…Mars, apparently. Or, at the very least the two appear to come from roughly the same general location rather than from separate planets 199 to 316 thousand miles apart.1
Surprised? Of course you are. For years you have been told that men’s and women’s brains simply could not be more different. How we love to think this is the case, and how the popular press/trash-science/book tour/lecture circuit reinforces the meme. Does not the Internet Itself tell us that it is true? Nor will most transgender blogs2 disagree. Indeed, this is the most common explanation for that condition which afflicteth me. Girl brain in boy body. Makes sense, right?
The Word for the Day is specious3–superficially plausible but actually false.
It turns out that that there is nothing in the universe quite so much like the brain of a woman as the brain of a man. Sure, some degree of variance exists, but with substantial overlap. Further, the differences that do exist often involve areas where better non-sexual explanations apply (e.g. the sensorimotor cortex is larger, on average, in men because their bodies, on average are larger), or MRI studies which measure regional blood flow, which may or may not have much to do with what is going on in terms of global function. Now, even that evidence seems to be tilting against the male brain/female brain hypothesis.4
Take a look at this nifty graphic, from the footnoted study:
Whether I ask you “Don’t they look alike?” or “Don’t they look different?”, you will probably think “yes”, unless of course you are rather contrary5, in which case you will likely answer them both “no”. Either way, if I remove the captions and show them to you in ten minutes, I guarantee that you won’t be able to tell which is which. Don’t feel bad–neither can a neuroscientist, at least not with any degree of confidence or consistency.
Add to this the fact that we are now finding loads of evidence indicating that the brain is not some rigid entity fixed at birth, but rather a complex, moldable structure which develops in response to use.6. The various characteristics (post-mortem brain measurements, blood flow on MRI) which were once used to argue for differences between male and female brains are strongly, in some cases chiefly, due to lived experience. Mathematicians acquire capacity to do math over time and through practice, changing their brain structure and connectivity in the process. Developed changes will show up on the old brain MRI just as much as the supposed male/female distinctions.
So why do men and women seem to act so differently? Well, again, largely because of what they have experienced. Subtle and not-so-subtle social cues press on them from the moment of birth. Before the moment of birth. A boy who articulates his opinions clearly is a leader. A girl who does the same thing is a bitch. A crying toddler is told either, “Let it out” or “That’s enough now” depending on whether they is7 wearing pink or blue, which was also chosen for them. You tell your nieces–but not your nephews–“Oh…you are so pretty!” so often that many of them grow up with paralyzing insecurities about their bodies. The fact that my then-girlfriend-now-wife grew up thinking it was improper to call me on the phone almost resulted in us failing to connect. I have endured soul-sucking shitty jobs at various points rather than to shirk my well-conditioned responsibility to provide. A young girl learns that someday her prince will come–and that this is what will make her life complete–at the same time that boys are learning that cars can turn into robots and blow up lots of shit.
It will take time and effort to unpack what is helpful and harmful about the way we currently gender children. First though, we need to stop seeing innate difference where it does not exist. Boys are not born to build things. Girls aren’t born more empathetic. The fact that they eventually show differences in these areas is just as likely to owe to nurture as nature. We should also start asking the question, “If not brain structure, then what?” Personally, I think that some of the dots are rather easily connected. Obsess about the physical beauty of little girls, and eventually they’ll do it too. Give one kid a toy lawnmower and the other a toy tea set, and they might just develop different interests as time goes on. As Aristotle said, “We are what we repeatedly do.” Or have done to us. Food for thought next time we plan a princess party for our BFF’s little angel or tell a timid adolescent male to grow a pair.
Which brings me at long last back to gender dysphoria.8 If male brains and female brains really aren’t much different, why do trans folk say that they have the wrong brain, or that they were born in the wrong body? Two reasons. First, we’ve been bathed in that same myth, and are no less drawn to its elegant, but unfortunately bullshit, simplicity. Second, we are, as a group, rather prone to feeling shut out, judged and shamed. We tell the stories that work, that convey the very real turmoil we experience in the manner least likely to produce a hostile response. You know, the same thing you do when you explain why you are 10 minutes late to work.
“All things are relative,” said Einstein. Never, actually.9 Every narrative has a narrator, and most truth is personal truth. It might be metaphorically useful to speak of mismatched brains and bodies, but that’s about it. Brain function is incredibly complex and poorly understood. We were foolish to think that firm conclusions could be drawn from the small variances in the way a brain looks on a scan or an autopsy table.
And, of course, we can’t really swap out brains or bodies anyway. Of the two, bodies are quite a bit easier to alter, so we try to do that (for those who desire it), but it would be a gross oversimplification to say that therapy, hormones, surgery or some combination of the three “cure” transgender identity. Better to acknowledge that it cannot be cured, or even better yet, that there is nothing that needs to be cured.
Being transgender is just my particular burden to bear, neither rare as it turns out, nor hopeless. I write about it because I can, and I think maybe it helps. Lots of things help. Psychotherapy helps. Having supportive friend and family helps. Chocolate helps. Learning to take charge of one’s transition helps. Sleeping helps. Going south once or twice per winter helps–a lot.
Perhaps the purest and finest Counseling McNugget my psychiatrist has given me over the years is that the real, lasting changes are gradual ones. I occasionally run into a transsexual biography or blog in which the author says that that she felt better instantly once she started taking estrogen. That’s wonderful, I suppose, but of course it’s also the placebo effect. It takes 3 or more years for hormones to make a boy or girl into a man or woman. Why would it be any faster for a fully formed adult?10 Knowledge11 seems to progress in this way. We gradually let go of rigid concepts of cause and effect, looking rather to a more complex picture of influences and variations, probabilities and possibilities, subtle effects and shades of gray. It takes longer to explain, doesn’t boil down to a pithy phrase and probably won’t sell as many books, but there you have it.
Finis. I don’t think I have laid a 1500 word epic on you for quite a while. My compliments to you for having worked your way to the bottom. With any luck, I’ll be back in a week with another spellbinding installment, almost certainly about hair. First though, a quick personal note. Given all the whining I have done over the past months about this or that trial, I would be remiss if I did not mention that I feel fine.
Live long, and prosper.
- Depending on orbital phase
- Don’t feel like you have to check them all out yourself. Just read this one and share the bejesus out of it. Trust me, I’m a doctor…
- Or possibly neuroplasticity. You decide. Whichever you use in a sentence today will make you sound, as they say in New England, wicked smaht.
- Yes, you.
- This is in the neuroplasticity bit
- Yes, is. They was the Oxford English Dictionary’s word of the year, recognized for striking changes in its meaning and grammatical use relating to new understandings of gender.
- The ongoing, bewildering sense that one’s complex gender identity as male or female differs from the simple designation based on body parts alone.
- However, he did say that physical law applies equally as calculated from the perspective all non-accelerating observers. This was the easier of his theories of relativity.
- I get it though. Really, I do. I felt better after I decided to try hormones too. Remember the part about taking charge of one’s transition? In terms of actual mental/emotional benefit, though, it several months before I became convinced that they were doing much more than improving the smell of my armpits or making my nipples hurt.
- And parenting
While male and female brain differences are insignificant, the referenced study does nothing to invalidate a biological basis for gender identity. I suspect you may be familiar with this research: http://transexualia.org/wp-content/uploads/2015/03/Medico_whitematterpsychiatrresearch.pdf and http://cercor.oxfordjournals.org/content/early/2012/08/30/cercor.bhs267.full .
I have now been on HRT for 10 months. While taking this positive step toward transition is a factor for the peace that I have enjoyed (and a placebo effect), I’m convinced that there are equally significant biochemical effects. Within days after starting HRT, elevated levels of cortisol and adrenalin were reduced, serum glucose dropped to normal, blood pressure dropped to normal, mood swings moderated, dreams were no longer conflicted, my death wish dissipated and my concentration improved. Before HRT, I was an endorphin (exercise) and serotonin (social contact) junkie and relied on meditation the rest of the time. Testosterone wasn’t working for me. This could be explained by androgen receptor mutation http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402034/ which appears involved in mediating MTF gender identity. Perhaps in the future gene therapy will be developed as an alternative to transition, but would we want it?
The first I had seen, but not the second. The caution I raise is that it is possible to read way too much into the structure and/or appearance of the brain when what most interests us is what it does and why. The connection is not necessarily linear. I would say that my HRT experience has been more modest, but I intend to reserve further comment until more treatment time has elapsed.
I am glad your results have been so incredibly positive!