The etiology of transsexualism, meaning the cause or causes of transsexualism has long been an area of interest for many transsexual people, physicians, psychologists, other mental health professionals, and family members and friends of transsexual people. Transsexualism is a condition in which a person identifies with a physical Sex different from the one with which they were born A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health Mental health professional A psychologist is a practitioner of Psychology, the systematic investigation of the mind including Behavior, Cognition, Mental health is a term used to describe either a level of cognitive or Emotional wellbeing or an absence of a Mental disorder. Currently, there is no scientifically proven cause of transsexualism. For many years, many people assumed that transsexualism was a psychological/emotional disorder caused by psychological factors. More recently, research has suggested that the cause of transsexualism is rooted in biology, and a large segment of the medical profession has come to view transsexualism as a physiological condition rather than a psychological one. Foundations of modern biology There are five unifying principles However, as of 2006, physiological causes of transsexualism have not been proven.
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Possible psychological causes
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, and a variety of sexual perversions and paraphilias, including autogynephilia. Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and Homosexuality refers to sexual behavior with or attraction to people of the same sex or to a Homosexual orientation. Sexual abuse, also referred to as molestation, is the forcing of undesired sexual acts by one person upon another Perversion is a concept describing those types of Human behavior that are perceived to be a serious deviation from what is considered to be orthodox or normal Autogynephilia (ˌɔːtoʊˌɡaɪnəˈfɪliə (from Greek αὐτό (self γῦνή (woman and φῖλία (love &mdash "love of oneself
None of these theories, however, could be successfully applied to a majority of transsexual people, and often not even to a significant minority. Many theories developed to describe transsexual women were even less useful when applied to transsexual men. A transwoman (also spelled trans woman or trans-woman) is a male-to-female transsexual and the term transwoman is preferred by many such A transman or transguy (often referred to as FTM) is short for Transsexual or Transgender man - a person who was naturally born or physically One such example was Ray Blanchard's theory that all transwomen could be divided into the categories of "autogynephilic" and "homosexual". Ray Milton Blanchard (born 9 October 1945) is an American-Canadian Sexologist, best known for his research studies on Pedophilia Autogynephilia (ˌɔːtoʊˌɡaɪnəˈfɪliə (from Greek αὐτό (self γῦνή (woman and φῖλία (love &mdash "love of oneself Homosexuality refers to sexual behavior with or attraction to people of the same sex or to a Homosexual orientation. Many psychological theories had also been applied to homosexual people, also usually without success. This led to theories which considered the possibility of physical reasons for transsexualism.
Experience with individuals who were sexually reassigned at birth, in order to correct deformities such as those caused by accidental castration or intersex conditions, suggests strongly that one's mental gender identity is not determined by the environment they are raised in. Sex reassignment surgery (SRS gender reassignment surgery, or sex-change operation is a term for the Surgical procedures by which a person's physical Castration (also referred to as Gelding, Neutering, Fixing, orchiectomy, and orchidectomy is any action surgical, chemical Intersexuality is the state of a living thing of a gonochoristic species whose Sex chromosomes, Genitalia, and/or Secondary sex characteristics Gender identity (or core gender identity) is a person's own sense of Identification as Male or Female. Individuals born male but raised as female, or vice versa, often show the same signs of gender dysphoria as transsexual people; rejecting their assigned gender. Male (♂ refers to the sex of an organism or part of an organism which produces small mobile Gametes called spermatozoa. Female (♀ is the Sex of an Organism, or a part of an organism which produces ova (egg cells One notable example was David Reimer. David Reimer ( August 22, 1965 as Bruce Reimer – May 4, 2004) was a Canadian man who was born as a healthy boy but was sexually Reimer later suffered depression and heroin addiction in adulthood, which has been taken as proof of gender essentialist biological theories; however, critics of the case study note that his twin brother suffered from the same conditions, and that their depressive moods were likely genetic in origin.
"Curing" transsexualism
Psychological treatments aimed at curing transsexualism are historically known to be unsuccessful. In 1972, the American Medical Association Committee on Human Sexuality published the medical opinion that psychotherapy was generally ineffective for transsexual adults. The American Medical Association (AMA founded in 1847 and incorporated 1897 is the largest association of Physicians and Medical students in the United States [1] A number of other treatments have been tested on transsexual people, including aversion therapy, psychotropic medications, hormone treatments consistent with the patient's birth sex, electroconvulsive therapy, and hypnosis. Aversion therapy is a form of psychiatric, Mental health or psychological treatment in which the patient is exposed to a stimulus while simultaneously Hormone therapy, or hormonal therapy is the use of Hormones in medical treatment Electroconvulsive therapy ( ECT) also known as electroshock, is a controversial psychiatric treatment in which Seizures are electrically induced Hypnosis is often thought to be a wakeful state of focused attention and heightened suggestibility with diminished peripheral awareness These treatments have also been shown to be ineffective.
Reparative therapy, which is usually aimed at gay and lesbian people, has also been applied to transsexual and transgender people. Conversion therapy has been defined by the American Psychological Association as therapy aimed at changing Sexual orientation, and by the American Psychiatric In the English language, gay is an Adjective that in modern usage refers to Homosexuality. A lesbian is a Woman who is romantically or sexually attracted only to other women The Kinsey scale once expressed a view of transsexualism as an extreme form of homosexuality; the medical community now rejects this part of Kinsey's theory. The Kinsey scale attempts to describe a person's sexual history or episodes of their sexual activity at a given time Reparative therapy is generally ineffective for transsexual and transgender people as well as gay and lesbian people. [2] Even though many major medical and psychological associations have condemned reparative therapy as not only ineffective, but actually harmful,[3] it continues to be advocated as a treatment for both homosexual and transsexual people by various organizations in the Western World, often with ties to the conservative Christian movement or other conservative religious movements. The term Western world, the West or the Occident ( Latin: occidens -sunset -west as distinct from the Orient) can have multiple meanings For conservative political views within Christianity see Christian right. Conservatism is a term used to describe political philosophies that favour Tradition, where tradition refers to various religious cultural or nationally defined A religion is a set of Tenets and practices often centered upon specific Supernatural and moral claims about Reality, the Cosmos
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 their gender identity and physical sexual characteristics. These people may not wish to pursue sex reassignment therapy, but may seek care to help deal with the conflicts they face. If individuals express the desire for psychological care without plans for sex reassignment surgery, supportive and psychoeducational counseling may be helpful. Sex reassignment surgery (SRS gender reassignment surgery, or sex-change operation is a term for the Surgical procedures by which a person's physical Additionally, some transsexual people 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 and/or SRS may include family and/or professional concerns, perceptions of the difficulty of transition, fear of loss of social standing or role, religious beliefs, political standpoints, 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 and/or sex reassignment surgery. In Medicine, a contraindication (pronounced as contra-indication is a condition or factor that increases the Risks involved in using a particular drug, 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 with medications. Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living Additionally, these individuals sometimes benefit from partial transition options, such as low dose hormone therapy, validation of the patient's desire to dress and live partially in the gender role consistent with their gender identity, or even simply allowing the person a safe outlet to express themselves as members of their target gender. These options can provide a great deal of comfort to individuals who, for any reason, choose not to fully transition. Such therapies may also benefit people who manifest transsexual-like symptoms but who are not diagnosable as "genuine" transsexual people.
Possible physical causes
A point of empirical evidence that a physical cause may be at hand in transsexualism, is that in the most common accounts of their childhood, transsexual (and also many other transgender) people claim to have had feelings of being either a girl or boy for as long as they are able to remember. Transgender (trænzˈdʒɛndɚ from ( Latin) derivatives As andectodal evidence, it is important to take it with a point of scepticism. However, the medical field for a long time had expected and required accounts such as this in order to receive access to medical treatment.
One study[4] gives strong evidence that transsexualism is based in structural and neurochemical similarities between the brains of transsexual people and brains typical of their gender identity; this study has been alleged to have numerous flaws. A second study has since replicated the results of the first study and included controls to help eliminate many of the alleged flaws, particularly the study included two individuals who had cross-gender hormone secreting cancers which were significant enough to have caused significant cross-gender development in both individuals. [5] Although transsexualism manifests itself as an anomaly in brain structure in which transsexual people have a neuron density in the central subdivision of the Bed Nucleus of the Stria Terminalis region (BSTc), similar to members of their target gender, it is not known whether this is a cause, consequence, or simply a manifestation of transsexualism.
As of December 2006, a new study funded by Ferring Pharmaceuticals was presented at the International Paediatric Endocrinology Symposium in Paris. This study[6] finds that prior to hormone replacement therapy, transsexual people have brain mass ratios of their birth sex. According to this study, a transsexual person's brain restructures itself to become typically structured for the individual's target sex with the administration of hormone therapy. This study did not analyze differences in specific sexually dimorphic regions of the brain, rather it focused on large-scale differences in overall brain structure.
Several animal studies have demonstrated that exposure to cross-sex hormones during certain stages of fetal development can reliably produce cross-sex behaviors in animals. In addition, twin studies have demonstrated a strong heritability of transsexualism. [7] This research provides additional evidence that transsexualism may be caused by genetics and in utero hormonal environment. Genetics (from Ancient Greek grc-Latn genetikos, “genitive” and that from grc-Latn genesis, “origin” a discipline of Biology, is For the Nirvana album see In Utero. In utero is a Latin term literally meaning "in the Uterus " There are several known cases of identical twins who were both transsexual, both male-to-female and female-to-male. Twins are Offspring resulting from the same Pregnancy, either of the same or opposite Sex.
A recent study from Germany provides additional evidence of a physiological basis for transsexualism. Germany, officially the Federal Republic of Germany ( ˈbʊndəsʁepuˌbliːk ˈdɔʏtʃlant is a Country in Central Europe. The study found a correlation between digit ratio and male-to-female transsexualism. The digit ratio is the ratio of the lengths of different digits fingers or toes typically as measured from the bottom crease where the finger joins the hand to the tip of the Male-to-female transsexual people were found to have a higher digit ratio than control males, but one that was comparable to control females. Because digit ratio is known to be directly related to prenatal hormone exposure, this tends to support theories linking such to male-to-female transsexualism. [8]
There is also evidence from transsexual people born between the 1930s and 1970s that exposure to a synthetic estrogen known as diethylstilbestrol(DES), routinely used at the time to prevent miscarriage and treat morning sickness, may have contributed to disrupting the hormonal balance within the womb. Diethylstilbestrol ( DES) is a drug, an orally active synthetic nonsteroidal Estrogen that was first synthesized in 1938 Miscarriage or spontaneous abortion is the natural or spontaneous end of a Pregnancy at a stage where the embryo or fetus is incapable of surviving generally defined Morning sickness, also called Nausea, Vomiting of Pregnancy ( emesis gravidarum or NVP) or pregnancy sickness Evidence suggests that an unusually high percentage of physical males whose mothers were known to have taken this medication present as transgender or transsexual, either in childhood or in later life. Child article read through the various talk pages for the debate -- it's been put on and removed twice
Due to incidents of birth defects and other side effects, the use of DES and other synthetic estrogen compounds has been largely abandoned or replaced with natural estrogens. A congenital disorder is a disease or disorder that is present at birth [9] Today, with widespread use of certain plastics and other substances, there are likely to be many environmental pollutants which closely mimic the chemical structures of the withdrawn drugs. This suggests that prenatal environmental factors could also influence the development of this condition.
A 2005 study found that prenatal exposure to phthalates reduced the anogenital distance in males. Phthalates, or phthalate esters, are esters of Phthalic acid and are mainly used as Plasticizers (substances added to Plastics to increase their In Human anatomy, the perineum is generally defined as the surface region in both males and females between the Pubic symphysis and the Coccyx. [10] Shorter anogenital distances were found to be associated with smaller penises, cryptorchidism, and lower levels of aggressiveness. Cryptorchidism is the absence of one or both Testes from the Scrotum. Although no transsexual patients were included in this study, it suggests that environmental pollutants can affect sexual development in physical males.
Objection against research of causes
Many scholars of gender theory, professionals who work with transsexual people, and transsexual and transgender people themselves, contest the very rationale of searching for a cause of transsexualism. Gender studies is a field of Interdisciplinary study which analyzes the phenomenon of Gender. An assumption behind this quest for a cause is that gender dimorphism (the idea that there are only two discrete, well-defined genders) is an established fact. 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 (see two-spirit, xanith, and hijra for examples. Anthropology (/ˌænθɹəˈpɒlədʒi/ from Greek grc ἄνθρωπος anthrōpos, "human" -λογία -logia) is the study of Two-Spirit (also two spirit or twospirit) people are Native Americans who fulfill one of many mixed Gender roles found traditionally among many Khanith (خنيث variant transcription Xanith) is a vernacular Arabic term for both standard written Arabic mukhannath and khuntha. In the culture of the Indian subcontinent, a hijra ( Hindi: हिजड़ा Urdu: حجڑا is usually considered a member of "the Third ) Historically speaking though, the binary gender model has been the most prevalent, and the "third" gender has been, more or less, a "curiosity", or its members have formed an underclass. The contemporary concept of the underclass is a sanitized term for what was known in the eighteenth and nineteenth centuries as the undeserving poor and may have been coined by American sociologist
One argument against the search for a cause of transsexualism is that it assumes a priori the legitimacy of a normative gender identity, i. Normative has specialized meanings in several academic disciplines e. gender identity congruent with the external genitalia. A sex organ, or primary sexual characteristic, as narrowly defined is any of the anatomical parts of the body which are involved in sexual reproduction and constitute This, affirm the critics, is an unproven contention. Historical research shows that the relation between 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. Social stigma is severe social disapproval of personal characteristics or Beliefs that are against cultural norms.
Additionally, many people do not consider transsexualism to be a disease or disorder. A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as [11] It should also be noted that the search for a physiological cause of transsexualism is in many ways similar to the search for a physiological cause of homosexuality. Many consider such research to be irrelevant, because they feel that, even if such a cause were established, it would not promote social acceptance of transsexual people, which is, for most transsexual people, the primary reason behind this quest for a physiological cause of their condition. Trasek, a Finnish organization for the transgender and intersex populations, suggested referring to transsexualism as a condition requiring medical intervention, similar to childbirth. Finland, officially the Republic of Finland ( is a Nordic country situated in the Fennoscandian region of northern Europe. Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or
References
- ^ Human Sexuality; The American Medical Association Committee on Human Sexuality; Chicago, 1972
- ^ Attempts To Change Sexual Orientation - Prof. Gregory Herek, University of California, Davis
- ^ COPP Position Statement on Therapies Focused on Attempts to Change Sexual Orientation - American Psychiatric Association
- ^ Zhou, Jiang-Ning; Michel A. The University of California Davis, commonly known as UC Davis, or just UCD, is a public coeducational university located in the city of Davis, The American Psychiatric Association (APA is the main Professional organization of Psychiatrists and trainee psychiatrists in the United States, and the Hofman, Louis J. G. Gooren & Dick F. Swaab (2 November 1995). "A Sex Difference in the Human Brain and its Relation to Transsexuality". Nature 37: 68–70. Nature is a prominent Scientific journal, first published on 4 November 1869 doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document.
- ^ Kruijver, Frank P. M. ; Jiang-Ning Zhou, Chris W. Pool, Michel A. Hofman, Louis J. G. Gooren and Dick F. Swaab (2000). "Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus". Journal of Clinical Endocrinology & Metabolism 85 (5): 2034–2041. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document.
- ^ Hulshoff, Cohen-Kettenis et al. (July 2006). "Changing you sex changes your brain: influences of testosterone and estrogen on adult human brain structure". European Journal of Endocrinology 155 (155): 107–114. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. ISSN 0804-4643. An International Standard Serial Number ( ISSN) is a unique eight-digit number used to identify a print or electronic Periodical publication.
- ^ Concordance for Gender Identity among Monozygotic and Dizygotic Twin Pairs, Diamond, M. and Hawk, S. Milton Diamond (born 6 March 1934 in New York New York) is a professor of Anatomy and Reproductive biology at the University ; American Psychological Association, 2004 Annual Meeting, July 28-August 1, 2004, Honolulu, Hawaii.
- ^ Schneider, Harald J. ; Johanna Pickel, Günter K. Stalla (2006). "Typical female 2nd-4th finger length (2D:4D) ratios in male-to-female transsexuals-possible implications for prenatal androgen exposure". International Society of Psychoneuroendocrinology 31 (2): 265–269. Elsevier, Oxford, UK. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. ISSN 0306-4530 PMID 16140461. An International Standard Serial Number ( ISSN) is a unique eight-digit number used to identify a print or electronic Periodical publication.
- ^ DES updates - Centers for Disease Control and Prevention
- ^ 'Gender-bending' chemicals found to 'feminise' boys - New Scientist
- ^ A defining moment in our history - Transsexual Road Map
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