Psych Central is ending. So I have decided to pull over some of my favorite articles where I got to discuss more than celeb fodder into this blog so that they can live on.
Originally Posted July 12th, 2020 by Quay Bowen for Psych Central. Some original links may be disabled.
JK Rowling broke out medical science to defend her controversial stance on trans women. Responding to twitter attacks—which included people falsely attributing anti-mental health quotes to Rowling—the author posted a series of tweets with links to articles that show her opinions are shared by some medical professionals.
In the thread, Rowling stressed the growing amount of scientific literature that raises concern over the use of “puberty-blocking” medications on trans children and adolescents. She reasserted her support and admiration of the trans community but emphasized that society was pushing young people struggling with their mental health to hormones and medications that have deleterious side effects which are often ignored by trans activists.
I am not one to disagree with very valid concerns about medicating children. I also agree that the potential side effects of puberty blockers cannot be ignored when discussing transitioning prepubescent trans kids. But it feels that Rowling’s self-described “extensive” research to understand issues faced by the trans community consists of combing through articles to find ones that support her positions.
Had Rowling dug a little deeper, she would have come across the myriad of articles about the severe depression, anxiety, and suicidality experienced by transgender individuals, which is largely linked to the stigma and discrimination that they experience.
She would have also come across articles on the ongoing psychological torment experienced by trans individuals who are forced to live as their biological sex and stories of trans tweens who are terrified of undergoing puberty because of the added stigma they will face from having their external physical makeup being a complete mix-match of who they are inside.
She would have also come across information about the substantial financial investment needed to undergo the many plastic surgeries needed to change the gender of trans people post-puberty. These surgeries consist of far more than just genital reassignment (breast removal, adam’s apple, and jaw shaving, vocal chord surgery).
She would have also come across articles about how the cost of these additional surgeries puts trans youth of color and from disenfranchised backgrounds at a significant disadvantage to being accepted as their “chosen” gender in society.
She would have certainly read about the continued psychological stress of people who could afford gender reassignment surgeries in adulthood but were stuck with permanent body changes that cannot be surgically altered (broad shoulders, fat distribution, muscle tone).
In the tweet thread, Rowling claimed that transitioning teens as a new type of conversion therapy being forced on young gay kids. This statement is particularly interesting as she’s previously shown support for “gender acceptance” therapy which is little more than trying to force trans children to deny themselves and live life in a way that society views as acceptable (the definition of conversion therapy). Given her “extensive research” Rowling must have come across articles linking “gender acceptance” therapies and increased suicidality among trans youth.
If as Rowlings says, her concerns are for the safety and wellbeing of trans children and their long-term mental health, why would she promote such damaging ideas to the public? Surely, she must have come across the many stories of the positive impact that families who support trans youth in transitioning have on the long term mental wellbeing of the kids.
Furthermore, in referencing trans youth as “gay” kids, Rowling is intentionally ignoring the existence of the many trans people whose sexuality would be considered straight based on their biological sex. If not intentionally ignoring this fact, Rowling is showing that despite her “extensive research”, her understanding of transgender people is still fundamentally flawed.
More Than Gender
Perhaps the disconnect/confusion for (probably) well-meaning people like JK Rowling is that at present, transgender individuals are viewed as having Gender Dysphoria, “a psychiatric condition where there is a conflict between a person’s physical gender and the one which he or she identifies.”
Both transgender and gender dysphoria emphasize the disconnect of the individual’s physical sex traits to the gender that they identify with. The problem with this labeling is that gender is a social construct, not a biological reality.
Gender norms vary culture to culture and are greatly dependent on the fashions of the time period. Thirty years ago, it was normal for macho cisgender men to wear cropped top shirts, in the 17th century European men wore heels, and women wearing pants in the Victorian era risked being confined to mental wards.
The emphasis on gender allows the general public to see trans adults as essentially just really committed “cross-dressers,” and reduce trans kids as tomboys and “boys who like to wear sparkly things” but it’s so much more complicated than that…
In all her misguided research, Rowling was right about one thing, looking to medical science may be the key to understanding the trans community.
This is especially true when one understands the role of neuroendocrinology in fetal development as well as the role it plays in another “gender” related phenomena that is gaining greater visibility…Intersex, the I in LGBTQI.
Sexual Determination in Utero Is A Complicated Process & A lot can go Awry
Note: For the purpose of clarity, the following definitions and associated terms will be used:
Gender: A social construct defining an individual existing on a continuum of Masculine or Feminine traits as defined by culture and society at any given point in history. This includes gender labels Cis, Trans, Two-Spirit, etc.
Sex: A biological phenomenon resulting from chromosomal makeup of an individual (XX/XY/XXX/XYY/XXY etc) and the phenotypical expression of sexual dimorphisms which can be defined as male (testes, penis, skeletal muscle build) or female (vagina, ovaries, skeletal muscular build). Labels: Man, Woman, Intersex.
In fetal development, the masculinizing and feminizing processes of the brain and body occur in separate stages. It involves multiple chromosome-dependent hormonal surges at various stages throughout fetal development. As such, gonadal (ovaries/testes) development occurs separately from external gender-specific sex characteristics (penis/vulva) and brain chemistry changes occur separately from both.
Simply put, becoming a “boy” or “girl” is a complicated multi-step process.
In normal development, this leads to people with XX & XXX chromosomes having characteristically female physical traits and people with XY & XXY chromosomes with characteristic male traits. It also explains the physical, neurological, and behavioral symptoms seen in conditions with other variants of these chromosomes such as Turner Syndrome (XO) and Klinefelter syndrome (XXY).
When the hormonal changes in utero do not occur as scheduled (for whatever reasons), this can lead to an otherwise healthy infant having physical sex characteristics that don’t match their chromosomal makeup and/or having ambiguous genitalia. The associated syndromes are collectively referred to as Intersex. Below are a few (very oversimplified) examples for your reference.
- Congenital Adrenal Hyperplasia (CAH): XX females who develop penis-like phalluses/elongated clitorises due to adrenal androgen surges in utero.
- Congenital Androgen Insensitivity (CAI/AIS): XY Males who develop external female genitalia and female-typical phenotypes due to a lack of or insensitivity to androgen surges in utero. Because their bodies are insensitive to androgens, in some cases they can go their entire lives without knowing they are genetically XY.
- Guevedoce/ 5 Alpha Reductase deficiency syndrome: XY males who, and this is super simplifying the issue, have external female sexual makeup due to the absence of the hormone 5 Alpha Reductase in fetal development. At puberty, the increases of other male sex hormones lead to affected individuals developing male sex characteristics including the development/maturation of male external genitalia. Again, this is all completely oversimplified but in essence, they literally transform from female to male naturally and without medical intervention.
What Does being Intersex Have to Do with Being Trans?
While “medical treatment” of the intersex community has ranged from controversial to cruel and amoral(#EndIntersexSurgery), the fact that medical science has identified, studied, and thoroughly documented the existence of a number of syndromes that produce external genitalia that “don’t match” chromosomal makeup means that when introduced to the topic, the average person is forced to view Intersex non-negatable non-debatable biological phenomena.
If a person is born intersex, arbitrarily surgically assigned a sex in infancy, and goes on to live their lives as the gender that they identify with rather than the sex that their body resembles, there’s no question about if that choice is rooted in mental illness. Their sense of self was not defined by their external physical makeup, their brains told a different story than their bodies. Their choice is them making a choice to correct an error and be their true selves.
Trans people should be viewed under this same lens.
As I mentioned, sexual differentiation occurs separately in the brain and body. Given the clear and undeniable cases of people’s external physical makeup not matching their chromosomal makeup. Why then is the potential of a person’s neuronal makeup (brain chemistry) not matching their chromosomal makeup even up for debate?
Current neurobiological research shows that the chemistry and physical makeup of the brains of trans individuals more closely match that of the sex they identify with rather than the one they physically resemble at birth. In simpler terms: There is scientific evidence to support the idea that the brains of trans women are female. The brains of trans men are male.
These differences are more than just the result of “brain rewiring” caused by living as a different gender. If such complete “rewiring” was possible, then the medically unnecessary sex assignments of Intersex individuals (and the rare cases of sexual reassignment due to botched circumcisions) done infancy wouldn’t have such traumatic effects on individuals who were assigned “the wrong sex.”
For people who were assigned the wrong sex, the internal frustration and emotional struggles throughout childhood, adolescence, and continuing through adulthood are almost identical to those reported by trans men and women.
It’d take multiple large and extensive longitudinal studies, all beginning at conception and lasting well into adulthood, for medical science to fully understand the likely many components contributing to the trans phenomenon. Its possible science will never fully be able to explain it. But looking at it from a medical lens rather than a psychiatric or political one can help people outside the trans community to accept trans individuals for who they are, not who society thinks they should be.
Contrary to what Rowling and other trans-exclusionary feminists argue, accepting trans women as women (and conversely trans men as men) does not in any way take away from the “shared experience” of “womanhood” or the identities of biological women.
It just involves understanding that trans women are women. And as women, they share many of the same experiences of cis women (sexual violence, marginalization, etc) but also have unique struggles of their own.
It’s no different than understanding and acknowledging the fact that the experiences of cis women can be drastically different based on race, religion, physical ability, fertility, reproductive health, sexuality, and socioeconomic status. Our experiences are all unique but do not negate the underlying fact that we are still women.
Then again, feminists like Rowling have long-struggled with ignoring/ dismissing the experiences of “certain types” of women in their fight for equality.
I presented all of this info in hopes of enlightening people on information that I never hear brought up in the discussion of trans rights. Usually, these arguments are all about feelings and opinions and theories rooted in what I honestly feel is the result of poor nomenclature. Rarely does anyone in the general public look at the potential biological basis for transgenderism. If biology is brought up it’s usually to argue against accepting trans men & women as men/women.
I won’t lie and pretend that I don’t sometimes struggle with more complicated issues related to trans rights or have opinions that are less-than “woke” (ex: is a sexual preference for cis-gender partners transphobia? I don’t think so #CancelMe). Still, I firmly feel that the “gender” identities of trans men and women should not be under constant scrutiny, especially by people they will never interact with and who are in no way impacted by trans people living as their authentic selves.
As for Rowling’s latest round of gender-critical grandstanding? At the end of the day, the potential long-term implications of transitioning trans children and the use of “puberty blockers” are issues that should be discussed between trans children, their parents, and their physicians. Not included in this mix? Their ex-favorite children’s book author.
It doesn’t take a thorough understanding of neuroscience or fetal development to accept people and understand their struggles. It also doesn’t take any effort just mind your own business…which is probably what Rowling should do the next time she feels the need to speak out about the trans community. Maybe then she won’t have to worry about petitioning against “cancel culture.”