Man or Myth?

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Unless you have been living in Iran you will be aware that the subject of transexualism  (gender dysphoria)  has been in the news a lot these days.

My first encounter with this subject was when we as med students watched a Swedish film depicting sex reassigning surgery. At the moment of the penile transection many of us felt dizzy and nauseated and one student passed out, though he was hung over from a frat party the night before.

My second encounter with transexualism was when on call as a resident, a man in feminine attire and affectations showed up in the ER with suicidal ideation. As I recall he had been waiting a few years for sex reassignment surgery and was distressed by the delay. I had spent a week in a gender identity clinic and had came to the conclusion that these patients were borderline psychotic. Now this was back in the day when we thrived on psychodynamic theorizing, and the Oedipus complex was at the forefront of most sexual “deviations”.

Being mentally healthy meant that the drive developing young boys had towards romantic love with their moms had to be relinquished. After that the wise decision was that you identify with dad. If you don’t you are at risk of becoming penisless. Read castration anxiety. I became aware this Freudian construct could be considered as a metaphor as it can also refer to being castrated symbolically the ensuing anxiety refers to the idea of feeling inadequate both generally and sexually.

But with transexualism the castration is the real deal. Failure to resolve the Oedipus complex could according to the theory lead at best to feelings of inadequacy and at worst to various types of sexual “deviancy” like homosexuality, tranvestitism or transexualism. This is occasioned by regression to an early female identification and fixation-mom-the primary erotic love object.

The difference is that with the former two the core gender identity is male. The latter however are convinced that they are females trapped in a male body. That is what the patient I saw in the ER said. Naturally I admitted him not just because he was a self harm risk but because at the time, I thought he was delusional. After all he had male genitals which he tried hard to disguise, and he had already had an augmentation mammoplasty. Taking this seriously was challenging. Which bathroom does he/she use? Do I need a nurse with me to do the physical?

This brings us up to how one forms an identity. Is it choice? Am I who I am because I choose to be, as Sartre might say or is it pre determined?

We know realize homosexuality is clearly not a choice or a deviation brought on by failed Oedipus but predetermined by neurobiology ie genetics. Transvestitism is a unconsious choice but the putative causation is related to feminizing childhood experiences by  a dominant mother, and weak ineffectual male role modeling. But the core identity is still male.

Transexualism however may have genetic roots parallel to homosexuality. What might be going on is in an obscure brain region called the forceps minor. On average, among “normal” males, the forceps minor contains parallel nerve fibers of higher density than in females. But the density in male>female transsexuals is equivalent to that in women. So the brain may be hard-wired female. This is also true of the hypothalamus. None of this research is certain at this stage, but does challenge Freudian reductionism.

So it seems that biology now explains homosexuality, transexuality, and even foot fetishism.

As for animal models transexualism unlike homosexuality is harder to define. I had a dog I was concerned  about though. There  can be little doubt when a female dog raises a leg to urinate, covering its legs in its own fluids, that a ‘male’ patch of neurons is causing the behavior. By the same token, this male dog  I observed squatting to urinate, and wetting its entire underbelly must have been operating from an internal and inborn female behavior map.

There are obviously no gender stereotypes in doggie culture. But without further study I would not recommend  putting  a pink bandana on a male pup…

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Fostering a solid gender identity

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2 Responses to “Man or Myth?”

  1. kristina nadreau says:

    As a veterinarian, I would suggest that you confine your comments to humans and not extend personal annecdotal observations that fit your theories. Personally and generally veterinarians assign urinating statures to hormone levels. By changing hormone levels the squatting or leg lifting reverts to sex linked behavior.

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