Waddayaknow, I’m Not Nuts!

by Grace C. Niedermayer, M.Div., M.Ed.

By that time I was three I was aware of the physical genital differences between males and females, and knew there was something wrong with my body. But, whenever I told an adult I should be a girl but there was something wrong, I received the same answer, “No, you’re not a girl. Just look between your legs. That’s what you are. Stop thinking you are something else. That’s crazy.” So, it came to pass that I decided I had to be crazy; especially because the sense I had would not go away. Eventually, I managed to bury it in the back recesses of my mind. Nevertheless, I lived in fear of exposure for decades, even after I “forgot” the thing of which I was so afraid.

In the years since my birth the scientific and medical communities have learned a world of new information about the physiology of the human body and the neuro-endochrinology of the brain. Today, we are learning things unimaginable forty years ago; things like the physical-chemical basis for gender identity and sexual response.

Six years ago, the Netherlands Institute of Brain Research published the results of a study they had been conducting. While the implications were startling, except for four brief paragraphs in Discover, it received little publicity in this country. A subsequent report was published last year in the leading international journal for neurological studies, The Journal of Clinical Endocrinology and Metabolism [85 (5): 2034-41; May, 2000].

Robert Sapolski, Ph.D., Neuroendochrinologist, Stanford University, commented on the article, “An extraordinary scientific study should change how we think about what is ‘disordered’ about transsexuality. The study suggests that when someone says, ‘This isn’t the sex I was meant to be,’ the structure of the brain agrees with them. Psychologists and psychiatrists have long opined about transsexualism. In some cases, it has been viewed as delusional and treated with drugs that counteract psychosis. In other cases, it has been viewed as an extreme defense against anxieties about one’s gender role, or over-identification with the parent of the opposite sex.”

What the researchers found were significant differences in the brains of men and women relevant to reproductive hormones, cognition, emotions and our body’s responses to them. The differences were both in magnitude and consistency and involve a region of the hypothalamus identified as the BSTc. Human males average about twice as many neurons within the BSTc as do females. In both males and females, transsexuals did not have the neuron number typical of their gender, but, instead, had the number typical of the sex they always believed they should be.

Further, it was found that the hormones used when a person undergoes a sex change did not account for this dramatic difference n the number of BSTc neurons that transsexuals have. The pattern was not only seen in transsexuals who had sex changes, but also in transsexuals who wished they had undergone treatment, but never did. And, non-transsexuals exposed to these same hormones for related medical reasons did not show a shift in neuron numbers.

The research suggests something new about the source of transsexuality: Your pattern of chromosomes, gonads, genitals, secondary sexual characteristics, the hormones in your bloodstream and the way you are treated by your parents, teachers, and society at large may all be in agreement that you are a certain sex. But, something as hard-nosed and biological as the number of neurons in a part of your brain may be telling your mind that no, that’s not who you are: You are the opposite sex. Imprisoned. The bodies transsexuals are born into actually are the opposite gender of who they really are because prenatally established brain structures determine innate gender feelings and gender identity:

These structures are “hard-wired” in the early stages of pregnancy, during a hormonally-modulated imprinting process in the central nervous system (CNS). All fetal brains are “wired” female. In normal male development, hormones act to practically double the number of neurons on the BSTc region of the brain, literally creating a “hard-wired”, unchangeable male-gendered brain, just as the chromosomes act to develop matching male reproductive organs.

When the hormones fail to act in this manner, the brain remains a permanently-wired female-gendered brain, but in a gender-incorrect male body created by the chromosomes. Likewise, hormones can act to create a permanently-wired male brain with the increased BSTc development, while the chromosomes act to create a gender-incorrect female body. These mis-matches occur in one of every 10,000 female births (mislabeled “male” because of the presence of a penis), and one of every 30,000 male-births (mislabeled “female” because of the absence of a penis).

In other words, if the BSTc structures are masculinized in early pregnancy by hormones in the fetus, the child will have a male gender identity, independent of whether the genes or genitalia are male. If the BSTc structures are not masculinized in early pregnancy, the child will have a female gender identity, again independent of the genes or genitalia.

Dr. Sapolski proclaimed, “These are dramatic, unprecedented, undeniable observations…The implications are far reaching, especially for those who suffer from cross-gender identities. Instead of those gender feelings being considered ‘psychological’, they can now be understood as being ‘neurobiological’ in nature.”

These birth-defect mismatches, because they are physical, are correctable by medical/surgical procedures, as are other physical birth-defects.

When I asked a theologian about the ethic of the correction, I was told, “Because our imperfect world does not create perfect beings, illnesses and defects are parts of life. Medical science exists because God gives us the gifts of intelligence and skill to heal and correct. In light of these gifts from God, ethically, gender correction is the same as club-foot correction.”


Grace C. Niedermayer has worked professionally as a counselor and manager of severe organizational conflict. Retired, she is now a writer, educator, and public speaker. She is an activist in her state for comprehensive rights legislation. She is also active as a volunteer with her local community and university LGBT support groups, a county AIDS Project, and leader of the lesbian Wiccan group in her Unitarian fellowship. She has recently completed her gender correction.

Biology and Gender

by Mistress Krista

This article raises some interesting issues which are worthy of further discussion. Let me preface this by saying that this is not intended as a critique of the author’s thought-provoking work (because I certainly understand that “Phew, I’m not crazy” feeling of relief which biological confirmation can provide), but more of the underlying issues which surround the arena of biological “proof” of transness, and the consequent implications.

The central question, to me, is what relationship biology plays with respect to gender identity. It is crucial here to point out that we should be wary of conflating gender identity, i.e. one’s internally felt sense of being boy, girl, boygirl, girlyboy, whatever, with gender role, i.e. behaviours and attributes which are commonly associated as being appropriate for each of the “two” genders. We should also be wary of making assumptions about what we are looking for when investigating gendered biological traits. It used to be “common knowledge” that homosexuality merely represented a gender “inversion;” so, for example, lesbians were often viewed as a rough equivalent of trans men (although sexologists did tend to find femme dykes somewhat perplexing). This train of thought continues to inform much of the current hypotheses into research about sexuality. Are male and female “opposites”? Are there only two settings for the human brain which represent this binary? And more importantly, if so, what does this mean for trans people’s actual lives?

Gender identity may well be biological, although we certainly do not know yet because the evidence has yet to be conclusive, and so much of what we do know is mired in the messiness of our own ideas about gender, making clear markers of gender harder to identify.

I believe it is essential, though, to point out a few things about what our investigation into biological roots of transness might mean. First, rooting gender identity in biological causes does not mean that everyone is the same. Human biology, while it shares some rough commonalities, is also rife with diversity. If all human biology was exactly the same, they could test drugs on one person, and then give pills out confidently to everyone, knowing that every person would experience identical effects. In “nature” (I use that term advisedly), diversity is the rule, not the exception.

Second, biology can change. It would be foolish to suggest that we are physically or psychically the same person we were twenty years ago. Bodies change and develop with time and environment. Some things remain approximately permanent, and others shift dramatically. What effect might these sorts of shifts have on how we experience our gender identity?

Third, biology is complex. I’m going to go out on a limb here and say that nothing, nothing in human beings can be linked to one single biological factor which operates in isolation. Let’s take appetite as an example. Appetite would appear to be quite a straightforward thing: you get hungry, you eat. But appetite is regulated by an enormous variety of feedback mechanisms: hormones such as insulin, estrogen, and serotonin, blood glucose levels, the macronutrient composition of whatever you ate at your last meal, external stimuli such as the smell of the bakery you’re walking past, internal psychological cues including whatever horrible fat joke some relative made to you when you were twelve, social rituals around mealtimes and meal practices, etc. Gender identity, in that it incorporates many levels of self-awareness, is quite likely something of similar complexity.

Fourth, neither gender role nor gender expression necessarily follow from gender identity. Gender role refers to the performance of activities which, in our society, are considered appropriate for particular genders. Gender expression refers to how one chooses to publicly indicate one’s gender to others, through dress, mannerisms, and other elements of external performance. So, for example, a biological woman, whose gender identity is female, might choose a “non-traditional” line of work, and prefer mechanic’s overalls to frilly dresses. But we understand that this does not change her gender identity as a woman. And, for the most part, we do not expect all women to perform their role or gender expression in exactly the same way, despite stereotypes to the contrary. If gender identity, expression, and role were seamless, we wouldn’t need to have so many social proscriptions about it. A cursory glance around various trans, and queer, communities will reveal that there is a wide variety of gender role and expression. People who share the same gender identity may perform it differently. What about non op trans people, transgendered people, two-spirited people, and/or trans people who are trans in a loose sense of being playmates with gender? Where do hard butches fit in, or sissyboys? Cross dressers? Androgynes? Thus we must be careful about inferring gender role and expression from gender identity. The author does remark that other people tend to “read” gender by examining genitalia, and that this is a mistake. Might we not exercise a similar caution about reading gender by examining brains?

Fifth, the consequences of defining trans status in this way should be considered. Trans people have often found their interactions with the medical institution to be disempowering. The juxtaposition of transness with club foot, the use of the language of “correction,” as one commentator does in the article, and the search for a biological “cause” in general seems to implicitly or explicitly define transness as a pathology. This not only erases the spectrum of happy trans people who have chosen a diverse range of ways to present their desired gender, but also privileges certain types of surgery as the only appropriate intervention. I do know trans people who felt immense relief and joy upon getting full genital surgery, and this is wonderful. Many do feel as if surgery does indeed represent a correction for something that was wrong. Yet this is not the case for all, just as all people with small breasts do not wish to see them surgically enhanced, nor have small breasts redefined as a disease.

But what of transfolk whose relationship to their bodies is not as straightforward as a clear binary of “wrong outsides, correct insides”? Many, while they make a range of interventions into their physical configuration, see systems of power and privilege as part of the problem. In this sense, the “correction” should be excision of social systems that do not permit people to live their lives and inhabit their bodies in the way they like. Surgery may be part of this, but in the context of exerting choice and control over one’s life, and as part of a range of possibilities for which trans folk are responsible. Transfolk should be a bit nervous about placing full responsibility for the fate of their bodies in the hands of an institution that has traditionally disempowered them.

This week I went to the library to get out a couple of books on transsexuality. I was looking for the body of literature produced by psychologists. Guess where books on transsexuality are shelved? Mixed in with literature on child molestation. In fact, some books even combine the two, such as Gender Identity Disorders and the Paraphilias, which covers the “obviously” related issues of so-called gender dysphoria, incest, foot fetishism, S/M, and pedophilia. In this literature, trans equals sexual deviance equals criminal freak, either through deliberate intent or some disorder which makes trans people victims of larger forces beyond their control. And above all, trans equals object, not person. This is how the medical establishment has historically thought of trans people. Think about the implications of that. Thus, given the history of how transness has been defined by the medical-psychological establisment, continuing to place transness into a disease/disorder/pathology model does nothing to fundamentally critique our notions of trans. It’s same shit, different pile. Only this time you’re not trans because you’re crazy, you’re trans because your brain is wired wrong.

I realize that some transfolk may find it empowering to have the responsibility of their identities shifted to their biology, as some people with depression might feel relieved that it’s not all in their heads (well, it is, but it’s not their imagination), of course. Yet as transfolk and people who love them, I believe we should continue to struggle for a range of options and choices that are not necessarily based on meeting a single biologically based criteria. What if a transperson who wants surgery does not measure up? This has already been the case for many psychological and personal criteria; I have heard of transfolk having difficulty securing the medical treatment they desired because their sexual orientation was “wrong,” they had worked as sex workers, they did not want the “proper” gender expression post-surgery (for example, a trans woman wanted to be a butch dyke), et cetera.

Consider the concept of trans as a medical identity, versus trans as a political identity, or an identity of choice. Which one feels more empowering to you? Which one makes you a subject, and not an object? Which one makes you an active agent seeking change in your world in the way that is best for you?

I look forward to the interesting discussions that this article will no doubt generate!