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TechnoratiFocus on gender politics: Is changing gender as simple as changing clothes?
Newsweek recently painted a sympathetic portrait of women imprisoned in men's bodies. Such people need a psychiatrist, not a surgeon.
Political correctness is not only contrary to the spirit of the First Amendment of the American Constitution but also makes for soporific discourse. Newsweek’s recent cover story on transgenders certainly proves that the priests of tolerance and diversity have successfully exorcised the ghost of satirist H.L. Menken from the mainstream media. Newsweek’s coverage was so saccharine that I needed wet wipes after each page.
An issue involving sex and castration should generate a lot of hotly disputed questions. Unhappily, Newsweek relegated any dispute to the usual evangelical bogeyman, with mild scepticism replacing controversy. After all, it averred, we can’t really know the difference between men and women, or male and female. Even the experts at the International Olympic Committee plead ignorance, it was claimed, when it comes to "scientifically" differentiating between a man and a woman. (If East Germany still existed I guess that its athletes could get their medals back!)
At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can't be reassigned.
Newsweek also avoided the other key debate about this difficult issue: whether or not transgenders have a mental illness or merely an inconsequential desire. The word "transgender" is a neologism coined by activists to denote people who at least sometimes identify themselves with the opposite sex. Typically, these folks are transsexuals and/or transvestites. Both transsexuals and transvestites have been in the psychiatric "Diagnostic and Statistical Manual of Mental Disorders" (DSM). Transvestitism is intense sexual arousal to women’s clothing. Transsexuals identify themselves as the opposite sex. In 1980, transsexualism was added to the third edition of DSM. In 1994, the term "gender identity disorder" replaced transsexualism.
Doctors get involved because transsexuals often demand hormones and surgery to fulfill their desires. But are physicians enabling a mental illness or merely complying with a cosmetic request?
Many transgender activists object to the "crazy" label. The brother/sister of actors, Rosanna, David and Patricia Arquette was featured in Newsweek. Alexis Arquette is on a crusade against current standards of care. He/she complains that sceptics are "questioning the sanity of people like myself". Most sexual reassignment centers require two years of counselling before the procedure. Alexis objects to the counselling and seems to propose that physicians ought to treat castration and penile amputations as casually as nose jobs.
A few years ago I attended a program at the American Psychiatric Association’s Annual Conference. An editor of the DSM was under attack for describing gender identity disorder as a mental illness. But in the course of the debate, in a remarkable display of having your cake and eating it too, the transsexual woman who argued against its inclusion was forced to admit that a DSM diagnosis was necessary after all. Why? Because otherwise people suffering from the disorder could not get their health insurance company to cover the cost of the procedures.
Which leads to the $64,000 question. If transsexualism is a disease, then is sexual reassignment the cure?
Let's look more carefully at this notion. Sexual reassignment, with hormone treatment and surgery, is a woolly term which is used far too casually. Take the word "reassignment". What are defenders of transsexualism implying when they use it? In my view, they are relying upon both hoary old Freudian ideas and a silly recent movement called constructivism. The upshot of these two schools of thought is that nature is unimportant compared to nurture. Society and technology always trump biology. So using the word "reassignment" implies that sex is an arbitrary category imposed by the dominant culture through the family. From this perspective, sex is merely a societal convention. In the same way that we expect men to be soldiers and women to be nurses, we expect boys to be boys and girls to be girls. But things can change: women can become soldiers and men can become nurses. So, hey, why can't boys become girls and girls become boys?
Our unquestioning acceptance of the phrase reflects the modern separation between sex and reproduction. Sex has lost its primary meaning as a relationship of two beings vis-à-vis the procreation of life. At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can't be reassigned.
What happens in sexual reassignment? Doctors employ a range of pharmaceutical, surgical and cosmetic procedures to produce either more feminine or more masculine features. Some trans-women may only take up electrolysis and breast augmentation. Others spend tens of thousands for amputation, castration and vaginal construction. Obviously, these procedures destroy the procreative relationship.
The most famous transsexual, Renee Richards, has publicly expressed regret about her decision. Born as Richard Raskind in 1934, she went to Yale and became an eye surgeon and an international tennis star. She even married and fathered a child. But in 1977 she had sex reassignment surgery. She even competed in the US Open in various women's and mixed doubles. But in February 2007, she told the New York Times, "Better to be an intact man functioning with 100 per cent capacity for everything than to be a transsexual woman who is an imperfect woman."
Newsweek presents transsexuals’ pursuit of sex change as inevitable. However, sex researcher J. Michael Bailey in his book, The Man Who Would Be Queen, notes the decision for sex reassignment has a "rational component" and that the "large majority of boys who start out looking transsexual ultimately do not pursue sex reassignment."
The most outspoken critic of sexual reassignment has been Paul McHugh, MD, a member of the President's Council on Bioethics. After becoming chairman of the Department of Psychiatry at the elite Johns Hopkins University in Baltimore, McHugh began studying gender disorders and the sexual reassignment program at his university. After discovering that many transsexuals had strongly masculine interests, McHugh became sceptical of the standard story about "women trapped in men’s bodies." He became convinced that reassignment should be discouraged. Eventually Johns Hopkins stopped doing the procedures.
McHugh’s scepticism was eventually supported by research indicating that bisexual and heterosexual transvestites and transsexuals are sexually aroused by the idea of being a woman. They fantasise about being the female during sex. A sexologist from the Canadian Clarke Institute, Ray Blanchard named this desire autogynephilia. Transsexual physician Anne Lawrence has described autogynephiles as "men trapped in men’s bodies."
In a 2004 article in the journal First Things, McHugh pulls no punches. In a long account of how he managed to persuade his colleagues that sex reassignment was bunk, he asserts that: "We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia."
I have witnessed a great deal of damage from sex-reassignment. The children transformed from their male constitution into female roles suffered prolonged distress and misery as they sensed their natural attitudes. Their parents usually lived with guilt over their decisions — second-guessing themselves and somewhat ashamed of the fabrication, both surgical and social, they had imposed on their sons. As for the adults who came to us claiming to have discovered their "true" sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it.
Many cities have had much less qualms about cooperating with this madness. Last November, New York City’s Public Health Board recommended that people be allowed to change the sex on birth certificates if they provided evidence from a physician that the change would be permanent. Transgender advocates praise the health board for eliminating anatomy -- and any other physiological, genetic or medical requirements -- as proof of sex. A spokesman for the New York Transgender Rights Coalition, offering some armchair Freudian insights, praised the change as "a move away from American culture’s misguided fixation on genitals as the basis for one’s gender identity".
In moving away from anatomical considerations, health commissioner Dr Frieden announced a new standard for redefining one's own sex. Frieden emphasized that it’s the "permanence that matters". Permanence? For Frieden this meant two years of living as the opposite sex. But how would a doctor prove that this two-year requirement? With hidden cameras? A physician would become merely a rubber stamp for anyone who appears in his office and claims to have lived as a woman for two years. Still, transgender advocates pushed for the elimination of any medical requirements.
The swift public response surprised the health board. Hospitals complained that women would be forced to share rooms with men. Prison officials complained that they would be forced to transfer men to female facilities. Dr McHugh warned the board that such changes would make sexual identification impossible. "I’ve already heard of a ‘transgendered’ man who claimed at work to be ‘a woman in a man’s body but a lesbian’ and who had to be expelled from the ladies’ restroom because he was propositioning women there," he said. "He saw this as a great injustice in that his behavior was justified in his mind by the idea that the categories he claimed for himself were all ‘official’ and had legal rights attached to them."
The Board of Health withdrew the proposal. "This is something we hadn’t fully thought through, frankly." Health Commissioner Friedan admitted. "What a birth certificate shows does have implications beyond just what a birth certificate shows."
The madness is beyond transsexualism.
Theron Bowers MD is a Texas psychiatrist.
Abol said:
‘Hormone shots that transexuals take have even been known to incr. the risk of reproductive cancers. Sex change surgeries don’t cure diseases-they cause medical & emotional harms, even if apologists say otherwise.’
I won’t face any risk whatsoever of ‘reproductive’ cancers because I have no reproductive organs. Transsexualism and the many variations of sexual formation that may occur in humans are not “diseases.” Sex assignment surgeries in adults have as their sole purpose the rehabilitation of bodies that are sexed opposite to the brain. Unlike the sex assignments perpetrated on infants, those adults give their informed consent prior to the procedure taking place. Scientific knowledge of the phenomenon of brain sex differentiation and its role in establishing the sexual identity we each have is growing rapidly. The research started with the psychiatrists but it is now definitely the province of geneticists, neurologists and neurospychoendocrinologists and a multitude of other specialists.
abolishsexchangesurgeries (may I call you abol for short?) A lot of late transitioning women end up being lesbian, but I suppose you’d call them straight because they have 46xy chromosomes. Your hypothetical “anti-gay” pill would affect these women how, exactly? What about the significant number of people with HBS that are asexual?
I see no evidence that being gay is a condition requiring a cure. One could just as well argue that if you gave a “Gay Pill” to straights, “the straights would say how their lives improved after they went gay.” I doubt it, there’s no evidence I know of either way.
Personally, I think administration of such treatment, in whatever direction, without fully informed patient consent would be monstrous. With patient consent, it may be very valuable, especially if both gynophillic and androphillic versions were available. I’d take one - I’m biologically attracted to guys, but would prefer to be lesbian. Or is that consequence not what you’d intended?
I don’t have time to argue with you, Abolish..., but in parting, here are a few words of advice: Quit trying to control other people and focus on your own life and personal conduct. You’ll be much happier. Besides, you have no right to tell others how to live their lives.
Wolfgang Eli Beilschmidt
Plastic surgeries for a burn or cancer victim is 1 thing. Removing a scar or reconstructing a disfigured is 1 thing. Changing breast size wastes science.Breast augmentations are known to incr. risk of breast cancer & to say otherwise is rubbish. Even with plastic surgeries to solve aging such as wrinkling, they’ll still happen, because aging continues.
I’m not religious. There are harms of injecting hormones over a lifetime. Steroids & athletes & the harms of taking steroid shots. Hormone shots that transexuals take have even been known to incr. the risk of reproductive cancers. Sex change surgeries don’t cure diseases-they cause medical & emotional harms, even if apologists say otherwise. What the Drs. & psychiatrists who are apologists for sex change surgeries say is blind faith rubbish & it’s best not to listen to their arrogance-thinking that because they’re psychiatrists, they know the answers. All surgeries & medicines are bad for you. If you need heart surgery in order to live, the heart surgery damages the arteries. Surgeries & medicines must only be used if needed to save lives.
Find the cure for transexuality & homosexuality-whatever the causes. If the 100% cures were discovered for GID & homosexuality, we would hear major coverage given to the medical harms which today get minor coverage. H&Ls;just as transexuals are known to have higher incidence of suicide & depression & even in societies tolerant of those behaviors such as Holland, the rates of suicides are the same.
Sodomy & oral sex carry more medical harms than others & H&L have higher incidence of piles, giardia (GBS) & even certain cancers caused by their sexual activities. If they found the shot or pill to cure homo&transexuality;, the medical & psychological commty would change their views again & the discussion would again change. Those who suffer from GID & homosexuality would take this pill or shot & the H&L would say how their lives improved after they went straight.
Abolish… wrote, “Transexuals have higher incidence of strokes, heart attacks & certain cancers caused by the hormone shots.”
Where did you get this information? Care to cite your source? Testosterone injections in transmen do cause a higher risk of heart disease--that is, higher than before, but the same as that of a typical man. Testosterone, whether from testes or injections, tends to raise LDL cholesterol and blood pressure, factors in heart disease.
There is a risk of blood clots with HRT, but they’re still fairly rare.
There is also a risk of cancer in the ovaries, which is why hysterectomy is advised within five years of beginning HRT. The risk of breast cancer, however, drops significantly with the decrease in estrogen production caused by the introduction of testosterone, and is further lowered, to the risk level of a typical man, after mastectomy.
I don’t know the medical details for transwomen.
Abolish.. wrote, “Incidentally, they must abolish plastic surgeries in most cases,...”
Incidently, I’ve found that most of the people who share this opinion with you tend to be really good looking. If this description fits you, then your opinion is invalid. That’s right--Invalid. Such an opinion only has merit if it comes from someone really ugly, physically of course. So if you’re really, really “plain-looking,” okay, but I still disagree.
Wolfgang Eli Beilschmidt
Quote:
“At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can’t be reassigned.”
What an odd and misleading statement. Children are being reassigned every day around the world. I speak on a daily basis with intersex people in Europe, Africa and elsewhere. They live with very damaged genitals from having been reassigned and for what purpose? So they can be made forcefully to mimic heterosexual intercourse and pretend to have been bestowed an unchanging role in procreation.
God did not make a male/female dimporphic creation. Man is the one insisting on doing this and ruining the lives of countless children in the process. We now know that sex, gender and orientation are all intricately linked and we also no that there are biological factors as well as social factors which contribute to one’s sense of being male, female or none of the above. However, we don’t know by looking at anyone what sex they really are. Why not leave that to the individual. They might have a clearer idea about who they are than an outsider who doesn’t know them.
I’m some1 who believes that we must abolish sex change surgeries-they are a sad wastage of science. They’re synonymous to Drs. amputating the healthy arms & legs of patients who have amputee identity disorder.
If some1 suffers from transexualism or GID, they must be given counseling only to overcome it, not mutilations. Sadly, only minor coverage is given to the harms of sex change surgeries. Transexuals have higher incidence of strokes, heart attacks & certain cancers caused by the hormone shots. It doesn’t take an expert to understand that injecting hormones & the rubbish of sex change surgeries harms the body. Incidentally, they must abolish plastic surgeries in most cases, unless 1 has been a cancer victim, burn victim or lost a hand or leg as a result of an accident.
Abolish sex change surgeries. What Drs. must do is find the cure for GID. They must also find a cure for homosexuality, oral sex & sodomy. The world will be a better place without GID & without homosexuality. Even if homosexuality is inborn, the fact remains that H&l activities, sodomy & oral sex are medically harmful. It’s straight missionary sex or no sex. They must make it illegal for Drs. to perform sex change surgeries.
Re Allison’s comment
Joan of Arc and the Spanish Inquisition? Here was I thinking that she was burned at the stake by the English (for heresy)!
It’s also important to realise that we’re not just talking about theoretical biology. We’re talking about people. People who have to deal with problems like infertility or sterility, people who because they often look different face stigmatisation and even violence.
Most transsexual people are not intersexed in other ways, but (contrary to 30 year old studies) a substantial minority are.
Quite a few are victims of infant genital “correction”, but often the same conditions that led to a misgendered brain have led to other anomalies too.
My transition was certain when I learnt that my medical condition had finally sterilised me, after many years of infertility. Biologically, I’m endocrinally odd, so much so that Medicare Australia deemed me female before any hormonal therapy commenced, despite the “boy” birth certificate.
Psychologically, a bog-standard Transsexual woman, boringly identical to thousands of others. The only non-standard thing was that I was one of the 20% who don’t cross-dress before Transition. Dr Bailey may be interested that I scored 5 in his test (3 is required for a diagnosis of AGP). But I’m given to understand that I get a “pass” because it doesn’t apply to the Intersexed.
I’ve seen no psychological difference between those of us who transition because of our somatic as well as “theoretical” neurological cross-gendering, and those who transition from “theoretical” neurological cross-gendering alone.
We have enough problems dealing with our condition. It adds insult to injury to be anathematised by a trained psychiatric professional, whose words will no doubt soon be widely quoted by groups in support of the proposition that people like me should be incarcerated, and disallowed employment, access to ameliorative medical treatment, and other basic human rights. Just as Dr McHugh’s have been.
I am not sure what TB’s point is about reproducing according to one’s determining genotype. Putting asside gestational pregnancies for now,
some XY/XO persons can produce functional oocytes. Some can produce functional spermatazoa. Some XX/XY persons can produce functional oocytes, and some can produce functional spermatazoa. XXY can result in fertile Klinefelter’s men and an XXY fertile female with the absence of SRY has been noted
(although it is likely that just as some environmental effects result in XY females, that envronmental infuences could result in a fertile XXY female). Also, XY oocytes do exist, and mice, horses, and other mammals have fertile XY females. This condition may very well occur in humans. But, since a primary reason to seek evaluation for one’s chromosomes is infertility (note, some XY female humans DO menstruate and develop secondary sex characteristics), if there are fertile XY females in humans, we are not likely to know about it, as they would have no reason to seek evaluation!
I do realize, that sex reassignment does not result in someone becoming fertile in their new sex. But, they are like persons who are infertile intersexed people. I don’t understand the main point of this area of the discussion.
Karen W. Gurney wrote, “Bowers might have an unchanging role in procreation, but such niceties are denied the genitally intersexed who were never asked their opinion before these irreversible procedures were performed on them!”
There is something awesomely beautiful about a person who is born whole. I completely agree with you that no medically unnecessary surgery should ever--Ever--be performed on an individual without his or her consent, and that includes neonatal male circumcision too. These barbaric practices have no place in a civilized society.
The body is a person’s most intimately private property. He or she must have absolute sovereignty over it. That’s one of the foundational principles of a free society.
Dr. Bowers, your intense focus on matters of reproduction in a discussion about transsexualism is interesting, but it seems that its application is misplaced. How, exactly, does fertility relate to sex reassignment or the political implications thereof? Transsexuals undergo chemical castration through HRT, and most eventually have at least their testes and ovaries excised. Fertility is a non-issue, beyond the occasional transsexual who wishes to bank ova or sperm for later use prior to transition.
Like all transsexuals, I made a conscious choice to undergo medical treatment that I knew would leave me infertile. I have many reasons for not wanting to produce offspring, and infertility was an easy choice, (assuming I was ever fertile to begin with, which I’ll never know).
Wolfgang Eli Beilschmidt
I must thank Dr Bowers for his courteous replies to what at times may seem a sea of troubles - or troublesome commentators.
The quality of his comments is far higher than that of the original article, and I’ll strive to match the standard he has set. I wonder if I’m right in stating that he is now aware of the fuzziness and uncertainty that is the Reality in this area, and perhaps has a little more sympathy for those members of the IOC (International Olympic Committee) who, counter-intuitively and against all “common sense”, were unable to come up with a simple, practical, and accurate test for biological sex.
Common Sense is a very valuable tool, we ignore it at our peril. But sometimes the obvious “ain’t necessarily so”.
Getting onto specifics: the Zhou etc articles have a far too small sample size for comfort. They have quality, but not quantity, hence my description of the evidence as “scant”. However, there is exactly zero evidence of equal quality that contradicts the findings.
I’ll quote from Mr Justice Chisholm of the Australian Family Court, as quoted in the Deakin Law Review 2004 Issue 22
”Re Kevin – Significant findings of Justice Richard Chisholm in respect of the expert medical evidence in that case as to the causation of transsexualism and as strongly affirmed by the Full Court on appeal
At paragraph [252]: ‘The traditional analysis that they are “psychologically” transsexual does not explain how this state came about. For example, there seems to be no suggestion in the evidence that their psychological state can be explained by reference to circumstances of their upbringing. In that sense, the brain sex theory does not seem to be competing with other explanations, but rather is providing a possible explanation of what is otherwise inexplicable’.
At paragraph [270]: ‘But I am satisfied that the evidence now is inconsistent with the distinction formerly drawn between biological factors, meaning genitals, chromosomes and gonads, and merely “psychological factors”, and on this basis distinguishing between cases of inter-sex (incongruities among biological factors) and transsexualism (incongruities between biology and psychology)’.
At paragraph [272]: ‘In my view the evidence demonstrates (at least on the balance of probabilities) that the characteristics of transsexuals are as much “biological” as those of people thought of as inter-sex’.”
Note the “on the balance of probabilities”. The evidence in 2003 was strong, and has been strengthened since, but is still inadequate for positive proof. The problem is that all other hypotheses remain mere conjectures, often with no evidentiary backup whatsoever.
Now one can reasonably disagree with the learned Judge and his colleagues as to the probabilities, but if so, one must adduce good, unimpeachable evidence of comparable quality that contradicts that judgement. Even then, one must accept that, as there has been no autopsy or other evidence that has ever contradicted Zhou’s results, that it is at least possible that people who are Transsexual are in fact neurologically Intersexed, rather than suffering from some psychiatric pathology.
Given that, baldly asserting that the Transsexual are Insane, and “in need a psychiatrist not a surgeon” is dangerous. Absolutist claims which, by ignoring inconvenient evidence, stigmatises people who are possibly merely suffering from a congenital problem as “insane” cause genuine harm.
There is naturally a place for Therapy, especially where the condition is mild, or surgery is contra-indicated. An analogy is the psychiatric support required for those congenitally paraplegic: their condition cannot be cured with current technology, so they need help living with it as best they can. To extend the analogy, assuming we had technology that, while not restoring full agility, would give some limited mobility, to state that congenital paraplegics need psychiatric help not surgery is equally absurd.
Finally, there is one argument for the “brain sex” theory that is highly pursuasive, yet has not been exposed very much.
We know from a veritable mountain of data that “male” and “female” behaviour is different, that certain personality traits have a bimodal distribution. Men tend, usually, to have one set of characteristic traits, Women another. These are tendencies, not absolutes, but still useful approximations. There is also unimpeachable data that, while some of the behaviour is socialised, much is inate: it is “hard wired” in our neurology. The human brain is a sexually dimorphic organ, men have one pattern, women another.
Now all other sexually dimorphic organs are subject to Intersex conditions. Mistimings of hormone release, inadequate or overabundant hormone availability, genetic and other factors all lead to the possibility of something going wrong, usually with a P of ~10e-3.
If the brain is somehow on a privileged state, immune to these effects, one would have to ask why? It seems highly plausible that there is no “special protection” for neural development.
In other words - if the concept of neurological intersex didn’t exist, it would be necessary to invent it. The only question then is what would the symptoms likely to be. There we are on far less certain grounds, but it seems that some or all of the set of symptoms of transsexuality would be a good candidates. Not positive proof : but adequate to refute absolutist, even dogmatic, positions such as Dr McHugh’s.
‘A couple of folks seem to argue that some people are intersex and both or neither male or female. Because of the intersex, it is implied by some that the male/female distinction invalid. However, I disagree that failure to mature sexually implies that the male/female distinction is invalid.’
You apparently deny the sex of the brain as an important factor in sex determination, so who is to decide the fate of the intersexed infant, and on what basis? Does the arbitrary inch of erectile tissue truly distinguish male from female as so many of you colleagues appear to think? If it’s chromosomes, how do you respond to individuals with mosaicism, chimerism or sex reversal syndrome? If it’s the ability to gestate, should the child gestated in the womb of an xy female call its mum, Dad? [Ref: Frydman, R. et. al. (1988) Pregnancy in a 46 XY patient. Fertil. Steril., 50:813-814… Kan, A.K.S., et. al. (1997) Two successful pregnancies in a 46, XY patient. Hum. Reprod.,12(7):1434-1435… Selvaraj, K., et. al. (2002) Successful pregnancy in a patient with a 46, XY karyotype. Fertil. Steril., Aug.; 78(2):419-420].
‘Those with the various intersex disorders (now called disorders of sex development) are sterile and if they are able to successfully reproduce then it’s in accordance to their determining genotype. So Turner’s may have children through pregnancy but they can’t produce sperm.’
It is now conceded that many men with Klinefelter’s are not sterile [ref: [Ref: Warburg, E. (1963). A fertile patient with Klinefelter’s syndrome. Acta Endocrinologica, 43, 12-26]. Rather, they are not commonly diagnosed because they actually have low fertility but an apparently normal phenotype {Ref: Abramsky, L., & Chapple, J. (1997). 47,XXY (Klinefelter syndrome) and 47,XYY: Estimated rates of and indication for postnatal diagnosis with implications for prenatal counseling. Prenatal Diagnosis, 17, 363-368]. And what if dad becomes pregnant? [Ref: Parvin, S.D.: Ovulation in a cytogenetically proved phenotypically male fertile hermaphrodite. Br. J. Surg., 69: 279,1982].
Fertility potential also exists in true hermaphrodites. Phenotypic male true hermaphrodites, however, seldom produce adequate quality sperm to be considered fertile. While ovulation is not uncommon, spermatogenesis has been reported in only 12% of cases of true hermaphroditism. [Ref: van Niekerk, W.A.: True Hermaphroditism. In: The Intersex Child. Pediatric and Adolescent Endocrinology. Edited by N. Josso. New York: S. Karger, vol. 8, p. 80,1981].
Back again. I wanted to respond to a couple of the scientific issues raised on this thread.
A couple of folks seem to argue that some people are intersex and both or neither male or female. Because of the intersex, it is implied by some that the male/female distinction invalid. However, I disagree that failure to mature sexually implies that the male/female distinction is invalid.
Those with the various intersex disorders (now called disorders of sex development) are sterile and if they are able to successfully reproduce then it’s in accordance to their determining genotype. So Turner’s may have children through pregnancy but they can’t produce sperm.
One writer mentioned Zhou’s work on the decrease number of limbic nuclei in male to female transsexuals. I don’t think the numbers are big enough to reach any definitive conclusions (9 TM’s). Moreover, I think that the results could have multiple interpretations.
I will accept Professor’s Italiono’s correction in regards to embryonic development and possible switch from XY to XX. However, this didn’t seem common and it is clear that very early in development there’s a genetic point of no return.
TB
Theron Bowers would perhaps do well to research a topic before unwisely pontificating upon it.
‘At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can’t be reassigned.’
Each year in America, around 1000 infants are born with an obvious combination of both male and female characteristics. Their appearance on the delivery table is regarded as a medical emergency, although in truth their underlying medical condition generally presents no threat to their physical well-being at all. Paediatric surgeons are called in and the infant’s external genitalia are fashioned to closely resemble those of a normally differentiated individual.
These assignments are determined more according to the ease of the relevant surgical procedures than any real understanding of the infant’s innate sexual identity. One of the pioneers of these procedures, who probably now regrets the fact, was recorded as saying “it’s easier to build a pole than dig a hole”. On the basis of such surgical expediency, many genetically male (xy) infants born with internalised testes and micropenis continue to be surgically reconstructed as sterile females every year.
Bowers might have an unchanging role in procreation, but such niceties are denied the genitally intersexed who were never asked their opinion before these irreversible procedures were performed on them! His colleagues play “god” and he plays with words. May God help his patients!!
‘Newsweek also avoided the other key debate about this difficult issue: whether or not transgenders have a mental illness or merely an inconsequential desire. The word “transgender” is a neologism coined by activists to denote people who at least sometimes identify themselves with the opposite sex. Typically, these folks are transsexuals and/or transvestites. Both transsexuals and transvestites have been in the psychiatric “Diagnostic and Statistical Manual of Mental Disorders” (DSM). Transvestitism is intense sexual arousal to women’s clothing. Transsexuals identify themselves as the opposite sex. In 1980, transsexualism was added to the third edition of DSM. In 1994, the term “gender identity disorder” replaced transsexualism.’
If Bowers took a closer look at history, he would know that “transgender” was a label coined by Charles “Virginia” Prince to avoid the pejorative “transvestite” being applied to him and his cohort of men who liked to ‘live as women’. He would also know that Prince specifically rejected “transsexuals” who sought to join his group. Transsexualism has been held to be a different diagnosis ever since 1923 when Magnus Hirschfeld first coined the term.
Hirschfeld had been studying a group of homosexual transvestites when it became apparent that there was another group within that assembly; people who actually believed they were female despite their opposite sex phenotype and who were prepared to do anything to correct the incongruence between body and brain. He recognised that only a somatic basis could explain the phenomenon which he placed in the then new intersex nosology but called “neurological transsexualism” to distinguish it from physiological hermaphroditism. It wasn’t until 1949, when Caldwell wrote of transsexualism as a delusional sexual deviance that American practitioners decided we were crazy. European practitioners continued to regard it as having a biological aetiology and do so even today.
Just as those poor individuals who were incorrectly “reassigned” by Dr Bowers’s colleagues know what their inherent sexual identity is, so do people born with transsexualism. Just as the genitals, gonads and chromosomes are normally sexually differentiated as to male or female, so is the brain. And just as ambiguities of sex can occur within or between those first three factors, ambiguities of sex can also occur between those factors and the brain.
‘A few years ago I attended a program at the American Psychiatric Association’s Annual Conference. An editor of the DSM was under attack for describing gender identity disorder as a mental illness. But in the course of the debate, in a remarkable display of having your cake and eating it too, the transsexual woman who argued against its inclusion was forced to admit that a DSM diagnosis was necessary after all. Why? Because otherwise people suffering from the disorder could not get their health insurance company to cover the cost of the procedures.’
Why blame people with transsexualism for the shortcomings of the profession and government? The American profession tried to indulge in the political correctness you criticised earlier in your article, and very mistakenly conflated the separate DSM III categories of transsexualism and gender identity disorder so that those who are transvestite/transgender and those with transsexualism were seen as just part of a spectrum of a unitised paraphelia. They did this despite the many different published research results produced by their own profession that proved the obvious difference. And your health insurers should be asked why it is they pay surgeons to carry out sex assignments in infants, but deny those payments to those who have actually been able to sensibly articulate their sexual identity. So who is the crazy one, I ask?
‘The most outspoken critic of sexual reassignment has been Paul McHugh, MD, a member of the President’s Council on Bioethics. After becoming chairman of the Department of Psychiatry at the elite Johns Hopkins University in Baltimore, McHugh began studying gender disorders and the sexual reassignment program at his university. After discovering that many transsexuals had strongly masculine interests, McHugh became sceptical of the standard story about “women trapped in men’s bodies.” He became convinced that reassignment should be discouraged. Eventually Johns Hopkins stopped doing the procedures.’
Ahhh! McHugh and John Hopkins. The same group and institution that promoted the ideas of John Money who held that nurture was more influential than nature and used this fallacy to justify the infant sex assignments still carried out around the world. I thought you wrote that nature was the over-riding determinant in such things?
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