The Unusual Gender Signatures
TS or HBS : TRANSSEX or SUNDROME of HARRY BENJAMIN TS means the most radical feeling of pertaining to the opposite gender. It is enrooted in the deepest part of our perception of ourselves. The gender identity is much mote deep than our name, address, family. In a deep amnesia we may remember nothing. Who we are, our family, name, work, if you are married or not, if uou have children or not. But as you continue remembering how yo breagh, how to eat, how to drink, how to drive a car or a bycicle, you remember you are a woman or a man. What this means?
This means the identity and the gender of the dentity are as printed in deep, old circuits of the brain, in the oldest part of it, in a place we may call the basal part of the brain.
Transsexuality is caused by a discord of gender of that part and the genitals. These parts so deep, are formed during gestation, in primates, kncluding humans. So transsexuality in its purest signatures, are always ghere since gestation and first childhood. The gestation time, maimly from ghe 2nd, 3rd month up until the 6th or 7th, is very important because that is the critical time, when genes and hormones do their main job in the basal brain masculinizing it or not..
One important thing is the emotional state of the mother during pregnancy. Happy moms probably will not generate mtf doughters. The XY fetus will develop probably as a mtm son. That happens because the stress interferes on yhe immune system of the mother and that systrm inyerferes on the production of hormones i ghe getus testis. The basal brain is turned male by trstosterone. If it fails, no male cusp catastrophe happens in the brain, that keeps being female.
So moms and dads, take care.
We may recognize these signatures, at a distance! It is not always easy, but we can
A small but important review of TS conception along the history.
Why someone that has normal genitals with a typical sexual development would radically feel and self-identify as pertaining to the opposite sex?
Psychiatrists and psychologists immediately concluded: they have a mental problem! They have not a correct perception of REALITY!
From then on, to have any help, these persons were considered to have a mental problem - a lack of correct perception of reality.
The point was, psychologists and psychiatrists - as doctors and families, including the law - understood some aspects of "reality" from a particular point of view:
- 1. The gender/sex bipolarity was "normal" and "radical", in an absolute (ideological) point of view;
- 2. The absolute determination of gender by genital conformation as an absolute (ideological) reality;
- 3. Each individual that would not perceive reality THAT WAY would surely not perceive (ideological) "reality" in the proper way, and would need a mental evaluation and mental treatment;
- 4. Any body change, mainly genital correction would not be a "correction" but a "crime" against the individual (due to its lack of good perception of reality), against society, against "God".
On one point, almost all therapists agreed: Someone that would like to "change sex", would necessarily be really a " radical homosexual". A kind of "foolish" homosexual - for whom to be a homosexual would not be enough, to change the body would be also necessary.
Then, someone that shows the necessity to "change sex" and was not a "homosexual" would be really absolutely unexpected. To change sex M to F and later act as a lesbian! Or vice versa as a gay man! Foolishness! A kind of "autogynephylia" or a kind of "autoandrophylia".
REMARK! TAKE CARE!
WHEN ENGLISH SPEAKING PEOPLE STARTS MIXING UP LATIN WITH GREAK - THAT MEANS THEY DON'T KNOW ABOUT WHAT THEY ARE TALKING ABOUT!
All these reactions to the FACT that gender identity IS NOT DEFINED by the genitals - nor the chromosomes, nor any other simple one cause - one effect, mislead the "experts", most up until today.
Another important FACT was, for almost all the time, the "experts" ignored that the self-perception is something erected THROUGH THE BRAIN, and so the brain is necessarily important in that erection of gender identity.
Since the 60's, Dr.Gunther Dorner, Ph.D., the head of the Department of Endocrinology at Humboldt University in Berlin (East side of Berlin then) started researching the sex differentiation of the brain - in rats and other rodends. He perceived, when he destroied parts of the brains of the rats, they changed their sexual posture. Original males showed "female lordosis" positions, and vice versa. The genitals were normal, the genetics were normal, the brains were manipulated.
In a way, the rat "self-perception" changed, changing the brain.
Dr.Dorner was generating "transsexual rats" in laboratory.
Unfortunately, the own researcher did not understand correctly his own results - in the 60's and 70's even 80's transsexuality was not the problem but homosexuality - and he interpreted his results as if the rats were changing from heterosexual rats to homosexual ones.
That way, his research was not accepted very well in Western world, and most of his research was almost wasted with time.
At the same time, in USA, Dr.John Money, Ph.D., stated TWO BIG DOGMAS:
1. That someone HUMAN "learns to be a boy or a girl as learns a language".
2. Only humans have gender identities - other animals even primates did have no sense of identity at all!
At the same time he did show David Reimer as the evidence, the sure evidence of his research and conclusions. Later, through Dr.Milton Diamond, Ph.D. and the journalist John Colapinto, the world knew David Reimer's results were a fake (later he took suicide), and he never learned how to be a girl.
Gunther Dorner was much more near the reality than John Money - and we took the wrong way.
The brain is the core part where all our self-perceptions are formed - including about gender.
The differentiation processes that govern the sexual differentiation of basal parts of the brain as stria terminalis, hypothalamus, amygdalas and other parts of the lymbic system, is different when compared with the genital tissues differentiation. They happen with different controls, at different moments during gestation. And a lot of experiences with Rhesus shows these basal brain parts are well developed and formed at birth for all primates, including man. So, as I stated in 1995, and was published in Brazil in 1998 ("Meu Sexo Real"- Martha Freitas (my pseudonym) - Vozes Editors, 1998), the gender identity is erected in the brain, and its core kernel part is the basal brain - and in primates, that formation happens during gestation - and may be in NEURODISCORD OF GENDER in relation to the genital tissues.
That term, Gender Neurodiscord (Neurodiscordancia de Genero - the original in Portuguese), was established by us - Dr.Dorina Epps Quaglia,MD, Ph.D.; Dr.Jalma Jurado, MD, Ph.D.; Dr.Julio Cezar Meirelles Gomes, MD, Ph.D. and myself, after a meeting held in Brazil about these matters, and later was considered in some papers.
Let's consider again the old points of view:
- 1. Gender is a bipolarity. Simply, it IS NOT A BIPOLARITY. It is a spectrum, where extreme events as gender neurodiscord - or transsexuality or Harry Benjamin Syndrome - surely happens. Happen at low probabilities, they are rare, as big earthquaques
are rare. But they exist and they ARE REAL, they are a part of reality.
- 2. Gender IS NOT DETERMINED BY THE GENITAL CONFORMATION. That is a simplification that leads to big mistakes. Gender identity is related to the brain - the brain is a part of the body. The brain need not to be in harmony with the genital tissues, due to the fact that the formation processes are different, with different controls, organized in different ways at different moments. The brain processes are much more complex than the genital ones, and both are complex and no simple relations exists among them.
- 3. The perception of reality is not based in Gaussian means only. Reality is something extremely complex, something that need Quantum Physics for some scales and Relativity Theory for others. Reality is in our scale much times fractal, self-similar, extreme events may happen and are real. The old simplicity - and the elimination of the unexpected as "abnormal" was the problem of lack of reality. The problem was in a superficial perception of "science" by "experts" and not in the subjects suffering from a gender neurodiscord - or a HBS/TS.
- 4. Why someone that feels bad with a part of the body, may not have the best correction to feel a whole person, in inner harmony?
Also gender neurodiscords (HBS/TS) are not foolish gays or lesbians. Nor nothing of that kind.
Extreme events happen. They happen in Nature. They happen inside our brains, inside our lives.
The HBS-Harry Benjamin Syndrome (gender neurodiscord or TS-transsexuality) is a radical development of gender identity, since the womb - perceived as since the first childhood - in an unexpected way - as an extreme event among all possible states determined by gender identity development.
It has a possibility of "diagnosis" (our Gendercare Web-based method we believe is the best for that diagnosis), may be easily recognized, is rare, is extreme, and need medical help.
It is not necessarily related to a mental problem - very rarely it is related to a mental problem, and when that happens, the mental problem is not the cause, but one consequence of sufferings and traumas.
The medical help HBS/TS needs are a good and fast diagnosis (as Gendercare's), later transition (MtF or FtM), with hormone therapy until the desired SRS-sex reassignment surgery, and a perfect post-op follow up - and from then on, the patient needs to live as a normal woman or a normal man - among the local society.
So, there is an explanation for HBS/transsex, and there is a cure - to assign the person properly to have inner and social harmony.
But all starts with the recognition of TS signatures.
- 1. The gender/sex bipolarity was "normal" and "radical", in an absolute (ideological) point of view;
TG: TRANSGENDERISM Transgenderism is a kind of incomplete transsexuality. Why it may happen? The causes here are more fluid, more variable, less determined. But we are not looking necessarily FOR CAUSES. It is good to know causes WHEN WE MAY ACT TO STOP A CONDITION WE WANT TO CHANGE.
As we may not change the structure of brains, we may not also change the feelings of transsexual and transgender persons.
Here we are not looking for causes, but the recognition of signatures. We may recognize it. Even at a distance!
Most of ghe time transgenders don't want sex reassignment. Some on the contrary, like to be sexually active, pteserbing all genital functionality. That is possible, no problem. We are prepared to solve all possibilities. Or almost all, I hope!
Being a not so clear condition than TS, TG conditions may be very difficult sometimes for the patients, needing more follow up of psycho therapy sometimes. The TG spectrum is more diverse than the TS, but we may always recognize its signatures.
TG is perhaps a bigger mistery than HBS/TS.
Why someone that has normal genitals with a typical sexual development would feel and self-identify as PARTIALLY pertaining to the opposite sex?
Psychiatrists and psychologists immediately concluded: they have a mental problem! They have not a correct perception of REALITY!
They have almost a,ways the same reaction. All is always a mental problem!
One other aspect very unexpected was ASTONISHINGLY most or almost all TG's do not want a sex reassignment!
They love their genitals, they love the way they work, and continue loving it!
In a gener gradation, they are in a kind of "limbus", they like to appear as women, feeling more or less as women, but also loving their male genitals and some male inner feelings!
If we study these states, plotting their incidence (considering Lynn Conway's incidence published 2002 data) versus intensity (considering Gendercare MF9 and FM1 free test measurements) we have a gradation - and a 1/f power spectrum pattern, as shows the next figure:
Considering the points from left to right, the first one represents the HBS/TS point (low incidence, highest intensity), the second point are the TG data (high intensity, but rare).
Again on one point, almost all therapists agreed: Someone that would like to "look like pertaining to the other sex", would necessarily be really a " radical homosexual". A kind of "foolish" homosexual - for whom to be a homosexual would not be enough, to change the body to "look like a woman" would be also necessary, even without "sex change".
Then, someone that shows the necessity to "look like the opposite sex" and was not a "homosexual" would be really absolutely unexpected. Foolishness! Also a kind of "autogynephylia" or a kind of "autoandrophylia".
Again, take care with these Latin-Greak names some use to show they do not really know about what they are talking about!
All these reactions to the FACT that gender identity IS NOT DEFINED by the genitals - nor the chromosomes, nor any other simple one cause - one effect, mislead the "experts", most up until today. Also, what is also important, gender identity may show a GRADATION, as showed in the log log plot!
Show TG's also, as HBS/TS's show, a brain differentiatiation problem?
No one surely knows, but we believe not necessarily. We believe TG is not a conformation condition since gestation necessarily, but may be an acquired condition. Since mainly early childhood perhaps, or still later. As we are not sure about causation - no dogmas is the best and most wise position!
In our casuistic, we may recognize most of the time, a relation between TG and early trauma. Not as a dogma please, but as a probability.
Obviously, as a midpoint, TG in our opinion is a more difficult condition to treat than HBS/TS. For HBS/TS, there is a cure, after complete harmonization between body, mind and social insertion.
For TG, all is more difficult, since the diagnosis, the treatment, and we see no "cure" because there is no "desease" to cure, no goal to achieve, no sense of harmony to reach.
What is important is society be prepared to accept that condition, that state as a natural one, and give these people the opportunity to live honestly as they are. No more guettos, no more ostracism.
After transition - always partial, a TG has the right to live, to work, to have a successful professional career in all possible professions. That is our goal, I believe.
CD: CROSSDRESSING Crossdressing is even more fluid, more diverse, but much less harmful.
Why someone that has normal genitals with a typical sexual development would feel and self-identify as pertaining to the same sex, but sometimes like to show characteristics of the other sex. Perhaps have some desires to have mild transitions in parts of the body, but most of the time intend only to use make-up and garments of the opposite sex.
Most of the time like very much the own genitals and to use it, with other sex relations, same sex or both. In a more sexually active or passive way, or both.
The variations are almost unlimited - as the causes are probably very variable.
Some may show some compulsive components, others some fetishistic ones.
Psychiatrists and psychologists concluded: they may have a mental problem! They may have not a correct perception of REALITY!
What may we do to help?
We developed a simplified 2 step evaluation that may help, when they intend a mild body change with no harm for the male function.
The simplified evaluation with friendly counselling we believe is the best option for any CD MtF that would like to have small and controlled body changes, with a follow up.
Others may need no body change and no evaluation and follow up.
We may help also FtM ones, with the evaluation.
For sute, even not knowing causes we may always recognize signatures
IG: INTERGENDER or ANDROGINOUS or GENDER BENDER (among others) . Persons who are Intersexed, born with a VSD (Variation of Sex Development) - designation suggested by Prof. Milton Diamond, with which we agree (we agree NOT with DSD-disorder of sexual development as proposed by a self-labelled "consensus") may develop an Intergender identity, or a gender identity which is not typically male or female.
� As our studies on gender identity development dynamics show, gender identity is not necessarily something which can be well defined as dimorphic with only two extreme bipolar conditions present in humans but more precisely a discrete spectrum with many potential variations within a space of multiple gender state development possibilities. We label that state space a gender space.
People who have a Typical Sex Development - more than 90% of humanity and who are considered "normal" as if something in humanity could be considered "normal", usually have the feeling of belonging to one gender or other, in a binary way. They really feel Male or Female.
Since reproduction is a main issue in our society - even if the overpopulation by humans may destroy the planet - this sexist binary classification is still important for most people and the medical community.
People may feel and live an unexpected gender development and feel their gender is not in harmony with their assigned sex but want to be included in a typical binary classification, as MtF HBS/TS or FtM HBS/TS do. �Most HBS/transsexuals feel gender identity binary but in discordance with the assigned sex.
Most transgenders (TG) feel a more flexible gender identity, as not definitely M or F, but still within a established binary concept.
Crossdressers usually have typical sex differentiation and have firm identities within the binary as most of the population does.
Intersex individuals are more likely than others susceptible to have gender identities all along the spectrum of Gender Space between the two extremes represented by Male and Female.� �Some easily do conform to gender identities firmly fixed at one end or the other of the two extremes as represented by Male or Female.� Others have a more fluid gender identity and some reject all binary definitions as part of their own identity.
John Money reported a lot of successes of his "sex of rearing therapy" when considering intersex. He considered - and generalized later his concept - considering intersex children could be "manipulated" to conform to one gender or the other. They were "gender labile".
In other words, Intergender exists, and is very common among the Intersexed, and they may need help just as anyone else but most importantly, they need to be respected and openly welcomed as part of humanity and an important part - as they are.
We have reasons to believe intersex children may really feel more gender labile than other people. See the next figure:
That figure shows the probability of a chaotic system between two poles - 0 and 1 - we may consider M and F. The systems tends to be more stable - an increase in probability, near the poles. That way, any situation between the poles is "labile!" as the intersex patients considered by John Money! That means John Money's results could not support a generalization - one of his mistakes - but were a very special condition when gender identity due to intersexuality may be "labile".
But surely not all intersex conditions ends with labile gender identity conditions.
Most of intersex conditions trigger intergender conditions - sometimes labile, sometimes not.
So what could we do to help them?
Do they actually need any help?
Most of them definitely do not need any help. But some could need some help to better understand their own identity and to adjust to the pressures of living in a society with very rigid gender expectations and stereotypes.
So, for those who feel they would like to know something more and who would like to better understand their gender identity, we may try to help them.
First of all we need to get to know the person who is requesting the evaluation and to understand why they are requesting it. �We call this the "anamnesis consultation", a mandatory step for a complete or a simplified gender identity evaluation.
As the second step we suggest the unexpected gender test. �For people assigned male (correctly or wrongly, that is not important here) we suggest taking the MFX test and for people assigned female, the FMX test.
The answers will give a better knowledge about someone is and how much the gender identity is "more male" or "more female"which will surely help to better understand the inner processes and dynamics, including mental ones.
That way we will be able to tell you : you are an Intergender with, let's say 70% M/30% F condition today and with some fluidity varying from Z to Y for example.
For possible intergenders we suggest always a contact with us before you start any evaluation - to define the best way to develop it.
What more could we do for you?
A psy-screening, through tests if you want to but only if you want one.
Probably nothing... if you do not have a gender identity which is fixed at one of the two extremes of the bipolar spectrum, such as would be the case for transsexuals. �But if you are happy with your body and wish no changes... good! �And we may stop it here!
Gendercare is always PATIENT CENTERED. So our tests and evaluations NEVER INTEND TO SUGGEST THAT THE PERSON BEING EVALUATED SHOULD BE AT ANY ONE POINT WITHIN GENDER SPACE.� We do the evaluations only to offer a description to the individual of the inner dynamics and processes and with no intention of changing or �judging� the Intergendered person in any way.� We would only suggest something if the person expressly ask for specific help.
NOS : GIDNOS (GENDER IDDNTITY CD DLOPMENT NOT OTHERWISE SPECIFIED For present day psychiatry and psychology, all gender nonconformity- all unexpected development of gender identity - is considered a "disorder", a "mental disorder", is classified in DSM-IVth from APA as a mental disorder.
We consider what is classified as GIDNOS as the only real situations we may consider a possible "mental disorder" may be related to the gender condition.
So, we consider GIDNOS not a grndrr idrnty disorder NOS but as GENDER IDDNYITY DEVRLOPMENT NOS. These are very rare, extremely rare conditions and show very atypical signatures, when compared with TS and even TG or IG signatures.
When there is no defined patterns, when there are not unexpected developments and possible mental associated problems, perhaps we consider a GIDNOS signature.
These are the most complex and difficult states not to recognize, but to help.
Prescription of transition, will need always continuous monitoring - suppervision, perhaps face-to-face when possible.
About GIDNOS we consider not generalizations. Each patient develops a particular very special condition.
Important REMARKS about UNUSUAL GENDER SIGNATURES and GENDER STATE SPACE Let's go a little deeper now.
Where forms in ourselves our gender identity? Based in which background? In which SPACE OF POSSIBLE STATES?
We feel, we perceive, as if we live in an Euclidean space, a state space formed by real numbers.
Where is our gender identity INSIDE THAT SPACE?
NOWHERE and EVERYWHERE. Nowhere, because we may not say, my car is parked in the garage and i put my gender identity inside the refrigerator yesterday. No, my gender is in nowhere. Because it is everywhere, all the universe (really my mind-universe, the universe i perceive and where i exist) is full of my perception of my gender identity.
So, the state space of my gender identity MAY NOT BE THAT EUCLIDEAN SPACE. If you have time, try to read this link ABOUT MIND. After you read it you will understand what I am talking about.
The state space of the gender identity is another kind of space, we call Hilbert space. It is not formed by real numbers but complex vectors.
So HOW COULD WE STUDY THAT SPACE?
The best scientists in the world history, as Heisemberg, Bohr, Schrodinger, Von Neumann, Dirac and Richard Feynman did the big work for us, also with the help of Einstein and the great John Bell. Feynman did it, trough its diagrams. These diagrams are maps, where Feynmann change the state space to a Configuration space (a logical space of symbols), mapping what really happens in a Hilbert state space, as diahrams in a configuration space of REAL NJMBERS.
Than it is much more easy for us to study REAL NUMBERS, configuration spaces, than complex vectors and tensors! We did try to do the same, following master Feynman and his ideas.
Feynman did discover that way, sygnatures for quarks, bosons and leptons and a full pandemoniun of particles. Very complex ones, with matter and antimatter. Our work was much more easy and simple. 5 signatures to recognize. No antimatter nor phantoms Not so complex.
We did it.
. Yes, Feynman and we, we did all, at a distance.