Transsexualism: Nature vs. Nurture

Rebecca Kastl

For many of us, the question of whether or not transsexualism, and transgenderism in general, has a biologic causation is usually more of a rhetorical question than anything asked seriously. The idea that transgederism is merely a "lifestyle choice" (the same as if we chose wear black, red, or grey on any given day) is about as preposterous as suggesting that the Pope get married. But if we intend on being honest with ourselves and the rest of society, we would each be better off having contemplated this question seriously, at least once. I've pondered this question as it relates to transsexualism, although much of what I've come across has more than just a passing relationship with the more general concept of transgenderism which encompasses transsexuals, cross-dressers, transvestites, and others.

To begin with, most psychologists and psychiatrists will acknowledge that transsexualism has its origins in some biologic condition, although there is considerable disagreement on the exact nature of the biologic condition. For some, they adhere to the findings of a study several years ago that the root cause of transsexualism lies in the brain, specifically in the BSTc region. Others lean towards a developmental anomaly during gestation that causes critical hormones (which influence physiologic development) to be under- or over-produced. Still others lean towards a combination of a biologic causation and environmental factors. There is also the case of Dr. Money's patient, Brenda/David, who had his gender reassigned in infancy due to an accident during a circumcision procedure. This last case would appear to cement the certainty of the Nature vs. Nurture debate, with the verdict landing squarely on the side of Nature. Who is right? Nobody knows for certain, and it will likely be a long time before we can have any real certainty. But do we really care? Should we care?

One of the arguments that is frequently used against LGBT rights is the concept that being trangendered, bisexual, or homosexual is not an "immutable biologic human characteristic" the way that our race or ethnicity are. Those who hold this point believe that identifying as LGBT is merely a lifestyle choice that one makes, and society would make a serious and unjust mistake to condone lifestyle choices by enshrining them in law. In this light, it becomes somewhat important that we be able to answer this question - at least as it pertains to transsexualism. But I'm not specifically searching after “the cause” to legitimize who I am to someone else. I'm trying to make a more general statement regarding the nature of transsexualism, and then consider what are the consequences of that statement, should it be accepted.

As has been pointed out by many I’ve spoken with, attempting to find the transsexual gene (or gay gene) is about as ridiculous as trying to find the genius gene. There is no proof of inherited intelligence, just as there is no proof of inherited homosexuality or transsexualism. But geniuses aren't discriminated against and socially stigmatized, either.

What I originally set out to do was gain some information that would better define the neurophysical origins and/or causation of transsexuality and work to take away the belief that it is a mere behavioral problem.

Transsexualism is likely a neurologic/neurophysical disorder. This does not necessarily equate tanssexualism to a mental disorder, per se. Neurologic/neurophysical refer to the physical makeup and structure of the brain and nervous systems. The study of neurology and neurophysiology deal with the neural structures themselves.

Psychology and psychiatry treat behaviors that may or may not have a causation related to neurophysical problems. But psychology specifically is focused on dealing with behavioral disorders through the use of non-medical treatments, and psychiatry primarily attempts to modify behaviors (regardless of origin) through the use of psychotropic, or psychoactive drugs. These are obviously oversimplifications of the practice of psychology and psychiatry, but for now they should suffice.

Unfortunately, since our conscious identity is seated in our brains, and not in say, our liver or kidneys, and since the treatment of just about anything related to the brain is almost always first and foremost the providence of the psychiatric/psychologic community, we are at a disadvantage to getting GID depathologized as a "mental disorder." But the more that the problem can be shown to be a neurophysically anomalous issue as opposed to a simple behavioral issue, we make steps toward placing the treatment and recognition beyond the psychiatric and psychologic communities.

One of the dangers that many transsexual people fear (and with good reason) is that by having transsexualism pathologized as a “mental disorder” they will be subject to being justifiably stigmatized by society because of it. Because of this, there is a growing movement within the transgendered community to move away from terms such as “Gender Identity Disorder” towards a term such as “Atypical Gender Identity,” effectively removing the stigma of the word “disorder” and placing the condition in the perspective of a natural differentiation.

Much of what has been discussed so far seems to be little more than semantics, bantering words about to make ourselves feel good. But is there a purpose for this? Yes, there is.

While it is a sign of good mental health to lead your life irrespective of the opinions society may hold, there is one overriding concern that we cannot ignore. When we walk out the door each day, when we go to the store, to work, to a restuarant, or to a shopping mall, we have to deal with society. Human beings are social animals - it’s inextricably woven into our nature. In this light, while we shouldn’t posit our happiness on the perceptions of others, we should at least acknowledge that there is a world out there that we have to deal with in order to survive and lead a healthy and productive life.

One of the biggest obstacles I've seen to the passage of gay/gender rights legislation, and an enduring one at that, is the argument surrounding immutability. Frequently, those opposed to such legislation point to the fact that there is currently no biologic "cause" for being homosexual, thereby nullifying inclusion as an immutable human characteristic such as race or age (arguments regarding the inclusion of religion withstanding).

First off, let me say that I think it is ridiculous to look for some gay gene, or genetic trait to indicate homosexuality -- People are much more than the sum of their genetic parts, and there are many more factors that play into shaping the human body and our conscious beings than mere genetics. An issue that has been consistently overlooked is the kind of developmental issues which might possibly occur during fetal gestation, or under other circumstances.

The study relating to the BSTc region of the brain, and the case of Brenda/David, goes a long way to prove the point that there is a biologic cause for transsexualism, and we are not merely deluded or otherwise incapable of dealing with the world around us.

In making the argument for transsexual rights, we have no real obstacles other than people's fears. If we can demonstrate in an objective manner that there is no rational foundation for those fears, then we have made a large step in our efforts. To the end that the less understanding people continue to put forth the idea that we are perverts, are deluded, and that there is "no immutable characteristic" underlying our situation, we must do what we can to counter those statements and demonstrate both empirically with our daily lives and scientifically with studies and fact, that we are just as deserving of equal protection under the law and require such protections in the face of the same bigotry that tries to deny those protections.

In the last year, there have been numerous assaults on the rights of transsexual persons in the courts. The standing of the transsexual person was a material issue to the cases brought before the court. In Texas, Christie Lee Littleton had to hear a court effectively say that regardless of her surgeries, hormones, psychological profile, and social role, she was, in the eyes of the court, still a man. In Kansas, another court tried to use the same argument to deny another transsexual woman her fundamental status as a human being

It is important to consider that in Kansas (Re: Estate of Gardiner), the court acknowledged and referenced numerous scientific articles on transsexualism and attempted to make a rational decision based upon the facts, not upon ideology. The opposite held true in Texas, where the same scientific evidence was blatantly ignored.

In the end, facts and science are useless when ideology is the means to a logical end, as they were in the Texas court with Mrs. Littleton. But just as the facts were ignored and contradicted, such as they were in Texas, there is hope. The Kansas court was asked to consider the Littleton case when making their decision. In the opinion, the Kansas court openly mocked and summarily dismissed the Littleton court calling their interpretation of the evidence "...a rigid and simplistic approach to issues that are far more complex than addressed in that opinion."

So while we may not have immediate success with bigoted judges trying to push a social agenda from the bench, or socially conservative groups who continually push to keep LGBT persons from enjoying the same freedoms and privileges as all other Americans, we can keep pushing for a rational approach to the evidence. The Kansas court, Minnesota, and Rhode Island have all shown that there are those out there who will listen.