Brain Sex?

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Originally posted 2017-08-01 11:27:00.

brain sex skull
Pic: Rod Fleming

Brain Sex? What is that? Some sort of cyber-intercourse?

No. ‘Brain sex’ is how many transgender activists explain how their condition came about. They specifically say that, ‘Transgender occurs when an individual of one sex has certain sex-related structures in the brain that are typical of the opposite sex.’

In other words, according to this notion, ‘brain sex’ is a physical condition and not a psychological one. Putting that more technically, what is being claimed is that what they call ‘transgender’ — not a scientific term — is caused by a form of intersexuality that is localised in the brain. This is ‘brain sex’. However, physical heteromorphism of this type should be observable. So is it?

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Intersex — what is it?

To understand that you need to know a little bit more about what intersex is. In this, individuals of one chromosomal karotype –XX or XY — may be born with sex-related structures typical of the other. In a condition called Complete Androgen Insensitivity Syndrome, the individual, as birth, looks like a perfectly normal girl child.

She grows up to appear to be a typical, healthy woman. Then, when she is unable to get pregnant, testing is done and at this point it is discovered that she is actually XY — she has male-typical chromosomes. What has happened is that her body is insensitive to the masculinising effects of testosterone.

There are many intersex conditions, like Partial Androgen Insensitivity, for example. There’s Klinefelter’s Syndrome, where the individual has three sex chromosomes, XXY, ‘mosaic’ (XYXY), congenital adrenal hyperplasia (CAH) and a host of others.

While these intersex conditions are relatively rare, there are still a large number of people with them. They are found all over the world in all populations. In some cases, their genitalia differ greatly from the ‘normative’ and this led, in the past, to many unnecessary surgical interventions to ‘correct’ it. (Thankfully this is much less the case now, but if you have a child you think might be intersex, then please find out as much as you can before agreeing to surgeries.)

Most importantly, perhaps, we can directly observe the effects of these conditions, although in some, like CAIS, this might not be at all obvious till much later in life.

Trapped in the wrong body?

Transgender activists, through the brain sex hypothesis, are suggesting that something similar causes transsexualism, but the site of the heteromorphism is in the brain.

This has been linked to another idea popular with many transgender people, that they are ‘trapped in’ the wrong body. ‘Look,’ they say (if they are male-to-female) ‘I may have a man’s body but I have a woman’s brain.’

They are claiming that transsexualism is caused by a physical condition. Specifically, a brain-restricted form of intersex.

It’s not clear when exactly this claim was first made, but it was certainly current by the 1980s.

Ray Blanchard.
Dr Ray Blanchard

During that decade, a young scientist called Ray Blanchard was working at the Clarke Institute in Toronto, Canada. One of his roles was to provide letters of recommendation, for individuals seeking Genital Reconstruction Surgery (GRS) or a ‘sex change’.*
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At that time, it had been broadly assumed that ‘True’ transsexuals were very like extremely feminine homosexual men. They were certainly physically attractive and very ‘passable’ as women. They tended to present while they were very young, often in their teens. But their most noticeable characteristic was a powerful sexual desire for men.

Blanchard had no difficulty with this group, but he soon realised he was seeing another group too. These were older, very masculine, didn’t look or act like women at all and — critically — were not primarily attracted to men.

However, they were in distress . So Blanchard began to develop an explanation that would allow him, ethically, to give them a letter of recommendation for GRS.

This difference had previously been noted by researchers and in most cases non-homosexual subjects were refused recommendation for GRS, because they were considered to be fetishistic transvestites.

Blanchard’s Typology.

Blanchard is a realist and he was not interested in the kind of pejorative thinking that would deny these people relief form their distress. So he carried our systematic statistical surveys over a period of years.

This allowed him to show that the non-homosexual subjects were actually exhibiting a condition he called ‘autogynephilia’ (AGP). This he described as ‘a man’s propensity to sexually aroused by the thought of himself as a woman’.

In accordance with this, Blanchard called the feminine, exclusively homosexual subjects ‘HomoSexual TransSexual (HSTS) and the masculine, non-homosexual ones AGP. The result was Blanchard’s Typology. Now, both types could legitimately be recommended for surgery, since both had a describable, albeit very different, condition that could be treated in this way.

HSTS transsexual. No facial surgery, just hormones and a boob job. Is anybody seriously going to confuse her with a man?

Unfortunately, rather than being thankful for this intervention, the proponents of the ‘brain sex’ hypothesis were upset. They attacked Blanchard for calling HSTS ‘homosexual’. That was a ridiculous attack; they were males who were attracted to other males. However, they were not gay men, they were transsexuals. Hence, HSTS. (All the HSTS I have explained this to, have agreed that it is accurate; and in any case, this is science, not some touchy-feely Post-modernist woo. There is such a thing as objective reality and taxonomy matters.)

Misreading Blanchard, and misleading the world.

However, in a blatant misreading of Blanchard, they also attacked him

for saying that AGPs were just closet fetishists who put on women’s clothes to masturbate.

In fact,  Blanchard defined three discrete orientations within AGP (bisexual, analloerotic or asexual, and gynephilic, attracted to women.) He also defined several different forms that AGP could take. So it’s a very broad description of an unusually complex condition and the only thing that holds it together is the core notion of being stimulated by the idea of being a woman, while also being attracted to women.

This cuts right across the ‘brain sex’ hypothesis, because this claims that inside their brains, these individuals are actually women.

Neurology

Before we look at neurology, which is clearly the only science that might resolve this, we have to know a few things about the brain. It is the most adaptive organ in the body. Just thinking about something changes it. The brain makes new connections all the time, in response to new thoughts and things learned. It’s changing as we change.
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For example, musicians have measurably different brains from non-musicians. But do their brains make them musicians or does being a musician change their brains?

Correlation is not causation.

What that means is that even if we were able to show that there were differences in brain morphology between transsexuals and other males, we could not just assume — as the ‘brain sex’ hypothesis does — that this makes them transsexual.

Pic: Rod Fleming

Establishing this would be next to impossible. Since changes in brain connections happen hand in hand with behavioural changes, we would have to test a random sample of children. We would have to note whether they had these, then observe them and see if they became transsexual, later. And all the while we would have to control for and exclude any influence that the experimental procedure itself might cause.

Good luck with designing that experiment and getting permission and funding to do it.

Brain sex in individuals.

Blanchard, aware of this, suggested that when it became possible to observe inside the brains of transsexuals, his HSTS type would be found to have brains more like women’s, whereas the AGPs would have men’s brains. Bear that in mind.

The ‘brain sex’ hypothesis got a major boost in 1996 when Zhou et al published results of autopsies on the brains of 6 MtF transsexuals. These were not controlled for HSTS/AGP. Zhou found heteromorphism in the BST corpus, which is a part of the amygdala, below the cerebrum.

‘Lo!’ claimed the ‘brain sex’ apologists, ‘We are vindicated! Transsexuals have women’s brains.’

They then argued that since the amygdala forms early in the embryo, this

A typical Western AGP. ‘Andrea’ James is a ruthless bully who threatens and intimidates people who disagree with her. This is she after countless thousands of dollars’ worth of cosmetic surgery. Would anyone seriously confuse her with a woman?

must be a precursor to transsexualism.

The problems were manifold. Firstly, just because an area of the brain forms early, does not mean it can’t change later.  The BSTc is particularly subject to change under the stimulus of sex hormones. Six subjects is not enough to ‘prove’ anything; it’s an observation, that’s all. The notion of causation was moot and to be fair, Zhou never claimed that the BSTc anomaly ’caused ‘ transsexualism. Others did that, for political reasons.

Unfortunately, these obvious problems didn’t stop the ‘brain sex’ enthusiasts from seizing on Zhou and putting it centre-stage. They even got the legendary Bob Sapolsky, he of the huge beard, to go along with this.

 

MRI Testing.

However, as so often in science, it was to be overturned. In the first decade of the 21st century, MRI testing became cheap enough that it could  be used for projects like this. In 2010 two teams set out to see if they could find out a bit more. Both these teams were experienced in using MRI testing in areas of sexuality, with proven track records.

One team, (Rametti et al) screened out AGPs by only testing exclusively homosexual subjects, and the other (Savic and Arver) screened out HSTS. So Rametti only scanned HSTS and Savic and Arver only scanned AGPs. These were large-scale studies with many controls were built in. They were conducted on individuals who had not yet commenced hormone treatment.

The results were compelling, as was repeated in Guillamon et al’s review paper, published in 2016.

Rametti found that HSTS have brains shifted toward the typical for women on ‘all tested parameters’. Savic and Arver found that AGP brains are no different from men’s.

This suggests two things.

As Guillamon put it, this, along with a welter of neurological evidence from other brains scans and autopsies, suggests two things. The first is that there is evidence for a localised form of brain intersexuality, but only in HSTS and not in AGPs. Secondly, Blanchard and, let us not forget, every serious researcher since Hirschfeld was right: there are two distinct types of Male to Feminine transsexuals — but only one of them has what might be called ‘brain sex’.

So where does that leave the ‘brain sex’ hypothesis? Well, in the first place, none of the testing, or Guillamon’s review, establishes causation. Brains are as likely to have been changed by behaviour as the other way around. As well as this, the principal advocates of the ‘brain sex’ hypothesis are identifiable as AGP. They have no such brain intersexuality, either as a result of their transsexualism or as a stimulus for it. They just have men’s brains.

So, maybe HSTS is caused by a form of brain intersexuality, or maybe being HSTS changes your brain; but if you’re non-homosexual, it doesn’t matter, because you have a standard man’s brain anyway.

The cause of non-homosexual transgender/transsexualism in males has nothing to do with ‘brain sex. It is caused by a  paraphilia — and one that the subjects themselves have been nourishing, sometimes for decades, rewarding it by their own habits and making it stronger.

Oh what a surprise.

The principal arguments of AGPs, which they have ruthlessly pushed, consistently bullying and ‘no-platforming’ anyone who dared challenge them with science, have been shot to tatters.
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There are indeed two types of MtF transsexual; and only one of them has a brain like a woman’s. That type is not the AGP. As far as they are concerned the ‘brain sex’ hypothesis — and they are the ones who have been pushing it — is dead in the water.

*The term ‘sex change’ is misleading. The surgery is purely cosmetic. The subject’s sex does not change in anyway. Strictly, the genitalia are reconstructed to look like those of a person of the opposite sex — sometimes very convincingly. Hence Genital Reconstruction Surgery or  GRS.

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16 Replies to “Brain Sex?”

  1. Hi Ray

    I like reading your articles on transsexual and transgender, some of your points I agree with and some I do not agree with. That does not mean to say that either of us are right or wrong.

    However, your latest writing “Brain Sex” has me in a quandary and the question I now ask myself is “Am I AGP or HSTS?”.

    Kind regards

    Emily Wells

    1. Hi Emily,

      Well the first thing to say is that neither term is pejorative and both models are equally legitimate. If I occasionally come across as tough on AGPs it’s because they have attacked me in the past and I take issue with some of their claims, not with their right to express their identifications as women.

      I don’t have a copy of the full Blanchard instrument and in any case it’s designed to be used by a clinician in interview so it’s not ideal for self testing. However, Prof Bailey did a ‘short form’, so what I’ll do is incorporate that into a new post and then you can read that and test yourself.

      In terms of my own research I have found the model in Asia to be quite different from that in the West. HSTS there tend to report their early emotional feelings as ‘having crushes on men’ whereas the AGPs usually describe ‘feeling that I was a girl’ or ‘feeling different’. AGPs there appear in their early teens similarly to HSTS; the classic Western age divide does not really exist. AGPs of the Western model do occur — middle aged, married, etc etc, but they are pretty rare. I am really hoping to do more intense controlled research in Asia because I think it may help younger Western transgender and transsexual people, for whom the Blanchard is perhaps culturally less helpful.

      Nice to talk to you and thank you for the support.

  2. Rod,
    I am what Anne Lawrence would describe as a divorced voluntarily closeted heterosexual partial autogynephilic MTF transsexual who is determined not to transition. I am a 68-year-old retired general surgeon. I work part time as a medical researcher looking into the metabolic syndrome in severely obese women. I believe that autogynephia may have a physical/neurological basis, and can be exacerbated and treated on occasion with medication, a notion supported by my own experience. I also believe that autogynephilia and transsexualism may be increasing in frequency in part due to an increasing worldwide exposure to hormone disruptors. From the mid-1940s to the mid-1970s, the principal culprits were lead, DDT, and DES (diethylstilbesterol). Today culprits include bisphenyl A found in many plastics, dioxins, upholstery flame retardants, and many commonly used herbicides and pesticides. Even some phytoestrogens like genistein in soy may be playing a role. This does not exclude mutagens, like viruses, other chemicals, and radiation, early childhood trauma to the mother-child relationship as documented by researchers at St. Lukes Hospital in Manhattan, or, as you have proposed, simply trying on female clothes, getting turned on by one’s appearance as a female, and masturbating. I have good reason to believe that my mother took DES while she was pregnant with me. She died with a slow-growing locally invasive uterine stromal cell sarcoma seen almost exclusively in women exposed to DES. I was born in a town downwind from Owens Lake that was subject to dust storms laden with lead, cadmium, and other heavy metals. Being engendered during the time when leaded gasoline was in wide use also suggest that I was exposed to lead as a fetus and infant. DDT was also in common use at the time and in the location where I was engendered and raised as an infant. At age 14 I became curious what it was like to be or dress like a girl. I had no sisters. I was the second of five boys. I dressed in my mother’s clothing and became aroused and masterbated. After doing this intermittently for about a year or two, I decided to stop because I thought this sort of arousal was inappropriate. I was not acquainted with the terms “cross-dresser,” “transvestite,” “transgender,” or “transsexual” at the time. I knew no one who exhibited these behaviors. Even in medical school in San Diego well after the publication of the Kinsey reports in the early 1970s, I heard no mention of transvestism, transgenderism, or transsexualism in a California State mandated sex education class for medical students. I did my internship at St. Vincent’s Hospital and Medical Center located near Greenwich Village on the lower West Side of Manhattan. My wife was studying with the Chair of the piano department at Juilliard. There I got an extensive exposure to a very sexually active gay community. AIDS was not known at the time, but IV drug addiction, hepatitis B, and tuberculosis were endemic in the gay community. A former Chief of Surgery at the hospital was dying of chronic liver failure from hepatitis B that he contracted from a needle stick from a gay male patient. St. Vincents Hospital had the largest published series of surgeries performed for removing foreign bodies from the rectum. If a gay man came to our clinic with a sore throat, the most likely cause was gonorrhea not strep. Cross-dressing was not a frequent public behavior in this gay community. “Looking gay” could be fatal in New York City at the time. We treated hundreds of gunshot wounds and stab wounds in gay men who had been assaulted by sailors cruising 42nd St. I had ceased cross-dressing for many years at the time I married and did not think of myself as a cross-dresser. I did occasionally cross-dress using my wife’s clothes and once or twice cross-dressed with my wife during intercourse, something actually condoned by some sexologists at the time as a way to “spice up” heterosexual sex. The urge to cross-dress did increase somewhat with time but diminished drastically in 1996 when I suffered a mid-brain bleed complicated with acute hydrocephalus that required emergency placement of a ventriculo-peritoneal shunt. I was lucky and survived with only chronic drowsiness due to damage to my arousal (sleep-wake, not sexual) center, ADD and decreased executive function from mild frontal lobe damage, and mild depression and a mild mood disorder due to deep limbic and temporal lobe damage. I closed my practice and have done odd jobs since then including janitorial work, waiting tables, delivering auto parts, and eventually teaching health and math in a junior high, and biology, microbiology, anatomy and physiology, pharmacology, heart and lung pathology, and health care administration and quality assurance to nurses, respiratory therapists, and others in two career colleges. Difficulties in planning and memory problems eventually led to my being encouraged to apply for total disability which I eventually received in 2009 just around the time my wife decided to divorce me. In 2002 my mother died and my wife began distancing herself from me due to my difficulties in keeping work. A month after my mother’s death, I started experiencing incessant urges to cross-dress. I was so alarmed by the unwanted and persistent nature of these urges that I called a local university-based emergency room and asked what to do. They referred me to a local cross-dresser support group. I called their head, a man named Debbie, who convinced me that the suicide I was considering was not a good option and that it would be better to live as a cross-dresser than not live at all. I kept my cross-dressing urges and behavior secret from my wife and family for two years. Then when I found that I could not get an erection with my wife without either wearing a bra or thinking of myself as a woman from the waist up at least, I decided that it was time to get help. I am a religious person and sought help from a counseling center sponsored by my church. It was the opinion of the psychologist I saw that I had OCD and should receive therapy for this. I underwent Exposure Response Therapy, Cognitive Behavioral Therapy, and “Come to your senses,” and Intense Psychotherapy without effect. I then sought medical treatment from a psychiatrist familiar with issues in the transgender community. I tried Buspar, which help minimally and eventually failed, Wellbutrin, Prozac, and other meds without effect. On a hunch, I tried St. John’s Wort for mild depression. The urges to cross-dressed ceased entirely but it exacerbated my chronic drowsiness. I was placed on Vyvanse, an amphetamine-like drug used for ADD in children and Luvox, an SSRI inhibitor that is useful in OCD. For a year and a half, I was completely free of cross-dressing urges except for a brief time when I ran out of Vyvanse and had to substitute it for cost reasons with a long-acting form of Ritalin called Methylin. For the two weeks I was on that medication, I had strong incessant urges to transition into a female. I didn’t cross-dress, but the mental effort to not give into the urges was exhausting. Unfortunately, the St. John’s Wort and Vyvanse proved toxic. I developed the serotonin syndrome and had a lacunar stroke characterized by slurred speech and left-hand clumsiness, which fortunately resolved after a couple of months. I was told I could never take central nervous system stimulants like Vyvanse because they could lead to another stroke nor could I take antidepressants like St. John’s Wort or SSRIs like Luvox because they could induce seizures. I was left without treatment of any kind for my chronic drowsiness, executive dysfunction, and depression. The sexual arousal of cross-dressing gave me the dopamine I needed to resume my life. It eliminated my depression. I felt happy while cross-dressing. And it improved my focus and executive function enough that I could work as a researcher part time with my brother in Cardiovascular Genetics. These developments, however, strengthened my wife’s determination to end our relationship after 35 years. We had four children. They all had some degree of learning difficulty despite being very bright. I spent 6-12 hours a day for 17 years tutoring them. My poverty and their hard work resulted in their getting full ride scholar ships to Amherst College, Yale, MIT, and Harvard. On serves as a lay bishop in my church. None like my cross-dressing but all accept my need to cross-dress. For a while, I cross-dressed in public. Local sentiments against my doing so, however, led to my decision to cross-dress only at home. I still see my wife and children frequently but I do not cross-dress in their presence. A few members of my church know about my circumstances and know that I cross-dress at home. I fully accepted now by my local religious community. You can see that my case is complicated and not typical, but touches on some of your views. I don’t think I am a pathological narcissist, but I do appreciate those who make an effort to at least not persecute those with this pesky, annoying, and repugnant need to cross-dress. In order to survive, I have to engage in positive self-talk. Like Eddy Izzard, I consider myself 100% male and 50% female, or better, on a plane with an X-axis for femaleness and a Y-axis for maleness that extend from 0 to 1, my coordinates are (0.5, 1). I have a preference to present myself as female despite a completely male gender self-identity, and I am turned on by that female presentation. I like my penis but am not attracted to it and have no desire to rid myself of that organ, but I like breasts, use homemade prostheses, and take a low dose of estradiol, which actually increases my libido. Autogynephilic MTF due have many obnoxious characteristics, but I think, like Anne Lawrence, at least a few are not the monsters you aptly describe. I don’t think that the cause of autogynephilia is just a self-reinforcing fetish. I believe it has multiple causes and contributing factors and many consequences, many bad and highly dysfunctional but some good and enabling. If SRS prevents suicide in some of these individuals, if it helps enable some to live with themselves better and function better as useful members of society, despite the hurt and dysfunction it often creates, then I think transition and acceptance are better than vehement, unnuanced condemnation and vitriol toward one’s self or others. However one gets this condition, I believe its obnoxious aspects need to be refined and its healing and helpful aspects need to be used and accepted.–and the condition does have some aspects like this, in my opinion. I personally find it helpful to think of myself as having acquired one way or another an intersex-like condition. I have female aspects to what I am even though I am a male. Even though I would love to shed those aspects, at the present time, I don’t know how and not suffer debilitating consequences. In the meantime, I try to rejoice in the good that cross-dressing does for me while recognizing its repugnance to my wife and family and many in society. Voluntary closeting seems to minimize the damaging effects of my condition. In the meantime, I continually seek non-toxic sources of central nervous system (CNS) dopamine that will substitute for the effects I get from cross-dressing. Amphetamines seemed to help but are off limits. Sources of CNS-norepinephrine like methylphenidate seemed to be decidedly unhelpful. St. John’s Wort’s main active ingredient inhibits the conversion of dopamine to norepinephrine and was extremely helpful, but it too is off limits for me. L-Dopa is a precursor to dopamine used in Parkinson, but has many problematic side-effects, is short acting, and must be supplemented with breakdown inhibitors. An option I have yet to try is Mucuna puriens, a rich source of dopamine that also stimulates pituitary LH which improves testicular function. I am both testosterone and estrogen deficient, a consequence, I believe, of DES and other toxic exposures. Keep in mind that a substance use or obsessive behaviors that seem self-reinforcing or addicting may not be if they are being used to treat some underlying condition or deficiency. Heavy narcotic use and even tolerance may not be signs of addiction in a person with real, severe chronic pain. Antidepressant use may not be a sign of character weakness or addiction in persons with real, persistent, and otherwise untreatable CNS serotonin, dopamine, and/or norepinephrine deficiency states. Likewise cross-dressing, even autogynephilic cross-dressing and occasionally HRT and SRS, may at times be due to physical and otherwise untreatable conditions that do require treatment, ideally among professionals that do not let obnoxious aspects of their condition dissuade them from doing what is best for them as individuals.

  3. Rod,
    I am what Anne Lawrence would describe as a divorced voluntarily closeted heterosexual partial autogynephilic MTF transsexual who is determined not to transition. I am a 68-year-old retired general surgeon. I work part time as a medical researcher looking into the metabolic syndrome in severely obese women. I believe that autogynephilia may have a physical/neurological basis, and can be exacerbated and treated on occasion with medication, a notion supported by my own experience. I also believe that autogynephilia and transsexualism may be increasing in frequency in part due to an increasing worldwide exposure to hormone disruptors. From the mid-1940s to the mid-1970s, the principal culprits were lead, DDT, and DES (diethylstilbesterol). Today culprits include bisphenyl A found in many plastics, dioxins, upholstery flame retardants, and many commonly used herbicides and pesticides. Even some phytoestrogens like genistein in soy may be playing a role. This does not exclude mutagens, like viruses, other chemicals, and radiation, early childhood trauma to the mother-child relationship as documented by researchers at St. Lukes Hospital in Manhattan, or, as you have proposed, simply trying on female clothes, getting turned on by one’s appearance as a female, and masturbating. I have good reason to believe that my mother took DES while she was pregnant with me. She died with a slow-growing locally invasive uterine stromal cell sarcoma seen almost exclusively in women exposed to DES. I was born in a town downwind from Owens Lake that was subject to dust storms laden with lead, cadmium, and other heavy metals. Being engendered during the time when leaded gasoline was in wide use also suggest that I was exposed to lead as a fetus and infant. DDT was also in common use at the time and in the location where I was engendered and raised as an infant. At age 14 I became curious what it was like to be or dress like a girl. I had no sisters. I was the second of five boys. I dressed in my mother’s clothing and became aroused and masterbated. After doing this intermittently for about a year or two, I decided to stop because I thought this sort of arousal was inappropriate. I was not acquainted with the terms “cross-dresser,” “transvestite,” “transgender,” or “transsexual” at the time. I knew no one who exhibited these behaviors. Even in medical school in San Diego well after the publication of the Kinsey reports in the early 1970s, I heard no mention of transvestism, transgenderism, or transsexualism in a California State mandated sex education class for medical students. I did my internship at St. Vincent’s Hospital and Medical Center located near Greenwich Village on the lower West Side of Manhattan. My wife was studying with the Chair of the piano department at Juilliard. There I got an extensive exposure to a very sexually active gay community. AIDS was not known at the time, but IV drug addiction, hepatitis B, and tuberculosis were endemic in the gay community. A former Chief of Surgery at the hospital was dying of chronic liver failure from hepatitis B that he contracted from a needle stick from a gay male patient. St. Vincents Hospital had the largest published series of surgeries performed for removing foreign bodies from the rectum. If a gay man came to our clinic with a sore throat, the most likely cause was gonorrhea not strep. Cross-dressing was not a frequent public behavior in this gay community. “Looking gay” could be fatal in New York City at the time. We treated hundreds of gunshot wounds and stab wounds in gay men who had been assaulted by sailors cruising 42nd St. I had ceased cross-dressing for many years at the time I married and did not think of myself as a cross-dresser. I did occasionally cross-dress using my wife’s clothes and once or twice cross-dressed with my wife during intercourse, something actually condoned by some sexologists at the time as a way to “spice up” heterosexual sex. The urge to cross-dress did increase somewhat with time but diminished drastically in 1996 when I suffered a mid-brain bleed complicated with acute hydrocephalus that required emergency placement of a ventriculo-peritoneal shunt. I was lucky and survived with only chronic drowsiness due to damage to my arousal (sleep-wake, not sexual) center, ADD and decreased executive function from mild frontal lobe damage, and mild depression and a mild mood disorder due to deep limbic and temporal lobe damage. I closed my practice and have done odd jobs since then including janitorial work, waiting tables, delivering auto parts, and eventually teaching health and math in a junior high, and biology, microbiology, anatomy and physiology, pharmacology, heart and lung pathology, and health care administration and quality assurance to nurses, respiratory therapists, and others in two career colleges. Difficulties in planning and memory problems eventually led to my being encouraged to apply for total disability which I eventually received in 2009 just around the time my wife decided to divorce me. In 2002 my mother died and my wife began distancing herself from me due to my difficulties in keeping work. A month after my mother’s death, I started experiencing incessant urges to cross-dress. I was so alarmed by the unwanted and persistent nature of these urges that I called a local university-based emergency room and asked what to do. They referred me to a local cross-dresser support group. I called their head, a man named Debbie, who convinced me that the suicide I was considering was not a good option and that it would be better to live as a cross-dresser than not live at all. I kept my cross-dressing urges and behavior secret from my wife and family for two years. Then when I found that I could not get an erection with my wife without either wearing a bra or thinking of myself as a woman from the waist up at least, I decided that it was time to get help. I am a religious person and sought help from a counseling center sponsored by my church. It was the opinion of the psychologist I saw that I had OCD and should receive therapy for this. I underwent Exposure Response Therapy, Cognitive Behavioral Therapy, and “Come to your senses,” and Intense Psychotherapy without effect. I then sought medical treatment from a psychiatrist familiar with issues in the transgender community. I tried Buspar, which help minimally and eventually failed, Wellbutrin, Prozac, and other meds without effect. On a hunch, I tried St. John’s Wort for mild depression. The urges to cross-dressed ceased entirely but it exacerbated my chronic drowsiness. I was placed on Vyvanse, an amphetamine-like drug used for ADD in children and Luvox, an SSRI inhibitor that is useful in OCD. For a year and a half, I was completely free of cross-dressing urges except for a brief time when I ran out of Vyvanse and had to substitute it for cost reasons with a long-acting form of Ritalin called Methylin. For the two weeks I was on that medication, I had strong incessant urges to transition into a female. I didn’t cross-dress, but the mental effort to not give into the urges was exhausting. Unfortunately, the St. John’s Wort and Vyvanse proved toxic. I developed the serotonin syndrome and had a lacunar stroke characterized by slurred speech and left-hand clumsiness, which fortunately resolved after a couple of months. I was told I could never take central nervous system stimulants like Vyvanse because they could lead to another stroke nor could I take antidepressants like St. John’s Wort or SSRIs like Luvox because they could induce seizures. I was left without treatment of any kind for my chronic drowsiness, executive dysfunction, and depression. The sexual arousal of cross-dressing gave me the dopamine I needed to resume my life. It eliminated my depression. I felt happy while cross-dressing. And it improved my focus and executive function enough that I could work as a researcher part time with my brother in Cardiovascular Genetics. These developments, however, strengthened my wife’s determination to end our relationship after 35 years. We had four children. They all had some degree of learning difficulty despite being very bright. I spent 6-12 hours a day for 17 years tutoring them. My poverty and their hard work resulted in their getting full ride scholar ships to Amherst College, Yale, MIT, and Harvard. On serves as a lay bishop in my church. None like my cross-dressing but all accept my need to cross-dress. For a while, I cross-dressed in public. Local sentiments against my doing so, however, led to my decision to cross-dress only at home. I still see my wife and children frequently but I do not cross-dress in their presence. A few members of my church know about my circumstances and know that I cross-dress at home. I fully accepted now by my local religious community. You can see that my case is complicated and not typical, but touches on some of your views. I don’t think I am a pathological narcissist, but I do appreciate those who make an effort to at least not persecute those with this pesky, annoying, and repugnant need to cross-dress. In order to survive, I have to engage in positive self-talk. Like Eddy Izzard, I consider myself 100% male and 50% female, or better, on a plane with an X-axis for femaleness and a Y-axis for maleness that extend from 0 to 1, my coordinates are (0.5, 1). I have a preference to present myself as female despite a completely male gender self-identity, and I am turned on by that female presentation. I like my penis but am not attracted to it and have no desire to rid myself of that organ, but I like breasts, use homemade prostheses, and take a low dose of estradiol, which actually increases my libido. Autogynephilic MTF due have many obnoxious characteristics, but I think, like Anne Lawrence, at least a few are not the monsters you aptly describe. I don’t think that the cause of autogynephilia is just a self-reinforcing fetish. I believe it has multiple causes and contributing factors and many consequences, many bad and highly dysfunctional but some good and enabling. If SRS prevents suicide in some of these individuals, if it helps enable some to live with themselves better and function better as useful members of society, despite the hurt and dysfunction it often creates, then I think transition and acceptance are better than vehement, unnuanced condemnation and vitriol toward one’s self or others. However one gets this condition, I believe its obnoxious aspects need to be refined and its healing and helpful aspects need to be used and accepted.–and the condition does have some aspects like this, in my opinion. I personally find it helpful to think of myself as having acquired one way or another an intersex-like condition. I have female aspects to what I am even though I am a male. Even though I would love to shed those aspects, at the present time, I don’t know how and not suffer debilitating consequences. In the meantime, I try to rejoice in the good that cross-dressing does for me while recognizing its repugnance to my wife and family and many in society. Voluntary closeting seems to minimize the damaging effects of my condition. In the meantime, I continually seek non-toxic sources of central nervous system (CNS) dopamine that will substitute for the effects I get from cross-dressing. Amphetamines seemed to help but are off limits. Sources of CNS-norepinephrine like methylphenidate seemed to be decidedly unhelpful. St. John’s Wort’s main active ingredient inhibits the conversion of dopamine to norepinephrine and was extremely helpful, but it too is off limits for me. L-Dopa is a precursor to dopamine used in Parkinson, but has many problematic side-effects, is short acting, and must be supplemented with breakdown inhibitors. An option I have yet to try is Mucuna puriens, a rich source of dopamine that also stimulates pituitary LH which improves testicular function. I am both testosterone and estrogen deficient, a consequence, I believe, of DES and other toxic exposures. Keep in mind that a substance use or obsessive behaviors that seem self-reinforcing or addicting may not be if they are being used to treat some underlying condition or deficiency. Heavy narcotic use and even tolerance may not be signs of addiction in a person with real, severe chronic pain. Antidepressant use may not be a sign of character weakness or addiction in persons with real, persistent, and otherwise untreatable CNS serotonin, dopamine, and/or norepinephrine deficiency states. Likewise cross-dressing, even autogynephilic cross-dressing and occasionally HRT and SRS, may at times be due to physical and otherwise untreatable conditions that do require treatment, ideally among professionals that do not let obnoxious aspects of their condition dissuade them from doing what is best for them as individuals.

    1. James

      Your experience is fascinating and moving; thank you for sharing.

      My issues — if I have them — are not with those who have AGP per se but with the political activities of some of them. I do not think Julia Serano, for example, is helping anyone. I am also concerned that HSTS are routinely erased by these activists and their identity appropriated. There is nothing in common between an AGP and an HSTS, save being born male.

      My own view, and I am not AGP, is that if the onset is early and strong then transition is a practical strategy. (I am a pragmatist.) Such a person, with appropriate HRT and perhaps some cosmetic surgery, can live as a woman and not be singled out for the wrong sort of attention (although in my experience, manuy AGPs just love attention! — the right sort). I think for older men, with respect such as we both are, then I think also this may be appropriate. I have grave reservations about the facile platitudes given about the effects of transition on spouse and family. I certainly receive messages that bring tears to the eyes ‘Where did my husband go?’ ‘Who is this person?’ ‘I want my dad back.’

      I’m a parent myself and my natural instinct is to feel that the children and dependants deserve better. If that means that men with AGP have to be assisted to manage the condition with, as you say, drug therapy, counselling, whatever, then I completely support them and do my best to answer queries from such men honestly and sympathetically.

      I personally think GRS surgery should be an option of last resort — we are seeing some terrible stories from younger people now who have desisted and, obviously, have a wrecked body to deal with and I do not believe it should be readily available. However, it is clearly better to proceed with surgery where a subject is at risk of severe self harm or suicide, than to let them to their devices. I think there is a big difference between really wanting something and having a disorder that, if not treated, might be terminal — and clearly, niceties aside, AGP at that level is a disorder: it has compromised the individual’s ability to live as they did.

      I am fascinated by your suggestion that there are environmental reasons for the apparent uptick in AGP. I have heard this argument before but have not read any supporting studies specific to AGP. But extrapolating from the work done on the more general reduction of testosterone, perhaps you have a case. I am cautious because I spend a lot of time in Asia (As Dr Sam Winter says, it’s odd to study transgender and not go to a place where they are on every street corner) and I would therefore have to ask, ‘Are these environmental factors globally consistent?’ I honestly don’t know but it seems an interesting avenue.

      Another that I have been considering, informed by my long periods in the Philippines particularly, is that the lowering of testosterone might actually have a cultural root. Bear me out. I lived for 6 weeks in a real matriarchy, upcountry in the Phils, earlier this year. The men were invisible. They were all away at work. When they appeared they were positively emasculated. It seems obvious that in a society like this, masculinity is suppressed. Is that having an effect on testosterone or other androgen production? I’m a journalist and I remember when women began coming into newsrooms. The ambience changed. When there were only a few, this made little difference but as they approached 50% male behaviour changed radically. It was not just a question of accepting women as equals, but of men being less masculine. So maybe an effect of the presence of women is reduction of masculinity. This might have an evolutionary cause, to reduce male aggressiveness when in the home space with the women and children.

      So I then ask, as women approach 50% in broader society, do we see a concomitant reduction in masculinity? This is clearly so in educational establishments. And is that actually caused by male bodies secreting less testosterone in the presence of large numbers of women? I’d be interested to know your thoughts on that.

      Again, that you are low in testosterone is interesting. Counter to this might be that some researchers, eg Dr JM Bailey, have reported success in containing AGP symptoms with strong testosterone-blockers.IIRC he referred to Leuraline. Again, I think your viewpoint might be useful.

      Kind Regards

      Rod

      1. Rod,

        Thank you for your kind and thoughtful response.

        I agree that there is, usually, a clear distinction between AGP and HSTS. There is never a time that I feel that I AM a woman, but there are many times that I WANT TO BE a woman and that IMAGINING that I AM a woman makes me feel good–ironically in a very male sort of way.

        I have zero attraction to males, so feeling coy or flirtatious is virtually impossible for me, which is decidedly UNfemale. I am solely attracted to heterosexual women who are completely turned off by female flirtation. I can’t even flirt with myself because I am a man, and flirtation by a man to a man turns me off completely–a decidedly UNfemale characteristic.

        The craziness of wanting to be female and imagining myself as female and totally not being female creates an odd brand of “gender dysphoria” in me–a distaste for being AGP. I have to WORK on liking myself in order to live with myself. The notion that I have an intersex-like condition and that I can feel good about my female presentation preference and be okay with that comforts me at the same time that it distresses me because the condition is so repulsive to my ex-wife and children.

        And how can I be upset that they are repulsed by a female presenting male? How natural is that? I believe it is as natural as having a sexual orientation. What many call homophobia is simply, in my opinion, a manifestation of the inborn feeling that as a heterosexual I find homosexual advances and attraction repulsive–not threatening.

        From an evolutionary standpoint, same sex sex results in no offspring–no continuation, the death of a branch of the evolutionary tree, the damming up of the flow of life, literally a form of DAMnation–which can be bypassed to some degree by adoption, the nurturing of the abandoned offspring of others. The development of a species-preserving repulsion for behaviors that diminish the fecundity of the species seems something that would have a high likelihood of occurrence.

        From a religious standpoint, I believe that, spiritually, most HSTSs are or can be spiritually female and can rise in the resurrection as females. I believe in the eternal nature of the family, that marital relationships can be eternal, and that a continuation of seed is possible in the eternities between purified righteous spiritual gender opposites.

        At the same time, I think there is room for the notion that some HSTSs are or can be regarded as spiritually male with mortal minds that have been poisoned by toxins to think of themselves as females and can rise in the resurrection as males. This line of thinking is not uncommon among Mormon HSTSs whose early, consistent, and persistent self-perceived gender identity has been female but have been coerced by society and family to suppress that identity. These HSTSs have gone on to develop physically as males, assumed male roles, acquired a heterosexual sexual orientation, married women whom they deeply love and cherish, fathered children, and want to be regarded as the FATHER of those children, which biologically they always will be, and the SPOUSE of their spouse. Many such HSTSs recognize that full transition and the aligning of their physical/mortal body with their self-perceived gender, however, makes them repugnant to those they love most deeply.

        The children of some HSTS fathers have been known to express the feeling “I hope Daddy can become the girl he wants to be, but I hope he will always be my Daddy.” The spouses, however, usually express the notion that “My husband is dead,” and how am I going to relate to this WOMAN who says she is the same person as the husband I was attracted to and married?”

        I have come to know some HSTSs in this circumstance. Some undergo partial transition with hormones, reluctantly forgo SRS, and dress androgynously most of the time–fully femininely some of the time and completely masculinely on special occasions such as at the marriage of a daughter. For them, imagining themselves as a male with a poisoned brain that has become completely feminized is helpful both to themselves and their spouses and family.

        For other HSTSs, this tactic is impossible. Divorce and remarriage as a female with an adopted family and a polite friendship with their former spouse are all they can muster. But even they usually want to be referred to as Daddy by their biological children.

        Being either AGP or HSTS, in my opinion, is a terrible burden that merits compassionate and reasonable accommodation and support. The failure to recognize these needs by family, health workers, community, and lawmakers can elicit “narcissistic rage” or a vehement desire to secure and preserve one’s inalienable rights of life, liberty, and the pursuit of happiness–a pursuit that unfortunately is often coupled with a good deal of obnoxious, inaccurate, and dysfunctional baggage as both of us have seen.

        I think that many HSTS who seem to acquire a love for women, marry, and have families often wish that they had been fully accepted as female as children, grown up as boy-crazy girls, undergone complete transition hormonally and physically with SRS, married men, and adopted children. They wish they had been mothers, not fathers. They cringe, however, at this thought because their wives and their children and some male advantages are deeply cherished by them. Imagining a life without their biological children is difficult for them to imagine. Their experience and feelings make them reluctant advocates for their own tortured but deeply fulfilling life experience.

        The incredibly dysfunctional complications and severe dysphoria experienced by both AGPs and HSTSs and the rarity of both conditions lead me to believe that these conditions are not the result of normal random variation in the human species, but the result of non-random causal/toxic factors.

        In the quality assurance field, it is critical to make this distinction. In the 1940s Bell Laboratories pioneered statistical methods to help make this distinction. Variation that fall outside two or three standard deviations from the mean are more likely to be due to “special causes” rather than “random causes”. So if a condition is present in only 1% or less of the population it is more like to have a “special cause” rather than a random cause. If a special cause is common and highly toxic, higher percentages can be seen. Influenza, for example, is a “special cause” of flu-symptoms that can become ubiquitous in an epidemic.

        Attempting to correct random causes leads to process instability, increased product variability, and a decrease in quality output. Finding and correcting special causes, in contrast, leads to decreased variability, and improvements in quality.

        The same principles, I think, apply to dealing with the transgender phenomenon. A vigorous campaign against hormone disruptors and toward ameliorating early maternal-child trauma along with enlightened tolerance and compassionate and reasonable accommodation will be far more effective in diminishing this burden on mankind than misguided psychotherapy, repressive laws, persecution, and ostracism.

        I think that the incidence of LGBT behavior in history can be correlated to a large degree to hormone disruptor exposure, particularly to lead exposure.

        In ancient Athens, where gay/lesbian behavior was fairly common and well accepted, fresh water was piped into the homes of the wealthy in lead pipes. The same was true in ancient Rome and in Medieval Italy, France, and England. In Germany and Scandinavia during the same periods, water was transported in wooden pipes. LGBT behavior was not as common in these areas throughout history but was common in the royal courts and families of Italy, France, and England.

        Even today, lead pipes are still in many structures in these areas that were built before lead was seen as a toxic substance. Their presence correlates to areas in the world where LGBT behavior is common.

        Lead is commonly found near silver and mercury deposits in the earth. Cultures that mined silver for money and jewelry may have increased incidences of LGBT behavior. “Two spirited” individuals are more common in tribes like the Navajo and Pueblos that created silver jewelry for centuries than, say, the Algonquin tribes that had little exposure to metals of any kind.

        Even in areas were hormone disruptors are common, the distribution of persons with LGBT behaviors is not uniform. If one looks at distribution maps of where individuals have undergone SRS, they exist in higher percentages in some countries than others, in some cities than others and in some rural areas than others. DDT, for example, was widely used in Thailand until 1995 for the prevention of malaria and has a higher per capita concentration of LGBT persons than many other countries.

        The commonality of transsexuality in Asia may be due to different causes. I think that genistein and soy may play a role here. I have a sleep apnea condition that gets worse when I use testosterone or androgenic herbs like fenugreek. I also found that soy products made my sleep apnea worse in high doses but better in very low doses. I was able to block this effect with finasteride and later with progesterone, which are potent inhibitors of the enzyme that converts testosterone to 5-hydroxy testosterone. Hormone disruptors like genistein, which is usually thought of as a phytoestrogen can also work as a phyto-androgen at high doses. Many hormone disruptors can work as both testosterone agonists and antagonists causing MTF changes in males and, less commonly, FTM changes in females.

        Soybean usage increased dramatically in the late 1940s after World War II when soybeans imports from China began in earnest as feed for livestock. Soybean production in the US increased slowly until the 1990s when herbicide and insect resistant strains were developed. Currently, soy consumption is increasing rapidly worldwide.

        Soy consumption may decrease breast cancer and improve heart disease but it may also be increasing transsexuality in my opinion. If not this, then the herbicides used to suppress the growth of weeds around soybeans may be responsible.

        I don’t think that the increased presence of women in the workforce and in schools is responsible for a decrease in masculine behavior but is responsible for an increase in the creative and civilized behavior of men in the workforce and in schools.

        There are some good studies that show that without exposure to attractive women men’s creativity and productivity is hampered but is increased in the presence of women and correlates with an almost instantaneous surge in testosterone and dopamine levels that can be measured in saliva and seen on functional MRI scans of the brain.

        Similarly, there are studies on women that show that exposure to men increases their tendency to be helpful and kind to others. There are some good demonstrations of these phenomena on YouTube.

        I think that a surge in testosterone and dopamine could be demonstrated in AGPs when they crossdress. I think that the attempt to surround one’s self with a feminine presence results in distinctly male surges in dopamine and testosterone that improve focus, mood, and creativity in AGPs. In non-AGP heterosexual males, cross-dressing generally results in nausea and disgust as does the viewing of combinations of male and female appearance.

        When I first saw a she-male, I reacted with extreme revulsion. Only later did I recognize that a shemale appearance was exactly what I was reproducing when I crossdressed. I still find viewing the donning of female clothing and makeup by a hairy, muscular male revolting but my own en femme appearance, once complete, pleasant and even attractive–an unnatural manifestation, in my opinion, of in utero toxic exposure to DES, DDT, and lead exacerbated by my mother’s death and my wife’s emotional abandonment due to my decreased financial worth after my mid-brain bleed.

        I think decreased testosterone levels among males in America and around the world are more likely due to in utero and early childhood hormone disruptor exposure than to the presence of women in traditionally male environments. Surges in testosterone are observed with such exposure. In marriage, I think most men become more creative, more civil, healthier, stronger, and more useful to society in the continual presence of females than when they live as bachelors–or divorcees.

        The use of testosterone blockers to diminish urges to cross-dress is interesting. I have no experience with it. My diminished testosterone levels haven’t seemed to diminish my cross-dressing urges nor have testosterone supplements increased or diminished my urges.

        Things that increase CNS norepinephrine seem to make my urges worse, and things that increase CNS dopamine levels diminish my urges. NuVigil diminished my cross-dressing urges substantially. Unfortunately, I rapidly developed a tolerance to it so that even high doses did nothing to improve my drowsiness or decrease my cross-dressing urges.

        I hope all this proves helpful to you and others.

        Sincerely,
        Jim

        1. I think you have a deep misunderstanding of what an HSTS is and are confusing pseudobisexual AGP’s with them. No HSTS is gonna start a family and transition after 30. It doesn’t happen. Virtually all HSTS’s transition before 28 full time, it pretty much disqualifies you if you do so later. On the flip side there are AGP’s that transition young so it doesn’t mean nessescarily that you are an HSTS if you do so. The behavior you are describing is not at all what I or any genuine HSTS relates too and in fact what you are saying would disqualify somebody from being an HSTS. And for us the thought of being with a woman is quite disturbing, there is absolutley no attraction there.

          I don’t even think your upbringing matters, an HSTS will leave their upbringing and parents behind the drive to be with a man and live as a woman is stronger than your attachment to your family. As we can see though it is far easier for an AGP to live their whole lives as a man.

          1. Hi Michelle

            James is not trans but a man struggling with AGP. I think you’re right, however, that he doesn’t really understand HSTS. Your observations are correct and frankly it’s a rare HSTS who transitions as late as 28 and any who do, will have been struggling to live as gay men up till that point.

            As an aside, if there is anything positive to come out of the current transtrender lunacy, it is that HSTS might feel less coerced by gay men and, sadly, some professionals, to become gay men and be miserable all their lives. The simple fact is that nearly all feminine gay men have or have had gender dysphoria and a significant proportion would be happier as girls. The south-east Asian experience, where there is far less such pressure, makes this crystal clear.

            Unfortunately the gay ‘movement’ is ruthless and always has been. It is based on lifestyle, not on orientation; otherwise they would all just accept their femininity. And to make matters worse, many gay men are sexual predators who are constantly seeking new ‘meat’. They are not interested in pursuing sex with women or transwomen, they just want submissive boys. Somebody needs to pull the covers off gay politics and expose the whole thing for the manipulative destroyer of lives that it is.

            It is unquestionably easier for AGPs to live as men. For a start, they can have somewhat normative relations with women. Again, in SE Asia, young transition for AGPs is the norm BUT significant numbers go back to living as men when they ‘lose their looks’ and often, then, establish relationships with women or sometimes, HSTS. (Less often they will take gay boys as partners.)

            I certainly know AGPs who began hormones at 14, while still at school. As soon as they left and could, they fully transitioned. 10 years later they are often beautiful — but a full head, usually, taller than any HSTS. But even there they don’t really seem to ‘get’ HSTS. Many of them definitely see HSTS as sexual targets and can be miffed when they are rebuffed.

            I’ve seen it many times. For example, if I arrive somewhere with an HSTS GF then an AGP will begin by hitting on me; when that doesn’t work, she turns her focus onto the girl with me– who, being HSTS, has zero interest. Fascinating.

            HSTS in Asia seem quite used to this, I have to say. From the AGP point of view, it’s clear that they don’t understand that HSTS are not attracted to femininity. Goes right over their heads. They just do not understand the quantum difference between AGP and HSTS; they are attracted to femininity and, in a typically masculine way, assume that so must all the other trans be. (By the way, without paying you will never get an HSTS there into a threesome with another girl of any kind, but threesomes with two guys? They dream of it. On the other hand, AGPs need NO second asking. )

  4. “Savic and Arver found that AGP brains are no different from men’s.”

    Unfortunately, this is where your analysis falls apart to some degree. Savic and Arver actually found that the brains of “nonhomosexual” MtFs had brain structures that were different from both men and women, in areas where men and women did not normally differ from each other.
    This suggests structures are at right-angles to both men and women.

    From Guillamon’s review:

    “Nonhomosexual MtFs have the same total intracranial volume as control males. They also show a larger gray matter volume in cortical regions in which the male and female controls did not differ in the study. These regions were the right parieto-temporal junction, the right inferior frontal, and the insular cortices. It was concluded that their data did not support the notion that the nonhomosexual MtF brain was feminized.

    With respect to subcortical structures, it was reported that untreated nonhomosexual MtFs had a relatively smaller putamen and thalamus than male and female controls although these two latter groups did not show sex differences in the two structures (Savic & Arver, 2011).

    In summary, the cortex of nonhomosexual MtFs presents morphological peculiarities in regions in which male and female controls do not differ.”

    “Savic and Arver (2011) found that nonhomosexual MtFs have larger gray matter volume than male and female controls in the right parieto-temporal junction and the right inferior frontal and the insular cortices. As shown above, these regions are related to body self perception. The authors suggested that the experience of dissociation of the self from the body may be a result of failure to integrate complex somatosensory and memory processes in these regions. Future research should explore possible differences in the structural connectivity of these regions.”

    Dissociation is a widespread phenomenon among the second type of transsexual:
    http://genderanalysis.net/2017/06/depersonalization-in-gender-dysphoria-widespread-and-widely-unrecognized/

    1. From Guillamon 2016: ‘Untreated MtFs and FtMs who have an early onset of their gender dysphoria and are sexually oriented to persons of their natal sex (ie, homosexual transsexuals) show a distinctive brain morphology, reflecting a brain phenotype.’

      And:

      ‘The review of the available data seems to support two existing hypotheses: (1) a brain-restricted intersexuality in homosexual MtFs and FtMs and (2) Blanchard’s insight on the existence of two brain phenotypes that differentiate “homosexual” and “nonhomosexual” MtFs.’

      Further to which, to paraphrase Blanchard, Homosexual transsexuals have brains more like women while non-homosexual (ie autogynephilic) do not. Elsewhere Guillamon writes:

      ‘The study of mixed samples implicitly assumes that transsexuals are a homogeneous group. This is far from the truth with respect to the onset of GD and sexual orientation. … These observations signify that control groups in studies of the transsexual brain must be homogeneous in regards to sexual orientation.’

      In other words, research into transsexual neurology which is not differentiated on the basis of orientation, is useless and again confirming that there are two types.

      Within the context of an article written to inform people with no prior knowledge of the subject or the science, it is sufficient to use broad terms, which is what I was doing. The ‘brain sex’ or ‘female essence’ theory has no support as regards AGPs and is a long way from having causation confirmed even in HSTS. Here is a link to an article written in much more academic terms (not my job.) https://sillyolme.wordpress.com/2016/07/02/brainstorm/

      The important thing to take from this is that HSTS and AGPs are not the same and that the claim to have a distinctive brain phenotype similar to women is true for HSTS but not for AGPs. There are many possible reasons for this and I have been careful not to ascribe causation, for which far more study would be required.

      However, in the context of social interaction with the two types, HSTS tend to be far more agreeable, non-confrontational, tend to compromise and generally behave just like women whereas AGPs are often positively disagreeable, confrontational, unwilling to compromise and behave really quite astonishingly like men. One wonders why. The brain data do suggest a possible reason.

      1. Would love to see your thoughts sometime on this newer study, published in May of this year.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434195/

        It studied equal numbers of “homosexual” and “nonhomosexual” MtFs against control groups of men and women. It seems to suggest that both types of pre-HRT trans women’s brains have a resting-state network unlike cis men or women, and that HRT shifts it to be more like that of cis women, regardless of orientation.

        “…this indicates a rather profound brain reorganization taking place during and after hormonal treatment in the GD individuals. Future research needs to clarify whether such changes in the brain connectivity correlate with behavioral and psychological changes often reported by GD individuals following hormonal treatment.”

        “What we can conclude already from the present study is that the hormonal treatment exerts a rather profound and strong effect on rs‐FC, indeed shifting patterns more toward the aspired gender. “

        1. Hi thank you. It’s a bit late here but I will definitely read that and reply in the morning. Just as a first thought, it wouldn’t surprise me if hormone usage caused measurable neurological changes in the brain, it certainly does elsewhere.

          I think it’s pretty much established that there is a significant set of physiological parameters in which HSTS are more like each other and differ from the average for males of their ethnicity — height, build, bone mass and strong tendency to neoteny being just a few. Given that alongside these we see a strongly GNC sexual orientation and what appears to be raised libido, I can’t think but that there is something innate going on. Regarding AGPs (nonhomosexual) Mike Bailey thinks this is innate, a separate orientation, he suggests, but I think this is less convincingly demonstrated. I’m not closed to the idea, however (and I have learned that one disagrees with Mike only when one’s ducks are lined up!) AGP is clearly a far more complex condition than HSTS, but it it seems logical that it should have one cause.

          Anyway I shall read the paper tomorrow (sorry I have been revising a book all day and my head is spinning right now!) and get back to you

          Best R

  5. When will there be a way to transform my female HSTS brain into a males brain since I was born male? I’m tired of feeling like a wimpy little girl all the time when I am over 6 fr and close to 200 pounds. On top of that I have other mental problems that can’t seem to get resolved either and the only way to not feel depressed is when I am around men. There is such a strong attraction to them that I cannot think or do anything else except focus on that. When I took adderall I felt more normal and actually like a guy as well as somewhat of an attraction to women. It had me convinced for years that being gay and feeling feminine was just all in my head and ocd until I stopped taking adderall and now it’s so powerful that I only think about that all day. Why can’t we masculinize what ever part of the brain has caused this later in life? So frustrating to feel like a boy and guy most of my life until I get off of adderall and discover that my whole life I was wired basically totally female and that I’d never be able to change.

    1. First question? Why are you so sure you are HSTS? Your physical profile makes you an outlier for this group. I’m not trying to offend you, but that’s the first thing to establish. The second is that Adderall is highly addictive; it’s basically amphetamine and is a euphoric stimulant. It’s no surprise you felt bad after coming off it (which does NOT mean you should go back.) These lifestyle drugs are far too widely prescribed when other therapies to address the reason for prescription are almost always available, but involve a lot more work.

      There is a possibility that coming off Adderall has triggered an upsurge in latent autogynephilia. Your body is craving the dopamine rush that Adderall gave you and your brain might just be substituting the very similar rush you get from satisfying autogynephilia.

      You are not homosexual in the strict definition, which is, ‘exclusively attracted to same sex since childhood’. (Homosexuals with your physical characteristics are rare anyway) and you make no mention of living as a woman etc, which I’d expect an HSTS to. It’s not possible to make a diagnosis on the basis of the information you’ve given me, but your self-diagnosis of HSTS sounds dodgy.

      I should suggest a course of psycho-analysis to establish the root cause of your symptoms. You state you have ‘other mental problems’ and, at the moment, there is something of a rush to conflate any mental disorder with transsexualism. This is wrong and it helps nobody. Autogynephilia is a disorder that often occurs in conjunction with other ones, something that is rarely the case in HSTS (HSTS, if they have mental issues, tend to have them as a result of social intolerance of the fact that they are actually HSTS; homosexuality is not a disorder.)

      Remember that autogynephilic males are not truly transsexual; they are instead feeding their dopamine receptors with the rush they get from playing the role of a woman. This becomes obsessive and that is why we see middle-aged men ruining their lives to ‘live their reality’. Except it’s not reality at all, it’s a destructive and addictive fantasy.

      Even for HSTS, the ‘wired basically female’ argument is moot. They are naturally highly feminised, but that’s not the same. Autogynephiles do not even have this, their brains, while modified through neuroplasticity, are male in every way. Their understanding of femininity is essentially a fantasised construct.

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