April 7, 2011

Do male to female transsexuals react differently to erotic material than cisgendered men?

There are a lot of studies out there that try to determine to what extent transsexuals differ from non-transsexual men and women ( also called cismen and ciswomen).

Today I will present a brain scan study that shows that male to female transsexuals react like when watching erotic material.

A methodological disclaimer

Brains are dissected and brains are scanned, but the results are hard to interpret -- for many reasons:

The scientists may define their experiments and interpret their findings based on a traditional view of gender.

In other words: They may find what they were looking for, even if it is not there. It was not that long ago scientists “proved” that women and black men were less intelligent than white men. They forgot to take the cultural and educational background into consideration when measuring what they called “intelligence”.

The findings are hard to interpret. What a scientist find statistically significant cannot be interpreted to mean that all cismen or all ciswomen are like this or that. The idea of normalcy means that the diversity is not communicated clearly. A statistically significant result that tells us that the brains of female to male transmen are more like the ones of men, does not mean that all FTM brains are like this. Nor does it mean that all “normal” men have “male” brains.

The brain is a flexible organ that changes constantly. Hormones and other substances change the brain. Stress can change the brain. Even learning will change the brain, which means that differences in brain structures or brain activity may be caused by upbringing or cultural conditioning.

Still, I appreciate the fact that researchers -- in spite of these obstacles -- try their best to make sense of it all.

Brain scan study

Here is one such study from 2008: “Specific Cerebral Activation due to Visual Erotic Stimuli in Male-to-Female Transsexuals Compared with Male and Female Controls: An fMRI Study”

The researchers compared twelve male and twelve female heterosexual volunteers with twelve MTF (male to female) transsexuals. Only “MTF subjects without any therapy “were chosen for the study. They were recruited from the outpatient Clinic of Psychosomatic Medicine at the University Hospital Essen in Germany. The M2F transwomen had not had hormone treatment or surgery and any difference in brain behavior can therefore not be attributed to such therapy.

The researchers showed the participants erotic film excerpts during a fMRI brain scan. The results seem to show that male to female transsexuals react more like women when shown erotic movies.


This is how the researchers sum up their work:

“Significantly enhanced activation for men compared with women was revealed in brain areas involved in erotic processing, i.e., the thalamus, the amygdala, and the orbitofrontal and insular cortex, whereas no specific activation for women was found. When comparing MTF transsexuals with male volunteers, activation patterns similar to female volunteers being compared with male volunteers were revealed. Sexual arousal was assessed using standard rating scales and did not differ significantly for the three groups. Conclusions. We revealed a cerebral activation pattern in MTF transsexuals compared with male controls similar to female controls compared with male controls during viewing of erotic stimuli, indicating a tendency of female-like cerebral processing in transsexualism.”

This sound pretty conclusive, does it not? MTF transwomen have the brains of “normal” ciswomen, at least sexual arousal wise.

Nature and culture

Unfortunately, it is not that easy.

The differences between men and women may reflect learned behavior or patterns of arousal. Many researchers argue that women react less intense to such stimuli than men. This is in accordance to gender stereotypes: Men like visual porn, women like romance. Still, if men and women are conditioned to react this way, this would give the same result as any biological foundation.

The researchers are very much aware of this:

“...the origins of transsexualism are still largely unclear but may be influenced by the prenatal sex steroid milieu [i.e. hormones in the womb]. Hormonal influence is also discussed for morphologic gender differences. Morphologic characteristics were not assessed in our study, as the group was not large enough. It has been observed that psychotherapy is not helpful in altering a crystallized cross-gender identity, and that transsexuals do not show severe psychopathology. But, as in the variation of gender identity expression in heterosexual men and women, social influences should nevertheless be taken into account in addition to a biological, e.g., hormonal, explanation. Baumeister, for example, found that the female sex drive is more malleable than the male drive in response to sociocultural and situational factors. Therefore, the differing activation patterns in fMRI may be due to neurobiological differences, but these results cannot clarify the underlying mechanisms of the different cerebral activation patterns of MTF transsexuals, as cultural and educational influences are also possible.”

This means that both men, women and transwomen may have learned to express their arousal a specific way that is reflected in the brain scan.

Still, even if that is the case, it would be interesting, because it would tell us that MTF transwomen can really adapt to a “feminine psyche”, even if they do not have one from the outset.

On autogynephilia

In discussions on “autogynephilia” and crossdreaming, the sexual orientation of male to female transwomen become important.

Ray Blanchard divided transwomen into two completely unrelated groups: “homosexual transsexuals” (meaning, in fact, androphilic or man-loving transwomen) and “autogynephilic heterosexual transsexuals” (meaning gynephilic or woman-loving transwomen).

The gender identity conflict of androphilic transwomen is caused by them being extremely effeminate gay men, Blanchard argues, while the gynephilic transwomen are perverted heterosexual men who have internalized their natural love object: women.

I find this dichotomy sexist, offensive and unfounded, but for the sake of argument I will play along with it.

Bananas and pears

If the two groups are completely different, studying male to female transwomen in general will not make much sense. Your group will consists of both bananas (“heterosexual men”) and pears (“homosexual men”).

In this study the researchers make it perfectly clear that the male to female transsexual participants are not autogynephilic: I quote: “The MTF were non-autogynephilic.” The term “autogynephilia” is not defined, but the fact that they use the term should imply that the researchers understand Blanchard’s theory.

Given that there is no autogynephilic control group, the study should therefore -- in principle -- be of little interest to us crossdreamers. Most of us are, after all, gynephilic. According to Blanchard all crossdreamers are.

Note also that the researchers presented the participants with heterosexual erotic videos, clearly in an attempt to capture reactions to “normal” heterosexual lust. The “normal” cispeople taking part were all heterosexual.

Wait a minute!

I will argue that the researchers most likely have misunderstood what autogynephilia means, and that most of the M2F transwomen taking part are-- in fact -- gynephilic. This would mean that the data is of interest to gynephilic crossdreamers.

I believe the researchers have interpreted “non-autogynephilic” to mean “non-fetishistic” or “non-paraphilic”, meaning that the main motivation for them transitioning is not sexual. They have not grasped that Blanchard believes that all gynephilic transwomen are autogynephilic perverts, regardless of what they say or believe.

The mean age of the MTF transsexuals in this sample is 36 years, within a range of 20–55. According to Blanchard and his supporters most androphilic transwomen transition at a very early age, normally in their teens or in their twenties.

And indeed, it turns out that a majority of the MTF transwomen are attracted to women, which -- of course -- they should not be if they were non-autogynephilic:

This is what the researchers write:

“Furthermore, the stimulus material could have had an influence on the cerebral activation patterns in MTF. We used erotic film excerpts with heterosexual couples. As the majority of MTF reported sexual interest in women film excerpts with female homosexual content might have had a higher impact for this group, even given the missing difference in subjective sexual arousal rating.” (My emphasis).

What this paragraph tells us is that a majority of the M2F transwomen covered were, in fact, gynephilic. It turns out ten of the transsexuals were gynephilic. Only two were attracted to men.

Falsifying Blanchard

I cannot tell whether these tranwomen were crossdreamers -- in the sense of them getting sexually aroused by the idea of having a female body. I do not think that all gynephilic transwomen have or have had such erotic fantasies. But according to the autogynephilia theory, they must have.

Following Blanchard’s logic this study shows us that MTF gynephilic transwomen show brain patterns more like women when watching erotic movies. If you believe in Blanchard’s framework it shows us that MTF autogynephiliacs react like women in this respect.

If we could trust these findings we would therefore have proof that falsifies Blanchard’s theory, as Blanchard’s theory requires that MTF transwomen have a male sexuality. They are men having the hots for their female self, remember? They ought to react like horny men looking for female prey, and that should show up in the brain scan. Instead the scans show a female pattern.

What about lesbian love?

One could argue that the gynephilic women would react more like men if they were shown lesbian love scenes. They do, after all, claim to be lesbians themselves. This is the problem the researchers are alluding to in the quote above. And they should have included homosexual scenes in the study.

Still, I believe that showing them lesbian sex scenes would not make much of a difference, as many gynephilic MTF transgender persons can get as much turned on by heterosex as lesbian sex scenes.

And Blanchard and his friends would have to agree with me, as their main explanation for why “autogynephiliacs” get turned on by the idea of having sex with a man, is that they use the fantasy male as a sex prop. This is, as far as they are concerned, proof of the “autogynephiliacs” being wired as men sexually.

For Blanchard & Co sexual orientation is the variable that determines femininity and masculinity. This study shows that it is not. The gynephilic transwomen react as women to heterosexual stimuli, even if they are not originally attracted to men.

How you can use Blanchard to show that Blanchard is wrong

The researchers make no attempt at explaining this question, which is an essential one for crossdreamers. I have a few ideas of what may be going on.

The gynephilic transwomen taking part do indeed have a female sexuality, but this one is not based on their sexual orientation, but on the role you play during intercourse. Crossdreamers most often have a receptive and reactive copulation instinct as opposed to a penetrative or mounting one.

This applies to many XX lesbians as well: The “femmes” may play the submissive role to a dominant “butch”, even to the point of being penetrated with a strap-on. In this case the transwomen react in the same way as the ciswomen to the idea of being taken by another human being.

Studies done by Blanchard himself indicate that women are more likely to get aroused by a wide variety of sexual interaction, including imagery of sex between bonobos. It seems it is the reciprocal care and attention that turns them on, not the visual stimuli of the male body exclusively.

If the transwomen reacts like ciswomen, this may explain why they react in the same way towards scenes of heterosex. They react positively to the human interaction, not to the male body per se. Their reaction is not a sign of perversion, but of them reacting to sexual stimuli in the same way as the average woman!

All the gynephilic transwomen taking part may not necessarily be gynephilic in the sense Blanchard & Co believe they are. Sexual orientation may not be a strict dichotomy between attraction to males versus attraction to females. Instead they may have a bisexual psyche, with a preference for women. If they manage to get through layers of cultural conditioning they may come to enjoy having sex with men.

I do find the study interesting. In one way it gets us into the heads -- literally! -- of MTF transwomen. Given the current request for peer reviewed “objective facts”, I would say this study is as good as any, and it does indicate that gynephilic MTF transwomen react like other women.


The reason I hesitate is this:

I believe many of the studies we see in this field is based on a cultural and historically based preconception: Men and women react dramatically different to sexual stimuli. I believe the cause of this understanding is ultimately found in the old fashioned narrative where the women are considered less sexually charged than men. You know: Men are hot fire, women are cold water (to follow Renaissance philosophy),or men are aggressive testosterone driven predators and women are passive estrogen powered milk cows (to follow 20th century science).

I am not saying that all present day researchers believe in such stereotypes. Far from it. But I am saying that they work withing a scientific paradigm and a theoretical and methodological framework that are based on such a world view. This is especially reflected in quasi-Darwinistic theories of the man as the hunter and woman as prey. (Cf. my posts about Roughgarden).

This means that the researchers look for sections of the brain that reacts in a way that correlates with this preconception. They search and search, and when they finally find an area that seems to react in a way the theory predicts, they sigh in contentment and write a paper.

That being said: the method used in this paper is much better than traditional brain autopsy studies. In this case it is, after all, possible to couple visual stimuli (the erotic movie) with brain patterns directly. The researchers did, of course, also show the subjects non-erotic movies, which gave different results. In brain autopsies you have no way of testing for what the identified area of the brain is for in real time.


I am sure some separatist transwomen will argue that the fact that the researchers excluded “non-autogynephilic” transwomen -- even if the researchers have misinterpreted the term -- show that this study cannot be used to say anything about the brain patterns of crossdreamers or “autogynephiliacs”. After all the crossdreamers were excluded, right?

Given that the researchers do not define “non-autogynephilic”, we have no way of really knowing.

Personally, I seriously doubt that it is methodologically possible to exclude tranwomen who have had such erotic fantasies from being included. This is not because they are lying to the researchers -- as Blanchard believes -- but because most of them will argue that the fantasies is only one of many ways their inner woman express herself. To exclude a transwoman because she gets turned on by the idea of having sex as a woman would be meaningless.This is of course also what some of the main transactivists are saying regarding cross-gender erotic dreams, including Julia Serano and Andrea James.

If the researchers were to cover all possible permutations of transgender disagreement, they would have to include 12 “non-autogynephilic” gynephilic transwomen, 12 “autogynephilic” transwomen, 12 “non-autogynephilic” androphilic transwomen and 12 “autogynephilic” androphilic transwomen.

You know what? I can understand that they did not.

Measurements and self perceptions

The subjects were also asked about their sexual arousal. That part of the study did not reveal significant differences between the groups.

This could mean that someone was lying, that someone was out of touch with their own feelings, or that the scanner readings did not really tell the researchers much about arousal patterns in men and women.

What about androphilic transwomen?

In my next post I will look at a brand new Spanish study that indicates that the brain patterns of androphilic transwomen are somewhere in between men and women.


“Specific Cerebral Activation due to Visual Erotic Stimuli in Male-to-Female Transsexuals Compared with Male and Female Controls: An fMRI Study” by Elke R. Gizewski, MD, Eva Krause, MD, Marc Schlamann, MD, Friederike Happich, MD, Mark E. Ladd, PhD, Michael Forsting, PhD, and Wolfgang Senf, PhD, The Journal of Sexual Medicine Volume 6, Issue 2, Article first published online: 28 Aug 2008.

Corresponding author: Elke R. Gizewski, MD, Deptartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45127 Essen, Germany, elke.gizewski@uni-due.de.

Appendix: On the use of the study

From the paper:

“The functional cortical activation patterns presented in this study revealed a female-like cerebral activation pattern in MTF transsexuals when compared with male volunteers and vice versa during viewing of erotic stimuli in brain areas relevant for erotic and emotional processing. These results indicate that transsexualism has a correlate in brain activation patterns elicited by emotional stimuli, in this case those erotic in nature. Therefore, fMRI using this erotic stimulus form may become a further tool during the assessment and diagnosis of transsexual patients, and may contribute to the complex and difficult decision regarding surgical treatment. The goal would be to further objectify the evaluation process and ultimately avoid cases where patients suffer from postsurgical regret.

A shortcoming of fMRI for clinical use, however, is its limited ability to do comparison analysis with single subjects. Furthermore, these results, together with anatomic differences described in other studies, support the biological theory of transsexualism [10]. However, fMRI studies cannot clarify the underlying mechanisms of altered activation patterns. Genetic predispositions, social influences, or learning mechanisms during life development may play a role.”

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