Wednesday, 16 January 2008


Atypical Gender Development - A Review (PDF) by Besser, M., Carr, S., Cohen-Kettenis, P.T., Connolly, P., De Sutter, P., Diamond, M., Di Ceglie, D. (Ch & Adol.), Higashi, Y., Jones, L., Kruijver. F.P.M., Martin, J., Playdon, Z-J., Ralph, D., Reed, T., Reid, R., Reiner, W.G., Swaab, D., Terry, T., Wilson, P., Wylie. K.

Cite as GIRES et al. (2006). Atypical Gender Development - A Review, International Journal of Transgenderism, 9(1) p29-44.

The best and most comprehensive overview of the medical issues I've yet found.

Now to look at the many other articles on the DES-Sons Yahoo group. In my copious free time, of course.


Jaimie said...

For a critique on some of the points, it is worth reading: Commentary on “Atypical Gender Development–A Review” KJ Zucker - International Journal of Transgenderism, Volume: 9 Issue: 1 2006

Zoe Brain said...

Thanks for bringing that to my attention. I've only read the critiques by Pfaeffler and Zucker in Abstract form, but I'll try to get the ANU library to subscribe to that journal.

One thing bothers me: I don't care whether the "biological cause" theory leads to more or less TS rights. I just want to know the truth, and let the cards fall as they may. The Human Rights issue I see as separate, and a different fight, or set of fights, which may or may not involve other "transgendered" groups. That part of the critiques - that evangelising for a biological cause is not necessarily helpful in gaining rights, I find irrelevant.

In my own case, I was willing up until a few weeks ago to consider the hypothesis that I was exaggerating things, and initially that I was delusional. But the series of anomalous blood test results made those hypotheses increasingly hard to justify.

Finally, I got a straight answer from my shrink, who had initially been sceptical - almost as sceptical as I was. I described my perceptions to her, and she agreed they accorded exactly with the reality of what she'd personally witnessed. Not just no delusion, that had been eliminated some time ago, but no detectable self-deception either. Too many witnesses, too much objective evidence. I'm ridiculously sane and objective considering the situation I've been in. Too sane to be entirely normal... :) A coping behaviour, such objectivisation, but a useful one for a scientist under the circumstances.

The point is, I was intellectually honest enough to consider hypotheses such as my being bonkers, no matter how uncomfortable they made me. So much so, that I hung onto them a little longer than I should have before eliminating them from consideration, simply because they made me uncomfortable, and I couldn't be sure of my own objectivity. I just want to know why, regardless of consequences.

Intersex of all other sexually dimorphic structures happens at a rate of O(10E-3), +/- an order of magnitude. (For non-geeks, that means somewhere between 1 in 100 and 1 in 10,000) If the CNS (brain etc) was immune, we'd have to wonder why. To over-simplify, if Transsexuality didn't exist, we'd have to invent it - or at least figure out why we weren't observing the expected symptoms of something we have to infer probably exists.

On to BSTc layers et al, and correlation. Correlation and causality have 4 possible relatonships. Two correlated phenomena, A and B can be causally related in 4 ways:

1) a coincidence, no causal relationship. The stronger the correlation, the less likely this is, till at some arbitrary point we eliminate it from consideration.

2) A can cause B. This requires though that A happens before B.

3) B can cause A, likewise.

4) Another set of phenomona, C, can cause both A and B, even if C cannot be detected. C must happen before either.

We know that Transsexuality cannot be the result of BSTc layer differentiation. TS symptoms occur before it happens. But the mechanism whereby BSTc layer changes happen is unknown, as hormone levels have no effect. Combine this with the increase in TS from DES exposure in gestation - though the degree of increase is open to debate - and the fact that at birth, neural networks are largely inchoate - and there has to be a common cause C, one set during gestation, one which is responsible for causing post-natal sexual differentiation of neural anatomy.

There is also much evidence showing many, perhaps most, have brains that could function adequately in either gender role. But some do not, and if the brain, or rather, the part(s) of it that determine gender identity, are cross-gendered, transsexality to a varying degree is the result.

The fact that so many boys with 5ARD have a male gender identity, despite a female upbringing, argues that post-natal influences generally play little part. The fact that a minority have a female gender identity argues that at least in some cases, nurture may play a bigger part than in others. Or it could be that 5ARD, like DES exposure, increases the chances of TS (in 5ARD that means a female gender identity) without always causing it.