sign up for the study, please visit: http://www.transyouthproject.org. If you have any questions, feel free to contact me, Dr. Kristina Olson, via email (krolson@uw.edu) or phone (206-616-1371). Thanks for considering being a part of this research or telling someone who might be!

Reference:

Kristina R. Olson, Aidan C. Key, Nicholas R. Eaton, “Gender Cognition in Transgender Children“, Psychological Science

Thomas D. Steensma, Roeline Biemond, Fijgie de Boer and Peggy T. Cohen-Kettenis, “Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study”
http://ccp.sagepub.com/content/early/2011/01/06/1359104510378303

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What the NEXT Wave of Transgender Activists Need to Know

Posted in Editorial by Kay Brown on December 9, 2014

CloudyThis post marks five years of writing on the subject.  It seems a good moment to stop and reflect on the reasons I’ve been writing, and to explore what has changed in my lifetime.  I’ve tried to keep the material mostly about the science and its implications.  It hasn’t always been easy, as there is in the background, from what I would call the “Second Wave” of transactivists, a powerful and very ugly, campaign of disinformation.  Why do I say, “Second Wave”?  Because I, and a few folks I knew from the ’70s and very early ’80s, were the “First Wave”.

Christine Jorgensen would undoubtedly have to be called the first, as she wrote and spoke about her life in the hopes that others like her would have a better life in the future. I still keep in my “memory box” a small ticket stub from the day that I attended a talk she gave at a local community college in February of ’76.  After she spoke, she welcomed the small cluster of transwomen who surrounded her, hoping to speak with their heroine.  Christine took a special interest in me, teasing me as a “Baby TS, all of eighteen years old!”

Silvia Rivera is of course oft mentioned when she spoke out from the streets of New York.  I’m sad that I never got the chance to meet Silvia before she died.  Other street warriors came forward, but their efforts were, sadly, largely symbolic, yet important none-the-less.  One of these was Angela Keyes Douglas.  I was with her the evening that she typed the infamous Sister letter that Janice Raymond would later, falsely, use as an example of transsexual misogyny, in her transphobic book, The Transsexual Empire.  Angela angrily pulled it fresh from her typewriter and asked me to review it.  It dripped with hyperbolic sarcasm, angry as she was over the transphobic treatment of Sandy Stone over her employment at Olivia Records, the seminal Womyn’s Music publisher.  I too was angry at the treatment that Sandy was enduring, being on friendly terms with her as well, but I diplomatically reported, “It’s too full of anger to do any good.”  Angela snorted, snatched the letter back from me, and posted it.  Even then, in ’77, it was very clear that Angela’s mind was deteriorating from progressive paranoid schizophrenia.

Joy_Candice

Dr. Joy Shaffer and Kay Brown in the mid-80s

Little known is the real hero of those very early days, transman Reed Erickson, who put his fortune to work helping both the gay and trans communities.  Through the ’60s and ’70s, he supported the Erickson Education Foundation, whose Executive Director, Zelda Suplee, an iconoclastic non-transsexual woman, was a lifeline, on the phone and through the mails, for many transsexuals who would otherwise have been all alone.  Zelda was a firm believer not only in the transsexual community, but in nudism and reincarnation.  Once, as I drove the three of us to a meeting of transactivists, my roommate, Dr. Joy Shaffer asked her, “Do you really believe in that stuff?”  Zelda quipped in reply, “It beats television!”

ACLUBut in the late ’70s came Joanna Clark, Jude Patton, and Joy Shaffer, who I’m proud to say invited me to join them in founding the ACLU Transsexual Rights committee.  Joanna and Jude also worked very closely with fabulously openly gay Paul Walker to continue the educational work of the recently defunct Erickson Foundation and to eventually found the Harry Benjamin Gender Dysphora Association (later renamed World Professional Association for Transgender Health (WPATH).  One night in the mid ’80s, Paul Walker, Joanna, Joy, and I were bar hoping in San Francisco, when we entered a bar that Paul liked to frequent, catering to mostly transwomen of color.  The patrons took one look at the towering whiteness of Joanna and informed us that “This is a private club.”  Joanna, with her typically irreverent, and oft dangerously inappropriate, sense of humor, loudly quipped, “Busted!!!”.  These would be the serious activists that pioneered efforts to work with lawmakers and the courts, physicians, surgeons, clinics and scientists… to earn legal and medical recognition, to enable the majority of transfolk to transition and receive appropriate and respectful medical and legal services.

From these early, daring days, came those that soon followed, expanding the ranks of organizations that took our early cutting edge openings, to expand it and now in most of the Western World we have nearly the legal recognitions and protections we need, with a few exceptions that we can all soon hope will be only a sad memory.

In the early ’90s, transactivists across the Western World began actively lobbying their governments.  In late ’96, transactivist lawyer, JoAnna McNamara asked me to work with her lobbying the Oregon legislature to address language in a new bill that would have stripped transfolk in that state of protections that JoAnna herself had only recently won in admistrative ‘court’.  I worked fulltime, alongside her, as we made appointments to speak to key legislators, using a deliberate one-two punch, in which she, as an older transitioner, not very “passable” would be assumed to be “the transsexual” discussed how transphobia worked to deny employment opportunities to transwomen like her.  As I sat quietly taking notes, I was assumed to be her natal female assistant… until I spoke up about what discrimination awaits transwomen like me who pass, but are later discovered by their employer… The sudden shocking realization would cause the legislator to rethink their opposition to our position.  It reached a climax in a public hearing about the bill in which the room was packed with transactivists that JoAnna and I had hurriedly put together on very short notice.  We won.  The anti-trans* languange was removed from the bill in committee.  Six months of full time lobbying paid off.

But from the very late ’90s came a Second Wave that took the previous work for granted… and started a new, and in my own personal opinion, disturbing direction. Not content with being able to transition and obtain legal recognition, these new activists have decided that they could bend the truth to their will, to use the power of the internet to coerce our best allies, the clinicians, therapists, medical practitioners, scientists, and even other transfolk, to ignore decades of clinical and scientific evidence regarding the uninvited dilemma that is transsexuality and transgender sexuality.  To my shame as a transwoman and transactivist, transfolk I knew and respected turned from respectability toward waging a vicious propaganda and slander campaign.

CedarStar

CedarStar

I first met Dr. Anne Lawrence in ’95, when Dr. Joy Shaffer brought her to have dinner at CedarStar, my Portland communal house.  While I prepared dinner, Anne and Joy explained Blanchard’s theory.  OF course, I totally understood and agreed, since I had been first educated about the very same issue when I was but 18 years old by my world wise transwoman of color friend, Marcella, who explained “older transistioners” as “… just TVs that need a bigger fix”.  I remember being amused at the thought that the scientists were finally proving it.

I first heard of Lynn Conway in 1982 from Joy’s father, who was a professor of electrical engineering.  Prof. Shaffer had proudly informed me that Lynn was also transsexual, offering the information to strongly encourage me to finish my undergraduate degree and apply at Stanford Graduate School, urging me to study to become an engineer like Joy’s younger sister was at the time, (joining my boyfriend’s mother in chorus, who being an engineer herself, also wanted her son’s girlfriend to also be an engineer). I finally met Lynn in the late ’90s, when she wrote to me regarding my TransHistory class I was teaching at the Harvey Milk Institute in San Francisco.  I had taken advantage of the web to post my class notes, which brought me to her attention.  I was very happy to finally meet this famous transsexual Silicon Valley pioneer.  Of course, during our conversations, during her frequent visits, over dinner, lunch, and at my house, etc.  I had a chance to explain Blanchard’s two type taxonomy.  I was under the honest impression that she understood and agreed with it.

Then, in 2003, Lynn called asking me to join her in protesting Bailey’s new book that she thought was so dangerous, The Man Who Would Be Queen.  Though I hadn’t read it, I had no interest in protesting what I personally believed was true.  Seriously, I can’t imagine what would lead Lynn to believe that I would join in a fight to deny the science I knew to be true.  But, I was not to take the steps that lead to this blog until I read Alice Dreger’s history of the horrendous behavior of these ‘Second Wave’ transactivists. In 2008, I read Alice’s article, Bailey’s book, and corresponded with a number of the players, including Bailey and Kiira Triea, who became a friend as a result.  I was horrified.  I was also ashamed; ashamed for our community, ashamed for my earlier cowardice for not having tried to stop Lynn and the others.  These people, our community, behaved abominably.  They attacked the very people who were working hard to understand us, to help us.  They falsely vilified both non-transfolk and transfolk alike, members of our own community… and established a poisonous atmosphere of fear and intimidation that persists. As Bailey and Kiira wrote in 2007,

“Beyond denying the role of autogynephilia in MtF transsexualism, some transsexual activists have mounted attacks on those who publicly disagree with them. In 2003, the first author published a book, The Man Who Would Be Queen, about male femininity, including MtF transsexualism. The section on transsexualism included summaries of Blanchard’s theory illustrated by transsexual women of both types whom he had met, and who agreed to let their stories be included. Upon publication, there was a firestorm of controversy among some MtF transsexuals. Most notably, the transsexual activists Lynn Conway (2006) and Andrea James (2006) led an internet “investigation” into the publication of the book. Conway (2004) likened the book to “Nazi propaganda” and said that it was “transsexual women’s worst nightmare.” As a result of Conway’s and James’s efforts, a number of very public academic, personal, and professional accusations were made against the first author. None of these accusations was true (Bailey 2005). The attacks on The Man Who Would Be Queen were precisely an attempt to punish the author for writing approvingly about Blanchard’s ideas, and to intimidate others from doing so.  The second author was also attacked by some of the same transsexuals after she helped create the Website transkids.us. This website was created by a group of homosexual transsexuals, or “transkids,” their nonclinical name for themselves, to educate the clinical and research communities in the wake of the controversy regarding The Man Who Would Be Queen. The writings on the site both endorsed Blanchard’s distinction between homosexual and autogynephilic MtF transsexuals and criticized the standard feminine essence narrative as being both false and harmful to homosexual MtF transsexuals. Subsequently, Andrea James (2007) conducted highly personal attacks on individual transkids (including the second author), urging that these transkids be exposed and asserting that they were “fakes” because they would not reveal their identities publicly”.

As an example of this attempt to intimidate those who might speak out… and “discredit” those who do, James spent a year trying to figure out who the last of the transkids.us website authors, “Cloudy” was… while simultaneously attempting to convince the trans-community that “Cloudy” was yet another “fake”.  After she discovered that I was “Cloudy” she attempted to intimidate me by email and phone, in which Conway participated in a minor way.  James, failing to intimidate me from further writing on this subject, produced a scandalously scurrilous webpage, describing me as both “fringe” and… well… you can search for it yourself.

Let my experience be an object lesson for the NEXT wave of transactivists.  It is not enough to work to change the world… we need to make sure that we ourselves maintain the values that we would wish in others: respect, cooperation, open-mindedness, kindness.  We need to stand up against bullies, even our own… NO, Especially our own. Above all… we need to maintain and reward a search for the truth, even if it is an uncomfortable truth.

References: Bailey, J. Michael – Triea, Kiira. “What Many Transgender Activists Don’t Want You to Know: and why you should know it anyway” – Perspectives in Biology and Medicine, Volume 50, Number 4, Autumn 2007, pp. 521-534 DOI: 10.1353/pbm.2007.0041

Alice D. Dreger, “The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Politics of Science, Identity, and Sex in the Internet Age” – Archives of Sexual Behavior, June 2008, Volume 37, pp 366-421 DOI: 10.1007/s10508-007-9301-1

Alice D. Dreger, “Galileo’s Middle Finger – Heretics, Activists, And The Search For Justice In Science“, 2015

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Winds of Change

Posted in Female-to-Male, Science Criticism, Transsexual Field Studies by Kay Brown on November 6, 2014

critical-thinkingIn a very recently published paper (not behind a paywall, thankfully) the issue of changes in self-reported sexual orientation in transsexuals over their lifetime is explored.   The paper has some interesting data… and some very, very problematic data.  One of the problematic data points was the surprising number of self-reported, putatively, originally exclusively androphilic MTF transwomen whose sexual orientation changed to something else.  But… there seems be something… well… fishy about the data.  Take a look at this table:

Initial sexual orientation and history of transition in MtF: N= 70
Orientation               androphilic        gynephilic        bisexual        analloerotic (asexual)
N =                               18 (25.7%)           36 (51.4%)       7 (10%)         9 (12.9%)
age  (SD)                     41.6 (16.4)          51 (9.6)             36(10.8)        47.9 (15.9)
Age of onset              7.2 (3.9)             11.6 (9.9)         11.7 (7.3)       14 (5.8)
first  counseling      32 (13.8)            42.6 (11.5)        31.3(8.7)       39(17)
Transition                 36.4 (10.8)        45.2 (9.6)          33 (7.7)          40.7 (12.1)
HRT                              31.1 (13.8)        42.8 (11.8)        31.9 (9.5)       41.1 (17)
SRS                               35.3 (14.1)        47.5 (10.3)        36.2 (9.3)      34 (12.7)

Do you see it?  Hint:  Compare the ages and ages of transition for the “androphilic” and “bisexual” groups.  Ummmm… sorry guys, that data disagrees with EVERY other study ever done.  The mean age of transition for transkids is closer to age 20.  This was seen in the Nuttbrock and Tsoi studies, in which half of the androphilic MTFs who had started HRT had done so as teenagers… here the average age is 31 years old???  How is it that the “bisexual” group had begun transition, on average, three and half years before the “androphilic” group?  And somehow the “androphilic” group had SRS before beginning transition???  WTF!?  NOT!  Something appears to be very wrong with the data.  The so called “androphilic” group in this study is essentially identical with the “bisexual” group.  So what’s going on?  Can we say, “Social Desirability Bias“?  It looks like there are no actual, genuinely, exclusively androphilic transwomen in this study sample… not even one.

The study suggests that five of the eighteen putatively originally androphilic transwomen had changed their sexual orientation to bisexual, gynephilic, or “unknown”.  I have another interpretation… these five individuals simply admitted to actually having always been non-exclusively-androphilic, finally acknowledge it, as they realized they didn’t have to keep up the pretense.

The rest of the study makes more sense, as six of the 36 of the originally gynephilic identified transwomen reported a shift to bisexuality and androphilia.  This sort of shift has been widely reported before.  Of course, these shifts are generally recognized to be a result of interpersonal autogynephilia,

“Autogynephilic MtF transsexual persons often report the fantasy of sexual intercourse as a woman with a man, that was repeatedly described as faceless and abstract. Yet this pseudoandrophilia has to be distinguished from genuine androphilia or homosexuality in MtF, or as Blanchard points it: ‘‘the effective erotic stimulus, however, is not the male physique per se, as it is in true homosexual attraction, but rather the thought of being a female, which is symbolized in the fantasy of being penetrated by a male. For these persons, the imagined – occasionally real – male sexual partner serves the same function as women’s apparel or makeup, namely, to aid and intensify the fantasy of being a woman’’. Similarly, one of our participants that formally reported a change of sexual orientation from gynephilia towards androphilia stressed that ‘‘I always wanted to experience sexual intercourse as a woman but I did not know what to do with my male body before the hormone treatment. I hated male bodies in general before’’. In this case a reported change in sexual orientation from gynephilic to androphilic can be attributed to autogynephilic fantasies.”

The more interesting data in this study is all about the FtM transmen, about which we have far fewer studies.  Of six originally androphilic FtMs, four of them experience a shift to being gynephilic during transition… and of the 33 originally gynephilic six experience a shift to being androphilic or bisexual.

“In gynephilic FtM a reported change of sexual orientation was less frequent. Six gynephilic FtM reported a change of sexual orientation towards bisexuality and androphilia in the present study. This may in part be explained by the fact that androphilic sexual behavior is complicated for FtM. Sex with male partners can induce intense gender dysphoria by being penetrated as a woman although feeling as a man. One participant in the study of Rowniak and Chesla stated that he didn’t like being ‘‘feminized in bed’’ and others used the description that they were unable to have sex with men ‘‘until they were a man’’. Thus in these 6 participants androphilia may have been the original sexual orientation that became possible only after transitioning. In this case we wouldn’t expect a genuine change of sexual orientation in these gynephilic FtM transsexual persons.”

I was friends with an FtM who stated exactly the same thing… that he ‘identified’ as and participated in the lesbian community because lesbians would let him be butch, but straight men wouldn’t.  As a gay identified FtM, he could finally be both butch and express his native androphilia.  He was in fact, autoandrophilic.  (See my essay on autoandrophilila in FtMs.)

It is gratifying that the authors recognize the weaknesses of their current study and make some recommendations for future studies,

“Self-reported sexual orientation studies have further been reported to be interfered by the fact that some persons do not answer the question truthfully. Some transsexual people for example may want to present themselves as particular feminine (MtF) or masculine (FtM) and thus ‘‘classical’’ transsexual persons.  Participants in the present study might have biased their reports on purpose or unwittingly towards a more gender-typical presentation. This may also involve worries on denial of sex reassignment surgery. We feel that attempts to minimize such worries are important in future studies. We also suggest that researchers should explicitly ask for autogynephilic and autoandrophilic sexual orientation.”

Further Reading:

Essay on Pseudo-Androphilia in Autogynephilic MTF transsexuals

Reference:

Matthias K. Auer, Johannes Fuss, Nina Hohne, Gunter K. Stalla, Caroline Sievers, “Transgender Transitioning and Change of Self-Reported Sexual Orientation”
http://www.plosone.org/article/fetchObject.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0110016&representation=PDF

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