Thursday, 20 January 2011

Transsexuals and the phantom penis

Further to my previous post of a few days ago, the transcript of an ABC Science Show program from 2007 on the subject : Transsexuals and the phantom penis - Science Show - 3 March 2007
But it is curious that most normal people who have carcinoma of the penis, which is not rare, and they have an amputation of the penis as a life saving measure, a majority of them, maybe about 80%, 85% of them, experience a phantom penis, including phantom erections. This is well known. Since this chap is saying his penis doesn't belong to him in the first place, what if his penis is amputated because he wants to become a woman, what happens then?

The answer is the majority of them don't experience a phantom penis. What's amazing is that your body image, which includes your genitals, is at least in part programmed by genes and your brain is hard-wired to incorporate the genitals as part of your body image. Even more amazing is the observation that women who undergo transgender sexual surgery who acquired an artificial penis, a majority of them since early childhood have experienced a phantom penis. This is absolutely extraordinary because it means that each of us has a brain-based body image which is detailed down to the fine anatomy, including your genitals.

If your brain body image does not match...normally your brain body image and your external morphology are synchronised in early development through hormones, through genetic mechanisms. If this gets uncoupled and they aren't in synchrony you end up with a body image that's morphologically male, so they experience a phantom penis. What's amazing is that all these years of culture being raised as a woman, as a girl, and even seeing that they don't have a penis does not correct this body image. This shows that even though your body image is extremely malleable, as we have shown with phantom limbs and mirrors and that sort of thing, it also turns out that there's a strong genetic contribution to your body image. This has, of course, great implications for understanding how your brain represents sexual behaviour and constructs body image.
The bit about "phantom limbs and mirrors", where the psychological distress can be alleviated by the use of mirrors "restoring" missing limbs in a reflection, might explain another phenomenon (according to a correspondent who wishes to remain anonymous).

The almost universal (80%) practice amongst trans people of cross-dressing prior to transition. By cross-dressing and then looking at one's reflection in a mirror, it might (I emphasise might) activate the same kind of soothing mechanism found when amputees see reflections of themselves that appear to cure their problem.

As an aside....I never cross-dressed, the phrase "putting lipstick on a pig" comes to mind as being appropriate. But I didn't even do it for fancy-dress parties, in fact I fanatically avoided even coloured shirts or patterned ties. Nothing even partly reminiscent of femininity.

Much as an acute alcoholic might fanatically avoid even a low-alcohol beer. I couldn't do it because then I wouldn't have been able to stop. Maintaining the "boy act" was so hard, the whole facade would have shattered, leaving me helpless to avoid a transition I was terrified of.


Zimbel said...

This is absolutely extraordinary because it means that each of us has a brain-based body image which is detailed down to the fine anatomy, including your genitals.

I thought that the neural density of genitals was fairly high; in other words, that to the neural system genitals are not fine anatomy, but fairly major anatomy (around the level of hands or lips/tongue).

My neurology is weak and antiquated, though - so my certainty isn't high.

Sarah Murphy said...

If I'd have known, I would have saved my comment on supernumerary phantom limb I made on the last post on this subject for this one.

There's that 20:20 hindsight.


MgS said...

I think it's also important to recognize that the most common form of GRS - politely called "penile inversion" - preserves the vast majority of the tissue involved in the penis. All that is really removed is a length of urethra and the erectile tissue.

That likely also means that the majority of the nerve connections remain after surgery, thus giving some grounding to neurological pathways that would otherwise be "floating" in the case of an outright amputation.

Psychologically, I expect that the transsexual is also much more likely to be active in 'remapping' their body after surgery.

Anonymous said...

I find the privileging of birth sex in the article to be highly problematic and transphobic. It (yet again) re-enforces the meme that what we were assigned as at birth is more "real" than what we know ourselves to be.

Supreme_Martian_Overlord said...

I remember listening to that one on the radio. Fascinating stuff.

Especially the suggestion you make of possible crossdressing function.

I wonder though how that works for people with the need to express both genders? Body dysphoria isn't unknown amongst them and I've known quite a few who struggle with it pushing them first in one direction then the other.

Anne said...
This comment has been removed by a blog administrator.
Anonymous said...

I think the article is exaggerating the numbers on the phantom penis.

An early piece by Ramachandran cites another study that found 58% of men who had their penises removed experience a phantom penis.

Ramachandran's interviews found that 30% of trans women experienced a phantom penis post-op. Meanwhile 60% of trans men had experienced a phantom penis before treatment.

There's a difference, but it's not as dramatic as the Science show is suggesting.

Ramachandran didn't interview that many people.

I also really wonder what his results mean - almost half of the cis men did not experience a phantom penis.

A third of the trans women did experience a phantom penis.

Anonymous Me