Biology, Health, recent, Social Science

No One Is Born in ‘The Wrong Body’

The idea that all people have an innate “gender identity” recently has been endorsed by many health-care professionals and mainstream medical organizations. This term commonly is defined to mean the “internal, deeply held” sense of whether one is a man or a woman (or, in the case of children, a boy or a girl), both, or neither. It also has become common to claim that this sense of identity may be reliably articulated by children as young as three years old.

While these claims about gender identity did not attract systematic scrutiny at first, they now have become the subject of criticism from a growing number of scientists, philosophers and health workers. Developmental studies show that young children have only a superficial understanding of sex and gender (at best). For instance, up until age 7, many children often believe that if a boy puts on a dress, he becomes a girl. This gives us reason to doubt whether a coherent concept of gender identity exists at all in young children. To such extent as any such identity may exist, the concept relies on stereotypes that encourage the conflation of gender with sex.

However, starting at a young age, children do tend to exhibit preferences and behaviors that we associate with sex (as distinct from gender). For example, male children display more aggressive behavior than female children. In addition, “cross-sex” behavior—or, more accurately, cross-sex stereotypical behavior—often is predictive of later same-sex attraction.

Can all of these findings be integrated? To start, just as sex influences the development of bodies, it also influences brains. There are in-utero differences in hormone exposures (male testosterone surges at eight weeks gestation, for example), and distinct developmental pathways are triggered based on the XX (typically female) or XY (typically male) chromosomal make-up of neurons. The integration of these sex-related and other developmental processes with environmental pressures gives rise to an individual’s unique personality and preferences.

It comes as no surprise then that population-based studies have demonstrated sex-related differences in personality and preferences that are independent of social influences. When social influences are weakened (in more egalitarian societies such as the Nordic countries of Europe), the sex-related differences in personality and preferences actually increase (the opposite of what one would expect if men and women were wired in an identical fashion). This suggests that as environmental pressures become relaxed, innate sex-specific preferences surface.

A closer look at personality traits shows that when data is analyzed in aggregate, there is a roughly 30% overlap between sexes, as schematized in the accompanying figure. The consequence of this overlap is that adolescent males who fall on the left end of the male (blue “masculine”) curve, and adolescent females who fall on the right end of the female (pink “feminine”) curve, will exhibit personality traits that diverge from the majority of other members of their own sex. In fact, due to the overlap of personality traits between males and females, the personality traits of some females will be more “male-like” than those exhibited by some, or even most males’ and vice versa.

In the case of an adolescent female whose behavior, personality traits and preferences are more “masculine” than most girls and most boys, she could be led to incorrectly conclude that she is really a male, born in the wrong body. That child’s parents could become confused as well, noticing how “different” their child’s behavior is from their own, or from that of their peers. In reality, that child simply exists at the end of a behavioral spectrum, and “sex-atypical” behavior is part of the natural variation exhibited both within and between the sexes. Personality and behavior do not define one’s sex.

There are approximately 40-million children in the United States between the ages of four and fourteen. The distribution curve above would suggest that roughly four-million of them have personality profiles that are “sex atypical,” but which are still part of the natural distribution of personalities within each sex.

The broad, but normal distribution of personality traits also explains studies showing a 28% concordance of transgender identity in twins. Twins have identical chromosomes, and so likely will have similar sex-related behaviors, as well as experience similar environmental influences in regard to those behaviors. Using twin adolescent males as an example: If their behaviors are at the “feminine” end of the male-typical distribution, they could both become confused as to what their behaviors and preferences mean about their sex.

In most cases, the thing that is now called “gender identity” likely is simply an individual’s perception of how their own sex-related and environmentally influenced personality compares to same and opposite sexed people. Put another way, it’s a self-assessment of one’s stereotypical degree of “masculinity” or “femininity,” and it’s wrongly being conflated with biological sex. This conflation stems from a cultural failure to understand the broad distribution of personalities and preferences within sexes and the overlap between sexes.

When a girl reports that she “feels like a boy” or “is a boy,” that sentiment may reflect her perception of how her personality and preferences compare to the rest of her peers. If the girl has an autism spectrum condition, she may even perceive “sex-atypical” behavior that does not actually exist, and thereby falsely self-diagnose as male even without experiencing any actual male personality traits.

It should be noted that these scenarios don’t apply to all cases of gender dysphoria, as many other triggers are described in the literature. But in most cases, counseling can help gender dysphoric adolescents resolve any trauma or thought processes that have caused them to desire an opposite sexed body.

Historical data suggests that about 0.5% of children develop gender dysphoria—distress caused by a perceived incongruence between one’s biological sex and gender presentation. Reinforcing studies in the medical literature show that, as children get older, childhood-onset gender dysphoria resolves (i.e. ends) in most cases. As two authors put it in a 2016 International Review of Psychiatry article, “the conclusion from these studies is that childhood GD [gender dysphoria] is strongly associated with a lesbian, gay or bisexual outcome and that for the majority of the children (85.2%; 270 out of 317 [studied individuals]) the gender dysphoric feelings remitted around or after puberty.”

Yet instead of offering counseling, medical professionals now are commonly telling children that they may have been “born in the wrong body.” This new approach, called “gender affirmation,” makes gender dysphoria less likely to resolve, pushing children down the path toward irreversible medical and surgical interventions. If aggressive transition options are pursued early in puberty, the combination of puberty-blocking drugs, followed by cross sex hormones, will result in permanent infertility.

The growing population of transgender-identifying high school students now is estimated to comprise about 2% of all students—a three-fold increase over the baseline 0.5% figure cited above. Many adolescents now are presenting to gender clinics, with some clinics seeing a 10-fold increase in new cases. Many of these adolescents have no history of childhood gender dysphoria. Higher rates of autism-spectrum conditions have been described in many of these adolescents, and the controversial “affirmation model” is being applied to this unstudied cohort as well. Not surprisingly, reports of transition regret, and de-transition, are growing in number.

To summarize, a lack of understanding regarding the distribution of sex-related personality and behavioral differences has led to confusion that impacts children who fall at the extreme tail-ends of the distribution, and who would be statistically more likely to grow up to be gay, lesbian or bisexual adults if allowed to experience uninterrupted puberty. Additionally, telling a child that he or she was born in the wrong body pathologizes “gender non-conforming” behavior and makes gender dysphoria less likely to resolve.

The fact is, no child is actually born in the wrong body. Adults should expand their understanding of what normal male and female behavior and preferences look like—which would lead them to appreciate that being male or female comes with a wider range of personalities preferences, and possibilities than old stereotypes would have us believe.

 

William J. Malone is an endocrinologist. He earned his medical degree from NYU School of Medicine. You can follow him on Twitter at @will_malone. Colin M. Wright is an evolutionary biologist at Penn State. You can follow him on Twitter at @SwipeWright. Julia D. Robertson is a journalist, award-winning author and Senior Editor of The Velvet Chronicle. You can follow her on Twitter at @JuliaDRobertson.

Photo by Sharon McCutcheon on Unsplash

Comments

  1. This conflation stems from a cultural failure to understand the broad distribution of personalities and preferences within sexes and the overlap between sexes.

    Yes!!!
    Just because you think like a boy, doesn’t mean you are a boy. If you have a femal physiognomy you are female. You may indeed want to cavil against the social construct of ‘womanhood’’, but that doesn’t mean you are not a woman. You may not wish to conform with the cultural norm by dressing, acting or talking like a woman. That’s fine. But don’t make the mistake of concluding that because most other women don’t act and think like you are still not a woman. You may chose to live like a man. That’s fine too. We will accept your choice. But you are not a man.

  2. Great article, and very brave given the current cultural climate. A while back, I read an article stating that NHS staff at the Tavistock clinic were having their jobs made significantly harder by parents and online activists intent on coaching kids, so that they can pass the diagnostic criteria for gender dysphoria- and this, in a climate where they are routinely accused of gatekeeping. These misguided parents and activists are causing harm in their attempts to implement an ideology, that would see the accumulated knowledge of trained medical professionals thrown to the winds. In many other Western countries, especially in the Anglosphere, Doctors have become simple facilitators of patients opinions, in scenes reminiscent of the prescription-happy beginnings of the opioid crisis- in this instance, the treatment prescribed guaranteed to be forever life-altering.

    The irony is that when trans activist critique the wealth of studies showing the effectiveness of trans desistance, their main criticism is that of the 65% to 90% of trans destisters who go on to have perfectly normal, happy lives in their sex assigned at birth, is that these studies don’t take into account people who might have been simply gender nonconforming. One can only presume that the problem is likely to be orders of magnitude higher, now that this ideology is overruling the medical decision process. Decades from now we are likely to find that, in all but the rarest of cases, generally it is better to let the mind conform to the body, rather than to force the body to conform to the mind.

  3. This is a very well-written and well-argued article.

    They omitted a discussion of the “scientific” evidence for transgender. Mostly this involves showing that some brain activation in M2F trans persons is more like female than male. This falls directly into the same argument as that made in this article. There is biological variability in many areas, and the brain is part of the biology. It certainly would make sense that those who identify as F would have brains that may resemble real normal F persons.

    That, however, is not enough to show that these are F. They are males on the F end of the curve. As Paul McHugh puts it, they are feminized males. There’s nothing wrong or bad in being a feminized male. I myself have a more powerful maternal drive than my wife in some ways. It’s not a defect. It’s just a part of my personality.

  4. The trans issue fascinates me. It seems to me to be utterly obviously wrong to promote transitioning children. I saw a video recently on a family with two children, of both sexes, each transitioned to the other sex. These parents talked like dumb puppets. I thought I was watching a Monty Python skit.

    One effect of social media is the rise of ‘IDIOT COMPASSION.’ The trans movement is exactly that. The reason for supporting your child’s transition is to prevent suicide. Subsequent entrance into opposite sex toilets is bullying prevention. Neither of these reasons make sense, yet you see people parroting this as if it were the truth. As if by parroting this nonsense, they are saving the lives of precious children. But what this is REALLY about, is THEM. How “good” they are. How “supportive.” How “compassionate.” Yet there is nothing compassionate about promoting a lie, cutting off your child’s secondary sex organs, and medicating them into perpetual puberty. An old friend announced his son was now the daughter he always wanted. Indeed, the son is pretty, but clearly he is gay if anything. The response to this announcement supports the idiot compassion argument. What “good” parenting! How fortunate this child is, to have my friend as a parent!

    This issue also intrigues me because I would have been a victim of it, if born at another time. The story would have gone that the school would tell my mother that I am really a boy, and my mother would have marched straight down there in her red boots to tell them to leave me the hell alone. “Why do you think that?” she would ask me. If I ever said it was because other people thought it, she would yell: “Don’t. Be. A. Sheep!”

    If only more parents were brave enough to stand up to this nonsense! The DE-Transition videos are painful to watch. Girls with mangled voices and bodies, regretting having fallen into this trap…

  5. The problem is that anyone endorsing this idea is by definition unscientific and irrational. To argue against them is a losing battle. Even if they were to hear everything you say, they will not process it or apply it to the lives they live. They are ruled by their terror of being rejected by the collective, and by the collective itself. If the collective demanded that they wear hats in the shape of vaginas, they’d all obediently do so. Oh wait…

    This collective makes them invested in an off-the-charts sexist view of gender whereby if you like dolls when you’re 2, ipso facto that means you’re a girl. That is, they simultaneously believe in two rigid and ridiculously reductive definitions of gender, and that it’s on a continuum and there are 100s of definitions. How can one argue with something so essnetially nonsensical? This ideology is so appealing to weak minded people, that we have otherwise intelligent doctors literally committing child abuse, destroying children’s lives forever by sterilizing future gay men and denying them the ability to have sex, and destroying future lesbians by denying them the ability to find pleasure in sex. Not to mention all the other side effects that haven’t been studied at all on these living Naziesque guinea pigs. We have the government jumping in feet first, both splashing, as well, perhaps because they are disproportionately filled with weak minded people who value collectivism? I don’t know. All I know is that this is handing over enormous power to the government that can literally tear a child from its parents arms for no reason at all except that they don’t belong to the collective and don’t want to harm their own child.

    Put another way, their idea of gender is religiously real to them, not scientifically real-- it exists in absence of any scientific markers, including brain scans, and only exists in the mind of the beholder, with no verifiable external markers, a classic definition of insanity.

    To fight insane, quasi-religious people who lust for power, with a carefully reasoned essay, is going to be doomed to failure in most cases. I mean, it’s important to write the essays and this one is well written. But what else are we to do? It seems like one of these things that almost no one wants, and yet everyone is being compelled to do.Why are we allowing the lunatics to rule the asylum?

    I’ll tell you one thing–if my kids were going to public schools now (they’re grown) I’d be very very very mindful of what they were being taught at school, and I might well homeschool them or pull them into a private school without this ideology.

  6. Issue here is that medical professionals can have exposure to accusations of malpractice either way.

    The real kicker is that the hormone therapies aren’t “harmless” and “zero sum.” In many cases, reduced fertility and/or permanent organ damage can result. Which is “harmless” in the sense of one’s own life, but does alter quality of life.

    And this is all being pushed by two groups: M2F who are angry that transitioning after puberty does not make them passable, and advocacy groups who are getting woke points. Neither group generally having, and therefore caring, about kids- they’re just collateral damage that puffs up the numbers they can claim, i.e. “It’s an epidemic!” or “There are X many of us!” This does not incentize honest reporting.

    I’ve mentioned before on Quillette, but according to the Minnesota Multiphasic Personality Inventory-II, I had “confusion about gender roles” in my early 20s (I was assessed due to a nasty bout of depression; turns out it was driven by early-onset hypothyroidism). Anyway, I also had a separate personality assessment about the same time that said I was most likely a 43 year old woman from Maryland or North Carolina. My parents, much like my wife and myself, are what I have since called “gender inverted”- my father by nature is a caregiver, my mother a hyper-driven vigilant hardass. This does not make myself or my father not manly, nor does it strip femininity from my mother or wife- it does mean all four of us are highly impatient with our own genders and find them irritating to be around. I find dealing with the constant competition of other men exhausting, my wife hates female “emotions” dominating girl time. So when I run into women like my wife in the tech industry- and you find a lot of what I’d call “gender inverted” women in tech- I look for a work event to introduce them, they generally hit it off.

    This does not mean that on balance we aren’t our birth gender- I like military history and building things and would rather not discuss my feelings and have things be “understood,” (Also, MEAT) my wife’s favorite film is the Colin Firth Pride and Prejudice by the BBC- which she’ll watch with her “chick-dude” friends and sit around after and say “Yeah, I like that. And Colin Firth is cute in that. Now what do you want to do?” It also does not mean any of us is gay- I’m sexually aroused by women, my wife by men. It means that we aren’t “gender typical”, but then, by definition if it’s a normal distribution, only a minority are and the rest of us are atypical on one side or another. It does mean my potential dating pool was smaller, is all. And again, not the same as being gay or transgender.

  7. @Ship

    “An old friend announced his son was now the daughter he always wanted.”

    I believe the parents need to be studied as well. I believe the parents who allow their children to transition are exhibiting signs of munchausen by proxy. This is sanctioned child abuse.

    Finally does insurance pay for the procedures involved? I could possibly see covering and adult but covering a child for transitioning costs, should be out of the question. I failed to see how this is any different from clitorectomies where the parent chooses a life altering medically unnecessary procedure for a child in order to enhance social standing.

  8. Having gender dysphoria doesn’t mean that you have the wrong body. As the article indicates, the majority of people with sex-atypical personalities don’t have gender dysphoria. Much more often they are just homosexual. Gender dysphoria is a separate psychological issue.

  9. The ultimate virtue signaling ploy is to participate in the mutilation of your own children’s genitals to show just how woke you really are.

  10. Would 99.5% not be congruent with your characterization of “large majority”?

    My position, which I thought I made clear, is that gender dysphoria, while real, is not the result of a person having the wrong body for their brain. There’s no evidence to support this idea. The majority of people who have the “wrong” psychology for their body (sex-atypical) do not have gender dysphoria. People without gender dysphoria and people with gender dysphoria have the same brains in terms of sex-associated psychology. Therefore gender dysphoria cannot be a manifestation of having the wrong body for one’s sex-associated psychology.

    Yes, gender dysphoria is real. No, you can’t be born in the wrong body. The two are not the same thing.

  11. That’s actually factually wrong. There is an objective test. It’s called DNA.

    When a person makes a claim, that person is responsible to support that claim. Thus, the onus is on the trans community to support this impossible claim. They must define criteria which show that a male body contain a female brain. So far, no one has come up with an objective way to show this.

    It is not incumbent upon the trans skeptic to prove that the contention is false. If someone says “I am Napoleon”, we know with certainty that this is false. Your contention is that if they say, as a male, “I am Josephine”, it is incumbent upon the trans skeptic to show that this is false. Nope. You have an impossible contention, the trans community must support it. We know there is mental illness out there, and the trans psychosis is no different than any other psychosis. We do not allow anorexics to modify their body to match their body dysmorphia. Similarly, the trans psychosis should not be supported by clueless parents who are desperate to believe that their child is not mentally ill. It’s a sad situation, but the child with a gender dysmorphia is mentally ill.

  12. You open up a really intersting topic there.
    I’ve often questioned whothe natural partner of a trans person is supposed to be.
    I would imagine that most gay men like men who have male characteristics. They aren’t really interesed in having sex with women, so why would they wnat to have sex with a man with false breasts and a feminine appearance? And why would heterosexual men want to have sex with a woman with a penis? The same would be true with trans men.
    Maybe the point is that trans men should partner up with trans men.
    It is all so humorous

  13. I have identified the missing social media icon: the trans-oriented emoji. Many trans persons have identified the lack of an emoji as a key feature in full social-media involvement.

    Clearly, the trans emoji is the Mr. Potato Head. You can take parts off and put parts on without any issue.

  14. A schizophrenic can have mind-reality/mind-body conflicts, but we don’t suggest we adjust realty to fit their mental model. A person suffering with a mind model that says they are fat when they are deadly skinny doesn’t suggest we accept that their body is indeed too fat. Dysphoria is a disease, and the solution cannot be to change their body and feed it hormones so their mental mismodel is accepted.

  15. An important fact worth considering with regards to sexual preference is that 70 % of trans people are “gay,” meaning attracted to the opposite of their birth sex. If these people were really born in the wrong body, you would expect their sexual proclivities to match that. Their occurrence of homosexuality should be similar to that of the general population.

    Most trans women keep their penises as well, which is incompatible with the claim they are dysphoric. If someone were really a woman, the most jarring thing would not be that they lacked 2 lbs of makeup or stripper-size breasts, but that they have a penis between their legs. There are plenty of ugly women and flat-chested women: it should primarily be the penis that induces dysphoria and that should be the first surgery if someone is dysphoric.

    This seems to me to primarily be a social phenomenon, where the need to be special has induced the most mentally-weak generation ever to pursue evermore niche identities.

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