January 11, 2012

On evolution, autogynephilia and Anne Lawrence 2

I my previous post I presented Anne Lawrence's argument for why male to female "autogynephiliacs" -- or crossdreamers, as I call us -- must be classified as mentally ill.

Or, to be more precise, she asked if the desire for sex reassignment in some men is  to be understood as a mental disorder in terms of a particular classification system of psychiatric conditions.

Her answer is yes; mine is no.

Lawrence's comment,  "Do Some Men Who Desire Sex Reassignment Have a Mental Disorder?", was originally a response to a paper by Dr. Heino F. L. Meyer-Bahlburg of Columbia University.

Dr. Meyer-Bahlburg was kind enough to give me a copy of his own response to Anne Lawrence's text, and I am going to give you a summary of his main arguments here.

A summary of Lawrence

Meyer-Bahlburg gives the following summary of Lawrence's paper (the  text in  brackets [...]  are my comments):

"1. In line with the original sex assignment on the basis of genital appearance at birth, the young child forms a core gender identity (as ‘‘biologically male’’)."

[Actually: Basically both Blanchard, Bailey and Lawrence say that a man is a man if he has a penis. Period.]

"2. Later development includes the activation of erotic heterosexual interest, which involves a mental mechanism responsible for locating erotic targets (females) in the environment external to the self (Freund & Blanchard, 1993). This mechanism is 'natural,' i.e., was developed by way of evolutionary selection. However, in the particular men under discussion, this mechanism fails its natural function; these men become autogynephilic instead of gynephilic, or both, and, thereby, experience a powerful erotic interest in turning their own bodies into facsimiles of their preferred erotic targets (females), thus generating the desire for sex reassignment. This desire to transform the body is an epiphenomenon to the primary mental dysfunction, namely the malfunctioning erotic-target location mechanism."

[In other words: Autogynephilia is the result of a masculine sexuality, not a feminine sex identity.]


"3. Experiencing the discrepancy between their actual (maletypical) body and their desired (female-typical) body causes significant distress for these men."

"4. The combination of a primary mental dysfunction with significant distress fits the definition of mental disorder provided by Wakefield and First (2003)."

[In the sense that autogynephilia is evolutionary disadvantageous; it reduces the possibility of getting offspring and transferring one's genes to the next generation.]

"5. The cross-gender identity that gradually emerges in the course of this development is merely one’s current sense of oneself as being psychologically male,  female, or of indeterminate sex, and does not really replace the core gender identity ('biologically male')."

No male identity

First Meyer-Bahlburg turns Lawrence's argument on its head. While Lawrence doubts that the autogynephilic child has a female gender identity, Meyer-Bahlburg questions the idea that  it has a biological based male identity.

"In young children, the initial development of gender identity does not depend on their perception of their primary sex characteristics, but on the gender labeling by their social environment, along with the imposed gender symbols, such as gendered clothing and hair styles, and the children’s psychological gender fit (in terms of activities and interests) with their local social environment, particularly the peer group if available. There are a number of studies that show the lack of salience of the genitals among the criteria by which gender-typical children categorize their peers by gender (McConaghy, 1979; Volbert, 2000)"

I am not sure that Blanchard and Lawrence would argue that it is the male bodied child's understanding of its penis that makes it male.  It could be that Meyer-Bahlburg is misreading Lawrence's text here. Lawrence writes that:

"Nonhomosexual [i.e. gynephilic] MtF transsexuals do not have a female or cross-gender core gender identity: In childhood, during pre-transition adulthood, and after sex reassignment, they know that they are, always have been, and always will be biologically male."

I suspect that Meyer-Bahlburg interprets this sentence to mean that the bodily awareness of the gynephilic M2F transwoman means that she has a male gender identity. The fact is that the sentence is virtually meaningless, as the only thing it says is that the "autogynephiles"  know that they have a male body. In time all male to female transsexuals understand that they have a male body. This also applies to the androphilic ones.

The fact is that the only meaningful parallell to gender identity found in the "autogynephilia" theory is sexual orientation. Homosexual men are feminine, and androphilic transwomen are therefore also feminine.  The reason androphilic transwomen are not mentally ill, according to this theory, is that they have the "proper" sexual orientation towards masculine men (proper for gay men, that is). Heterosexual men are not feminine, and because of this the "autogynephile's" sense of a female self must be false.

(Yeah, I know. It is absolutely amazing that scientists can get away with this!)

Meyer-Bahlburg' argument is still valid though. He believes gender identity is primarily a social construct. Indeed, he argues that the reason children start to focus on genitalia is in response to the protests of the parents. The argument "You cannot be a girl, because you have a penis!" leads to the wish of seeing the penis gone. In other word: The experience of being a girl instead of a boy (or vice versa) comes first. The interest in the genitals is an effect of the parents' protests.

Meyer-Bahlburg also refers to interesexed persons with XY chromosomes (46,XY children with certain disorders of sex development) who have been raised as girls and who have been given feminized genitalia through surgery, nevertheless insist that they are boys. For these reasons, Meyer-Bahlburg argues, it does not make much sense to speak of a core gender identity as ‘‘biologically male’’ that begins in early childhood.

In other words: The early gender identity is not based on the shape of the body, but on a psychological sense of self.

Bye, bye binary

He also argues against the idea that children will identify either as male or female. Few gender researchers believe so, he argues:

"Yes, most people identify either as male or as female, but within such an overarching categorical identity people can perceive themselves as being more or less masculine or feminine. The latter is not an alternative form of an identity, just a qualification of one’s overall self-categorization in terms of the given binary gender system."

He then presents a model that is similar to the "slider" model  presented in this blog, conceptualizing "gender identity as a multidimensional construct"  encompassing "a variety of evaluative components that interact in a complex developmental process."

In other words: He is rejecting Lawrence's reductionistic/simplistic approach to gender development.

Putative theory

Like me he finds the erotic target location error theory unfounded ("putative"). He especially makes a point out of the fact that such a target location error cannot be found in non-human mammals.

I am not sure that is a very strong argument, as I do not think anyone has looked for erotic target location errors among animals.

Given that autogynephilia represent a mental preference, I am not sure it would be possible to prove or disprove its existence among -- let's say -- bonobos. Lack of interest in copulation could be caused by other factors than autogynephilia, and since the male to female bonobo cannot tell us about  his wish to become a female bonobo, we have no way of knowing.

Although it is possible to explain how human autogynephiliacs can get offspring (social pressure), it is hard to explain how bonobo autogynephilia could survive as an inherited trait.

That is not the point Mayer-Bahlburg makes, however. He questions the very premise of calling such a trait dysfunctional among humans. We are no longer living in the wild: 

"Are arguments based on traditional evolutionary theory, i.e., on procreation success, really appropriate for such aspects of the human condition, given the complex, urbanized, industrial and postindustrial societies of the twentieth and twenty-first centuries, from which the classical evolutionary selection pressures have largely been removed, while the opportunities for individual psychological specializations have enormously expanded?"

He also argues that we would  have to apply the evolution-based argument, if it was still valid, to paraphilias, celibacy, contraception habits, homosexuality, and more, and label all of those ‘‘dysfunctions’’. That would not be  plausible.

Brain research

Meyer-Bahlburg  refers to recent brain research, arguing that such findings suggest at least a vulnerability, perhaps even an underlying endophenotype (genetic marker), for the development of a gender identity in conflict with the assigned gender:

"Either would indeed be based on biology, namely variations in the factors that ordinarily bring about the sexual differentiation of the brain, but this concept appears to be at odds with Lawrence’s concept of a (biological, body-appearance based) core gender identity."

As I noted before, it is more at odds with Lawrence's idea that sexual orientation equals femininity/masculinity, which can be thought of as a proxy for gender identity. But the end result is the same.

On distress

Meyer-Bahlburg's most important argument, however, is the one on distress. He does not accept that distress is an obligatory part of being a gynephilic M2F transsexual.

"I see distress as an ascertainable emotional condition, and that condition varies tremendously across individuals with GIV."

This is line with the research I referred to in my post on the  Study on differences in mental health between homosexual and heterosexual transsexuals, which showed that not only are gynephilic transwomen in general mentally healthy; they are in fact as healthy as the androphilc ones.

This means that the only way Blanchard and Lawrence can put the "mentally ill" label on the male to female crossdreamers is to make use of her evolutionary argument, instead of an argument based on the emotional well being and social abilities of an individual.

Reference

Heino F. L. Meyer-Bahlburg: "Do Some Men Who Desire Sex Reassignment Have A Mental Disorder? Response to Lawrence (2011)",  Arch Sex Behav (2011) 40:655–65

22 comments:

  1. Why would you waste time on Anne Lawrence?

    ReplyDelete
  2. Again this troll? it starts bothering me!

    ReplyDelete
  3. Does this bother you too? http://www.tsroadmap.com/info/anne-lawrence-experiences.html

    ReplyDelete
  4. Having lived a long time in the "trans community" and having lived in the female role for a decade, I first argued vehemently against Anne Lawrence... and then slowly over time came to agree with her. Of the hundreds of people I saw through transition to sex reassignment, the only ones who seemed truly whole and at-peace post-srs (10+ years) were those who were medically diagnosed intersexed at birth. All of the others -- including myself -- were AG and seemed to "lose direction" over a long hormones regimen (7+ years) -- especially post-srs. Passing well and having created great turmoil in my family when I transitioned, it (AG) was the hardest pill I've ever had to swallow... and having been a poster-child by local therapists for MtoF transition, I was ashamed. Having gone back to life as male, to this day I have to take small doses of Spiro or I'll start down that obsessive AG road.

    I would like to say that AG isn't a mental illness, but from everything I have seen and lived, it is. What ultimately causes it? That's the true question... but from what I've seen, it's not identity... it's sexuality that confuses identity.

    ReplyDelete
  5. @Anonymous

    "Having gone back to life as male, to this day I have to take small doses of Spiro or I'll start down that obsessive AG road."

    Does taking the small doses of Spiro only filter out the AG or does it remove all of your sexual desires and needs from your system? Does the taking of Spiro interfere with your sexual relationship with your partner?

    Whilst you were living full time as a female with the full dose of all hormones, you still felt AG motivated? But from what you also say that after 7 years AG then switched off, was this because Spiro was introduced at the 7 year mark or was it your own body just switching off AG after long hormone use?

    Do I take it that you were perfectly happy living as a female while under the AG influence (the first 7 years)?

    When you lost direction and AG switched off can you describe how it felt being a female with the AG no longer there? Was it a feeling that there is simply no point in being female and you don't feel female any more?

    You have not had SRS but have you ever considered an orchidectomy, as 95% of your T would be removed but your brain would still produce a very small amount which may help. Might be easier than taking the Spiro which may knock out 100% T ?

    I believe we have spoken before on here?

    I would be very interested in hearing your full story as I really feel that your experience is of great help to others. Perhaps you could do a piece and get Jack to publish it as an anonymous blog entry?

    ReplyDelete
  6. This comment has been removed by the author.

    ReplyDelete
  7. @Anonymous

    I would like to say that AG isn't a mental illness, but from everything I have seen and lived, it is. What ultimately causes it? That's the true question... but from what I've seen, it's not identity... it's sexuality that confuses identity.

    I totally agree.

    Living back as a male now. How is your day to day existance as you must have been feminised to a great degree? You must be a very strong person which I totally respect - but does your feminised state cause you problems? Do you get taken as a female when trying to pass as male?

    ReplyDelete
  8. @Anonymous

    " the only ones who seemed truly whole and at-peace post-srs (10+ years) were those who were medically diagnosed intersexed at birth. All of the others -- including myself -- were AG and seemed to "lose direction" over a long hormones regimen (7+ years) -- especially post-srs."

    This does not in any way rhyme with the information I get from other post-op transwomen or from most sexologists or psychiatrists working with tranwomen. Nobody denies that this can be extremely hard and even traumatizing, but the general message is that many -- if not most -- are content with the outcome of their process. Very few transition back to their birth sex.

    Now, I do not know you and have not lived your life, and if you now say that transitioning was a mistake and that your sex identity truly is male, I'll believe you. But if you generalize on the basis of this and say that nearly all transwomen are like you, you do the same mistake as Anne Lawrence, believing that everybody have to be like yourself.

    ReplyDelete
  9. @Jack Molay

    "This does not in any way rhyme with the information I get from other post-op transwomen or from most sexologists or psychiatrists working with tranwomen. Nobody denies that this can be extremely hard and even traumatizing, but the general message is that many -- if not most -- are content with the outcome of their process. Very few transition back to their birth sex."


    All of the post ops I have known have initially been very happy with the outcome for several years. However in the cases I have known things seem to take a turn many years later. Two I know who have been post op for 15+ years and both were very happy for many years but now they say "I really don't know why I did it", or "I'm not very good at being a woman, my personality is the same as its always been". I also hear about the total loss of sexual drive which is low to start initially after the op but then switches off to one orgasm a year if they are lucky after say 5 years or so of post op life.

    ReplyDelete
  10. @Cheryl

    "All of the post ops I have known have initially been very happy with the outcome for several years. However in the cases I have known things seem to take a turn many years later. "

    I am sure that happens, and it would be naive to think that a post-op transwoman would suddenly be able to forget some 20 to 50 years of male living and suddenly behave and feel like a woman born woman in every way.

    It is hard enough to be a non-transgender person, and we all know that being transgender makes it even harder. And given society's reluctance to understand -- let alone embrace -- transgender person, I am not surprised that many experience a backlash.

    But we must be very careful not to mistake this as proof of the "autogynphilia" theory being right and that these women have no true female sex identity. I am convinced most of them have. Sexual desire is not unnatural, not bad, not a perversion. That the transgender condition will express itself in sexual fantasies is to be expected. I

    I find it much harder to understand those transwomen who say they have never felt sexual arousal together with the dream of being a woman. They are either very repressed or extremely asexual.

    The fact that some transwomen lose their orgastic capability after surgery has nothing to do with the cause of their transgender condition.

    In this thread Deena and Pebbles wonder why I spend time on Anne Lawrence. This is the reason: That so many of us end up adopting a view point that is both destructive and degrading.

    ReplyDelete
  11. @Jack Molay

    "The fact that some transwomen lose their orgastic capability after surgery has nothing to do with the cause of their transgender condition. "


    I appreciate what you say, but what if the sexual response or awareness (even if very, very low) once post op is required to keep the female identity alive? If after x number of years it switches off and the female identity dies then you're in trouble.

    There are some post ops who have low testosterone mixed in with their estrogen treatments. This never used to happen it seems to be a recent method. I am not suggesting that this is the way it is for all TS's but only with the AG driven ones.

    From my own experience AG is fueled by T, even small levels. The problem is knowing if the inner woman can survive without T in the system.

    I've been thinking outside the box of late about the AG (Crossdreaming) condition. I wonder if the Crossdreamer can have the condition so bad that it completely mimics the true GID condition. The sufferer will genuinely feel that they actually have a true inner female core identity. But it is driven by the river of sexuality within the person. Even when T levels are really low with all of the hormones digested.

    Having been out and about on the TG scene for many years I have to confess as to believing that the great majority of TG's who say they are TS are in fact crossdreamers who have got it bad. In their own mind they are genuine but the AG / crossdreaming condition makes them see it the way they want to.

    The TS who has a genuine inner female core is very, very rare. I have only come across one or two in the last twenty years.

    ReplyDelete
  12. Having said all of the above I still do believe the the AG / Crossdreamer can still have a true female core identity. AG / crossdreaming simply being a symptom of a genuine repressed TS state.

    ReplyDelete
  13. There was some experiment a few years back wherein, a group of gay men, both masculine as well as the effeminate ones, were administered huge doses of testostterone in order to determine what effect it would produce on their sexuality.
    It turned out that more than anything else, the effeminate males became even more effeminate and flamboyant while the masculine men turned more macho.However, there was no change in sexual orientation.
    This actually means testosterone/estrogen hormones have no effect on the direction of sexual-orientation and also the type of gender expressions, but actually control the intensity of both!
    This means an effeminate male who is attracted to women will become more effeminate or perhaps even close to a lesbian if given more testosterone,and may have some masculinity enhanced if given some female hormones.However, he will not really have a considerable change in his sexuality and he will also be forever feminine, only in varying intensities.
    This I guess has a lot of relevance with why AGP transwomen have some calming effect post-op.
    This thing could explain why after taking female hormones and surgeries, an AGP transfemale is likely to feel less sexual,less sexually aggressive and have a calming effect, which may be to a point that (s)he indeed starts feeling so less feminine that (s)he begins questioning the whole point of transitioning in the first place!
    However, that does not mean the male was a 'man' and his sexual responses pre-op were that of some perverted man.
    The fact is that even post-op, he was female in sex identity. He simply had more testosterone in his system which made him highly sexually driven and aggressive inhis effeminacy.
    Most sexually aggressive straight natal women also have higher doses of testosterone which makes them prone to promiscuity. Same for effeminate gay males and metrosexuals.
    The reverse also is true. Transmen, whether straight/bi or gay also become highly sexually horny post-op!

    ReplyDelete
  14. I guess this is actually the main reason why the "Men are from Mars and women are from Venus" is a powerful social stereotype even today.
    I however feel it should be reframed as:
    "Testosterone humans are from Mars and estrogen humans are from Venus".
    Testosterone humans may be anyone, a man, woman or even transgender (MTF/FTM).

    ReplyDelete
  15. @Cheryl

    "Having said all of the above I still do believe the the AG / Crossdreamer can still have a true female core identity. AG / crossdreaming simply being a symptom of a genuine repressed TS state."

    Exactly. I think it is necessary to repeat this, as unprepared readers may otherwise conclude that this is nothing but a sexual perversion.

    ReplyDelete
  16. @Namrata

    ""Testosterone humans are from Mars and estrogen humans are from Venus".
    Testosterone humans may be anyone, a man, woman or even transgender (MTF/FTM)."

    I agree!

    I actually tried to find proof of testosterone being linked to aggression and estrogen being linked to the opposite and found to my surprise that no such clear proof exists!

    But I did find that in order to make a man, nature uses estrogen as a trigger.

    I love these paradoxes, but hate the way the stereoypes have been allowed to steer social biology.

    ReplyDelete
  17. Hey Jack,

    I wanted to chime in.

    The idea that gender identity is not entirely set but based on how we discover ourself actually feels somewhat true to me. I grew up gender confused and while I generally have identified as a female, I have also had periods where I have not or felt that I was a male wanting to be a female or.. It has been complex and this actually makes me feel better about myself. I suspect some people never feel such confusion but I also suspect many people lie. I have trouble understanding how someone can act so masculine and yet call themselves a woman. We are all combinations of male and female traits to different degrees though.

    I have always believed that flamboyancy is effeminancy tempered with testosterone. I hear a lot of gay men claiming that it means that they are artificially effeminate. I feel this is wrong. I suspect genetic women would come off somewhat flamboyant if given enough testosterone. I am not much surprised by the effect of testosterone on gay men. I think these traits are part of the natural mating dance all sexes do at puberty. Too much testosterone and I become flamboyant, too much estrogen and I become too prissy. I think it is a natural way of getting noticed during those years. It is also probably why it is harder to hide being gay during puberty.

    I bounce around on what I think about a lot of tg people. I just don't get a lot of them and it makes it harder. I always think that a duck generally walks like a duck but gender is hard. I often claim that if I were a very masculine looking person, I would probably identify as a gay male.

    Amanda

    ReplyDelete
  18. Two phenomena:

    1. Person with testicles wants to express self female;
    2. That person finds the thought of self as female erotic.

    Chicken and egg. How could one decide whether one of these had caused the other, and if so, which?

    Amanda: it is a good weapon to target at me: "You are unfeminine, so cannot be properly transsexual". Um. While that would have got me confused and upset at one time, it does so less now. I have no wish to revert to presenting male.

    ReplyDelete
  19. Have we all forgotten that the default gender and sex is female? Have we forgotten that Jamie Lee Curtis is a genetic XY woman? Have we forgotten that biological sex, gender orientation, and sexual orientation exist and are influenced by culture, social conditioning, stereotype AND hormonal influences? Why are so many so-called AG women so good at math and science and gravitate toward technical careers? If all of this is simply mistargeted eroticism that manifests as AGism, then call me an idiot but there are no easy answers. Blanchard and Lawrence are partially correct and only partially. Don't some genetic women feel sexy? Isn't that auto eroticism? Western culture over values masculinity, and the medical profession has been dominated by patriarchal attitudes for centuries. Examine the American Indian culture and the two-spirit people. They were accepted, revered and led productive lives. They were trans, and unfortunately, we can't answer whether they were AG or not. In a desperate attempt to find one answer for the MtF trans condition, we must be very, very careful.

    ReplyDelete
  20. @Anonymous said: "I first argued vehemently against Anne Lawrence, and then slowly over time came to agree with her." "Of the hundreds of people I saw through transition to sex reassignment, the only ones who seemed truly whole and at-peace post-srs (10+ years) were those who were medically diagnosed intersexed at birth."

    I simply find this hard to believe. It's easy to find many people who transitioned long ago and are happy -- I know quite a few myself, and they were not intersexed.

    Personally, I've had a female gender identity from early childhood, but for a long time felt there was nothing I could do about it because of having a male body. There was never any AG going on, no arousal from imagining myself as a female, etc. And I never "cross-dressed". It was simply that I felt mentally/spiritually female. I tried to live the male role for years, but I just couldn't -- it wasn't me. I couldn't go on, never showing my real face to the world. That's why I transitioned.

    I'm bisexual (attracted to both), but in my male life I only ever had one girlfriend, and I never had sex with a man because I found male-male sex practices a bit repulsive. Therefore, on that irrelevant basis, Anne Lawrence would label me an autogynphile for seeking transition. I dare her or anyone to say that to my face. What a crock of b.s. and quackery.

    ReplyDelete
  21. Fascinating discussion on a very complex issue. I am more on the side of jack here. My own life experience tells me that there is some previous genetic core that is female which then brings on the dressing, guilt, purge cycle and then for some transition. The autogynephelia theory is too simplistic, dismissive of anomalies within the test samples which makes it bad science...

    ReplyDelete

Click here for this blog's Code of Conduct!

Discuss crossdreamer and transgender issues!