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.


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

Discuss crossdreamer and transgender issues!