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What Causes Transsexualism?
by Lynn Conway
Copyright @ 2000-2003, Lynn Conway.
All Rights Reserved.
- Many causes for
transsexualism have been proposed over the years. As discussed earlier
TG/TS/IS information, it's long been known from intersex data that
the genes do not determine gender identity, and recent follow-ups on
intersex infant surgeries show that consistency of "genitals and
upbringing" does not determine gender identity.
- Instead, current
scientific results strongly suggest neurobiological origins for
transsexualism: Something appears to happen during the in-utero
development of the transsexual child's central nervous system (CNS) so
that the child is left with innate, strongly perceived cross-gender body
feelings and self-perceptions. We still don't know for sure what causes
this neurological development, and more research needs to be done. But
the neurobiological direction for these explorations seem clear.
- However, even without
any scientific evidence to back them up, many psychiatrists and
psychologists over the past four decades have simply assumed that
transsexualism is a "mental illness". By DEFINING this socially
unpopular condition to be a mental illness, these mental health
professionals have shaped much of the medical establishment's and
society's views of transsexuals as psychopathological "sexual deviants".
- This page is an
investigative report that describes and contrasts the older "mental
illness" concept of transsexualism with more recently emerging
scientific evidence of neurobiological bases for innate gender identity
It is a
capital mistake to theorize before one has data.
Insensibly one begins to twist facts to suit theories,
of theories to suit facts -
[in Arthur Conan Doyle's "A Scandal in
Traditional behaviorist psychological theories of transsexualism
- Behaviorist psychology
was a dominent school of thought during the 1950's-80's, and has left a
deep imprint on theories of gender and sexual behavior. Behaviorists
"believe" that an infant's mind is a blank slate upon which social
factors and conditioning act to produce all aspects of personality,
including gender. This belief takes the form of an axiom in their works
- a basic assumption not based in evidence but upon which they derive
results. Because of this belief in the infant's "mind as a blank slate",
they have long had faith in John Money's "genitalia and upbringing"
theory of gender-identity formation.
- Readers should
carefully study the section on
Basics in Lynn's TG/TS/TS Information pages for background on John
Money's theory, and on
the recent shattering of Money's theory when it was discovered that
he had fabricated many results and concealed any counterevidence. For
many decades his theory was the basis for arbitrary surgical sex
reassignments of intersex infants, mostly boys with tiny or missing
penises who were turned into "girls". Many of these kids reassigned as
infants required later re-reassignments as boys when their innate gender
identities became clear during childhood. In most cases, the boys lives
were shattered by the surgeries that had been forced upon them as
infants (they lost what genital tissues they had, as well as the ability
to have orgasm). Money never reported any follow-ups of these infant
surgeries that revealed the horrors that had been going on.
- As we'll see,
behaviorist theory has also had horrific impact on the lives of
transsexual people, by classifying them as being "mentally ill", instead
of being open to the scientific possibility that they too have innate
gender feelings. Denying the existance of any inborn gender identity,
behaviorists (following Money's ideas) see transsexualism as a failure
of a person to properly socialize into their correct gender during
childhood and adolescence, leading to "sexually deviant practices" in
the adult which then brings on "mental illness" including the urge to
- From this viewpoint,
transsexualism is viewed as psychopathological. It is even listed as a
mental illness in the American Psychiatric Association's Diagnostic
and Statistical Manual of Mental Disorders, under the term "Gender
Identity Disorder" (GID). This listing stigmatizes transsexualism as a
mental illness, just as psychiatrists stigmatized "homosexuality" and
"nymphomania" in the past (of course being gay is now seen as a natural
variation in sexual-partner orientation, and being a sensual woman is
now a sought-after-norm by many women).
- In the absence of
definitive scientific explanations for transsexualism, which await a
deeper understanding of developmental biology, certain dogmatic
psychologists and pyschiatrists have seized the opportunity to spout and
publish unscientific behaviorist "theories" without much challenge from
the public, the medical establishment or the scientific establishment.
They have long defended their theories in the same manner as John Money
defended his: by maintaining dominant positions in their peer networks,
attacking the "credentials" of any challengers, and attempting to
suppress any counter-evidence put forward by others.
- Unfortunately, this
sort of behavior can be effective in one's advancement in niche fields
such as sexology and gender studies, fields that attract few serious
scientists and that are not subjected to close outside scrutiny by
serious scholars. So powerful is the impact of a domineering "leader"
like a John Money in a niche fields such as sexology that many
wanna-be's imitate his "dominance wins" style of behavior. When
aggregated, such behaviors lead to the degeneration of such fields into
non-scientific cliques of "experts" who rant about nonsense-theories not
based in evidence, with each expert doing "whatever it takes" to get
their pet theory accepted. Unfortunately, this "he who dominates wins"
methodology is the only "scientific tradition" underlying many
behaviorist psychiatrists' theories in the realm of gender studies.
transsexualism to be a mental illness, behaviorist psychiatrists often
try to treat transsexual people by "conditioning" and/or "aversion
therapy". Many transsexuals, especially young transsexuals taken to
psychiatrists by their parents, have undergone years of costly
psychiatric counseling to "cure their transsexualism". There have no
reports of permanent cures. After inevitably failing to cure a
transsexual, and considering her to be "permanently mentally ill", these
psychiatrists may sometimes approve her for SRS. Of course the years of
useless therapy cost thousands of dollars and waste valuable
gender-corrected living-time that can never be recovered.
"two-type" behaviorist theory of transsexualism
- In the late 80's,
certain behaviorists proposed a very specific "two-type" theory of
transsexualism that has since "caught on" in psychiatric circles as
"explaining the cause of transsexual mental illness". Two types of
sexual urges were "intuited" and then described by behaviorists to
explain MtF transsexualism: (i) extreme "effeminate homosexuality", and,
more recently, (ii) obsessive "autogynephilic autosexuality". These
so-called "deviant adult practices" are thought of as gradually
"conditioning the transsexual" to want to "change into a woman". The
theorists proclaim that these are the only causes of transsexualism, and
all MtF transsexual people are of either one type or the other. This
theory was developed and elaborated BEFORE the collapse of John Money's
theory of gender was discredited, and it promotors are scrambling now to
- The main promoters of
this "two-type theory" are Ray Blanchard, Ph.D., a clinical sexologist
at the notorious Gender Identity Clinic of Ontario's
Clarke Institute of
Psychiatry who originated the idea, and his chief protege,
J. Michael Bailey, Ph.D., a psychologist at Northwestern University.
- Only by reading Bailey
in the original can you get some idea of how totally bogus and
methodologically flawed this so-called "scientific work" is. For
example, Bailey's website contains a paper entitled
"Women Who Were Once Boys" that simply asserts as fact, without any
basis, that there are "two categories of transsexuals: homosexual and
autogynephilic", and he then uses various anecdotal evidence from
"interviews" to show how TS people fit into this categorization.
- Bailey's paper even
goes on to include a simple twelve question "test" on how to tell the
two types apart! However, it concludes with the warning: "Keep in
mind that people don't always tell the truth. This interview could be
invalid if the transsexual is actually autogynephilic but is either (a)
worried that you will think badly of her or deny her a sex change if you
know the truth, or (b) obsessed with being a "real" woman."
Apparantly Bailey easily disregards any answers that don't agree with
his theory by simply characterizing the responder as a "lier"!
- For more insight into
the shallow, speculative, pseudo-scientific theorizing of people like J.
Michael Bailey, see the quote of Bailey attached
below regarding "stereotypes of gay people that are real".
Unfortunately, the writings and lecturings of "sexologists" like
Blanchard and Bailey are taken fairly seriously in psychiatric
counseling circles, where few people have the courage or the wits to
challenge the ideas of these aggressive theory-promoters who publish
widely in obscure sexological journals.
- Let's now consider
each of these "two types" ideas in turn, and learn how the
sexologists/psychologists/psychiatrists went wrong in their
- There have always been
some gay males who are very effeminate. Some of these men will
occasionally dress in drag. But such males do not want to become women -
they love being men, and love other men - and they are simply signalling
their homosexuality using methods that are traditional in the gay
community. Such a gay male is never "conditioned by his sexual activity"
to want to become a woman. The sexologists' error is to not
differentiate between the effeminate homosexual male and the young
transsexual girl whose cross-gender feelings developed long before
puberty. The sexologists thus mistakingly jump to the conclusion that
effeminate homosexuality is equivalent to transsexualism, and,
conversely, that addiction to "homosexual behavior" must have been what
caused the transsexualism of those young TS girls who incorrectly appear
to be effeminate homosexuals to the psychiatrists.
- In this theorizing,
the sexologists and psychiatrists are victims of another of their
errors, namely their notion that transsexualism is extremely rare. By
assuming that transsexualism occurs in only 1:30,000 males, and then
only looking for and sampling "transsexuals" in the gay male bar scene
(where only a tiny fraction of TS girls hang out), they "confirm" their
theory that most young TS girls come from among young "effeminate gay
males" who have become addicted to receptive sex. After all, they find
more than enough TS girls in that scene to cover the 1:30,000 prevalence
number. What they do not perceive is that the young effeminate males and
the young TS girls themselves know that they are two totally different
kinds of people, even though they may hang out in some of the same bars.
By overfocussing on the gay bar scene as a source for "transsexual
research subjects", the psychiatrists miss seeing the vastly larger
number of TS girls who have no contact with that scene, who've had no
"homosexual conditioning", and who are strong counter-examples to their
- By insisting on the
validity of the theory that "young transsexuals cause their
transsexualism by addiction to homosexual practices", the sexologists
and psychiatrists never seemed to notice the important group of "strong
counter-examples" to this theory - namely that a moderate percentage
(perhaps as much as 20% to 30%) of all young TS girls are actually
"lesbian" in their female gendering and prefer other girls as
love-partners. Worse yet, the psychiatrists years ago made the existance
of these young girls "invisible" by never writing letters of support for
SRS for any TS girl who was known to be "lesbian"! In other words, since
these girls didn't fit their theory of transsexualism, they were denied
SRS because "they weren't transsexual" according to the psychiatrists.
As a result, even to this day, many young TS girls who are lesbian try
to avoid their gender counselors about their sexual preference for
girls, fearing that this preference will hurt their chances for approval
- Therefore, we see that
two errors in "theory", namely (i) that transsexualism is extremely rare
and (ii) that transsexualism is caused by conditioning to receptive
homosexual sex, are compounded and mutually support each others'
apparant validity. This compound error is only recognized if one
realizes that MtF transsexualism is
about two orders of magnitude more common than previously recognized
and that it mostly occurs in young boys who are not or were not immersed
in the gay male bar scene.
- Then, in recent years,
a new phenomenon has appeared that has also caught the psychiatrists'
attention: A number of intensely transvestic males have become aware,
later in life, that the physical transformations made possible by
transsexual medical and surgical technology might revitalize and enhance
their solitary sexual pleasures. These are male-gendered persons who
desire to live in, and enjoy sexually playing with themselves in, the
body of a woman. These individuals may even seek SRS, even though they
are male gendered and in many cases have no particular desire to
socially transition. The appearance of this phenomenon is simply a
byproduct of the availability of gender modification technology - an
application of that technology for something different than it was
originally designed for (correction of transsexualism).
- Such men are now
called "autogynephiles", although in public they usually call themselves
"transsexuals" in order to present a more socially recognized and
socially accepted explanation for their physical gender modifications.
The recent tragic death of Ernest Hemingway's son Gregory publicly
revealed him to likely be an autogynephile, and revealed insights into
the autogynephilic gender trajectory.
Gregory had a long history of intense addiction to transvestism, and had
apparently undergone SRS at sometime during his life. However,
according to news reports Gregory only occasionally dressed as a woman
in public, and he was referred to by the Hemingway family as Gregory
(rather than Gloria or Vanessa, which were names Gregory sometimes used
when dressed as a female).
- In such cases, the
psychiatrists' model of sexually conditioned behavior appears to offer
an explanation for the behavior, because these people often
self-describe their condition to counselors as being males who want to
heighten their transvestic pleasures. However, such intensely
transvestic autogynephilic males retain their male gender feelings even
after being transformed physically into females. Therefore, they are on
a completely different gender-identity trajectory from that of
transsexuals. The psychiatrists' mistake is to that they confuse
autogynephilia with being equivalent to late-transitioning
- The existance of these
two visible and identifiable groups of males (effeminate "homosexual"
transsexuals and autogynephiles) who "appear to be transsexual", and
whose "transsexualism" appears to fit the behaviorist's model that
"sexual disorders are caused by conditioning", has led many
psychiatrists and psychologists to the generalization that ALL
transsexualism is explained by just these TWO particular types of male
sexual pleasure-seeking activity.
- Although there is no
scientific basis for these behaviorist ideas, many male psychiatrists
just can't imagine anything except powerful male sexual urges gone awry
that could cause an apparantly normal male to want to become a woman.
Such psychiatrists thus try to stall-off transsexual surgeries as long
as possible, even for decades in some cases, until it is obvious that a
patient's "homosexual urges" or "autogynephilic urges" cannot be further
contained. Operating under an incorrect model of transsexualism they can
do irrevocable harm by long-delaying the gender transitions of many
actual transsexuals who come under their guidance.
- [By the way, these
same male psychiatrists never question why an FtM transsexual would want
to be a man, nor do they generate theories that FtM people want to be
men because of "powerful female sexual urges gone awry". To them it
seems obvious that any woman might want to be a man, and thus it is only
the MtF transsexual who is considered to be "mentally ill". There is
also present in their thinking a quaintly Victorian notion that only
males have strong sexual drives, that only males masturbate and have
orgasms, and that women are inherently passive sexually.]
- This situation has
been worsened by additional over-promotion of the "theory of
autogynephilia as the main cause of transsexualism" by an AG person who
happens to run a very visible and oft-accessed TS women's support site.
This person, openly identifying as an autogynephile, projects their own
experience and condition on most other transsexual women (except those
who were very early transitioners and who admit having early
"homosexual" activity). When doing this projection and when theorizing
that most transsexual women are actually autogynephiles, this person
mimics the well-known macho-dominant style of John Money - doing
anything possible to promote their "theory" and to defame as "liers"
those who "deny being autogynephiles".
- Amazingly, the
promoters of the autogynephilia theory of late-transitioners don't seem
to notice that many late transitioners do not just spend their lives
alone engaging in solo-sex after transition as their theory would
suggest. Instead, many late transitioners go on to form wonderful loving
relationships - some with women and some with men - relationships in
which they are fully sexual love-partners. Sadly, the widespread
promotion of the non-scientific "autogynephilia theory" has caused a lot
of angst among transsexual women who correctly perceive this as yet
another trigger for public stigmatization and humiliation.
- Unfortunately, many
decades of such speculative, non-evidence-based theorizing about the
causes of transsexualism have greatly muddied the waters of thinking
about this condition. To this day, the mental-illness model of the
condition permeates the general medical profession and negatively
impacts public stereotypes of transsexual people. All of this
"theorizing" is without any scientific foundation whatsoever, being
little more than the "intuitions" of the most dominant thought leaders
among sexologists, starting with John Money.
- Maybe we should raise
the question "what causes people to become sexologists", apply the same
"intuitive" methods to answer that question, and then see how
sexologists react to our resulting theories!
Applying some common sense to question these behaviorist "theories"
- Now let's apply some
common sense here. The deep sense of being incorrectly gendered begins
in childhood for intense transsexuals, long before sexual feelings
develop. After puberty, many young pre-op TS girls are attracted to boys
just like any other girl would be. TS girls who are feminine and
attractive may find boyfriends and make love with them while pre-op,
just as any other girl would do. But these are not boy-to-boy homosexual
relationships. These young transsexuals are thought of as girls by their
boyfriends (just as Lynn was at ages 19-22), and their boyfriends are
heterosexual, not homosexual. For psychiatrists to say that the
"homosexual" sexual experiences of pre-op TS girls' CAUSES their
transsexualism is an incredible reversal of cause and effect. Instead it
is their innate feelings of being female that cause them to seek the
love of boys, and then in some cases to have sex with boys (always as
"the girl") in order to find affirmation of their femaleness.
- Also, many older MtF
transsexuals if long untreated become obsessed with the idea of becoming
women. Is that so surprising? Older pre-op transsexuals without partners
may also be autosexual. But aren't most humans without partners
autosexual? Masturbation itself is not a solely a "male" activity nor is
it a sign of "autogynephilia", as these psychiatrists seem to suggest.
Many women enjoy their bodies very much, and many women masturbate for
sexual pleasure and orgasmic release. Autosexuality on the part of
pre-op (and postop) transsexuals of any age is just a natural part of
their human nature, whether male or female, instead of being a "male
sexual fetish". (It seems likely now that the old time male behaviorist
psychologists didn't even know that many women masturbate and can have
- To say that "thinking
about being a woman while engaging in autosexual activity" CAUSES
transsexualism is clearly another reversal of cause and effect. My
goodness, do you think that a preop MtF transsexual would have
masturbation fantasies in which she is a man? Common sense says she will
have sexual fantasies in which she is a woman, because that is her inner
identity. Therefore, to say that ALL late-transitioning transsexuals are
autogynephilic is similarly a reversal of cause and effect.
- Unfortunately, most
male psychiatrists and psychologists, never themselves having
experienced the intense gender-identity-alienation, cannot get the idea
out of their heads that "sexual urges must be the cause" (their own male
sexual urges being the strongest urges they themselves have ever felt).
- In summary: Common
sense tells us that the sexual practices of pre-op transsexuals, as they
struggle during their difficult life trajectories to cope with bodies
that are mis-gendered, can be far more easily explained and understood
as being a natural BYPRODUCT of, rather than the CAUSE of, their
transsexualism. Thus the old "mental illness" theories of transsexualism
are based on a classic error in science: They have confused, reversed
and conflated CAUSE and EFFECT.
- A lot of damage is
done by the old mental illness theories. When psychiatric authority
figures subtly brainwash a transsexual patient into believing that she
is causing her own transsexualism by engaging in "homosexuality" or
"autogynephilic masturbation", and then attempt to delay her transition
for years or decades, she can lose all chances of ever later
assimilating into society as a woman. Even if she transitions, she may
actually think of herself as a deviant male rather than as a woman, and
may be stuck with that self-image forever. This is especially true in
cases where her psychiatrists insist that she buy into and parrot their
theories, forcing her to admit that she is a "mentally-ill man" as a
condition for signing letters of consent for her SRS.
- When a counselor uses
the terms homosexual transsexual and autogynephilic transsexual to
classify their clients, it's a sure tip-off they believe that ALL
transsexuals are mentally ill sexual deviants who have caused their own
transsexualism. Lynn advises transsexuals to avoid counselors who label
transsexuals in these judgmental behaviorist categories. Transsexuals
are also advised to avoid TG/TS support groups whose members identify
primarily as autogynephilic, because they will not fit-in well and will
not learn useful skills for assimilation as women in such groups. [On
the other hand, older highly transvestic males who desire transsexual
physical modifications should seek out such support groups; they should
also seek counselors whose practice primarily involves autogynephiles,
and who will refer such males for transsexual surgery, including SRS.]
- For further discussion
regarding the psychological and psychiatric profession's unscientific
conception of transsexualism as a mental illness, see
Illness: Issues of Psychiatric Classification by Katherine K.
Wilson of the Gender Identity Clinic
of Colorado (GIC). GIC has also developed a new webpage resource for
the Reform of Gender Disorders in the DSM-IV-TR, located at
- Also consider
recent research by psychiatrists in Norway that has found that TS
patients selected for sex reassignment showed a relatively low level of
psychopathology both before and after treatment. This new research also
casts doubt on the old view that transsexualism is a "severe mental
- For a further
indictment of the professionalism, scientific credibility, factual
accuracy and veracity of the APA and the DSM-IV regarding
transsexualism, see Lynn's discussion of the question "How
frequently does transsexualism occur?".
Recent neurological theories of transsexualism
- Except for the
behaviorists (who unfortunately are still dominant among "sexologists"
and "gender theorists"), most schools of psychological thought have
ruled out causes related to upbringing, social interactions and sexual
practices as leading to transsexualism. As in other fundamental areas of
personality, most scientific researchers now believe that the formation
of gender identity most likely occurs at an innate neurobiological
level. Serious scientific research on the formation of gender identity
is now focused on understanding the processes of CNS neurological
integration of the fetus during pregnancy.
- Recent research
indicates that MtF transsexualism may result from a female
differentiation in a genetic male of the BSTc portion of the
hypothalamus, during interactions between the developing brain and fetal
sex hormones; this brain region is essential to sexual feelings and
behavior. The first such research was reported in 1995: See NATURE,
378: 60-70, 1995 (this paper is also web accessible at
http://www.symposion.com/ijt/ijtc0106.htm ). Significant extensions
of this earlier work have just been reported, in May 2000 (see following
abstract and link to the full paper) :
The Journal of Clinical Endocrinology &
Metabolism, May 2000, p. 2034-2041
Copyright 2000, The Endocrine Society Vol. 85, No. 5
Male-to-Female Transsexuals Have Female
Neuron Numbers in a Limbic Nucleus
Frank P. M. Kruijver, Jiang-Ning Zhou, Chris
W. Pool, Michel A. Hofman,
Louis J. G. Gooren, and Dick F. Swaab
Graduate School Neurosciences Amsterdam
(F.P.M.K., J.-N.Z., C.W.P., M.A.H., D.F.S.), Netherlands
Institute for Brain Research, 1105 AZ Amsterdam ZO, The
Netherlands; Department of Endocrinology (L.J.G.G.),
Free University Hospital, 1007 MB Amsterdam, The
Netherlands; and Anhui Geriatric Institute (J.-N.Z.), The
First Affiliated Hospital of Anhui Medical University,
Hefei, Anhui, 230032 China
Address all correspondence and requests for
reprints to: Frank P. M. Kruijver, M.D., or Prof. Dick F.
Swaab, M.D., Ph.D., Graduate School Neurosciences Amsterdam,
Netherlands Institute for Brain Research, Meibergdreef 33,
1105 AZ Amsterdam ZO, The Netherlands. E-mail:
Transsexuals experience themselves as being
of the opposite sex, despite having the biological
characteristics of one sex. A crucial question resulting
from a previous brain study in male-to-female transsexuals
was whether the reported difference according to gender
identity in the central part of the bed nucleus of the stria
terminalis (BSTc) was based on a neuronal difference in the
BSTc itself or just a reflection of a difference in
vasoactive intestinal polypeptide innervation from the
amygdala, which was used as a marker. Therefore, we
determined in 42 subjects the number of
somatostatin-expressing neurons in the BSTc in relation to
sex, sexual orientation, gender identity, and past or
present hormonal status. Regardless of sexual orientation,
men had almost twice as many somatostatin neurons as women
(P < 0.006). The number of neurons in the BSTc of
male-to-female transsexuals was similar to that of the
females (P =3D 0.83). In contrast, the neuron number of a
female-to-male transsexual was found to be in the male
range. Hormone treatment or sex hormone level variations in
adulthood did not seem to have influenced BSTc neuron
numbers. The present findings of somatostatin neuronal sex
differences in the BSTc and its sex reversal in the
transsexual brain clearly support the paradigm that in
transsexuals sexual differentiation of the brain and
genitals may go into opposite directions and point to a
neurobiological basis of gender identity disorder.
- Support for this
brain-differentiation and CNS imprinting theory of gender identity also
comes from the recently reported
research studies on intersex boys who had been surgically changed
into girls and raised as girls, yet who grew up insisting on being boys
(see the important earlier section on the
intersexed). These follow-up studies demonstrate that having female
genitals and being raised as girls did not make these brain-sexed boys
into girls. They somehow deeply knew that they were boys, in spite of
all the external evidence that they were girls - in other words, they
presented just as if they were FtM transsexual boys.
- The we an see how the
old behaviorist "genitals plus upbringing" psychological theory has
caused tremendous pain and suffering, especially amongst (i) intersexed
children who've undergone unwanted genital surgery and incorrect gender
reassignment during their upbringing, and (ii) transsexual children
who've undergone extended psychiatric "treatment" such as shock therapy,
aversion therapy and behaviorist conditioning therapy in futile efforts
to "reverse" their transsexualism, and who've been forced to grow up in
the wrong gender in spite of their pleas and suffering. In the case of
transsexual children there is also the added social stigmatization of
being declared "mentally ill" by the psychiatric profession.
- Emerging scientific
understanding of gender identity and the accumulating empirical evidence
of successful gender transitions can help society and the medical
community avoid such terrible treatments and misclassifications in the
future, and better help these innocent children to find their best paths
in life in each individual case. If anyone doubts that those who undergo
gender transition can go on to lead full and happy lives, all they need
do is study the empirical evidence at Lynn's "TS
Women's Successes" and "Successful
if there is no cause? Could gender transition just be a "lifestyle
- Is gender transition a
"choice" or "fate"? This question very often arises in conversations
about transsexualism. The notion that transition is a lifestyle "choice"
is rather prevalent in our society, and can be just as stigmatizing as
the idea that it is due to a mental illness. But why do people jump to
the conclusion that it is a choice? Perhaps it is because of the
apparent suddenness of the onset of many transsexual transitions.
- Transsexual women
often appear to be completely normal males before announcing they are
going to "change sex". The apparent suddenness of these transitions, and
the rapid and dramatic physical changes that follow, fuels speculation
among family, friends and co-workers that these "decisions" are very
irrational ones. People often interpret unexpected transitions as
"mental breakdowns", or as sudden "choices" to do something totally
weird and prurient and probably for "sexual reasons". (These
interpretations are furthered by the occasional cases of autogynephilic
males who go through hormone therapy and SRS specifically for sexual
reasons, and who remain rather visibly transgendered and do not "vibe"
as women afterwards).
- What most people
cannot comprehend is the extreme gender distress these transsexuals have
endured during their entire lives. Forced by extreme family and societal
pressures to keep their distress a secret from everyone else and never
show any signs of cross-gender feelings, they simply suffer horrifically
in silence, never revealing what is wrong inside. When the gender angst
becomes totally overwhelming, and transsexual people seek counseling and
discover options for gender-transition, the floodgates open in their
minds: Transition then becomes an intensely sought-after goal, and to
others may appear to have arisen out of the blue, as if it were a sudden
"choice". However, gender transition is NOT a choice. Instead it
is destiny for those who are intensely transsexual.
is there so much fixation on "causes" anyway?
we really need to know the cause in order to treat the condition?
- Why is there so much
fixation on "causes" anyway? The answer is simple: Transsexualism has
been such a socially unpopular condition in the past that the issue of
"what causes it" has always raised in discussions about what to do about
- In the past many
behaviorist psychologists and psychiatrists have inherently blamed
transsexuals for causing their own "sexually deviant mental illness",
giving those psychiatrists a claim to responsibility for "treatment and
cure of transsexual people" and giving society a rationale for
discrimination, marginalization and ghettoization of transsexual people.
- However, as we've
seen, transsexualism is most likely a neurological condition of as yet
unknown origin and not a "mental illness". There are many other intense
neurological conditions such a pain, depression and bipolar disorders
for which we do not know the underlying causes but suspect biological
causes. We know that these other conditions are real because we see
people in distress, and we treat those people medically and with
compassion to relieve their suffering.
- Why should it be any
different with transsexualism? We now know how to relieve the suffering
of transsexual people, having many options for practical counseling,
social transition and hormonal/surgical gender reassignment. Why not
accept those treatments as valid, since they truly relieve suffering and
enhance the quality of life, even if we aren't sure what causes the
underlying condition. And why stigmatize people just because they have
sought medical treatment for this condition.
- Fortunately there are
a rapidly growing number of compassionate non-behaviorist gender
counselors who provide practical help for transitioning transsexual
people. These counselors follow a model of "informed consent" for their
clients, presenting options for treatments and counseling clients on
pragmatic, effective ways of resolving their gender issues.
- Most present-day,
self-reliant transsexual people who are planning and managing their own
transitions seek the advice and counsel of the modern-day pragmatic
gender-counselors, and they avoid traditional psychiatrists like the
plague. Modern medical treatments can resolve the transsexual condition,
even in the absence of scientific understanding of the detailed
biological mechanisms that determine one's innate gender identity.
Lynn's TG/TS/IS information page
- The following quote of
Michael Bailey will help readers calibrate the incredibly naive and
non-scientific level of thinking common among so-called "sexological
researchers" when they speculate about and characterize their "research
subjects". Any intelligent reader will sense the arrogance, shallowness
and lack of perceptiveness in Bailey's thinking, his lack of sound
evidence upon which to base conclusions, and his total conflation of
causes and effects. Ask yourself if YOU'D like to be on the receiving
end of "scientific thinking" like this? Need I say more?
From an Interview on Stereotypes of
With J. Michael Bailey, Department of
Psychology, Northwestern University
Q: What stereotypes have turned out to have
some truth to them?
A: One big thing is occupational and
recreational interests. In fact, hairdressers, professional
dancers, actors and designers tend to be gay men, at least
at much higher rates than their population rate, which is
somewhere between 1 and 4 percent. And women who are in the
armed services, or professional athletes (two of the three
best all-time women's tennis players are lesbian), are
Children who are sex-atypical do tend to become homosexual.
Especially males. Boys who want to be girls become men who
want men. Most very masculine girls probably become
heterosexual women, but their rate of homosexuality is
probably still higher than would be expected given the
population rate of female homosexuality, which is probably
less than 1 percent.
Recently, we have shown that on average, gay
men and lesbians are very different on average from straight
people in the way they walk and speak. There is such a
thing, evidently, as a gay voice. And lesbians tend to look
different than straight women -- in particular, they have
On the other hand, some stereotypes about homosexual people
are due to the fact that they are in certain other ways
psychologically like straight people of their own sex. For
example, gay men have lots of sex partners compared with
straight men. This is because they have a male-typical level
of interest in casual sex, but because they are seeking
other men with the same interest, they can have as many
partners as they want. Straight men are constrained by the
desires of women. I think that there is nothing
intrinsically "gay" about having hundreds of sex partners.
Lots of straight guys would if they could. But they can't,
because they can't find female partners who'll have
anonymous sex with them.