Homosexual Transsexuals Research Articles

A Review of the Status of Brain Structure Research in Transsexualism.

The present review focuses on the brain structure of male-to-female (MtF) and female-to-male (FtM) homosexual transsexuals before and after cross-sex hormone treatment as shown by in vivo neuroimaging techniques. Cortical thickness and diffusion tensor imaging studies suggest that the brain of MtFs presents complex mixtures of masculine, feminine, and demasculinized regions, while FtMs show feminine, masculine, and defeminized regions. Consequently, the specific brain phenotypes proposed for MtFs and FtMs differ from those of both heterosexual males and females. These phenotypes have theoretical implications for brain intersexuality, asymmetry, and body perception in transsexuals as well as for Blanchard’s hypothesis on sexual orientation in homosexual MtFs. Falling within the aegis of the neurohormonal theory of sex differences, we hypothesize that cortical differences between homosexual MtFs and FtMs and male and female controls are due to differently timed cortical thinning in different regions for each group. Cross-sex hormone studies have reported marked effects of the treatment on MtF and FtM brains. Their results are used to discuss the early postmortem histological studies of the MtF brain.

Attraction and Sex Symbol of Males in the Eyes of Malaysian Male-to-Female Transsexuals

Male-to-female transsexual issues, especially their sexual orientation, has become complicated due to their tendency to regard themselves as women, and are exclusively attracted to men. This paper explores one group in male-to-female transsexuals, which is homosexual transsexuals, and their attraction towards homosexual and heterosexual men. The objective of this paper is to identify aspects of sexual attraction in the body or nature of the men that attract homosexual transsexuals to develop romantic relationship with them. Qualitative methods were used in gathering the data. This includes in-depth interviews that have been carried out on six homosexual transsexuals, which were selected using purposive and snowball sampling. The location of the fieldwork was Port Dickson, Negeri Sembilan, Malaysia. The result shows that facial appearance, specific body parts such as chest, calves and buttocks, and specific social behaviors, especially caring and affectionate, have been regarded as men's sex symbols.

Comment on Cantor (2011)

In Cantor’s (2011) Letter-to-the-Editor, he cited two MRI studies (Rametti et al., 2011; Savic & Arver, 2011) and suggested that these‘‘bear out’’Blanchard’s hypothesis that‘‘homosexual transsexuals’’ but not ‘‘non-homosexual transsexuals’’ would exhibit brain regions shifted toward that of non-transsexual women. This contradicts the recent observation by Meyer-Bahlburg (2011)thatmostresearchfrombrainstudiesindicatesthatthe‘‘heterosexual’’ transsexual group may have brain regions that are shifted toward female. Meyer-Bahlburg (2011) included results from brain studies other than those using MRI (e.g., PET results, autopsy findings) to support his suggestion. Surprisingly, Cantor did not include results of non-MRI brain studies with respect to their bearing on Blanchard’s hypothesis. Yet,eventheinterpretationbyCantoroftherelationshipofonlythe MRI studies to Blanchard’s hypothesis is problematic. For instance, although Rametti et al. (2011) used exclusively ‘‘homosexual transsexuals,’’theydidnot,asCantorsuggests,usea researchdesignthatwasanalogoustothatusedbySavicandArver (2011). Savic and Arver used voxel based and volume of interest MRItomeasureregionalbrainvolumes.Ramettietal.(2011)used diffusion tensor imaging to measure fractional anisotropy. These representqualitativelydifferentmethodologiesandtoolsfor investigating issues in brain research. Second, unlike Savic and Arver (2011), the study by Rametti et al. (2011) measured only white matter. In fact, most of the sexuallydimorphicregionsinvestigatedbyRamettietal. (2011)were not those investigated by Savic and Arver (2011). Thus, we don’t know how unique the findings of each study are for a particular Blanchard transsexual type (homosexual vs. non-homosexual). Third, since neither study compared‘‘homosexual transsexuals’’with‘‘non-homosexualtranssexuals’’nordideitherstudycompare each type with non-transsexual controls, we don’t know how unique the findings of the different transsexual groups are when compared with each other or when each are compared with nontranssexual controls. SexualorientationisonevariablethatCantor(2011)focusedon when suggesting that Blanchard’s hypothesis‘‘now appears to be the case.’’However, it would seem prudent to wait for studies that use the same investigative tools as well as better control groups before jumping to such a conclusion.

New MRI Studies Support the Blanchard Typology of Male-to-Female Transsexualism

Twoindependentempiricalarticleshaverecentlyappearedintheliterature that, taken together , bear out an hypothesis Blanchard(2008) postulated in the Archives about brain development intranssexualism:[T]he brains of both homosex ual and heterosexual male-to-female transsexuals probably differ from the brains oftypicalheterosexualmen,butindifferentways.Inhomo-sexual male-to-female transsexuals, the difference doesinvolvesex-dimorphicstructures,andthenatureofthedif-ference is a shift in the female -typical direction. If there isany neuroanatomic intersexuality, it is in the homosexualgroup. In heterosexual male-to-female transsexuals, thedifferencemaynotinvolve sex-dimorphic structuresatall,andthenatureofthestructura ldifferenceisnotnecessarilyalong the male–female dimension. (p. 437)Blanchard’s prediction follows from studies that have repeat-edly shown that the homosexual male-to-female transsexualsare‘‘female-shifted’’in multiple, sexually dimorphic character-istics,whereastheheterosexual male-to-femaletranssexualsarenot(Blanchard,1989a,1989b).Forexample,homosexualmale-to-female transsexuals are sexually attracted to natal males,expressgreaterinterestinfemale-typicalactivities(eveninchild-hood), and are naturally effemina te in mannerism. In contrast,heterosexual male-to-female transsexuals are indistinguishablefrom nontranssexual natal males o n these variables. The hetero-sexual transsexuals are still dis tinct from typical males in otherways, however, such as by manif esting ‘‘autogynephilia’’—theeroticinterestinorsexualarousalinresponsetobeingorseemingfemale. The consistent detection of cross-sex features amonghomosexual male-to-female tra nssexuals, but not among heter-osexual male-to-female transse xuals, led Blanchard to predictthat the cross-sex pattern would also emerge at the level of brainanatomyandbelimitedtothehomosexualmale-to-femaletrans-sexuals.Thatpredictionnowappearstobethecase,withRamettiet al. (2010) supporting his prediction for the homosexual trans-sexuals, and Savic and Arver ( 2010), for the heterosexual trans-sexuals.The Rametti team used an MRI technique called DiffusionTensor Imaging to compare homosexual male-to-female trans-sexuals(n=18)withnontranssexual,heterosexualcontrolmales(n=19) and with nontranssexual, h eterosexual control females(n=19). They contrasted the male controls with the femalecontrols to identify the sex-dimorphic portions of the brain andthen contrasted the homosexual transsexuals with each of thecontrol groups on the dimorphic brain regions so identified. Theinitial contrasts identified six sex-dimorphic brain regions. Thehomosexual transsexual sample w as intermediate in volume onall six brain structures, significan tly different from the male con-trolsonfiveofthesix(andsignific antlydifferentfromthefemalecontrols on all six). That is, the se male-to-female transsexualsweredifferentfromthecontrolmales,shiftedtowardsthefemaledirection on all parameters.Savic and Arver (2010) applied anatomical MRIs with ananalogousresearchdesign,identifyingthesex-dimorphicpor-tions of the brain and contrasting the (this time) heterosexualtranssexual sample (n=24) with each control sample (n’s=24each)onthesex-dimorphicbrainregions.Oftheeightbrainregionsthatdistinguishedmalefromfemalebrains,thehetero-sexual transsexual sample differed from the male controls onnone(Savic&Arver,2010,Table3).Ofthefourbrainregionsthat distinguished these heterosexual transsexuals from themale controls, sex-dimorphism was present in none (Savic &Arver,2010,Table3).AsSavicandArverthemselvesempha-sized, ‘‘Contrary to the primary hypothesis, no sex-atypical

Birth Order and Ratio of Brothers to Sisters in Spanish Transsexuals

Three Western studies have shown that male-to-female (MF) homosexual transsexuals tend to be born later than their siblings and to come from sibships with more brothers than sisters. The objective of this study was to determine whether these variables would be replicated in 530 MF and female-to-male (FM) Spanish transsexuals according to sexual orientation. The results showed that MF homosexual transsexuals had significantly more older brothers than the non-homosexual MF group. Compared with the expected rates in the general population, birth order was significantly higher in both MF (Slater's Index = 0.59; Fraternal Index = 0.61; Sororal Index = 0.58) and FM homosexual transsexuals (Slater's Index = 0.65; Fraternal Index = 0.68; Sororal Index = 0.67), and sibling sex ratio was significantly higher than expected in homosexual MF (sex ratio = 0.55) but not in homosexual FM transsexuals. No significant differences were found in the non-homosexual subgroups. The replication of the later birth order and sibling sex-ratio effect in MF homosexual transsexuals corroborates previous findings in a variety of groups from different cultures and may suggest a common mechanism underlying the etiology of transsexualism.

Dreger on the Bailey Controversy: Lost in the Drama, Missing the Big Picture

others. Bailey’s book has reinforced cultural stereotypes of male-to-female transsexuals, beginning with the demeaning cover. He maintains that transsexuals are motivated by lust, not gender identity issues, that transsexuals lie, and that they are drawn to shoplifting. He asserts that one ‘‘type’’ of transsexualism is in fact a ‘‘paraphilia,’’ linking some MTF transsexuals with ‘‘necrophilia, bestiality, and pedophilia’’ (p. 171) and that the members of the other ‘‘type,’’ homosexual transsexuals, ‘‘might be especially well-suited to prostitution’’ (p. 141). By not acknowledging that Bailey’s book panders to popular prejudice, Dreger shows an appalling lack of understanding of the power of psychiatry to enforce and justify societal oppression. Psychiatry has a long, shameful history of participating in the stigmatization and abuse of disenfranchised people. Beginning with the 19th century diagnosis of ‘‘drapetomania’’ (the desire of a slave to run away from his/her master), for well over a century psychiatric diagnosis has tended to reinforce the prejudices of society against women and racial and sexual minorities. And the abuse carried out in the name of psychiatric healing—forced incarceration, invasive and often painful treatments, forced sterilization, and clitorodectomies, not to mention loss of employment, housing, children, etc.—has been

Birth order and sibling sex ratio in homosexual transsexual South Korean men: Effects of the male‐preference stopping rule

Two biodemographic variables - birth order and sibling sex ratio - have been examined in several Western samples of homosexual transsexual men. The results have consistently shown that homosexual transsexuals have a later birth order and come from sibships with an excess of brothers to sisters; the excess of brothers has been largely driven by the number of older brothers and hence has been termed the fraternal birth order effect. In the present study the birth order and sibling sex ratio were examined in an Asian sample of 43 homosexual transsexual men and 49 heterosexual control men from South Korea. Although the transsexual men had a significantly late birth order, so did the control men. Unlike Western samples, the Korean transsexuals had a significant excess of sisters, not brothers, as did the control men, and this was largely accounted for by older sisters. It is concluded that a male-preference stopping rule governing parental reproductive behavior had a strong impact on these two biodemographic variables. Future studies that examine birth order and sibling sex ratio in non-Western samples of transsexuals need to be vigilant for the influential role of stopping rules, including the one identified in the present study.

What Many Transgender Activists Don't Want You to Know: and why you should know it anyway

Currently the predominant cultural understanding of male-to-female transsexualism is that all male-to-female (MtF) transsexuals are, essentially, women trapped in men's bodies. This understanding has little scientific basis, however, and is inconsistent with clinical observations. Ray Blanchard has shown that there are two distinct subtypes of MtF transsexuals. Members of one subtype, homosexual transsexuals, are best understood as a type of homosexual male. The other subtype, autogynephilic transsexuals, are motivated by the erotic desire to become women. The persistence of the predominant cultural understanding, while explicable, is damaging to science and to many transsexuals.

Transsexual subtypes: Clinical and theoretical significance

The present study was designed to investigate whether transsexuals can be validly subdivided into subtypes on the basis of sexual orientation, and whether differences between subtypes of transsexuals are similar for male-to-female (MF) and female-to-male transsexuals (FMs). Within a large transsexual sample ( n = 187), homosexual and nonhomosexual subjects were compared on a number of characteristics before the start of treatment. Differences within MF and FM groups were also investigated. Homosexual transsexuals were found to be younger when applying for sex reassignment, reported a stronger cross-gender identity in childhood, had a more convincing cross-gender appearance, and functioned psychologically better than nonhomosexual transsexuals. Moreover, a lower percentage of the homosexual transsexuals reported being (or having been) married and sexually aroused while cross-dressing. The pattern of findings was different for MFs and FMs. No differences between homosexuals and nonhomosexuals were found in height, weight, or body mass index. A distinction between subtypes of transsexuals on the basis of sexual orientation seems theoretically and clinically meaningful. The results support the notion that in the two groups different factors influence the decision to apply for sex reassignment. The more vulnerable nonhomosexual transsexuals may particularly benefit from additional professional guidance before and/or during treatment.

Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography

Men's sexual arousal patterns are category-specific: Men typically display significantly greater physiological responses to sexual stimuli depicting members of their preferred gender category. Category-specific patterns of sexual arousal have not been consistently reported in natal women. We used vaginal photoplethysmography to examine patterns of sexual arousal in 11 male-to-female (MtF) transsexuals following sex reassignment surgery (SRS) and in 72 natal women. Subjective arousal was measured with a continuous response lever. Video clips depicting sexual activity between two males, two females, or one male and one female were used as erotic stimuli. All transsexual participants displayed category-specific sexual arousal. Five homosexual transsexual participants (attracted exclusively to males before sex reassignment) showed greater genital and subjective responses to male than to female stimuli, while six nonhomosexual transsexual participants showed the opposite pattern. Vaginal pulse amplitude (VPA) was lower in transsexual participants than in natal women. The mean correlation between VPA and subjective responses was high in nonhomosexual transsexuals, but was significantly lower in homosexual transsexuals and in natal women. One transsexual participant who reported a change in sexual orientation following sex reassignment displayed VPA and subjective responses consistent with her pre-reassignment sexual orientation. We conclude that male-to-female transsexuals display male-typical category-specific sexual arousal following SRS, and that vaginal photoplethysmography is a promising methodology for studying patterns of sexual arousal in postoperative transsexuals.

Tests de personnalité et identification sexuée chez des transsexuels masculins

The aim of this research project was to study gender identification in male transsexuals compared to male and female controls, using the Rorschach test and the MMPI. In the international literature, many researches have shown that the nature of the human response on Rorschach card III is linked to gender identification, as is the MMPI Mf scale. Ten untreated male homosexual transsexuals and 18 treated and operated male homosexual transsexuals were compared to 10 male and 12 female controls regarding verbal IQ, human content on Rorschach card III and the MMPI Mf scale. Absence of hormonal treatment for the first group of transsexuals was checked by a blood test at the time of the psychological testing. Responses on Rorschach card III were scored according to different kinds of human contents: male (M), female (F), gender-unidentified/neutral (N), bisexual (B), feminine then masculine or the opposite (M/F), and nonhuman (NH). N, B, M/F and NH responses were rare in all Rorschach protocols. As expected, responses given by participants in the control group were significantly more consistent with their anatomical sex than with the opposite sex. Untreated transsexuals do not differ from treated and operated transsexuals on Rorschach data, and both transsexual groups give significantly more female human representations than male controls. Transsexuals' results are similar to female controls. Untreated transsexuals' mean score on the MMPI Mf scale is significantly higher than that of treated and operated transsexuals' score, in the male profile (biological sex). Both groups of transsexuals score higher on the Mf scale in the male profile than in the female profile. The mean Mf score in the male profile is significantly higher than that of male controls, whereas, in the female profile, the mean Mf score is similar to that of female controls. This study shows that for both groups of transsexuals, results are homogenous in respect of Rorschach and MMPI, showing hyper-conformism to self-perceived gender. Results in both groups are similar to results of female controls, but tend to show even more feminine gender identification. The absence of any significant difference between untreated and treated and operated transsexuals seems surprising, suggesting that the hormonal treatment has not had a major impact on gender identification processes. It would doubtless be interesting to study gender identification using even more kinds of data: all human contents in the Rorschach protocol (not just the responses given to card III), MMPI Mf scale, Draw-A-Person Test and Animal-and-Opposite Drawing Test. This would enhance result liability and could provide useful information about how gendter identification processes evolve after surgical sex reassigment.

Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals

We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome. Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were used to evaluate treatment. Results between subgroups were compared to determine post-operative differences. Adults and adolescents were included to study predictors of treatment course and outcome. Results were statistically analysed with logistic regression and multiple linear regression analyses. After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes. The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.

Organizing and activating effects of sex hormones in homosexual transsexuals.

The cause of transsexualism remains unclear. The hypothesis that atypical prenatal hormone exposure could be a factor in the development of transsexualism was examined by establishing whether an atypical pattern of cognitive functioning was present in homosexual transsexuals. Possible activating effects of sex hormones as a result of cross-sex hormone treatment were also studied. Female-to-male and male-to-female transsexuals were compared with female and male controls with respect to spatial ability before and after treatment. The data were consistent with an organizing effect, but there was no evidence of an activating effect. Homosexual transsexuals, who prior to hormone treatment scored in the direction of the opposite sex, may have reached a ceiling in performance and therefore do not benefit from activating hormonal effects.

Organizing and activating effects of sex hormones in homosexual transsexuals.

The cause of transsexualism remains unclear. The hypothesis that atypical prenatal hormone exposure could be a factor in the development of transsexualism was examined by establishing whether an atypical pattern of cognitive functioning was present in homosexual transsexuals. Possible activating effects of sex hormones as a result of cross-sex hormone treatment were also studied. Female-to-male and male-to-female transsexuals were compared with female and male controls with respect to spatial ability before and after treatment. The data were consistent with an organizing effect, but there was no evidence of an activating effect. Homosexual transsexuals, who prior to hormone treatment scored in the direction of the opposite sex, may have reached a ceiling in performance and therefore do not benefit from activating hormonal effects.

A typology of transsexualism: gender identity theory and data.

An analysis of postoperative data obtained from 42 male-to-female transsexuals showed them to fall into three distinct categories: homosexual transsexuals, asexual transsexuals, and heterosexual transsexuals. Additonal data covering the areas of gender vs. sexual dysphoria, surgical details, background characteristics, sexuality-related behaviors, and postoperative adaptation further differentiated these groups and suggest that the categorization is theoretically meaningful and relevant to understanding the causes and course of the transsexual phenomenon. An extensive developmental theory is suggested to account for both differences and commonalities among the different subgroups of transsexuals, as well as among these and related groups, such as effeminate homosexuality and transvestism. The theory is sufficiently specific for making empirical predictions.