Not A Choice? What Causes it?
This is a question still being explored by the scientific community and over past decades various theories have been proposed, however, current information is pointing toward genetics and physiology.
Throughout history the transgendered person has existed and it wasn’t until the major religions began to exert their “understanding” on the non-believers that people began to shun us.
It is basic human nature to shun what is not understood, and this often turns to fear of the unknown. There was no definable cause for the transgender person so this fear was natural even though misplaced.
There has not been a great deal of research into transgender condition because as I pointed out earlier it is not a common nor perceived to be of any significance to the scientific community. Most of the research has been sociological rather than medical including psychological. Often the research conducted has been done by people with vested interests in transgender and as such their conclusions have often been questioned by the scientific community or outright dismissed. This is changing.
Dating back to the late 1950’s and 60’s the train of thought was that cause was psychological, that it was a choice and as such the “cure” was through psychiatric means that today would be abusive. Forced behaviour modification was usually the treatment including electro shock therapy and drugged detention.
Dr. Harry Benjamin
Dr. Harry Benjamin who is generally regarded as the leader in transsexual research began his studies in earnest in the late 1940’s at the request of Dr. Alfred Kinsey who referred a child transsexual to Dr. Benjamin. In contrast to the psychiatric community and its approach, Dr. Benjamin took a physiological approach. He began by treating transsexuals with hormones; Estrogen (Premarin®) to be exact, and reported a “calming effect” on his patients.
In 1954 he coined the term transsexualism (this obscure claim is often disputed and really is moot.) then embarked on a treatment path that included carefully selected members of the medical community. By and large, the psychiatric community of the day considered Benjamin’s approaches as contraindicated despite his successes in “treatment”
During this time the proposed causality was considered to be chromosomal, however once Benjamin’s treatments with hormones became more widely known, the thinking shifted toward hormonal release during pregnancy. It was thought that if hormonal release was not timed correctly the X-X chromosome of the female embryo would deviate from the X-X or X-Y (to create the male), would actually add an extra chromosome. This thinking lasted well into the late 1990’s until Genetic Researchers at UCLA discovered a genetic link.
J.-N. Zhou et al
Perhaps of all studies into transgender, one of the most important deals with neurology and was conducted by Dr. J.-N. Zhou of the Netherlands Institute for Brain Research and titled “A Sex Difference In The Human Brain And Its Relation To Transsexuality” 1995. http://faculty.bennington.edu/~sherman/sex/TRANSGENDER.pdf
This research was conducted over a period of eleven years. In order to conduct the research, the subjects gave consent for brain dissection post mortem. Each of the subjects provided in-depth case histories in order to eliminate the variables from the focus of the study.
The importance of this research is indisputable for a couple of reasons primary being why hormone replacement therapy works for the transsexual’s mental issues, and secondly because it does provide strong clues for physiological cause.
First, the study discovered that the male and female brains differ in the size of the area for sexual functioning. In the normal male brain this area (central subdivision of the bed nucleus of the stria terminalis (BSTc), a brain area that is essential for sexual behaviour) is approximately 62% larger than the normal female. However, the male to female transsexual brain had a much smaller BSTc area for sexual function such as would normally be found in a normal natal female. This discovery was significant because any influence of drug therapies or physical alteration (Orchidectomy) were ruled out as having any effect on the BSTc portion of the brain. The study then concluded that the only possible cause could be that this anomaly could only have occurred during brain development in-utero.
This information only adds credence to the theory of the hormone wash during the first trimester of pregnancy and when taken into consideration with the UCLA Genetics study, presents a very strong argument for physiological cause although still, far from conclusive.
More in-depth study is required to unravel the reasons for Transsexuality. There is little impetus in the scientific community to pursue this research and so it is “underfunded”.
The information that follows is a news article outlining the findings of UCLA genetics researchers.
While this information is a very strong link to cause, it is far from absolute and more research is required in order to develop the theory. Despite this need for additional research, it would appear that to date, the genetic link would provide the most substantial clue to cause of transgenderism. Combined with the hormonal cause there is no doubt that the typical male and female brains are “wired” differently and the transgendered brain is somewhere in the middle.
Further research by Australian researchers have conclusively confirmed the UCLA findings and expanded on it by establishing that the M2F brain is nearly identical to the natal female brain. (2007)
Dr. Eric Vilain
This is exerpted from an interview with this world renowned genetic researcher from UCLA
"But you can look at [it]
with a different perspective which is the makeup of the gonads, whether they're
testes or ovaries and that's a completely different perspective on it. We know
there are individuals who have ovaries yet they can be XY and conversely you can
have testes and be XX. So they're two independent primaries.
* * * * *
The current thinking within the medical community is leaning more towards physiological cause for transsexuality as more research is conducted. While all of this is fascinating, it does nothing in the way of relieving the stresses experienced with Gender Dysphoria. This falls squarely on the shoulders of the trans person who must necessarily learn to cope through skills acquired in therapy. Even with the introduction of hormone therapy, some dysphoria will continue to exist although it will be much less intense.
The negative side to this is that there is a small but very influential body within the psych community who cling to disproven theories and protocols of treatment for transsexualism. Their approaches do not do any great favours for the sufferer. Despite the knowledge that their protocols are outdated and in fact harmful, their influential positions within the community remain and so the psych community is split as a result. However, the World Professional Association for Transgender Health do not ascribe to these theories of transgender being rooted in psychology and they reject such notions outright.
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This site was last updated 12/29/11