What Transsexuality Is: Definition, Cause, and History


    INTRODUCTION:
    Transsexuality, also termed 'Gender Dysphoria' is now reaching the point of being reasonably well understood, though many myths and general foolishness about the subject still abound. This document concerns the classic definition of transsexuality, as defined by Benjamin, Money, Green, and so forth. Intersexuality and transgenderism will not be addressed other than obliquely.
    IN A NUTSHELL: This is about standard, classical transsexuality.

    SUMMARY DEFINITION:
    Gender Dysphoria, literally a misery with regard to gender, is the condition of being in a state of conflict between gender and physical sex.
    A transsexual is a person in which the sex-related structures of the brain that define gender identity are exactly opposite the physical sex organs of the body.
    Put even more simply, a transsexual is a mind that is literally, physically, trapped in a body of the opposite sex.
    IN A NUTSHELL: Transsexuality means having the wrong body for the gender one really is.

    GRAND OVERVIEW:
    Gender and Sex are very separate things, though the terms are often considered interchangeable by the less aware. Sex is physical form and function while Gender is a component of identity. There can be considered to be some legitimate overlap in that the brain is structured in many sex-differentiated ways, and the brain is the seat of identity. However, with regard to the dilemma of the transsexual, the difference between sex and gender are at the very core of the issue.
    A transsexual person, born to all appearance within a given physical sex, is aware of being of a gender opposite to that physical sex. This conflict, between gender identity and physical sex, is almost always manifest from earliest awareness, and is the cause of enormous suffering. It is common for transsexuals to be aware of their condition at preschool ages.
    This agony can and does lead to self destruction unless treated. The incredible difficulties that surround achieving treatment are themselves often agonizing, the sum total of which can play havoc with the lives of the gender dysphoric. Indeed, it is apparent that some fifty percent of transsexuals die by age 30, usually by their own hand.
    The standard treatment for a diagnosis of transsexuality is to reassign the transsexual to a physical sex congruent with their gender identity, a process involving the administration of appropriate hormones and surgery. The success of this treatment is exceedingly high, and many transsexuals go on to live successful lives.
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Intersex: celebrating the beauty in difference




    Some children are born with gender variations that have previously been met with silence and stigma and often unnecessary surgery. Now there is growing awareness among medical professionals so that people can grow up in a way they want to, rather than conforming to gender stereotypes.
    At 13-years-old, Sean Saifa Wall was admitted to hospital with pain in his groin. He says that he was given very little information about what might be causing it, and doctors didn’t discuss different options for treatment with him. He was told that his testes had to be removed immediately.
    “I remember before surgery… I asked the nurse what was going on, and [she] was saying that I have these gonads that need to be removed. I’m 13 – I don’t know what gonads are.” The nurse told Saifa that it was because “they’re not good”. To Saifa it sounded logical: “If it’s not good and it’s in my body, it probably should be taken out.”
    But today he still doesn’t know what, if anything, was dangerous about keeping his testes or what was causing the pain. Not too long after the surgery, he remembers one conversation in particular: “The surgeon was talking about how he wanted to create a vagina. The way he described it… it sounded barbaric.” Saifa says, recalling that he was sat in the surgeon’s room in horror. “My mum was to my right… and I was probably turning green, and [she] looked at me and said, ‘Do you want to go through with this?’ ”
    Saifa immediately said no. “I remember the surgeon was saying, ‘We’re going to shave down the clitoris.’ And I was like, this all sounds painful and horrible. I think, in that second, that one moment, that was what spared me from genital surgery.”
    As a child growing up between New York and North Carolina in the late 1970s and early 1980s, Saifa was at the cusp of a change in thinking about the medical management of intersex conditions in the US. He is one of seven living relatives with the same intersex condition. Three of these relatives identify as female, having undergone surgeries in childhood to remove their testes.
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    Imaging studies and other research suggest that there is a biological basis for transgender identity



    Some children insist, from the moment they can speak, that they are not the gender indicated by their biological sex. So where does this knowledge reside? And is it possible to discern a genetic or anatomical basis for transgender identity? Exploration of these questions is relatively new, but there is a bit of evidence for a genetic basis. Identical twins are somewhat more likely than fraternal twins to both be trans.

     Male and female brains are, on average, slightly different in structure, although there is tremendous individual variability. Several studies have looked for signs that transgender people have brains more similar to their experienced gender. Spanish investigators—led by psychobiologist Antonio Guillamon of the National Distance Education University in Madrid and neuropsychologist Carme Junqué Plaja of the University of Barcelona—used MRI to examine the brains of 24 female-to-males and 18 male-to-females—both before and after treatment with cross-sex hormones. Their results, published in 2013, showed that even before treatment the brain structures of the trans people were more similar in some respects to the brains of their experienced gender than those of their natal gender. For example, the female-to-male subjects had relatively thin subcortical areas (these areas tend to be thinner in men than in women). Male-to-female subjects tended to have thinner cortical regions in the right hemisphere, which is characteristic of a female brain. (Such differences became more pronounced after treatment.)

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    Transsexual differences caught on brain scan



    Antonio Guillamon‘s team at the National University of Distance Education in Madrid, Spain, think they have found a better way to spot a transsexual brain. In a study due to be published next month, the team ran MRI scans on the brains of 18 female-to-male transsexual people who’d had no treatment and compared them with those of 24 males and 19 females.
    They found significant differences between male and female brains in four regions of white matter – and the female-to-male transsexual people had white matter in these regions that resembled a male brain (Journal of Psychiatric Research, DOI: 10.1016/j.jpsychires.2010.05.006). “It’s the first time it has been shown that the brains of female-to-male transsexual people are masculinised,” Guillamon says.
    In a separate study, the team used the same technique to compare white matter in 18 male-to-female transsexual people with that in 19 males and 19 females. Surprisingly, in each transsexual person’s brain the structure of the white matter in the four regions was halfway between that of the males and females (Journal of Psychiatric Research, DOI: 10.1016/j.jpsychires.2010.11.007). “Their brains are not completely masculinised and not completely feminised, but they still feel female,” says Guillamon.

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    A trans person's brain is similar to that of the gender they identify with

    Gender Identity and DES Exposure


    Several published studies in the medical literature on psycho-neuro-endocrinology have examined the hypothesis that prenatal exposure to estrogens (including Diethylstilbestrol) may cause significant developmental impact on sexual differentiation of the brain, and on subsequent behavioural and gender identity development in exposed males and females. There is significant evidence linking prenatal hormonal influences on gender identity and transsexual development.
    Gender identity and Diethylstilbestrol DES exposure image
    There is a possible connection between DES exposure and gender variance
    In 1999, Dr. Scott Kerlin (founder of the DES Sons International Network) began researching the effects of Di-Ethyl Stilbestrol®on the health of genetic maleswho had been exposed prenatally. A substantial amount of research had been done on women who had been exposed but relatively little had been done on men and DES sons. When it became apparent that a significant portion of his research group were eithertranssexualtransgendered or intersexed, he began to explore the possibility of a connection between prenatal DES exposure and gender variance. Dr. Kerlin is not the first researcher to note a correlation between DES exposure and feminized behaviour in genetic males; studies go back as far as 1973. However, Dr. Kerlin has delved much deeper than those who came before.

    Dr. Dana Beyer is the medical advisor and web manager of the DES Sons International Network, on the effects of endocrine disrupting compounds such as Diethylstilbestrol, DDT, phthalates and bisphenol A, on human sexuality and reproduction, as well as providing personal support and mentoring. In 2005 she presented a breakthrough paper, with her colleagues Dr. Scott Kerlin and Dr. Milton Diamond, to the International Behavioural Development Symposium, delineating the impact Di-Ethyl Stilbestrol® has had in causing intersex and gender variations in human beings.
    I understand this is a sensitive and controversial matter but I feel it is important to bring this issue to light and break the wall of silence around what is still nowadays considered as “taboo”. I would like to invite all DES exposed individuals who have a knowledge of DES exposure and gender identity either through research or personal experience to share their comments and stories.