Definition & Synopsis of the
Etiology of Gender Variance
Gender Identity Research and Education Society
www.gires.org.uk
MELVERLEY, THE WARREN, ASHTEAD, SURREY, KT21 2SP
tel: 01372 801554.
© GIRES 2008 Version 2.01
July 18, 2009

Definition & Synopsis of the Etiology
of Gender Variance
1. Severe gender variance in adults (sometimes still referred to as gender
dysphoria) describes an inconsistency between the physical phenotype
and the gender identity1, that is, the self identification as a
man or as a woman. When this is experienced in a very extreme
form, known as transsexualism2, individuals may need to adapt their
phenotype through hormones and surgery to make it congruent with
their gender identity. Individuals experiencing this condition are referred
to as trans people, that is, trans men (those who transition
from living as women to living as men) and trans women (those who
transition from living as men to living as women).
2. Transsexualism can be considered to be a neuro-developmental condition
of the brain3. Several sex dimorphic nuclei have been found in
the hypothalamic area of the brain (Allen & Gorski, 1990; Swaab
et. al., 2001). Of particular interest is the sex dimorphic limbic nucleus
called the central subdivision of the bed nucleus of the stria
terminalis (BSTc) which appears to become fully volumetrically sex
differentiated in the human brain by early adulthood. This nucleus
has also been found to be sex dimorphic in other mammalian and
avian species (Miller et. al., 1989; Grossmann et. al., 2002). In human
males the volume of this nucleus is almost twice as large as
in females and its number of neurons is almost double (P < 006)
(Zhou et. al., 1995; Kruijver et. al., 2000; Chung et. al., 2002).
3. The Kruijver et. al. study, cited above, indicates that in the case
of transsexualism this nucleus has a sex-reversed structure. This
means that in the case of trans women (n = 7), the size of this nucleus
and its neuron count was found to be in the same range as
that of the female controls (n = 13) and, therefore, women in the
1The term ‘gender identity’ is used, in the UK, however, terminology varies around
the world, and the term ‘sexual identity’ is preferred by many in the US. (pace Professor
Milton Diamond). See “Sex and Gender are different: Sexual Identity & Gender Identity
are Different”, (2000) Clinical Psychology & Psychiatry, Vol 7 (3):320–334.
2The transsexual condition is also referred to in various ways (Diamond M, 2002)
“Whats In a Name? Some terms used in the discussion of Sex and Gender”. Transgender
Tapestry.
3The UK government recognises that transsexualism is not a mental illness. See Lord
Chancellors Department (now renamed Department of Constitutional Affairs)— government
policy concerning transsexual people
general population. In the only available brain of a trans man, the
volume and structure of this nucleus was found to be in the range of
the male controls (n = 21) and, therefore, men in the general population.
It is hypothesised that this male-like BSTc will be present
in other trans men as well. These findings were independent of sex
orientation and of the use of exogenous sex hormones. In the 42
human brains collected for this study, the BSTc was found to have a
structure concordant with the identification as men or women. It is
inferred that the BSTc is an important part of a sex dimorphic neural
circuit, and that it is involved in the development of gender identity
(Kruijver et. al., 2000).
4. Sex differentiation of the mammalian brain starts during fetal development
and continues after birth (Kawata, 1995; Swaab et. al.,
2001). It is hypothesised that in humans, in common with all other
mammals studied, hormones significantly influence this dimorphic
development although, at present, the exact mechanism is incompletely
understood. It is also postulated that these hormonal effects
occur at several critical periods of development of the sex differentiation
of the brain during which gender identity is established, initially
during the fetal period, then around the time of birth; and also
post-natally. Factors which may contribute to an altered hormone
environment in the brain at the critical moments in its early development
might include genetic influences (Land´en, 1999; Coolidge
et. al, 2002) and/or medication, environmental influences (Diamond
et. al., 1996; Whitten et. al., 2002), stress or trauma to the mother
during pregnancy (Ward et. al., 2002; Swaab et. al., 2002).
5. Gender identity usually continues along lines which are consistent
with the individual’s phenotype, however, a very small number of children
experience their gender identity as being incongruent with their
phenotype. Adult outcomes in such cases are varied and cannot
be predicted with certainty. It is only in a minority of these children
that, regardless of phenotypical socialisation and nurture, this incongruence
will persist into adulthood and manifest as transsexualism
(Green, 1987; Ekins, 1997; Prosser, 1998; Di Ceglie, 2000; Ekins &
King, 2001; Bates, 2002).
6. As stated, in trans people, a sex-reversed BSTc has been found.
The findings of a specific sex-reversed brain organisation in trans
people provides evidence consistent with the concept of a biological
element in the etiology of transsexualism. The evidence for an
innate biological predisposition is supported by other studies, one
example of which, indicates a higher than average correlation with
left-handedness (Green & Young, 2001). Where the predisposition
for transsexualism exists, psycho-social and other factors may subsequently
play a role in the outcome, however, there is no evidence
that nurturing and socialisation in contradiction to the phenotype can
cause transsexualism, nor that nurture which is entirely consistent
with the phenotype can prevent it (Diamond, 1996). There is further
clear evidence from the histories of conditions involving anomalies
of genitalia, that gender identity may resolve independently of
genital appearance, even when that appearance and the assigned
identity are enhanced by medical and social interventions (Imperato-
McGinley et. al., 1974; Imperato-McGinley et. al., 1979a; Imperato-
McGinley et. al., 1979b; Rsler & Kohn, 1983; Meyer-Bahlburg et al.,
1996; Diamond, 1997; Diamond &Sigmundson, 1997; Kipnis & Diamond,
1998; Reiner, 1999; Reiner, 2000). It is not possible to
identify one single cause for transsexualism: rather, its causality is
highly complex and multifactorial. The condition requires a careful
diagnostic process, based largely on self-assessment, facilitated by
a specialist professional.
7. In conclusion, transsexualism is strongly associated with the neurodevelopment
of the brain. (Zhou et. al., 1995; Kruijver et. al., 2000).
The condition has not been found to be overcome by contrary socialisation,
nor by psychological or psychiatric treatments alone (Green,
1999). Individuals may benefit from an approach that includes a
programme of hormones and corrective surgery to achieve realignment
of the phenotype with the gender identity, accompanied by wellintegrated
psychosocial interventions to support the individual and
to assist in the adaptation to the appropriate social role (Green and
Fleming, 2000). Treatments may vary, and should be commensurate
with each individuals particular needs and circumstances.

original authors are asteriskedg
Dr Henk Asscheman, MD, PhD. (The Netherlands)*
Professor Michael Besser, DSC, MD, FRCP, SmedSci. (UK)
Dr Susan Carr, MPhil. MFFFP. DDRCOG. (UK)
Professor dr Peggy Cohen-Kettenis PhD. (The Netherlands)
Dr Pamela Connolly PhD. (USA)
Professor dr Petra De Sutter, PhD. (Belgium)
Professor Milton Diamond, PhD. (Chair) (USA)*
Dr Domenico Di Ceglie, FRCPsych., DIP. PSICHIAT. (Italy) (Child Section)
(UK)*
Professor Louis Gooren, MD, PhD. (The Netherlands)
Professor Richard Green, MD, JD, FRCPsych. (UK)
Dr Lynne Jones, MP, PhD. (UK)
Dr Frank Kruijver, MD. (The Netherlands)*
Dr Joyce Martin, MRCGP, MB, ChB, D.Obst.RCOG. (UK)*
Dr Zoe-Jane Playdon, BA(Hons), PGCE, MA, MEd, PhD, DBA, FRSA. (UK)*
Mr David Ralph, MBBS, BSc, FRCS, MS. (UK)
Mrs Terry Reed, JP, BA(Hons), MCSP, SRP, Grad Dip Phys. (UK)*
Dr Russell Reid, MB, ChB, FRCPsych. (UK)*
Professor William Reiner, MD. (USA)
Mr M. Royle, MBBS, FRCS (Urol) (UK)
Professor Dick Swaab , MD, PhD. (The Netherlands)
Mr Timothy Terry, BSc, MB, BS, LRCP, FRCS (Urol), MS (UK)
Mr Philip Thomas MBBS, FRCS (Urol). (UK)
Professor James Walker, MD, FRCP, FRCOG. (UK)
Dr Philip Wilson, DPhil MRCP MRCPCH FRCGP. (UK)
Dr Kevan Wylie, MB, MmedSc, MD, FRCPsych, DSM. (UK)

Many transsexuals, therapists, human sexuality researchers, religious liberals, and others believe that transsexuality is determined before birth. Some believe that it is determined by one's DNA at conception. others hold to the theory that it is caused by irregular levels of sex hormones to which the fetus may be subjected. These beliefs are grounded in research into genes and traits of transsexuals.

 

Cristine Shye

Is transsexualism genetically determined?

As noted elsewhere in this thread a transsexual is a person who experiences Gender Identity Disorder (a.k.a. Gender Dysphoria), Their genetic gender is different from their perceived gender. Some describe themselves as a woman trapped in a man's body, or vice versa.

This disorder is rare. It generally causes serious personal conflicts and depression, often starting in pre-school children. Their level of frustration and anxiety is often so high that many become suicidally depressed. The rate of completed suicide for transsexuals was once believed to be about 50% by age 30. Since then, sex reassignment surgery (SRS) has become more widely accessible. Many transsexuals can now have their physical appearance modified to make them appear more like the gender that they feel they are. This surgery has been shown to be generally effective, and the suicide rate among transsexuals has apparently been greatly reduced.

Religious conservatives generally believe that transsexuality is a chosen lifestyle to which a person can become addicted. The solution is therapy and prayer.

The opinion of some gays, lesbians, and bisexuals towards the causes of transsexuality may be influenced by a desire to support their belief that sexual orientation is similarly genetically determined.

Australian DNA study during 2008:

Australian researcher Professor Vincent Harley has led an Australian-American study of transsexuality. He acknowledges that the cause(s) of transsexuality have been debated for years. He said:
"There is a social stigma that transsexualism is simply a lifestyle choice. However our findings support a biological basis of how gender identity develops."

He was the lead researcher in the an Australian-American genetic study of transsexuals -- the largest to date. Included were several research groups in Melbourne Australia and in the University of California in Los Angeles (UCLA). It was funded by the National Health and Medical Research Council in Australia, and the National Institutes of Health in the U.S.

They compared DNA from 112 MTF (male-to-female) transsexuals with DNA from 250 males who did not experience gender dysphoria. Results of the study were published in the 2008-OCT-27 edition of the journal Biological Psychiatry.

The researchers found that the transsexual subjects were more likely to have a longer version of the androgen receptor gene in their DNA.

Lauren Hare, a researcher at Prince Henry's Institute said:

"We think these genetic differences might reduce testosterone action and under-masculinize the brain during fetal development."

"Studies in cells show the longer version of the androgen receptor gene works less efficiently at communicating the testosterone message to cells. Based on these studies, we speculate the longer version may also work less efficiently in the brain."

Terry Reed from the Gender Identity Research and Education Society said:

"This study appears to reinforce earlier studies which have indicated that, in some trans people, there may be a genetic trigger to the development of an atypical gender identity."

"However, it may be just one of several routes and, although it seems extremely likely that a biological element will always be present in the aetiology of transsexualism, it's unlikely that developmental pathways will be the same in all individuals."

Researcher Trudy Kennedy, director of the Monash Gender Dysphoria Clinic, said the study supported previous evidence that genetics and brain gender were important in transsexuality. She said:

"This is something that people are born with and it's certainly not a lifestyle choice as some have suggested."


Studies of fingerprints, left handedness, and ancestry of transsexuals:

During 2000-JUL, Professor Richard Green, visiting professor of psychiatry at Imperial College in London, UK discussed transsexuality at the annual meeting of the Royal College of Psychiatrists. His presentation was based on a study of 400 male-to-female (MTF) and 100 female-to-male (FTM) transsexuals in the late 1990s at the gender identity clinic in Charing Cross Hospital in London. His group determined that:


Over 50% of transsexuals are left-handed -- many times that of the general population.
Transsexuals had distinctive styles of ridged finger prints, and
Transsexuals had more aunts than uncles on their mother's side.
Male transexuals had more older brothers than average.

This post was edited by Cristine Jennifer Shye. BL at February 20, 2021 10:51 PM GMT

Thankyou Tammy.

Obviously I never wrote all of  it, presuming you have read my article on the home Page with regards to Reifensteins syndrome, well I'm off back to Addenbrooks, hospital on the 15 November to take part in ongoing research into the above articles. Where the term guinea pig came from I have no idea, but I have always wanted to learn more about my own condition, perhaps one day initial clinical testing of DNA for abnormalites will go some way to establishing and validate ones claims to GD and help the general public to be more accepting of a condition we struggle to understand amongst ourselves.

This post was edited by Cristine Jennifer Shye. BL at September 30, 2011 10:02 AM BST

Thankyou Tammy

Yes it is also thought in some medical circles, that it can be attributed to even minor afflictions like low virility in males the inability to father children, whilst looking and to all intense and purpose being normal males, Its not necessarily congruent with gender identity
disorders either.   So it will probably never be know what the true percentage of society is actually affected, its estimated that one in 180 M women carry the gene, and one in 30 odd million of the male children born to those women will inherit the condition.

This post was edited by Cristine Jennifer Shye. BL at September 4, 2012 12:49 PM BST

1. Introduction The role of the androgen receptor in CNS masculinization or the absence of same in male feminisation

The medial posterior region of the bed nucleus of the stria terminalis (BSTMP) and the locus coeruleus (LC) show opposite patterns of sexual dimorphism. The BSTMP in males is greater in volume and number of neurons than in females (male N female) while in the LC, the opposite is true (female N male). To investigate the possible role of the androgen receptor (AR) in the masculinization of these two structures, males with the testicular feminization mutation (Tfm) were compared to their control littermate males. No differences were seen in the number of neurons of the BSTMP between Tfm and their control littermate males, while in the LC, Tfm males have a greater number of neurons than their control littermate males. These results show that the AR is involved in the control of neuron number in the LC but not in the BSTMP. Results based on the LC suggest that when females have a larger brain area than males, masculinization in males may be achieved through the AR, with androgens perhaps decreasing cell survival.

Sex differences in the mammalian brain have two main characteristics: they often occur in neural circuits related
to reproductive physiology and behavior and they are seen in two opposite morphological patterns In one
pattern, males have greater volumes and/or number of neurons than females (male N female), while in the other, the opposite is true (female N male) Existing evidence suggest that gonadal androgens are involved in the development of sex differences in structures that are larger in males than in females,

http://portal.uned.es/pls[...]CES.PDF

Nature Versus Nurture in Gender Identity

Scientists and sociologists have argued for centuries over which influences people's personalities more: nature (genetics) or nurture (upbringing and cultural context).

Contemporary feminist theory holds that, excluding biological sex characteristics, all "masculine" or "feminine" behavior is the product of culture. In the 1980s, Candace West and Don Zimmerman coined the term "doing gender" -- acting in accordance with male or female behavioral norms. A woman who uses flirtatious mannerisms, according to this theory, is doing so not as a result of genetics, but rather because she's performing feminism to fit in with social norms -- because of her nurture.

But a recent study of male-to-female transsexuals -- people who have male genitalia but self-identify as females -- isolated a genetic peculiarity in its subjects.
Genetic Basis for Transsexualism

A transsexual is a person who does not identify with his or her biological sex. A male-to-female transsexual was born with male genitalia but self-identifies as a woman; a female-to-male transsexual was born with female genitalia but self-identifies as a man.

In October 2008, researchers at several universities published a study where they had compared DNA samples from 112 Australian and American male-to-female transsexuals with samples from 250 typical men. The research -- led by Vincent Harley of Prince Henry's Institute in Melbourne, Australia -- focused on three genes encoding sex hormones. One of these three, the androgen receptor gene, was longer in transsexual subjects than in non-transsexual controls. The significance?

A longer androgen receptor gene could reduce testosterone during brain development, a hormone vital for male sex characteristics and behavior. So if male-to-female transsexuals have longer androgen receptor genes, they might have less testosterone, the precursor to their female self-identification. If this biological explanation is true across the board, it argues against the possibility that transsexualism has no basis in genetics.


The Long View

Harley's study indicates that gender identity could have genetic roots, but it is important to keep these findings in perspective. First, the sample size -- at a little over 100 subjects -- was fairly small. Second, the study only examined three genes. And third, it would be imprudent to extrapolate from a study of a very specific subject group (male-to-female transsexuals) to make broader theorizations about gender identity without examining other populations. Similar to research on homosexuality genetics, it is not conclusive, but it does raise some interesting questions and opportunities for future research.

http://Read more: http://[...]7p5Y29T

Does your brain hurt as well?


Zhou J-N, Swaab DF, Gooren LJ & Hofman MA. (1995) Sex Difference in the Human Brain and its Relation to Transsexuality. Nature 378, 68-70. “…in one of the human brain structures that is different between men and women, a totally female pattern was encountered in six male to female transsexual (people)…This was not due to cross-sex hormone treatment. These findings show that a biological structure in the brain distinguishes male to female transsexuals from men”;
Male to female transsexuals have female neuron numbers in a limbic nucleus. The Journal of Clinical Endocrinology & Metabolism 85(5):2034-2041. “Regardless of sexual orientation, men had almost twice as many somatostatin neurons as women. The number of neurons in...male to female transsexuals was similar to that of the females…In contrast, the neuron number of female to male transsexuals was found to be in the male range…The present findings of somatostatin neuronal sex differences in the BSTc (a part of the brain) and its sex reversal in the transsexual brain clearly support the paradigm that in transsexuals sexual differentiation of the brain and genitals may go into opposite directions and point to a neurobiological basis of gender identity disorder.

The term ‘transsexualism’ rather than ‘transsexuality’ is preferred, since the latter misleads by giving the impression that the issue here is ‘sexuality’, which it is not. Some individuals prefer to describe themselves as transgender, as a catch-all description of many gender/sex variations across a broad spectrum. Although the term ‘transsexual’ is still used as a noun, it is preferable to use it as an adjective—transsexual people—or, better still, is the use of the more up-to-date terminology, trans men and trans women, as used in this paper. The usage of all these terms is continuously changing, especially as our understanding and perceptions of the condition change. Some, having transitioned from assigned to core gender, do not identify as trans at all; understandably, they identify simply as men and women. The clinical definition of the condition is Gender Identity Disorder. This is regarded as stigmatising and should be avoided...........

The microstructure of white matter in male to female transsexuals brains before
cross-sex hormonal treatment. A DTI study

I don't even pretend to know what everything is. could be some form of spaghetti. but. you can get the gist of it.

Transsexualism is an extreme form of gender identity disorder( American Psychiatric Association, 2000). Male to female (MtF)
transsexuals are characterized by persistent cross-gender identification,discomfort with their assigned gender, cross-dressing and
a search for hormonal and surgical sex reassignment to the desiredanatomical sex to become females. The etiology of transsexualism is unknown but biological variables could play a role in its development (Cohen-Kettenis and Gooren, 1999; Gooren, 2006; Swaab, 2004). Postmortem anatomical studies have shown that some subcortical structures are feminized in MtF transsexuals. The volume and the number of neurons of the central part of the bed nucleus of the stria terminalis (BSTc) and the third interstitial nucleus of the anterior hypothalamus (INAH3), which present sex differences in control subjects, are feminized in MtF transsexuals (Garcia- Falgueras and Swaab, 2008; Kruijver et al., 2000; Zhou et al., 1995). These studies all suggest that the feminization of the BSTc
and the INAH3 in MtF transsexuals is related to neither their sexual orientation nor their cross-hormonal treatment.

Conclusion
In conclusion, our results show that the white matter microstructure
pattern in untreated MtF transsexuals is intermediate
between male and female controls. The direction of the differences
suggests that some fasciculi do not complete the masculinization
process during brain development before the individual seeks
treatments.

http://portal.uned.es/pls[...]11B.PDF

http://www.newscientist.c[...]an.html

Hiya Rachel, Thankyou.

Yes there are other tests, done by extracting a sample of spinal fluid, Testing for a hybrid or mutant gene in the DNA, The white matter described in the previous posts and new discoveries being made all the time only go to demonstrate, there are physical and clinical reasons for Gender dysphoria, apart from the its all in the mind or life style choice. The only trouble I can see for the future though, will a diagnosis depend on a clinical scientific evaluation and disregard the psychological aspect.

http://www.identitygender.com/2011/02/03/gene-variant-for-enzyme-cytochrome-p17-linked-to-transsexuality.html

 

 

 

 

Linda Geddes, of New Scientist, cites the research of scientists at Medical University of Vienna, Austria, who discovered a gene variant in the enzyme Cytochrome P17 that controls the metabolism of sex hormones.  The presence of the gene variation could "cause higher than average tissue concentrations of male and female sex hormones, which may in turn influence early brain development."  The proportion of MtF transsexuals with it was similar to control males, but 44% of FtM transsexuals had it, versus 31% of non-transsexual women.

 

 

 

This variant is insufficient to imply direct causality for transsexualism, but "the finding raises the possibility that the variant makes women more likely to feel their bodies are of the wrong sex." "If other gene variants with a stronger association to transsexuality are identified, establishing a diagnosis might become easier.This might allow gender reassignment surgery or hormone therapy to start earlier in life,

 

The research by Drs. Hare, Bernard, Sanchez, Baird, Vilain, Kennedy, and Harley in Australia complements the MRI studies taking place at UCLA, indicative of significant brain gray matter activity in pre-hormonally treated male-to-female transsexuals that has similarities to cisgender females.  Although there is insufficient data to fully comprehend the phenomena of transgenderism, it is clear that there are significant genetic and brain morphology differences in male-to-female transsexuals, even prior to hormone treatments, that may be significant, if not determinant, antecendants to transsexualism.

 

 

 

Hopefully, in all the studies, discoveries, it will not become a prerequisite for treatment, surgery and all that entails soley on the results of DNA samples and brain scans.

This post was edited by Cristine Jennifer Shye. BL at April 11, 2015 11:30 AM BST

Al

 

Is research similar to this likely to lead to a change in social attitudes, or even some sort of accomodation/acceptence? 

 

I think eventually it will be recognised and ''put up with'' same as Dwarfism, and  other birth defects.    As far as social acceptance goes, an insight into that is another article I put together Heteronormativity. so these two subjects are congruent with each other, both sides of the coin.

Genetic basis for transsexualism
Deborah Smith - Sydney Morning Herald - October 27, 2008

http://www.martinfrost.ws/htmlfiles/oct2008/genetic-basis-transsexualism.html

Definition and Synopsis of the Etiology of Adult Gender Identity Disorder and Transsexualism

1.Gender Identity Disorder is defined as an incongruence between the physical phenotype and the gender identity[1], that is, the self identification as male or female. The experience of this incongruence is termed Gender Dysphoria. The most extreme form, in which individuals need to adapt their phenotype with hormones and surgery to make it congruent with their gender identity, is called transsexualism[2], Those individuals experiencing this condition are referred to as trans people, that is, trans men (female to male) and trans women (male to female).

2.Transsexualism can be considered to be a neuro-developmental condition of the brain. Several sexually dimorphic nuclei have been found in the hypothalamic area of the brain (Allen & Gorski, 1990; Swaab et. al., 2001). Of particular interest is the sexually dimorphic limbic nucleus called the central subdivision of the bed nucleus of the stria terminalis (BSTc) which appears to become fully volumetrically sexually differentiated in the human brain by early adulthood. This nucleus has also been found to be sexually dimorphic in other mammalian and avian species (Miller et. al., 1989; Grossmann et. al., 2002). In human males the volume of this nucleus is almost twice as large as in females and its number of neurons is almost double (P <0.006) (Zhou et. al., 1995; Kruijver et. al., 2000; Chung et. al., 2002).

3. The Kruijver et. al. study, cited above, indicates that in the case of transsexualism this nucleus has a sex-reversed structure. This means that in the case of trans women (n=7), the size of this nucleus and its neuron count was found to be in the same range as that of the female controls (n=13) and, therefore, women in the general population. In the only available brain of a trans man, the volume and structure of this nucleus was found to be in the range of the male controls (n=21) and, therefore, men in the general population. It is hypothesised that this male-like BSTc will be present in other trans men as well. These findings were independent of sexual orientation and of the use of exogenous sex hormones. In the 42 human brains collected for this study, the BSTc was found to have a structure concordant with the psychological identification as male or female. It is inferred that the BSTc is an important part of a sexually dimorphic neural circuit, and that it is involved in the development of gender identity (Kruijver et. al., 2000).

4. Sexual differentiation of the mammalian brain starts during fetal development and continues after birth (Kawata, 1995; Swaab et. al., 2001). It is hypothesised that in humans, in common with all other mammals studied, hormones significantly influence this dimorphic development although, at present, the exact mechanism is incompletely understood. It is also postulated that these hormonal effects occur at several critical periods of development of the sexual differentiation of the brain during which gender identity is established, initially during the fetal period, then around the time of birth; and also post-natally. Factors which may contribute to an altered hormone environment in the brain at the critical moments in its early development might include genetic influences (Landèn, 1999; Coolidge et. al, 2002) and/or medication, environmental influences (Diamond et. al., 1996; Whitten et. al., 2002), stress or trauma to the mother during pregnancy (Ward et. al., 2002; Swaab et. al., 2002).

5. Gender identity usually continues along lines which are consistent with the individual's phenotype, however, a very small number of children experience their gender identity as being incongruent with their phenotype. Adult outcomes in such cases are varied and cannot be predicted with certainty. It is only in a minority of these children that, regardless of phenotypical socialisation and nurture, this incongruence will persist into adulthood and manifest as transsexualism (Green, 1987; Ekins, 1997; Prosser, 1998; Di Ceglie, 2000; Ekins & King, 2001; Bates, 2002).

6. As stated, in trans people, a sex-reversed BSTc has been found. The findings of a specific sex-reversed brain organisation in trans people provides evidence consistent with the concept of a biological element in the etiology of transsexualism. The evidence for an innate biological predisposition is supported by other studies, one example of which, indicates a higher than average correlation with left-handedness (Green & Young, 2001). Where the predisposition for transsexualism exists, psycho-social and other factors may subsequently play a role in the outcome, however, there is no evidence that nurturing and socialisation in contradiction to the phenotype can cause transsexualism, nor that nurture which is entirely consistent with the phenotype can prevent it (Diamond, 1996). There is further clear evidence from the histories of conditions involving anomalies of genitalia, that gender identity may resolve independently of genital appearance, even when that appearance and the assigned identity are enhanced by medical and social interventions (Imperato-McGinley, 1979; Rösler & Kohn, 1983; Diamond, 1997; Diamond & Sigmundson, 1997; Kipnis & Diamond, 1998; Reiner, 1999; Reiner, 2000). It is not possible to identify one single cause for transsexualism: rather, its causality is highly complex and multifactorial. The condition requires a careful diagnostic process, based largely on self-assessment, facilitated by a specialist professional.

7. In conclusion, transsexualism is stongly associated with the neurodevelopment of the brain. (Zhou et. al., 1995; Kruijver et. al., 2000). The condition has not been found to be overcome by contrary socialisation, nor by psychological or psychiatric treatments alone (Green, 1999). Individuals may benefit from an approach that includes a programme of hormones and corrective surgery to achieve realignment of the phenotype with the gender identity, accompanied by well-integrated psychosocial interventions to support the individual and to assist in the adaptation to the appropriate social role (Green and Fleming, 2000). Treatments may vary, and should be commensurate with each individual's particular needs and circumstances.

[1] The term 'gender identity' is used, in the UK, to indicate the self-identification as male or female. However, terminology varies around the world, and the term 'sexual identity' is preferred by many in the US. (pace Professor Milton Diamond). See "Sex and Gender are different: Sexual Identity & Gender Identity are Different", (2000) Clinical Psychology & Psychiatry, Vol 7 (3):320-334.

[2] The transsexual condition is also referred to in various ways (Diamond M, 2002 In Press) "What's In a Name? Some terms used in the discussion of Sex and Gender". Transgender Tapestry.

n.b.The UK government recognises that transsexualism is not a mental illness. See Lord Chancellor's Department - government policy concerning transsexual people.

Getting beyond "labels", and thinking of gender feelings, gendered behaviors and gender trajectories instead

 

 We've seen that there are many variations and combinations of gender conditions, across a wide continuum of possibilities. These are major realities that deeply affect the lives of large numbers of people in close human love relationships. Unfortunately, we don't yet have a truly adequate vocabulary for talking about this wide range of phenomena, and most people are left to their own devices when struggling to cope with gender confusions or transgender identities in their love relationships. The tendency of psychiatrists, psychologists, physicians and gender counselors to "label" us as "transvestites", ''crossdressers'', "transgender", "transsexual", etc., can greatly obscure what is going on in any given case. Gender-variant people themselves often get trapped into confusions and arguments about these labels. Counselors and their clients often dwell endlessly on questions such as "is this person (or am I) a transvestite, or really a transsexual?"  Or, "is this person a DQ or a TG or a TS?" And on and on it goes, often with an overlay of judgementalism, paternalism and condescension, with some conditions being "more acceptable" than others, or vice-versa, depending who you talk to! Wouldn't it be better to ask questions, rather than try to answer meaningless questions with and about ill-defined labels? Someone may be crossdressing, but that may or may not mean that they are a "transvestite". They could be TG or TS or DQ instead. Someone may be taking hormones and enjoy their breast development, but that doesn't necessarily mean that they are TS or even TG for that matter! Can you see how labels get in the way? Labels give the illusion of standing for something real, but when you probe deeper, they sort of evaporate! We are what we do, what we feel, how we behave, and what trajectory we follow. We are always a "work in progress", just as all other human beings are. We cannot be defined once and for all by simply having a label pinned on us. 

• What really counts is what you are feeling inside. What is your body and heart telling you that you need to do? What behaviors have you actually been engaging in? What experiences have you actually had? What gender trajectory seems to make sense for you? What physical and social changes can you, and should you make in order to find a more natural and comfortable physical/social place in life. Can you make those changes and follow that trajectory without sacrificing too much, in employment, family relations, and expectations for finding a love partner in your later life?
•  
• Now those are real questions that need real answers. Someone cannot simply diagnose you and tell you: "You are TS, and thus you should do X, Y and Z". It just doesn't work that way. It is far more complex than that.  There are so many variables that it doesn't make sense to attempt "in advance" to try to figure out who is CD vs TG vs TS. You find out by watching what they actually do over time. Some people crossdress and that is enough to make them happy. You could call them "CD's", but how do you know what they might do in ten years? Some people go on to transition socially (usually with the aid of hormones). You could call them "TG's", but what does that really mean? After all, they might go further and get SRS someday, or they might even de-transition someday. Some people go on to social transition and also undergo sex reassignment surgery. You might call them "TS's"  this too has proven to be a mistake in some cases.

The only thing that you CAN be sure of, when it comes to others, is their real observed behaviors and trajectories: If someone crossdresses, that is a REAL behavior and you can say "that person crossdresses". If someone undergoes social transition, that is a REAL behavior and change-point in their gender trajectory. You can say "so and so underwent TG transition". If someone transitions socially and undergoes SRS, that too is a REAL behavior and change-point in their gender trajectory. You can say, "so and so underwent a TS transition". But there is no meaning to labeling these people as CD, TG and TS - except as a sort of "shorthand notation" for very informally referring to those people.

 

Gender-minority labels don't work any better for pinning down "gender minority roles" than "role-playing" used to work to define meaningful real roles in the gay community. Labels, and the presumed roles that go along with them, are just too static. Labels are too confining and too limiting in their effect on people. They are useless as predictors of what someone should do and actually will do as they discover how they really need to live and present themselves to society. Only you can decide what your heart and body are telling you to do at that particular time in your life,, what behaviors you should explore, and what detailed gender trajectory you should follow. In doing so, you should consider the widest range of options and possibilities. Do not jump to the conclusion that you are a "CD", or are a "TS", and then mimic stereotypes of "what a CD should do or not do", or what "a TS should or should not do". As you go along, be sure to allow your gender trajectory to veer off in possibly unexpected directions from your originally predicted path, as your body and heart learn to feel new things along the way. 

This post was edited by Cristine Jennifer Shye. BL at October 5, 2014 2:11 PM BST

http://www.switchnewmedia.com/lgbt/VOD/Terry_Reed_Day3_Video_Archive.htm

 

Watch it through and learn

 

 

Previously, without  having ANY scientific evidence to back them up, many psychiatrists and psychologists over the past four decades have simply assumed that transsexualism is a "mental illness". By DEFINING this socially unpopular condition to be a mental illness, psychiatrists have shaped much of the medical establishment's and society's view of transsexuals as "psychopathological sexual deviants". However, those viewpoints are gradually fading away as the old generation of traditional "behaviorist" psychiatrists passes on, and as the underlying neurobiological bases for many basic human behaviors have begun to be understood.

 

Do we really need to know the cause in order to treat the condition?

 

Why is there so much fixation on "causes"? The answer is simple: Transsexualism has been such a socially unpopular condition in the past that the issue of "what causes it" is always raised in discussions about what to do about it. In the past many behaviorist psychologists and psychiatrists have inherently blamed transsexuals for causing their own "sexually deviant mental illness", giving those psychiatrists a claim to responsibility for the "treatment and cure of transsexuals" and giving society a rationale for discrimination, marginalization and ghettoization of transsexuals. However, as we've seen, transsexualism is most likely a neurological condition of as yet unknown origin and not a "mental illness". There are many other intense neurological conditions such as pain, depression and bipolar disorders for which we do not know the underlying causes but suspect biological causes. We know that these other conditions are real because we see people in distress, and we treat those people medically and with compassion to relieve their suffering. Why should it be any different with transsexualism? We now know how to relieve the suffering of transsexual people, having many options for practical counseling, social transition and hormonal/surgical gender reassignment. Why not accept those treatments as valid, since they truly relieve suffering and enhance the quality of life, even if we aren't sure what causes the underlying condition?And why stigmatize people just because they have sought medical treatment for this condition?

How frequently does transsexualism occur?

'Prevalence' is the number of cases present in a given population at a given time. If there are 100 cases of some condition in a city of 100,000, then the prevalence there at that time is 1 in 1000 (1:1000). Fortunately, we can make good estimates of the prevalence of transsexualism without being a research scientist. Any good journalist could easily triangulate on good ball-park estimates. Medical authority figures often quote a prevalence of 1 in 30,000 for MtF transsexualism and 1 in 100,000 for FtM transsexualism. You'll see these numbers over and over again, as in recent news stories in the Washington Post and the New york times. But don't these figures seem odd to you? They portray transsexualism as being incredibly rare. However, many people nowadays know a transsexual personor know of one in their school, company or small community. Where do these "extreme rarity" figures keep coming from?These figures are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The numbers are often sent to the media by the two "elite psychiatric centers" that have long promulgated and dominated thinking regarding "psychiatric theories of transsexualism", namely the Clarke Institute in Toronto, Canada and the Johns Hopkins School of Medicine in Baltimore, MD. However, the figures are from decades-old data when modern sex reassignment surgery (SRS) first became available, and only include the numbers who bravely stepped forward and asked for SRS at a time when discrimination was incredibly intense. Common sense says there were many more who suffered in silence than came forward openly. But how many? Let's do some "numerical detective work". We can triangulate the prevalence of MtF transsexualism in the U.S. by estimating how many transsexuals here have already had SRS. We can then divide that number by the population of adult males in the U.S. (up to about age 60, since those older had little access to the surgery in the past). Before 1960, only a tiny handful of SRS operations were done on U. S. citizens Georges Burou. Aeminant surgeon from Massab;lanca in Morroco then began doing a large series of operations in the 1960's using a vastly improved new "penile-inversion" technique. Harry Benjamin, M.D., a U.S. physician who had done pioneering research and clinical treatments of transsexualism, began referring many U.S. transsexuals to Dr. Burou and to several other surgeons who used Burou's new technique. (Lynn later learned from Dr. Benjamin that in 1968 she had been among the first 600 to 700 transsexual women from the U.S. to have had SRS).The U. S. numbers grew in the 1970's as gender-identity programs at Johns Hopkins and Stanford University triggered an easing of restrictions on SRS in U.S. hospitals, and several U.S. surgeons began performing SRS. In 1973  Dr. Benjamin confirmed  that 2500 SRS operations had been done on U. S. transsexual women by that date.

 Beginning with that data, the table below shows Lynn Conway's estimate of SRS operations done by major SRS surgeons both here and abroad on U. S. citizens in recent decades, extrapolated to include those done by many secondary surgeons (each performing smaller numbers per year). A range of values is given, from conservative to most likely numbers. At present about 800-1000 MtF SRS operations are now performed in the U. S. each year, and that many or more are performed on U.S. citizens abroad (for example in countries like Thailand, where the quality of SRS is excellent and the cost is much lower). The top three U. S. surgeons (Eugene Schrang, Toby Meltzer and Stanley Biber) together now perform a total of 400 to 500 SRS operations each year. Stanley Biber alone has done over 4,500 SRS operations since he began doing the surgeries in 1969; for many years Dr. Biber did two SRS's per day, three days per week!

 

 

 

 

 "Lynn Conway's Numbers": Estimates of MtF SRS operations among U. S. residents:

 

 

                      1960's             1970's                 1980's                    1990 - 2002

                      1,000             6000-7000          9,000-12,000          14,000-20,000

 

 

 

Adding up these numbers we find that there are at least 30,000 to 40,000 post-op transsexual women in the U. S. Of course some surgeries done by U.S. surgeons are on foreigners (perhaps 15%?), and some who've undergone SRS have passed away. However, the majority of post-op transsexuals had SRS within the past 15 years, and a high percentage of them are still living. TS's in the smaller group who underwent SRS in the 60's to mid-80's were mostly young - in their twenties and early thirties, and thus most of those women are still alive too. Even accounting for mortalities, Lynn estimates that the number of post-ops in the US is greater than 32,000. To determine the prevalence of MtF SRS, we simply divide 32,000 by 80,000,000, which is the number of U. S. males between 18 - 60 (the age range from which most current post-ops originated):                                      

 

   

32,000/80,000,000 = 1/2500. We discover to our amazement that at least one out of every 2500 persons born male in the U. S. has ALREADY undergone SRS to become female! This 1:2,500 estimate is vastly higher than the 1:30,000 estimate so oft-quoted by the medical community. The DSM-IV number is clearly way off, and by at least a factor of 12! However, on closer examination we will find the error is far worse than even that! 

 

 

 

 

This post was edited by Cristine Jennifer Shye. BL at April 21, 2015 12:54 PM BST

http://gendersociety.com/articles/176/the-science-behind-reifenstein-s

The Gendered Self © 2010, Anne Vitale PhD, All rights reserved

 

The Gendered Self: Further commentary on the transsexual phenomenon

 

http://www.thegenderedself.com/TGSintroduction.pdf

pass.

 

http://www.thegenderedself.com/

 

The Gendered Self-- Further commentary on the transsexual phenomenon

When all available hypotheses have been evaluated, the scientific method chooses the one that best meets the above criteria. A simpler explanation will be preferred over one that is complex or requires a leap of faith to accept.

 

Califia (1997) reports that three different schools of thought can be identified within the debate on Gender Dysphoria. These are not all that have been proposed over
the years but these form the majority of the currently credible arguments.   First, the psychoanalytic approach based on innate bisexuality in humans has been
proposed. This suggests that male-to-female transsexualism might result from a failure
of a boy to separate himself from his mother in early boyhood. Instead of identifying with the father, the boy identifies with the mother. Such traditional analyses consider lack of a cohesive self, opposite gender envy and jealousy combined with positive reinforcement such as a parent encouraging opposite gender behavior as the driving force behind the feeling of discomfort or confusion with the persons’ gender identification. A relatively high incidence of these factors has been observed in studies during supervised therapy for both male-to-female and female-to-male transsexuals (Califia, 1997).

 

The psychoanalytic theories, with many variants, present a hypothesis for a cause for Gender Dysphoria, but none of these theories has been investigated to see if the existence of these initial conditions correlate with resulting Gender Dysphoria. Studies of intra-family relationships, divorce rates, parental dominance, marital harmony, and many other factors have not revealed a common pattern that could account for Gender Dysphoria. In fact, the evidence is that stable and harmonious intra-family relations do not exclude a transsexual outcome of one or more children. This approach certainly does

not explain the significant numbers of people who display gender variant behavior and have not come from these kinds of family background.
The second school of thought is behaviorism, also known as Social Learning Theory.    Gender identity development is viewed as the result of a learning process that is imposed on the developing gender identity of a child. Gender identity develops as the result of “imprinting” and “conditioning” processes (Califia, 1997).

 

In gender dysphoric people the conditioning is different to that which would normally be expected. A typical example of this process would be a parental figure encouraging “tomboy” behavior for a child born as a female or encouraging a male child to dress up and behave like a girl.   This theory has been elaborated by introducing biological factors (by chemicals, hormones or by brain differences) and by introducing the concept of a “critical period” to
account for the fact that many people have experienced periods where they were encouraged to behave outside “usual” gender roles and have not experienced Gender Dysphoria    In the critical periods, biological, psychodynamic, and environmental factors (in particular, the parents’ expectations and the way they rear their
child) have an effect on the development of their gender identity. Prior and subsequent to this critical period, such an effect does not occur.

 

A prominent researcher, John Money, has drawn an analogy with the critical period of genital differentiation known to operate in the fetal period. Based on the result
of his extensive research, he has hypothesized that the process of gender identity formation can be compared with the process of acquiring a language.

This school of thought is quite complex in the way it describes many special cases and variations in cause. It therefore becomes very difficult to test or to make predictions from a set of initial conditions. It does have the advantage of being quite descriptive.   The whole process may, in fact, be quite complex and require complexity to adequately explain it.

 

The introduction of biological influences, known as the Biological Theory, at or prior to birth seem to be quite explanatory of many things observed in gender dysphoria, but they are difficult to test. For instance, the brain differences can only be discovered after a person dies by dissection. Prospective studies are hard to achieve in those circumstances. Monitoring of hormonal variations prior to birth is too intrusive to hope
to perform a useful analytical test of this idea

The third school of thought assumes that the development of gender identity is related to the maturation of cognitive development (Cognitive-Developmental Theory).   At about eleven years of age, a child’s gender identity starts to become consolidated or fixed as formal thought and abstract reasoning become possible. An abstract concept of gender identity develops rather than the concrete concept of boy or girl and this concept can be related to the rest of the world as a whole. This idea is in line with the work done by Piaget and others on childhood developmental processes. This school addresses some additional observations but has difficulty addressing all of the observations. All authors on gender identity development agree that a sense of gender identity termed core gender identity can be found in every child before 3 years of age. Core gender identity can be described as the child’s recognition that he is a boy or she is a girl.

 

Research shows that this concept proves to be highly resistant to change in later life. On the basis of clinical evidence, it seems that there is a solid argument that the foundation of gender dysphoria is laid before the age of three. Further research of this period is needed in order to understand more about the origin of gender dysphoria.

Gender may well be the most basic element that makes up human personality. In fact, gender is so basic to our identity that most people mistakenly assume
our sense of being male or female is defined with absolute certainty by our anatomical sex. Contrary to popular belief, one’s sense of gender and one’s anatomical sex are two distinct elements each developing at different times in different parts of the body.   More theories surround what causes Gender Identity Disorder and where it originates. These theories are sub-categories in two very popular sociological theory bases, Social Constructionism and Essentialism (Stein, 1999).

What started out as a criticism of socially constructed roles developed into a theory of gender, which denied Essentialism Gender Identity Disorder 50 in every form, stating instead that society took the biological differences of procreation, and instilled in them an artificial behavioral difference. The theory denies that there is any natural basis for gender identity. Thus, it denies to transgender people any rational cause, while at the same time presenting no reason why not. To some authors this meant that transgender people were free to express themselves in any manner they chose since all gender expression is a valid as any other. Only societal convention stands in the way of such freedom. Such conventions can be modified by the society as is deemed desirable. To some, all such restrictions are to be avoided in a live and let live ethos. Other authors, Janice Ramond and Germain Greer, being notable examples, saw male-to-female transgender people as exploitive of women, supporting the artificial sexist forms that oppress women. It is interesting that in this regard they exhibit a hidden Essentialism, one that focuses on the genitalia as defining classes of human beings. They decried the restrictions on one class, while despising those of the other class when they break those very restrictions

Still the existence of transgender people poses a challenge to the social constructionist theory. One must explain both why gender identity exists, how it is perpetuated, enforced, and why some rare individuals chose to express a gender identity at odds with socially prescribed gender expression norms.

 

This post was edited by Cristine Jennifer Shye. BL at October 5, 2014 2:14 PM BST

This post was edited by Cristine Jennifer Shye. BL at October 5, 2014 2:15 PM BST

Increased Cortical Thickness in Male-to-Female Transsexualism Luders et al, Journal of Behavioral and Brain Science, 2011

Abstract:

Results: Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus).
Conclusion: These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.

The scientific literature has already come to a consensus on the existence of cognitive sex differences, especially with regard to spatial ability. Both neural/hormonal and social factors contribute to those differences. See Diane Halpern's "Sex Differences in Cognitive Abilities".

Stereotypes, including gender stereotypes, are mostly accurate. So saying that some view or conclusion is a gender stereotype is not a real criticism. See Lee Jussim's "Social Perception and Social Reality: Why Accuracy Dominates Bias and Self-Fulfilling Prophecy".

Finally, let's assume the real reason why women have bigger corpus callosums is that they have smaller brains. Does the relation between sex and corpus callosum size cease to exist? No. Women on average will still have larger corpus callosums and all the (presumed) behavioural/cognitive characteristics associated with it.

 

If you look at the sexual dimorphism from an evolutionary perspective, this makes perfect sense. In early human societies, men went out to hunt while women stayed in the village (with very few exceptions).

The traits that made men more successful were those that allowed them to be better hunters and warriors: so coordinated action, perception of environmental opportunities and dangers. For the women in the village, their success is more dependent on "politics" and relationships. Instead of organizing hunts, the successful woman is one who is well liked by people and use strong communication skills and wits to solve problems (and not braun since they will lose to the stronger males).

Thus over time, as the traits that marks a successful man and woman differs, it makes sense that there should be sexual dimorphism in brain structures.

 

Which in turn is a probable and logical cause for some brain structure difference in male to female transexuals.

This post was edited by Cristine Jennifer Shye. BL at April 10, 2015 7:33 PM BST