A young woman classmate of mine approached me this afternoon, as I was headed out of the law school for home. She had a basic question for me, but was a bit hesitant to ask. I assured her that whatever she wanted to know, I was willing to respond to, to the best of my ability.
Essentially, she wanted to know how trans people know they're trans. What a great question, and I'm delighted that she took the risk to ask me.
Of course, I don't have an answer, I have only my own experience and the benefit of what reading and conversation I've enjoyed with other trans folk to inform me.
Not far removed from this question is also the question of what causes transgenderism. I answered that question first -- with an emphatic "I don't know", although I did allude to the research that suggests there might be some biological underpinnings (note paragraphs 33-35 of this document (Aug 2004 – Atypical Gender Development – Gender Identity Research and Education Society (GIRES)) - also reproduced below the fold). But, her question wasn't really about causation, it was more about internal recognition of it.
I think there must be many different responses to this question and I'd be delighted to have other people comment upon this. How do you know what sex you are? Is there such a thing as an innate recognition of gender identity? Even if we grant the assertion that men and women have different brains and process information differently, how does one know they're doing it differently from others with their body type (or, for that matter, processing information the same as others of their body type)?
For a long time the psychiatric profession held transsexuals to the model of "when I was a kid I always played with [the opposite sex's] toys." Eventually, perhaps in recognition of the obvious stereotyping at play (no pun intended) there, that approach was abandoned. I know that when I first began seeing a psychologist, I was required to take several standardized tests, including the Minnesota Multiphasic Personality Inventory (MMPI). That test was then scored, using two different scales -- one based on the "average male" results and the other based on the "average female" results (I was told at the time (12 years ago) that tens of thousands of these tests had been administered and that there was a discernible difference between scores of men and women). According to the report, my thought processes were much more closely aligned with a woman's than with a man's (I'm still not sure I buy all that, btw).
But, even then, so what? How does one know? For me, it ultimately came to a realization that I was more comfortable around women then I was around men. I related better. It was as simple as that. I've got all the other stories, too - about cross-dressing as a young child, playing jacks and hopscotch, etc. - but they don't really answer the question for me, perhaps because they are so steeped in stereotype and cultural norms.
At the end of the day, that's how I answered this young woman. I told her that I thought I just felt more comfortable around women - as if I were part of their circle - but that if society were structured differently, so that we didn't make such a big cultural distinction between men and women I don't know if I would have felt the need to transition. Of course, our culture is the way it is and I am delighted that I did transition! :)
33. It is postulated that, in those who experience severe gender dysphoria, the sex differentiation of their brains has not followed the pattern usually predicted by the earlier steps in the differentiation process (such as the chromosomes, genitalia and gonads) “but has followed a pattern typical of the opposite sex in the final stage of that differentiation process” (Gooren, 1999; Gooren and Kruijver, 2002). This hypothesis is substantially supported by two important studies on post-mortem brains, including those of trans individuals (Zhou et al, 1995; Kruijver, 2001). 34.
34. These studies followed others that found several sex-dimorphic nuclei in the hypothalamic and other areas of the brain (Allen & Gorski, 1990; Le Vay, 1993; Swaab et al. Of particular interest, in regard to transsexualism, is the sexdimorphic region called the central subdivision of the bed nucleus of the stria terminalis (BSTc). This nucleus appears to become fully volumetrically sex differentiated in the human brain by early adulthood. In human males the volume of this nucleus is almost twice as large as in females and its number of neurons is almost double (P <0.006) (Zhou et al., 1995; Kruijver et al., 2000; Chung et al., 2002). The Kruijver et al. study found that in the case of trans women (n=7), the size of this nucleus and its neuron count was in the same range as that of the female controls (n=13) and, therefore, women in the general population. When all the subjects were included, the neuronal differences between the groups were found to be highly significant. In the only available brain of a trans man, the volume and structure of this nucleus was found to be in the range of the male controls (n=21) and, therefore, men in the general population. The latter is not a significant result, but in the context of the overall findings, it leads to the hypothesis that this male-like BSTc will be present in other trans men as well.
35. In the 42 human brains collected for the Kruijver study, the BSTc was found to have a structure concordant with the psychological identification as male or female. It is inferred that the BSTc is an important part of a sex-dimorphic neural circuit, and that it is involved in the development of gender identity (Kruijver et al., 2000; 2002; 2003). These findings were independent of sexual orientation and of the use of exogenous sex hormones. No depression of neuron numbers in the BSTc was noted in association with estrogen administration, anti-androgen treatment and orchidectomy, in either trans women or in male controls. A high, male neuron number was found in the BSTc of the female to male trans individual. The 83 year old individual who had identified strongly throughout life as female in contradiction to both karyotype and phenotype, and who had undergone no feminising treatment of any kind, had a BSTc fully in the female range.
