Transsexuality: Encyclopedia II - Transsexuality - Causes of transsexualism

Transsexuality - Causes of transsexualism

There is no scientifically proven cause of transsexualism. However, many theories have been proposed which suggest that the cause of transsexualism has its roots in biology. Because of this, the medical care profession is increasingly viewing transsexuality not as a psychological issue, but as a physical one. But many religious conservatives and others still believe that the causes of transsexualism are predominantly psychological.

Transsexuality - Proposed psychological causes

In the past, many psychological causes for transsexualism have been proposed; including "overbearing mothers and absent fathers", "parents who wanted a child of the other sex", "repressed homosexuality", "emotional disturbance", "sexual abuse" or a variety of sexual "perversions". (Compare autogynephilia.)

None of these theories, however, were able to be applied successfully to a majority of transsexual people, and usually not even to a significant minority. Many theories also were developed in order to describe transsexual women, and when applied to transmen, they were even less useful. One such example was Ray Blanchard's theory that all transwomen could be divided into the categories of autogynephilic and homosexual. Many of these theories had also previously been applied to homosexuals, where they did not work out, either. This led to theories which consider physical reasons for transsexualism.

Experience with individuals who were surgically reassigned at birth, in order to correct deformities such as those caused by accidental castration or intersex conditions, suggests strongly that the mental gender identification is determined at birth - individuals born male but raised as female often show the same symptoms of gender dysphoria as transsexuals.

However, many religious conservatives and others still hold strong beliefs that the causes of transsexualism are psychological and/or emotional in nature.

Psychological treatments aimed at curing transsexuality are historically known to be unsuccessful. As early as 1972, the American Medical Association Committee on Human Sexuality published the prevailing medical belief that psychotherapy was generally ineffectual for adult transsexuals and that sexual reassignment therapy was more useful. (Human Sexuality. The American Medical Association Committee on Human Sexuality. Chicago. 1972.) A number of other treatments have been used in the past that are now considered ineffective for people with significant and persistent cross gender identity, including aversion therapy, psychoactive medications, electroconvulsive therapy, hormone treatments consistent with the birth gender, and psychotherapy alone.

Reparative therapy aimed at gay or lesbian people has also been applied to transsexual and transgender people, since gender variant behaviour is seen by proponents of reparative therapy as an extreme form of homosexuality (a view that has long since disappeared from almost all scientific discourses). While the Kinsey scale expressed a similar view, the scientific community now rejects this part of Kinsey's theory, making reparative therapy useless to transsexual people as well as gay and lesbian people. Even though many of the major medical professional associations have repeatedly condemned reparative therapy as not only ineffective, but actually harmful, it continues to be advocated as a treatment for both homosexuals and transsexuals by several organizations with ties to the conservative Christian movement. However, in modern western medicine, reparative therapy generally is not considered to be good medical/psychological care.

However, for certain transsexual persons, therapies aimed at resolving gender conflicts, other than somatic treatments to reassign physical sex, may be effective and useful. Some people may have milder conflicts between gender identity and their physical sexual characteristics. These individuals may not actually wish to pursue gender reassignment therapy, but may seek care to help deal with the conflicts they face. If individuals express this desire for psychological care without SRS, supportive and psychoeducational counseling may be helpful. Additionally some transsexuals, who may have a significant lifelong conflict between gender identity and their sexed-body may present for care without requesting SRS. Their reasons for forgoing transition may include family or professional concerns, perceptions of difficulty of transition, fear of loss of social standing or role, firmly held religious beliefs, real or perceived inability to finance transition, and advanced age or chronic medical problems, which may, in some cases, be considered medical contraindications to hormone therapy or sex reassignment surgery. Regardless of their reasoning, if their decision is consistent, it should be respected. These individuals often seek alternative methods with which they can improve their functional status, promote acceptance of their gender identity as valid, and ameliorate mood symptoms caused by gender conflict through psychotherapy and sometimes medications. Additionally, these individuals sometimes benefit from partial somatic treatment. Low dose hormonal therapy only, validating patients desire to dress and live partially in the gender role appropriate to their gender, and even simply allowing the person a safe outlet to express themselves as a male or female can provide a great deal of comfort to patients who, for one reason or another, choose not to transition.

Transsexuality - Physical causes

Many transsexual (and also many other transgendered) people have assumed that there is a physical cause of their transsexualism, because they claim to have had the feeling of being a girl or a boy for as long as they can remember. Several studies have shown evidence that there might actually be such a physical cause.

While the article by Zhou, [1], has been touted as strong evidence that transsexuality is based in structural and neurochemical similarities between the brain of transsexuals and brains typical of their gender identity, this article has been alleged to have numerous flaws. A second study by Kruijver, et al replicated the results of the first study, and included controls to help eliminate the alleged flaws.

Interesting evidence also comes from numerous animal studies demonstrating that exposure to cross-sex hormones during development can reliably produce cross-sex behaviors in animals. In addition twin studies have demonstrated a strong heritability for transsexuality. (Concordance for Gender Identity Among Monozygotic and Dizygotic Twin Pairs. Diamond, M and Hawk, S. American Psychological Association 2004 Annual Meeting. July 28 - August 1, 2004, Honolulu, Hawaii.) This research provides more suggestive evidence that transsexuality may be determined in part by genetics and in utero hormonal environment.

A recent study in Germany provides even more evidence for a physical basis for transsexualism. The study found a correlation between digit ratio and male to female transsexualism. Male to female transsexuals were found to have a higher digit ratio than control males, but one that was comparable to control females. Because digit ratio is directly related to prenatal hormone exposure, this tends to support theories linking such to male to female transsexualism. (Schneider, Pickel & Stalla 2005)

Many religious conservatives have criticized all of the studies suggesting physical causes of transsexuality as being seriously flawed due to methodological problems, erroneous conclusions, or both.

Transsexuality - Objections against research of causes

Many scholars of gender theory, gender professionals and transsexual and transgender rights activists contest the very rationale of looking for a "cause" to transsexualism. The basic assumption behind this quest for "causes" is that gender dimorphism (the idea that there are only two discrete, well defined and dichotomous genders) is an established fact. The critics cite, among other things, historiographic and anthropological findings pointing to the fact that different cultures had diverse concepts of gender, some of them including three or more genders.

The main argument against the search for a "cause" to transsexualism is that it assumes a priori the legitimacy of normative gender identity, i.e. gender identity congruent with the external genitalia. This, affirm the critics, is an unproved contention. Historical research shows that the relation of genitals and gender identity changes across cultures. Assuming a priori that variant gender identity is anomalous (and therefore that its "causes" should be investigated) distorts science's view of gender and contributes to the stigmatization of gender non-conformists.

Closely related to the above argument is the belief of many people that transsexualism is not a disease or disorder and that no attempts should be made to cure transsexualism psychologically.

Adapted from the Wikipedia article "Causes of transsexualism", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki