If you ask most experts in the field what causes someone to become transgender (as in experiencing gender dysphoria or being gender incongruent), they will tell you that this most likely caused by a combination of biological, cultural, social and personal factors. Most of them will agree that there is a significant biological component.
This is important, because it means that it is hard to dismiss gender incongruence as something imaginary caused by political and cultural pressure from sinister people promoting some kind of "gender ideology". All serious scientists in the field acknowledge that the identities of trans people are real and tangible and the great majority believe there are biological factors influencing the development of gender incongruence.
That does not mean that our concepts of gender are not influenced by culture. They most certainly are, as seen in the anti-trans insistence on gender being reduced to "biological sex", another concept that is as vague and ambiguous as the term "gender".
"Biological sex", as it is used by anti-trans activist, is a political and cultural construct that goes against everything we know about gender variance and intersex conditions, both in humans and in other animals.
In intersex people chromosomes, gonads, genitalia and hormones do not match in wide variety of combinations, and in trans people a persistent and intense experience of a gendered self does not mach the gender assigned at birth. Dismissing this as "illusions" or "irrelevant variations" does not cut it.
What science says about the biological component
Research indicates significant biological factors influencing gender identity and dysphoria, particularly in brain structure and function.
Neuroimaging studies reveal sex-atypical brain features in transgender individuals, aligning more closely with their experienced gender than their assigned sex.
Genetic studies suggest a polygenic component (involving many genes) to gender dysphoria, with higher concordance rates in monozygotic twins compared to dizygotic twins, indicating heritable influences. (Monozygotic twins are twins that develop from one single fertilized egg that splits into two embryos early in pregnancy.)
The prenatal endocrine environment refers to the hormonal conditions in the womb during pregnancy that influence the development of the fetus. Prenatal hormone exposure plays a crucial role in brain sexual differentiation. Conditions with atypical androgen signaling show increased rates of gender dysphoria, suggesting that the prenatal endocrine environment significantly impacts gender identity development.
Current research provides evidence that gender identity and gender dysphoria are strongly influenced by biological factors, especially brain sexual differentiation and genetics, within a complex mind/body/society framework.
Relevant literature
Saksham, S., Deeksha, S., Udithi, B., & Vinayaka, G. (2023). The neurobiology and neurocognition of gender dysphoria. InterConf. https://doi.org/10.51582/interconf.19-20.12.2023.026
Nowak, K., Stępień, P., Marczak, A., Halczuk, I., Stachura, B., Górska, J., Gawryszczak, S., Gliwa, A., & Halczuk, I.(2024). Gender dysphoria and incongruence - neurophysiological diversity and genetic factors. Current Problems of Psychiatry. https://doi.org/10.12923/2353-8627/2024-0023
Boucher, F., & Chinnah, T. (2020). Gender Dysphoria: A Review Investigating the Relationship Between Genetic Influences and Brain Development. Adolescent Health, Medicine and Therapeutics, 11, 89 - 99. https://doi.org/10.2147/ahmt.s259168
Altinay, M., & Anand, A. (2019). Neuroimaging gender dysphoria: a novel psychobiological model. Brain Imaging and Behavior, 14, 1281 - 1297. https://doi.org/10.1007/s11682-019-00121-8
Ettner, R. (2020). Etiology of Gender Dysphoria. Gender Confirmation Surgery https://doi.org/10.1007/978-3-030-29093-1_2
Sari̇, M., Savci, U., Balta, B., Öztürk, Y., & Tufan, A. (2023). Neurobiological Components of Sexual Identity Development and Epigenetic Effects of Environmental Stressors - Current Approaches in Psychiatry.https://doi.org/10.18863/pgy.1238867
Duisin, D., Barišić, J., Milovanović, S., Bizic, M., & Đorđević, L. (2018). Neurobiological basis of gender dysphoria -actual hypothetical models, 40, 54-72. https://doi.org/10.5937/engrami1802054d
Stevenson, D., Murray, J., Muglia, L., Wong, R., & Katz, M. (2023). Challenges to the study of gender dysphoria.Acta Paediatrica, 112, 2273 - 2275. https://doi.org/10.1111/apa.16975
Fernández, R., Ramírez, K., Lorente-Bermúdez, R., Gómez-Gil, E., Mora, M., Guillamón, A., & Pásaro, E. (2024).Analysis of single nucleotide polymorphisms of the metabotropic glutamate receptors in a transgender population.Frontiers in Endocrinology, 15. https://doi.org/10.3389/fendo.2024.1382861
Mueller, S., De Cuypere, G., & T Sjoen, G. (2017). Transgender Research in the 21st Century: A Selective CriticalReview From a Neurocognitive Perspective.. The American journal of psychiatry, 174 12, 1155-1162.https://doi.org/10.1176/appi.ajp.2017.17060626
Saraswat, A., Weinand, J., & Safer, J. (2015). Evidence supporting the biologic nature of gender identity. Endocrinepractice : Official journal of the American College of Endocrinology and the American Association of ClinicalEndocrinologists, 21 2, 199-204. https://doi.org/10.4158/ep14351.ra
Swaab, D., Wolff, S., & Bao, A. (2021). Sexual differentiation of the human hypothalamus: Relationship to genderidentity and sexual orientation. Handbook of clinical neurology, 181, 427-443. https://doi.org/10.1016/b978-0-12-820683-6.00031-2
Saleem, F., & Rizvi, S. (2017). Transgender Associations and Possible Etiology: A Literature Review. Cureus, 9.https://doi.org/10.7759/cureus.1984
Kauffman, R., Guerra, C., Thompson, C., & Stark, A. (2022). Concordance for Gender Dysphoria in Genetic FemaleMonozygotic (Identical) Triplets. Archives of Sexual Behavior, 51, 3647 - 3651. https://doi.org/10.1007/s10508-022-02409-1
Fernández, R., Guillamón, A., Cortés-Cortés, J., Gómez-Gil, E., Jácome, A., Esteva, I., Almaraz, M., Mora, M.,Aranda, G., & Pásaro, E. (2018). Molecular basis of Gender Dysphoria: androgen and estrogen receptor interaction.Psychoneuroendocrinology, 98, 161-167. https://doi.org/10.1016/j.psyneuen.2018.07.032
Saffie, J., & Bäuerle, N. (2023). Etiology of gender incongruence and its levels of evidence: A scoping review protocol. PLOS ONE, 18. https://doi.org/10.1371/journal.pone.0283011
Thanks to Davida for putting up the list of sources.
Illustration: Getty
Jack, thank you (and Davida) for this article.
ReplyDeleteI spent all of 2015 reading everything (academic articles, books) I could find and speaking with professionals with a single aim: to determine for myself whether or not gender dysphoria has a biological basis. Although by that time I had over a half century of personally experiencing it, I wanted to be sure. If not, I felt, there ought to be a way (through therapy, most likely) to help me with my pervasive feelings. I came away convinced that although at least at that time, there was an imprecise understanding, that gender dysphoria has its roots in the brain.
Regarding cultural and sociological factors: of course they also have influence. As a transgender woman born raised on the West Coast of the US, I naturally prefer my expressions of identity much differently than, say, women in the Middle East.
The proof is in the pudding as they say. I transitioned nine years ago and am pleased to report much greater comfort in my skin and no regrets.
As someone who does not know life without dysphoria I resoundingly agree with Emma. I had a normal and safe childhood to boot
ReplyDeleteThis seems important for anyone involved in a serious discussion on this topic to know, and a very helpful collation of available research. Thank you.
ReplyDeleteI'd like to add that I find it interesting about the focus on gender dysphoria having a basis in biology. Why not the same attention and research for things like handedness? We never question anyone's being left-handed do we? Similarly, homosexuality. Some years ago this was the alarm that anti-gay people were sounding.
ReplyDeleteLike all of these things: there is no choice. Sure, I might have a biologically-based propensity for gender dysphoria. Okay, but so what? I am what I am.
Read. https://theparadoxinstitute.org/articles/debunking-the-brain-sex-hypothesis-excerpt-from-binary
ReplyDeleteHello again, Anonymous! I was sure you'd be back...
ReplyDeleteTruly, I like it that scientists are trying to find objective differences in brains of people for sexuality, gender, handedness, and other things. See, I would love it if there was an objective test for such characteristics. I'm sure there will be someday but for now all we have is subjective experience.
In 2015 (the year that I was working on my own assessment of biological basis for trans identity and gender dysphoria) I attended a lecture by Dr. Daphne Joel who was visiting Stanford. Her conclusions were:
- No, there is no biological basis because she had used all the tools she had to find a difference and... could not. Therefore, she concluded, such differences don't exist.
- In her experience (as a cis woman) she is a scientist during the day and a mother at night, and easily shifts from a more male-like role at work to a woman's at home.
Her premise and conclusions ignore that no one knows even if there is a " specific location" for such characteristics, she admitted that she had to make guesses for where she looked, and there was no way of knowing if her equipment had/has sufficient resolution to even detect such differences — if they were there.
The problem is that if one wants to believe that there are no such differences one will look but not find them. As I wrote earlier, I really needed to understand — not convince myself — if there is an answer to the question of biological vs. nature vis-a-vis gender identity.
I just did a Google search to find articles about this question. Indeed, lots has happened since 2015! Handedness and sexuality has been found to have brain differences. And gender is hot on the heels of such research. Here's a link to an article in our very own National Institute of Health: https://pmc.ncbi.nlm.nih.gov/articles/PMC8955456/
Why don't you just address the arguments that are actually made in the article that a posted the link from? Can you? Because you're not doing it here.
DeleteOkay, reasonable. Answers:
ReplyDelete1. It's not worth my time. I have more important things to do.
2. As I wrote, I highly doubt its veracity and conclusions.
3. It's very challenging, especially given current neuroscience, to prove a negative conclusion.
4. Last, honestly, I don't care that much. I guess, sure, it would unsettle me a little to learn that there is no biological basis for gender dysphoria. But I so highly doubt that that I'm not worried about being proven wrong.
So, I'm being honest and forthright.
This comment has been removed by a blog administrator.
DeleteLikewise, I'm sure. Also, as noted to you previously, you hide behind an "Anonymous" name. What are you afraid of?
DeleteThis comment has been removed by a blog administrator.
DeleteIf you address a lifelong dilemma and the result is improved mental calm and balance then you have acted correctly. You need not prove to anyone why your actions are correct because someone else's opinion has no relevance or direct consequence on your life.
ReplyDeleteHaving been a LGBTQ activist for some 18 years now, there is one thing I have learned about the way social and cultural systems oppress marginalized groups.
ReplyDeleteThe system (which is not some kind of evil cabal, but a reinforcing complex of beliefs, language and power structures) recruit people who are themselves outsiders. They use these outsiders to police the boundaries of what is accepted within this system.
These trolls take comfort in the role of warriors fighting for «common sense» and «decency». This role gives their lives meaning and direction, and they need that, because they do not - in fact - embody the kind if «normalcy» they think they are defending.
Most of them are themselves outsiders. Indeed, I am sad to see that some of the most virulent homophobes and transphobes are themselves some shade of queer. But since they so desperately want to be seen as «normal», they do everything they can to suppress not only their own queerness, but also to oppress the constant reminder queer and trans people out here represent.
ReplyDeleteThey repeatedly appeal to «scientific facts», but when I provide long lists of science paper documenting that trans identities are real, they ignore that, favoring instead some long tail pseudoscience that seems to confirm their own beliefs. This is not about science as an open fact based discourse for seeking truth. No, their «science» is there to give legitimacy to their own prejudices.
But on one level I think they do recognize that they are caught in some kind of irrational psychosis. The reason I am saying this is that they are so desperately seek my respect. They need me to take their bigotry seriously, because that will entail some kind of affirmation from my side, as if I see them as equals.
ReplyDeleteMind you, I do take many people who express anti-trans arguments seriously if I sense that there is some kind of honesty and openness to fair arguments there. This especially applies to LGBTQ people who are struggling with internalized queer-phobia, or cis/het people who have not had the opportunity to study the topics in depth. There is room for a fruitful dialog there.
But the trolls do not deserve my respect. They deserve my pity, yes, and compassion even, but not respect, which is why I have a zero tolerance for that kind of transphobia ion the platforms I control.
You wrote, "...I do take many people who express anti-trans arguments seriously if I sense that there is some kind of honesty and openness to fair arguments there." I agree 100%. That's exactly where I am coming from, too.
DeleteI get it that gender dysphoria is unusual. I can also well imagine that unlike sexuality (which we are all intimately familiar with), gender identity is so taken for granted that for people like me to seriously express and live their lives as genders they were not "born as" is so remarkable as to be shocking. But it is what it is. So is willful ignorance.
Very well put Jack :)
ReplyDeleteThank you for this post and for the useful list of research literature around the topic.
ReplyDeleteSue x