Nature and Nurture- Trans and LGB Research Update

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Brain Research

Researchers (Gliske 2019) propose some new theories about the cause of gender dysphoria that goes beyond the popular “pink brain/blue brain” narrative that emphasizes cross-sex brain similarities (true in homosexual transexuals, not in autogynephilic transexuals). The term this paper uses for this is “cross-sex brain theory.” The authors point to regions in the brain relating to dissociation from the body and anxiety about the body and the networks between brain regions. This is different from the more common and simplistic view of innate brain sex. Gliske uses the term “multisense.” Below is a summation of the findings:

We hypothesize that in individuals with gender dysphoria, the aspects of chronic distress, gender atypical behavior, and incongruence between perception of gender identity and external primary sex characteristics are all directly related to functional differences in associated brain networks. We evaluated previously published neuroscience data related to these aspects and the associated functional networks, along with other relevant information. We find that the brain networks that give individuals their ownership of body parts, that influence gender typical behavior, and that are involved in chronic distress are different in individuals with and without gender dysphoria, leading to a new theory—that gender dysphoria is a sensory perception condition, an alteration in sense of gender influenced by the reflexive behavioral responses associated with each of these networks. This theory builds upon previous work that supports the relevance of the body ownership network and that questions the relevance of cerebral sexual dimorphism in regards to gender dysphoria. However, our theory uses a hierarchical executive function model to incorporate multiple reflexive factors (body ownership, gender (a)typical behavior, and chronic distress) with the cognitive, reflective process of gender identity…

After considering this hypothesis, we present a new theory of gender dysphoria, consistent with the latest neuroscience data, that stands in contrast to the common opposite brain sex theory and builds upon the work relating body perception with gender dysphoria (Burke et 112  al., 2017b; Manzouri et al., 2017; Manzouri and Savic, 2019). We denote this new theory the multisense theory of gender dysphoria. This new theory focuses on function, including sense of gender and its inputs, rather than male/female dichotomy in anatomical size and shape (the focus of the opposite brain sex theory). For clarity, in this document we use “sense of gender” to refer to the emergent sense arising from the function of multiple networks, and “brain sex” to refer to anatomical characteristics of the brain relative to male/female dichotomy. We also use the term “transgender” throughout this manuscript, though recognize that some references instead use the word transsexual to refer to the same concept. We observe, based on previously published data, that the primary mechanism behind the experience of gender dysphoria appears not to be that the anatomical brain sex is opposite to gender assigned at birth. Instead, we propose that systemic changes in functional networks, specifically the distress, social behavioral and body-ownership networks, result in the incongruence between sense of gender and gender assigned at birth.

Newsweek published an article that contains critiques of the paper’s positions and Gliske’s suggestion that there may be other alternatives to help GD beyond medical treatment. In current gender discourse, there tends to be strong pushback if any person suggests it would be a better outcome to avoid genital surgery, mastectomy, and the known negative side-effects of taking high doses of cross-sex hormones:

Simona Giordano, an expert in gender identity and Reader in Bioethics at The University of Manchester Law School, who did not work on the study, told Newsweek she was surprised Gliskesuggested altering neural structures and networks is less invasive than providing gender-affirming treatment.

Giordano also argued Gliske's suggestions for treatment would "get rid of gender incongruence," and expressed concern this amounts to a form of "medical conversion." 

While understanding the mechanisms of sexual orientation and gender identification is a "legitimate scientific effort," Giordano argued, she said "science that singles out gender minorities as subjects of study might inadvertently suggest that there is an underlying medical problem."

"Should we use these hypothetical therapies, we would no longer have gender dysphoria sufferers because we would no longer have transgender people," she said.  

Giordano highlighted that various international organizations, such as UNESCO, and the Council of Europe, have called de-pathologization of gender diversity. Last year, the World Health Organisationrenamed gender identity disorder as gender incongruence to "reflect the international consensus that gender diversity is not a disorder or illness," she said.

Professor Catherina Becker, acting director of the Centre for Discovery Brain Sciences at the U.K.'s University of Edinburgh, who did not work on the paper, also critiqued the work. She commented in a statement: "The present paper is a review and reinterpretation of other studies without providing significant new experimental or epidemiological data.

Here are two other articles from The Daily Mail and Inverse.

Biological Factors in In Identity & Orientation

A new study (Nila, 2019) confirms the fraternal birth order (FBO) effect noted in homosexual males in an Indonesian population:

Abstract

Male homosexual preference (MHP) is an evolutionary enigma because it is partially heritable and imposes a fertility cost. In occidental societies, homosexual men are feminized at various levels and they have more older brothers than heterosexual men. To evaluate whether femininity and the fraternal birth order (FBO) effect are universal features of MHP or not, we collected original data from homosexual men, heterosexual men, and heterosexual women from Java (Indonesia). Facial photographs were used to test whether homosexual faces are feminized when compared with heterosexual ones. We found that faces manipulated to resemble the average face of homosexual men are perceived as facially feminized, suggesting that homosexual men are facially feminized compared to heterosexual men, although a higher facial femininity was not captured by morphological analyses. Then, family data were used to detect differences in siblings’ composition between homosexuals and heterosexuals. Homosexual men displayed a higher number of older brothers than heterosexual men, even when sibship size was controlled for, suggesting that the FBO effect exists in Indonesian populations. Independent of sexual orientation, men with older brothers seem more feminized than those without older brothers, consistent with the immune origin of the FBO effect. In conclusion, MHP in Indonesia is partially feminized and they have more older brothers. Such features are also associated with MHP in other cultural contexts, suggesting a cross-cultural effect of men homosexual preference. An evolutionary explanation is available for the feminizing effect, although the FBO effect remains unexplained even if proximal mechanisms start to be identified.

A new study (Rahman 2019) reviewing the populations of lesbian, gay, and bisexual people in various countries supports arguments for innate sexual orientation:

Abstract

The prevalence of women’s and men’s heterosexuality, bisexuality, and homosexuality was assessed in 28 nations using data from 191,088 participants from a 2005 BBC Internet survey. Sexual orientation was measured in terms of both self-reported sexual identity and self-reported degree of same-sex attraction. Multilevel modeling analyses revealed that nations’ degrees of gender equality, economic development, and individualism were not significantly associated with men’s or women’s sexual orientation rates across nations. These models controlled for individual-level covariates including age and education level, and nation-level covariates including religion and national sex ratios. Robustness checks included inspecting the confidence intervals for meaningful associations, and further analyses using complete-cases and summary scores of the national indices. These analyses produced the same non-significant results. The relatively stable rates of heterosexuality, bisexuality, and homosexuality observed across nations for both women and men suggest that non-social factors likely may underlie much variation in human sexual orientation. These results do not support frequently offered hypotheses that sexual orientation differences are related to gendered social norms across societies.

A quote from the article appears to show possible cultural influence on whether or not men will identify as gay and there is more variability in countries around women and bisexuality:

However, prevalence rates of men’s homosexual identity were more variable, across nations, than prevalence rates of women’s lesbian identity, p = .009. When sexual orientation was assessed in terms of participants’ same-sex attraction, women were more variable than men, across nations, in their prevalence of being moderately attracted to the same sex, p < .004. However, women and men did not differ significantly in the variability of their prevalence of not being attracted to the same sex and being predominantly attracted to the same sex (all ps > .05).

There appear to be more gay men than lesbians but more bisexual females than bisexual males:

However, a higher percent of men (4.9%) than women (2.1%) reported a homosexual identity, t(54) = 5.22, p < .001, whereas a lower percent of men (5.1%) than women (7.2%) reported a bisexual identity, t(54) = − 3.25, p = .002

In summary:

Finally, the relatively small cross-nation SDs reported in Table 4—particularly for prevalence rates for homosexual identities and predominant same-sex attractions—suggest substantial consistency across nations. Thus, despite the existence of variations across nations, sexual orientation rates were nonetheless relatively stable across nations.

A study on feminine Samoan males (called fa ‘afafina) reveals men who have sex with feminine (intact) males display a variety of orientation patterns from bisexual to primarily homosexual or heterosexual. This shows that these men are a diverse group. Ray Blanchard, a gender dysphoria expert and psychologist, coined the term gynoandromorphalia for males who are interested in trans MtFs or cross-dressing males. But it appears this may be a diverse group:

Abstract

In Samoa, feminine natal males who possess male-typical genitalia are known locally as fa’afafine. Some Samoan men express sexual interest in fa’afafine, whereas others do not. To assess the sexual orientation of men who are sexually interested in fa’afafine, we collected sexual attraction ratings and viewing times of Samoan men’s and women’s faces. Study 1 (N = 130) focused on men who were insertive or versatile during anal sex with fa’afafine partners. These men were compared to each other, as well as to males (i.e., men and fa’afafine) who were exclusively sexually interested in either women or men. Study 2 (N = 180) compared men who had sex with fa’afafine and women; men who had sex with fa’afafine, women, and men; and men who had sex with fa’afafine and men. These men were compared to each other, as well as to males who were exclusively sexually interested in either women or men. These studies suggest that men who have sex with fa’afafine are a heterogeneous group. A small portion of the men who are sexually interested in fa’afafine shows a relatively bisexual pattern of sexual attraction ratings and viewing times, namely men who have sex with fa’afafine, men, and women. In contrast, a larger number of men who were sexually interested in fa’afafine responded in a manner similar to men who were exclusively sexually interested in either women or men. The present research suggests that additional insights into male sexual orientation can be garnered by focusing on how sexuality is expressed in non-Western cultural contexts.

Social Contagion

GHQ reviews the large rise in young people identifying as trans in Topic 10 and Topic 11. A parent group called the Kelsey Coalition made a post reviewing some more recent statistics concerning the large increases of trans-identification in teenagers:

-In Oregon, 6% of 8th graders and 5.5% of 11th graders identify as transgender or non-binary. 2019 Oregon Health Teens Survey. 

-In Hawaii, over 3% of over 38,000 public high school students surveyed identify as transgender. Hawaii Sexual and Gender Minority Health Report (2018):

-2% of Minnesota 8th grade girls identify as transgender, while an additional 3% were not sure. Minnesota 2019 Student Survey

-Among Wisconsin high school students, 1% identified as non-binary, 1% as gender fluid, 1% as transgender, and 2% were not sure. Dane County, Wisconsin Youth Assessment Survey, 9th-12th Grade Report (2018). Among Wisconsin middle school students, 2% identify as non-binary, 1% as transgender, and 3% were nv County, Wisconsin Youth Assessment Survey, 7th-8th Grade Report (2018).

-Surveys of Maine high school students found 1.5% identify as transgender and 1.6% of students were unsure of their gender identification. Maine Integrated Youth Health Survey (2017)

This paper reviews the data indicating a major increase in trans-identified young people in Nordic countries:

Abstract

Purpose: To explore whether the increase observed in referrals to child and adolescent gender identity services (GIDSs) has been similar in four Nordic countries and in the UK.

Materials and methods: Numbers of referrals per year in 2011–2017 were obtained from all GIDS in Denmark, Finland, Norway, Sweden and the UK and related to population aged <18.

Results: A similar pattern of increase in referral rates was observed across countries, resulting in comparable population adjusted rates in 2017. In children, male:female birth sex ratio was even; in adolescents, a preponderance of females (birth sex) was observed, particularly in Finland.

Conclusions: The demand for GIDSs has evolved similarly across Nordic countries and the UK. The reasons for the increase are not known but increased awareness of gender identity issues, service availability, destigmatization as well as social and media influences may play a role.

Body dysmorphia around gender isn’t the only body dysmorphia increasing rapidly. More you females are seeking labiaplasty surgery:

Dr Naomi Crouch, a leading adolescent gynaecologist, said she was concerned GPs were referring rising numbers of young girls who wanted an operation.

Labiaplasty, as the surgery is known, involves the lips of the vagina being shortened or reshaped.

The NHS says it should not be carried out on girls before they turn 18.

In 2015-16, more than 200 girls under 18 had labiaplasty on the NHS. More than 150 of the girls were under 15…

Anna - not her real name - considered having labiaplasty from the age of 14.

"I just picked up from somewhere that it wasn't neat enough or tidy enough and I think I wanted it to be smaller.

"People around me were watching porn and I just had this idea that it should be symmetrical and not sticking out.

"I thought that was what everyone else looked like, because I hadn't seen any normal everyday [images] before then.

"I remember thinking, 'If there's surgery for it, then clearly I'm not the only one who wants this done, and maybe it won't be that big a deal.'."

References

Gander, K. (2019, December 12). Transgender People Suffering From Gender Dyphoria May Have Key Brain Differences, Scientist Says. Newsweek. Retrieved from https://www.newsweek.com/transgender-people-gender-dysphoria-brain-differences-scientist-1475013

Kaitiala, R, Bergman, H., Carmichael, P., de Graaf, N., Rischel, K., Frisen, L. (2019). Time trends in referrals to child and adolescent gender identity services: a study in four Nordic countries and in the UK.

Mackenzie, J. (2017, July 3). Vagina surgery 'sought by girls as young as nine.' BBC. Retrieved from https://www.bbc.com/news/health-40410459

Nila, S., Crochet, P., Barthes, J., Rianti, P., Juliandi, B., Suryobroto, B., Raymond, M. (2019). Male Homosexual Preference: Femininity and the Older Brother Effect in Indonesia. Evolutionary Psychology. doi.org/10.1177/1474704919880701

Petterson, J. L., Dixson, B.J., Little, A. C. (2020). Heterogeneity in the Sexual Orientations of Men Who Have Sex with Fa’afafine in Samoa. Archives of Sexual Behavior, 1-13. https://doi.org/10.1007/s10508-020-01646-6

Rahman, Q., Xu, Y., Lippa, R.A. et al. (2019). Prevalence of Sexual Orientation Across 28 Nations and Its Association with Gender Equality, Economic Development, and Individualism. Archives of Sex Behavior, 1-12 doi.org/10.1007/s10508-019-01590-0

Articles: Nature and Nurture- Causes of Trans Identity and Sexual Orientation

News

On the GHQ website, Topic 10 ( NATURE VERSUS NURTURE: WHAT OTHER FACTORS BESIDES “INNATE GENDER IDENTITY” CONTRIBUTE TO TRANS IDENTIFICATION IN YOUNG PEOPLE) reviews the research that addresses biological and environmental factors in the formation of trans and LGB identities. We are updating our site with new articles and research addressing these issues.

*Blog posts updating relevant information regarding our 17 “Topics” are linked at the end of each topic to keep our site updated with the newest information to aid anyone who may be researching these subject matters.

Social Contagion

An article titled “Culture-Bound Syndromes: Satanic Panics, Multiple Personality Disorder & ROGD” on the website Areo discusses mental health issues and social contagions. GHQ covers this same subject in Topic 11, providing a long list of examples of social contagions, most involving female teens and young adults. This may be relevant to the large increases of female trans-identified teenagers.

The author, Louise Perry, first reviews the rise is diagnoses of MPD/DID (multiple personality disorder):

MPD/DID was a psychiatric phenomenon that appeared suddenly in the 1970s, following the release of Sybil, a book (and later a film) that portrayed a woman who had developed multiple personalities as a result of childhood trauma. Within a short time, the condition became astonishingly well known. More people were diagnosed with MPD/DID in the five years prior to 1986 than in the preceding two centuries. But then, just as suddenly, it disappeared.

Perry also covers the “Satanic panic” child cult-ritual sexual abuse scandals that started in the 1980s. A lot of damage happened due to false accusations and therapists were implicated in leading children on:

Satanic panic created an antagonistic binary, which still persists to this day, between those who believed in the existence of the cults, and those who didn’t. It was perversely difficult to adopt a position somewhere in between—to suggest, for instance, that, although the apparent cult victims had experienced sexual abuse, which had caused them long-term trauma, the satanic elements of their accounts were likely exaggerated or invented, the result of social contagion.

Diane Ehernsaft, one of the most aggressive supporters of the affirmative model in treating gender-dysphoric children/teens, was involved in reviewing claims by children of satanic sex abuse. She published a paper in 1992 covering this matter.

Perry describes the social contagions as “culture-bound syndromes” and provides several more historical examples of psychic epidemics to add to a long list covered on the GHQ website here.

We can now see, with the benefit of hindsight, that MPD/DID is an example of a culture-bound syndrome, an anthropological term for a psychiatric condition that is unique to one culture and historical time period. Examples from other parts of the world include Amok, a condition found in Malaysia, in which sufferers are understood to suddenly become extremely violent towards anyone in their immediate vicinity, having never previously shown signs of aggression. Another well-studied example is Dhat, a condition of the Indian sub-continent, in which men report physical weakness and impotence as a result of semen supposedly leaking out of their bodies when they urinate. Culture-bound syndromes have long been a source of fascination for anthropologists, as they often highlight crucial cultural differences in understandings of the relationship between mind and body. 

Such conditions are to be found in the western world too, although they may be harder for westerners to identify. Edward Shorter is a historian of psychosomatic illnesses, who has studied the psychiatric conditions of nineteenth-century Europe, including hysteria and neurasthenia, which fit the profile for culture-bound syndromes.

The author describes the relationship between suggestibility of these new diagnoses and Borderline Personality Disorder. BPD is known for identity instability and emotional dysregulation:

It is now known that patients diagnosed with MPD/DID are clinically indistinguishable from those diagnosed with Borderline Personality Disorder (BPD). This condition is characterised by emotional volatility, propensity to self harm, extreme vulnerability to negative emotions and difficulty in maintaining stable relationships. It is mostly found in women: it seems that men with similar tendencies are more likely to manifest Antisocial Personality Disorder.

This is relevant to the discussion of gender dysphoria because some GD mental health professionals are reporting a large number of females with BPD presenting to gender clinics. Aydin Olson, an affirmative model advocate, discussed this at a Gender Odysee conference in 2017. An anonymous source has told GHQ the same thing about a gender clinic in the central United States.

Perry then discusses “Rapid Onset Gender Dysphoria” which describes teens coming out as trans despite not expressing GD in childhood and studied by Lisa Littman. Affirmative model advocates and trans activists have strongly condemned the concept as the article points out. But there have been clusters of trans-identified teens in numbers unheard of in the past:

Aside from MPD/DID, there are a number of conditions recognised by contemporary Western psychiatry that seem to fit the culture-bound syndrome model. Anorexia nervosa is one example that has been a source of interest to anthropologists, and so-called Rapid Onset Gender Dysphoria (ROGD) is another—more controversial—possibility that has only recently emerged…

She [Littman] found that a large proportion of these young people had announced their intention to transition suddenly, out of the blue, having previously shown no signs of cross-sex identification. Littman also notes that:

​”The expected prevalence of transgender young adult individuals is 0.7%. Yet, more than a third of the friendship groups described in this study had 50% or more of the AYAs [adolescents and young adults] in the group becoming transgender-identified in a similar time frame, a localized increase to more than 70 times the expected prevalence rate”…

Other researchers have expressed support for Littman’s conclusions, among them Ray Blanchard and Kenneth Zucker, two of the leading experts on the treatment of Gender Identity Disorder. Moreover both Blanchard and Zucker have explicitly compared ROGD with MPD/DID. Some of the similarities are indeed arresting. Both the trans movement and the MPD/DID movement arose suddenly, although the groundwork had been laid over a long preceding period. Both saw a huge spike in diagnoses among young, vulnerable females. Both made extreme claims about the nature of identity, which seemed to defy conventional wisdom. Both were (and continue to be) politically charged, with an established dichotomy between goodies who are on the side of suffering victims, and baddies who refuse to accept those victims’ accounts of themselves.

Perry cautions the mental health profession not to promote potentially harmful fads:

Hence, patients unconsciously draw from what Shorter terms “the symptom pool”—the limited array of symptoms that are considered credible, not only by medical professionals, but by other members of a given society. For young women in nineteenth-century Vienna, this might mean sudden limb paralysis. For their counterparts in 1980s America, manifesting MPD/DID was a far more acceptable way of expressing trauma. Dogmatic therapists, who were convinced not only that MPD/DID was a real condition, but also that it was far more common than anyone else realised, subtly encouraged their patients to manifest the symptoms. Allen J. Frances, chair of the group who put together the fourth edition of the DSM, at the height of the MPD/DID phenomenon, writes now that the role of social contagion is indisputable…

However, we must be vigilant against the potential harms of psychiatric phenomena that offer false certainty to vulnerable people. Fear of causing offence should not be a barrier to rigorous research, particularly when patients are considering undergoing irreversible medical interventions. It is not kind to promote such conditions without evidence, nor is itcruel to be sceptical of them. Sometimes, in fact, scepticism can be a form of kindness.

Alexander Korte is a gender clinician and researcher who has expressed concern for early transition as being a form of gay and lesbian eugenics (Korte 2008):

(Korte 2008)

Interview with Dr. Alexander Korte contains commentary from his involvement in the treatment of youth with gender dysphoria. He addresses the drastic rise in referrals, the changing demographics towards large increases of trans-identified females, possible comparisons to the MPD craze, and discusses the risk of pediatric transition to LGB youth who may not be given enough time to mature. Some comments from the interview below:

Regarding this, we see a marked increase in the number of biological girls, especially teenagers, in early or mid-adolescence.

What are the reasons for that?

One important reason, I think, could be that puberty requires much greater integration and adaptation skills of biological girls than it does of boys.  In this sense, we may possibly draw a parallel to eating disorders.  For anorexia, we assume a similar cause, namely that female adolescents are overwhelmed with the integration of sexuality at this age.  Some fail to rise to this challenge in puberty.  In particular they are overwhelmed with the underlying beauty and body image ideals, which they perceive as a powerful stressor and which put a lot of pressure on them.

You want kids to go through puberty.  Why?

Evidence shows that puberty-blocking treatments, which are presented by the advocates of such treatments as medically harmless, further a transsexual development and render it impossible for the patient to make experiences necessary for the formation of their identity including socio-sexual formation, i.e. relationships.  These are necessary experiences, also, for a homosexual coming out.  So in this I see the real problem.  That a puberty blocking treatment, to put it bluntly, could possibly be something like a homosexuality averting project.  Now this is obviously unethical for a medical treatment and nobody would wish for something like that…

I think what we are dealing with is a zeitgeist moment…

I have taken a clear stance. I am critical of the treatment [puberty blockers]. I think it needs to be reconsidered. The problem is the proportion of children taking puberty suppressing drugs who later decide to take cross sex hormones as a further step: the proportion of these children is close to 100%…

From a cultural-studies or sociological perspective view I would summarize: what’s driving this is modern society’s utopian belief in progress. This belief promises total satisfaction of needs…

Yeah, well, so whenever you talk about it as a doctor or a scientist, you have to expect criticism. This really only shows how ideologically mined the terrain is. And it is just this mostly ideological discussion that makes a fact-based and calmly conducted scientific examination of the subject impossible at times. That’s tragic, of course. We know this: ideology is the death of science just as populism is the death of democracy.

Similarities between Trans & Opposite Sex Controls

We are adding three studies on “third gender” individuals not previously referenced on the GHQ website. “Striving for Prestige in Samoa: A Comparison of Men, Women, and Fa’afafine” discusses effeminate males in the South Pacific and their attitudes about altruism:

ABSTRACT

In numerous non-Western cultures around the world, a small but meaningful proportion of individuals occupy alternative gender categories beyond the man/woman binary. A substantial body of past research has shown that feminine, same-sex attracted males in Samoa—a nonbinary gender known as fa’afafine—are more altruistic toward their nieces and nephews than are Samoan men and women. The present study examined the degree to which these kin-directed altruistic tendencies of fa’afafine are motivated by striving for prestige, and hence demonstrating value, within their family. Results showed that cisgender men and women do not differ in the degree to which they seek familial recognition of their altruistic behavior toward nieces and nephews. However, compared to men, fa’afafine sought significantly more acknowledgment of this altruism. These results illustrate one proximate cognitive mechanism for the elevated kin-directed altruism of fa’afafine and highlight the importance of the sociocultural context in which these motivations develop.

“Birth order and recalled childhood gender nonconformity in Samoan men and fa'afafine” discusses homosexuality and fraternal birth order. It seems to be a fact that a male is more likely to be homosexual the more older brothers he has.

"A Retrospective Study of Childhood Sex-Typed Behavior in Istmo Zapotec Men, Women, and Muxes" is a very relevant study to the GHQ website as it compares transgender effeminate males and homosexual males and finds the transgender individuals tend towards more female pattern behavior than homosexual males.

It would be extremely helpful if there could be a way to identify these children in distinct categories to understand how best to help them deal with being gender nonconforming in the gender-focused culture that exists everywhere. However, much of the information on the GHQ website points to a continuum between gnc gay/lesbian and trans that makes the issue of medically altering minors much more complicated and likely to risk false positives:

Abstract

Previous research has consistently demonstrated that both transgender and cisgender androphilic males (i.e., males attracted to adult males) display and recall higher levels of childhood female-typical behavior (CFTB) and lower levels of childhood male-typical behavior (CMTB) compared to gynephilic males (i.e., males attracted to adult females). In adulthood, the recalled CFTB and CMTB scores of cisgender androphilic males tend to be intermediate to those of opposite-sex-attracted men and women, whereas transgender androphilic males tend to score similar to women. These studies have been mostly conducted in Euro-American cultures. We examined recalled childhood sex-typed behavior (CSTB) among the Istmo Zapotec—a pre-Colombian culture in the Istmo region of Oaxaca, Mexico, where cisgender and transgender androphilic males are recognized as a third gender, known locally as muxes. The present study sought to determine whether Istmo Zapotec men (n = 180), cisgender muxe nguiiu (n = 63), transgender muxe gunaa (n = 120), and women (n = 138) differ with respect to recalled CFTB and CMTB. Our results indicate that men recalled significantly less CFTB and more CMTB than women. Cisgender muxesscored in between men and women. Transgender muxes scored similar to women. These findings provide further evidence that childhood sex-atypical behavior is a cross-culturally universal and normative developmental aspect of male androphilia, regardless of whether it manifests in the cisgender or transgender form. This is the first study to present quantitative data comparing the recalled CSTB of cisgender and transgender androphilic males from within the same non-Euro-American culture.

The Trans Youth Project has released several papers around their study that shows trans-identified children look the same on gendered behavior measures as the opposite sex they identify with. This finding is similar to the prior study on trans muxes who also report gendered behavior and interests that match up with female averages.

“Similarity in transgender and cisgender children’s gender development” provides charts that show responses to tests on gendered behavior look very similar to cross-sex controls as demonstrated by the graphic below:

Gülgöz (2019)

There is an observable pattern that children who are more extremely gender nonconforming are more likely to have gender dysphoria and are more likely to seek social transition. Parental and other outside influences are not shown to affect the child’s gender nonconforming (gnc) behavior. This reality isn’t something that we argue against on our site. Gender Health Query opposes any gender behavior policing of young people. But the evidence points to a continuum of gender dysphoria where there may be some children at risk for over-medicalization as children/tweens/teens as they exist between a place of insistent trans-identified youth and youth who may accept themself as a gnc, likely gay/lesbian person.

A statement from their paper is an example of the variations in behavior and identification:

“Predicting Early-Childhood Gender Transitions”

They also speak to the power of gender stereotypes and their effects on children whether trans-identified or not (called here “essentialist” thinking):

Gülgöz (2019)

“Gender essentialism in transgender and cisgender children”

While these charts may be used to argue for gender essentialism in trans-identified children, the authors state this isn’t proof their identities are sure to be static as they grow:

Gülgöz (2019)

Autogynephilia

The GHQ website covers the topic of autogynephilic MtF trans identity in heterosexual/bisexual males. They generally reveal their identity post-puberty and differ from the homosexual transexuals who present as very feminine as children. A graphic by clinical psychologist Dr. Morandina, shows the developmental pathways:

@Morangreenie, Australian Association of Cognitive Behaviour Therapy (AACBT) lecture

Autogynephilia (AGP) is a typology coined by Dr, Ray Blanchard. Quillette interviewed Dr. Ray Blanchard on the subject (What Is Autogynephilia? An Interview with Dr Ray Blanchard”):

This typology—which continues to attract a great deal of controversy—categorizes trans women (that is, natal males who identify as women) into two discrete groups.

The first group is composed of ‘androphilic’ (sometimes termed ‘homosexual’) trans women, who are exclusively sexually attracted to men and are markedly feminine in behaviour and appearance from a young age. They typically begin the process of medical transition before the age of 30.

The second group are motivated to transition as a result of what Blanchard termed ‘autogynephilia’: a sexual orientation defined by sexual arousal at the thought or image of oneself as a woman. Autogynephiles are typically sexually attracted to women, although they may also identify as asexual or bisexual. They are more likely to transition later in life and to have been conventionally masculine in presentation up until that point.

A quote from the article references bioethicist Alice Dreger who has written on the subject:

Although Blanchard’s typology is supported by a wide range of sexologists and other researchers, it is strongly rejected by most trans activists who dispute the existence of autogynephilia. The medical historian Alice Dreger, whose 2015 book Galileo’s Middle Finger included an account of the autogynephilia controversy, summarises the conflict:

“There’s a critical difference between autogynephilia and most other sexual orientations: Most other orientations aren’t erotically disrupted simply by being labeled. When you call a typical gay man homosexual, you’re not disturbing his sexual hopes and desires. By contrast, autogynephilia is perhaps best understood as a love that would really rather we didn’t speak its name. The ultimate eroticism of autogynephilia lies in the idea of really becoming or being a woman, not in being a natal male who desires to be a woman.”

The theory is also supported by psychologist Michael Bailey who discusses this in “The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism.” Motivations for this are explained by MtF researcher, Anne Lawrence, who identifies as autogynephilic:

Autogynephilia is defined as a male's propensity to be sexually aroused by the thought of himself as a female. It is the paraphilia that is theorized to underlie transvestism and some forms of male-to-female (MtF) transsexualism.

Blanchard on autogynephilia and trans activism and the way this promotes denialism in the mental health profession:

Subsequently other strange and unexpected (to me) events befell my notion of autogynephilia. Modern trans activists reframed transsexualism/transgenderism as a political problem rather than a clinical problem. The flat denial that autogynephilia exists became a canon of modern trans activism, trans activism become a sub-department of the Social Justice Movement, and the Social Justice Movement became a primary combatant in the ongoing, pervasive Culture Wars…

Subsequently other strange and unexpected (to me) events befell my notion of autogynephilia. Modern trans activists reframed transsexualism/transgenderism as a political problem rather than a clinical problem. The flat denial that autogynephilia exists became a canon of modern trans activism, trans activism become a sub-department of the Social Justice Movement, and the Social Justice Movement became a primary combatant in the ongoing, pervasive Culture Wars.

The upshot is that most trans activists—and, in solidarity, their “allies”—deny that autogynephilia exists. Since most university psychologists, sociologists, and humanities professors are “allies,” the topic of autogynephilia may be omitted from Human Sexuality or Gender Studies courses for a generation. The other side in the Culture Wars (whatever one wishes to call that side) are prepared to recognize the existence of autogynephilia as soon as they learn of it, but they tend to hurl it as an insult at male-to-female trans who offend them. That, of course, is not what I intended when I coined the term 30 years ago…

At present, many heterosexual MTFs—in their own view, lesbian trans women—police online forums ceaselessly for any mention of autogynephilia.

Blanchard on the demographics of this fairly common paraphilia:

When I looked at the relative numbers of autogynephilic and androphilic gender-dysphoric males back in 1987, the autogynephilic cases were already a majority, approaching 60 percent. The proportion had reached 75 percent by 2010, and it might be even higher now.

Blanchard supports medical transition but not affirmation in all cases:

This depends on the intensity of the autogynephilia and, perhaps more importantly, on the severity of any gender dysphoria that arises in consequence of it. For mild or intermittent gender dysphoria, counselling or cognitive behavior therapy may be sufficient to help the patient through “flare-ups” of dysphoric feelings. This would be a logical choice of treatment if the patient has a marriage that he wants to maintain or a valued career that would inevitably suffer if he attempted to transition to the female role.

He does not believe trans activist agreements that females are also autogynephilic in their sexuality and thus “just like trans women”:

It seems a lot less feasible when one considers the various other ways in which some autogynephilic men symbolize themselves as women in their masturbation fantasies. Examples I have collected include: sexual fantasies of menstruation and masturbatory rituals that simulate menstruation; giving oneself an enema, while imagining the anus is a vagina and the enema is a vaginal douche; helping the maid clean the house; sitting in a girls’ class at school; knitting in the company of other women; and riding a girls’ bicycle. These examples argue that autogynephilic sexual fantasies have a fetishistic flavor that makes them qualitatively different from any superficially similar ideation in natal females.

There is also the telling phenomenon of autogynephiles who are involuntarily aroused by cross-dressing or cross-gender ideation, and who complain about difficulties changing into women’s attire without triggering erection or ejaculation. It seems likely that few natal women would give the analogous reports that they wish that they could put on their clothes without triggering vaginal lubrication or orgasm.

GHQ has discussed the rise in heterosexual females coming out as trans and identifying as gay men. Blanchard does not believe this is a reverse situation and refers to these individuals as autohomoerotics:

Do you think that natal females ever experience autoandrophilia [sexual arousal at the thought or image of oneself as male]?…

Until recent times, autohomoerotic female-to-male transsexuals were quite rare. The differences between autogynephilia in males and autohomoeroticism in females may seem subtle. Autogynephilic (male) gender dysphorics are attracted to the idea of having a woman’s body; autohomoerotic (female) gender dysphorics are attracted to the idea of participating in gay male sex. For autogynephiles, becoming a lesbian woman is a secondary goal—the logical consequence of being attracted to women and wanting to become a woman. For autohomoerotics, becoming a gay man appears to be the primary goal or very close to it.

There are also striking differences in developmental history. Many autogynephilic trans people report a period in their lives, usually during puberty, when they put on women’s undergarments (often “borrowed” from their mothers or sisters) and masturbated to orgasm. In contrast, self-reports of masturbating to orgasm in men’s underwear are missing in the histories of autohomoerotic females.

Due to the sexual nature of autogynephilia, there has been a strong activist backlash, involving very abusive behavior, that has been successful in eradicating this as a diagnosis among mental health professionals. The reasons for this are purely political. Due to the rise of the internet, there are AGPs who admit this this is the main motivation for heterosexual males who transition, and AGP narratives that fit this diagnosis can be found everywhere on trans social media sites. Some of them actually created an “Autogynephilia Awareness Day” for November 20th.

@AGPAwarenessDay

As a result of the charged identity politics around autogynephilia, the mental health community has not addressed the reality of this condition. Dr. Bailey believes this is dishonest and malpractice:

Examples of how some of these individuals seek validation for their autogynephilic drives from the lesbian community (which is causing a lot of conflicts within the LGBT population) can be found here.

Autism spectrum

Gender clinics have noted a consistent pattern of high rates of autism in people with gender dysphoria. We are linking a few studies here to understand this subject further.

“Is exposure to high levels of maternal intrauterine testosterone a causal factor common to male sex, autism, gender dysphoria, and non-right-handedness?”:

Abstract

We present evidence that male sex, autism, gender dysphoria and non-right-handedness share a common cause, viz. high levels of maternal first-trimester intrauterine testosterone. This provides an explanation for the (as yet unexplained) co-occurrences and co-morbidities between these conditions and pathologies…

“Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents”:

Abstract

Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence. This study develops initial clinical consensus guidelines for the assessment and care of adolescents with co-occurring ASD and GD, from the best clinical practices of current experts in the field…

The paper “Perspectives of Mothers of Transgender and Gender-Nonconforming Children With Autism Spectrum Disorder” discusses parents reactions to having a child with GD and ASD:

This study represents findings from interviews at two time points with three mothers of transgender and gender-nonconforming (TGNC) children (ages 8 to 12 years at T1) with autism spectrum disorder (ASD). Of interest was the mothers’ experiences of raising a TGNC child with ASD, and whether/how the children’s autism played a role in their understandings of their children’s gender identities and expressions. The mothers’ fear of a transphobic/cisnormative society and wondering about whether their children’s ASD influenced or caused their children’s gender variance were barriers to fully embracing their children’s gender nonconformity. Unclear causes of children’s social/emotional difficulties and lack of adequate resources and support were identified challenges. Positive interventions and resources were also discussed. Recommendations for clinicians and other professionals who serve TGNC youth with autism and their families are presented.

Like gender dysphoria, autism has become politicized with social justice and identity politics rhetoric. From Aeon:

Worryingly, this trend of romanticising autism has extended to other conditions that can be severe, debilitating, and life-threatening. There are now groups of self-advocates who celebrate depression and schizophrenia. This could also be related to the growth of pro-anorexia websites, as well as the more recent emergence of ‘addiction pride’.

The idea that autism is ‘a variation of normal’ is at odds with scientific understanding of the condition. The general consensus among neuroscientists is that autism has neurodevelopmental origins, with recent research showing that it is associated with abnormalities in brain cell numbers and white-matter structure, and defects in synaptic pruning, the process by which unwanted synaptic connections are eliminated.

There are some parallels to autism “social justice” and the demand society uses third gender pronouns for people with gender issues. And they blame higher rates of mental health problems non-binaries have on “bigotry.”

However, neurodiversity advocates reject the medical model of autism, in favour of an as-yet undetermined social model that blames the problems faced by autistic people on systematic ‘ableist’ discrimination. Some of their reasons for doing so are valid. Historically, autistic people have existed on the margins of society, and have been victimised by the medical-industrial complex that aimed to coercively eliminate them and others considered to be disabled. For example, Asperger was complicit in the Nazi regime’s euthanasia programme for disabled children…

Neurodiversity advocates still label those who express a desire for treatment or cure as Nazis and eugenicists. ‘When we fight for autism rights, we are fighting for our continued existence,’ wrote the self-advocate Jackson Connors in the People’s World newspaper this June. ‘Against our dehumanisation. Against a “cure”, which is a dogwhistle for ableist eugenics. And against the systems that push so many of us to poverty and suicide.’

In their zealous pursuit of autistic rights, some advocates have become authoritarian and militant, harassing and bullying anyone who dares to portray autism negatively, or expresses a desire for a treatment or cure. This extends to autism researchers in academia and the pharmaceutical industry, and also to the parents of severely autistic children. One widely used treatment is Applied Behavioural Analysis (ABA), which involves intensive one-on-one therapy sessions aimed to develop social skills. However, neurodiversity advocates consider ABA to be cruel and unethical, and campaign for withdrawal of government funding for the treatment

Yale has published a review of autism and gender dysphoria issues in 2015 we are adding here (“Gender identity and autism spectrum disorders”). A picture emergers that ASD youth take longer to mature which is why some parents and health professionals are concerned about pediatric transition and autism.

A Kinder Culture Towards Gender Nonconforming Youth?

“New intervention may help ease young children's biases against gender-nonconforming peers” is a study on the environmental and cultural effects of the way children see gender and other gender nonconforming children.

The study verifies the poor treatment of gender nonconforming children by other children:

The study found that the children as young as 4-years old gave less positive appraisals and shared less generously with peers who did not conform to stereotypical expressions of gender. This finding was stronger when the children watching the vignettes were older or the children in the videos were boys.

The study shows that children show more positive attitudes towards gnc youth if shared characteristics are emphasized:

"Our study suggests that highlighting positive attributes of individuals and qualities that gender-conforming and nonconforming children share more broadly--without highlighting whether they are conforming or nonconforming--could be helpful," according to Doug VanderLaan, assistant professor of psychology at the University of Toronto Mississauga and co-corresponding author of the study. "For example, teachers could create opportunities for children to learn about how each person is special as an individual and ways that they are potentially similar."

The authors of the study write:

“Our study breaks new ground by showing that 8- and 9-year-olds can be influenced to be more positive toward their gender-nonconforming peers," notes Ivy Wong, assistant professor of psychology and gender development at the Chinese University of Hong Kong and the University of Hong Kong, who led the study. "The findings can help develop strategies to reduce bias against gender nonconformity; a bias which appears to place some children at risk of peer rejection."

References:

Costandi, M. (2019, September 12). Against neurodiversity. Aeon. Retrieved from https://aeon.co/essays/why-the-neurodiversity-movement-has-become-harmful

Dreger, A. (2006, May 13). The Blog I Write in Fear. Retrieved from http://alicedreger.com/in_fear

Ehrensaft, D. (2019). Preschool child sex abuse: The aftermath of the Presidio case. American Journal of Orthopsychiatry, 62(2), 234–244. doi.org/10.1037/h0079332

EurekaAlert. (2109, October 24). New intervention may help ease young children's biases against gender-nonconforming peers. Retrieved from https://www.eurekalert.org/pub_releases/2019-10/sfri-nim101719.php

Gülgöz, S., DeMeules, M., Gelman, S.A., Olson, K. (2019). Gender essentialism in transgender and cisgender children. Plos One. doi.org/10.1371/journal.pone.0224321

Gülgöz, S., Glazier, J., Enright, E., Alonso, D., Durwood, L., Fast, A.A., Lowe, R., J. Chonghui, Heer, J., Martin, C.L., Olson, K. (2019). Similarity in transgender and cisgender children’s gender development. PNAS. doi.org/10.1073/pnas.1909367116

Interview with Dr. Alexander Korte. (2019) Retrieved from http://gdworkinggroup.org/2019/11/15/interview-with-dr-alexander-korte/

James W.H., Grech, V. (2019) Is exposure to high levels of maternal intrauterine testosterone a causal factor common to male sex, autism, gender dysphoria, and non-right-handedness? Early Human Development. doi.org/10.1016/j.earlhumdev.2019.104872

Jiménez, F. R.G., Court, L., Vasey, P.L. (2019). A Retrospective Study of Childhood Sex-Typed Behavior in Istmo Zapotec Men, Women, and Muxes. Archives of Sexual Behavior. DOI: 10.1007/s10508-019-01544-6

Kuvalanka, K.A., Mahan, D.J., McGuire, J.K., Hoffman, T.K. (2018) Perspectives of Mothers of Transgender and Gender-Nonconforming Children With Autism Spectrum Disorder. Journal of Homosexuality 65(9), 1167-1189. doi.org/10.1080/00918369.2017.1406221

Korte, A. (2008). Gender Identity Disorders in Childhood and Adolescence – Currently Debated Concepts and Treatment Strategies. Deutsches Aerzteblatt Online. doi:10.3238/arztebl.2009.0318b

Perry, L. (2019, November 6). What Is Autogynephilia? An Interview with Dr Ray Blanchard.” Quillette. Retreived from https://quillette.com/2019/11/06/what-is-autogynephilia-an-interview-with-dr-ray-blanchard/

Perry, L. (2019, October 23). Culture-Bound Syndromes: Satanic Panics, Multiple Personality Disorder & ROGD. Aero. Retrieved from https://areomagazine.com/2019/10/23/culture-bound-syndromes-satanic-panics-multiple-personality-disorder-rogd/

Rae, J.R., Gülgöz, S., Durwood, L., DeMeules, M., Lowe, R., Lindquist, G. Olson, K.R. (2019) Predicting Early-Childhood Gender Transitions. Psychological Sciences. doi.org/10.1177/0956797619830649

Semenyna, S.W., VanderLaan D.P., Vasey, P.L. (2017). “Birth order and recalled childhood gender nonconformity in Samoan men and fa'afafine”. Developmental Psychobiology 59(3), 338-347 doi.org/10.1002/dev.21498

Semenyna, S.W., Vasey, P.L. (2018). Striving for Prestige in Samoa: A Comparison of Men, Women, and Fa’afafine. Journal of Homosexuality 66(11). 1535-1545. doi.org/10.1080/00918369.2018.1503461

Strang, J.F., Meagher, H., Kenworthy L., de Vries, A.L.C., Menvielle, E., Leibowitz, S., Janssen, A., Cohen-Kettenis, P., Shumer D.E., Edwards-Leeper L., Pleak R.R., Spack N., Karasic D.H., Schreier, H., Balleur, A., Tishelman, A., Ehrensaft, D., Rodnan, L., Kuschner, E.S., Mandel, F., Caretto, A., Lewis H.C., Anthony, L.G. (2018). Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents. Journal of Clinical Child and Adolescent Psychology 47(1).105-115. doi: 10.1080/15374416.2016.1228462.

van Schalkwyk, G.I., Klingensmith K, Volkmar, F.R. (2019). Gender identity and autism spectrum disorders. Yale Journal of Biology and Medicine 88(1), 81-3.