By CURT SUPLEE Washington Post
Scientists in Holland have found preliminary evidence that male transsexuals - men who identify sexually with women - have a strikingly different brain structure from "ordinary" men, at least in one key area about one-eighth of an inch wide.
In today's Nature, a team of researchers from Amsterdam reports that they conducted post-mortem exams on the brains of six male-to female transsexuals. Specifically, they studied one particular part of hypothalamus, called the central division of the bed nucleus of the stria terminalis (BSTc).
This area, which is thought to influence sexual behavior, is on average 44 percent larger in men than women. Yet all six subjects had BSTc regions that were female sized, Dick Swaab of the Netherlands Institute for Brain Research and colleagues found.
BSTc volume is not related to homosexuality, the researchers concluded from post-mortem analyses of 36 other brains, including those of homosexual men and het erosexuals of both sexes: "The BSTc was 62 percent larger in homosexual men than in heterosexual women." Nor does it appear to be a factor in sexual orientation in general. Of the six transsexuals, three had been attracted to women, two to men and one was bisexual.
Psychiatrist Sandra Witelson of McMaster University in Hamilton Ontario, said the work adds "to the body of knowledge that has been accumulating in the past five or six years, all of which shows that there are biological correlates to variation in human sexual behavior." Per haps the most celebrated such find ing came in 1991 when Simon LeVay, then at the Salk Institute in California, reported that gay and straight men differed dramatically in yet another area of the hypothalamus.
The authors of today's paper argue that the transsexuals' "feminine" BSTc volume arose from biochemical conditions early in life perhaps during fetal development. The findings, they conclude, "support the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones."
In an accompanying commentary, however, neuroscientist Marc Breedlove of the University of California at Berkeley warns that "this will be far from the final word on the subject." Breedlove notes that of the six subjects, five had had their testicles surgically removed and all had tak en the female hormone estrogen, as well as a drug that blocks the action of male hormones called androgens. Those conditions, he writes, might have affected the size of the BSTc region. Moreover, he writes, it is impossible to know whether the small BSTc size influenced the subjects' transsexuality or vice versa.
Richard Restak, a Washington, D.C., neurologist who has written extensively on brain research, observed that recent studies have shown that "estrogen has an enhancing and modulating effect on neurotransmitters in the brain. Thus, it's conceivable that it might encourage or discourage some change in brain structure."
The researchers acknowledge that possibility but cite the fact that two transsexual subjects who quit taking estrogen shortly before their deaths nonetheless had "a small, female-like BSTc." They also stud ied two other men whose testicles had been removed in the course of treatment for prostate cancer, elim inating their bodies' main source of androgens. Both had BSTc volume "at the high end of the norrnal male range."
The new research "doesn't mean that learning or culture or environment are irrelevant" to transsexuality, Witelson said, "not at all. But it is one more report of a relationship between anatomy and behavior."
Medical Research currently being done appears to support the theory that transsexualism is a genetic birth defect.
Scientists have determined that the SRY gene, a portion of the XX or XY chromosome, is responsible for gender, and believe that it is a small portion of the SRY gene which determines gender identity. While the actual portion of the SRY gene which controls these factors has not yet been found, science is very close to discovering it.
Gender Dysphoria is a condition which, for the past 40 years, has successfully been treated only through a combination of psychological and physical therapy.
All attempts to treat it via denial that physical therapy is necessary have been proven to be futile. And recent studies have shown that, when physical therapy is withheld, patients suffer from additional neuroses which then need to be dealt with in addition to the condition of gender dysphoria which does not go away. It is for these reasons that transsexualism can hardly be refered to as anything OTHER than a medical problem.
--> www.sue.net/spirit.html (Transsexual women sprituality)
What sex assignment should an indivisualwith abnormal sex chromosom have? Is a Klienfelter's syndrome child a male with and extra X? Or a female with a superfluous Y? A Klienfelter's child is usually assigned as male, the gonads are small, always sterile, and produce little androgen and some estrogen. As an adult the individualmay have somewhat mixed somatic features, taller than average, a tomboyish figure or eunuch body depending on body fat levels, minor breasts developement, lack of upperbody strenght, and feminine hair distribution. There is believed to be a slight chance of mild mental retardation or learning disabilities and the brain sex is often ambigiousto female. It is not unusual for an individual with Klienfelter's Syndrome to be also Homosexual or Transsexual. Treatmentwith hormones is usually recommended by physicians to better fit typical male or female somatic expression, testerone for male identified individuals, estrogen and progesterone for female identified individuals.
What sex is a XX chromosome child with SRY gene transfered onto it? There are a genes normally on the Y chromosome that ocasionally get transfered or transposed onto the X chromosome.Such individuals look like Klien Felter's save that they are not as tall, nor do they have the slight mental retardation. They are however sterile. Brain sex is ambigious to female. Treatment is the same as Klienfelter's.
Occasionally the SRY gene is missing from the Y chromosome. This leads to a female appearance but sterile gonads. Brain sex is usually female.
November 13, 1995 Volume 146, No. 20
Transsexuals often claim they were born the wrong gender. Microscopic studies of a key region of the brain suggest they may be right BY CHRISTINE GORMAN
Most young children like to play dress-up, parading around the house in their dad's wing tips or smearing their mom's lipstick all over their face. But for a few youngsters, usually boys, this childhood rite is more than a game. They are obsessed with their mother's clothes and wear them at every opportunity. It is as if a part of their mind were trying to erase the maleness of their body and allow an inherent femaleness to emerge. As they grow older, their discomfort with their gender often increases, until finally they turn to doctors for help. Some take feminizing hormones to grow breasts. Some even have their sex organs surgically altered so they can live completely--including anatomically--as women.
But are such people, who are known as transsexuals, truly women trapped in men's bodies? For years, scientists searched for but never found any measurable differences between most men and the ones who become transsexuals, whether in the level of hormones, the shape of genitalia or the number of chromosomes. Nor did scientists find any fundamental similarities between transsexuals and women.
Last week, however, investigators from the Netherlands Institute for Brain Research in Amsterdam reported preliminary evidence that transsexuals may be inherently different, after all. Their study of six male-to-female transsexuals showed that a tiny structure deep within a part of the brain that controls sexual function appeared to be more like the type found in women than that found in men. If confirmed, the study seems likely to challenge long-held beliefs about what it takes to make someone a man--or, a woman.
The Dutch research is part of a growing body of evidence suggesting that nature is just as important as nurture in determining how we think and behave as sexual beings. Neurobiologists have cataloged apparent differences in the way men's and women's brains process information and interpret facial expressions. Geneticists have begun sifting through tantalizing clues that sexual orientation--as opposed to sexual identity--may at least be partly inherited (see box). Yet the subject matter is so charged from an emotional, political and even religious perspective that evaluating all the various claims dispassionately can be very difficult.
In many respects, studying transsexuals would seem to be the most difficult undertaking of all. Not to be confused with transvestites or cross dressers, true transsexuals are rare. By some estimates, no more than 1 person in 350,000 believes he or she was born the wrong gender. Moreover, the portion of the brain that seems to be different in transsexuals is smaller than a pinhead. Even advanced imaging techniques, like the pet scan or MRI, cannot detect such tiny variations. To do their research, the Dutch team, led by Dr. Dick Swaab, had to dissect the brains of transsexuals in autopsies and examine them under a microscope. Little wonder, then, that it took Swaab's team 11 years to find transsexual candidates, persuade them to donate their brains and then wait for them to die to make the comparisons.
Despite these constraints, Swaab and his colleagues were able to detect some intriguing patterns. They compared the brains of two dozen "ordinary" men and women. For the most part, the brains appeared to be the same until the researchers examined a section of the hypothalamus called the BSTc. Although no one knows for sure what this tiny patch of neurons does in humans, earlier studies have indicated that, in rats at least, it plays a key role in regulating male sexual behavior. Half the men in the control group were heterosexual and half were homosexual. Yet, regardless of their sexual orientation, they all had a BSTc that was 50% larger than that in the women.
When the researchers examined the BSTc of the transsexuals, they found a marked difference. The transsexuals' BSTc was more like the women's than the men's. In fact, the transsexuals' BSTc was, on average, slightly smaller than the women's. The researchers seemed to have found at least one biological motive for the transsexuals' desire to change sex, although it may not be the only one. Says Swaab: "Our results indicate that other structures in the brain could be involved."
How could the brain and the body become so mismatched? Several explanations are possible. One is rooted in the process by which embyros take on sex differences. All human embryos develop in the very earliest stages of gestation along more or less feminine lines. Those destined to become males differentiate from the master template after a complex series of hormonal secretions starts to masculinize the embryo. Miscues in this process could result in crossed signals in the portions of the brain that are responsible for gender identity. That would help explain why there are more male-to-female transsexuals than female-to-male.
Not everyone is convinced, however. All the transsexuals in the Dutch study took the feminizing hormone estrogen. The smaller BSTc may therefore have been the result rather than the cause of their quest to become women. Swaab concedes this possibility but notes that two women in the study's control group were postmenopausal and presumably no longer manufactured much estrogen. Their BSTc was still the same size as the younger women's, which may mean that estrogen has no effect on the structure's size. There are simpler explanations--stress, for example. "Think about it," says Roger Gorski, a neurobiologist at UCLA who has studied rats' sexual behavior for 30 years. "These people undergo a lot of emotional trauma. To cut everything off to become a woman has got to be awfully stressful, and that has got to affect brain structures."
But for most transsexuals, there is no question that something deeper is going on. From the time she was a boy of six, Bea Jansen, 46, who lives outside Amsterdam, knew her body did not reflect her true gender. "I felt there was something that didn't fit," she says. "And that something was a penis." Jansen, who plans to donate her brain to Swaab's study when she dies, underwent a sex-change operation five years ago. She speaks for many transsexuals when she describes her transformation as a liberation: "I felt as if I could finally take off a mask that I had been wearing for a long time." With Jansen's help, scientists may someday understand how that mask got there in the first place.
Reported by James Geary/Amsterdam and Alice Park/New York
Copyright 1995 Time Inc. All rights reserved.
Men and women whose gender identity more closely matches the other sex are termed transsexual. These individuals desire to rid themselves of their primary and secondary sexual characteristics and live as members of the other sex. Hormonal and surgical techniques make this possible, but it is a difficult, disruptive, and costly process, and must not be undertaken without psychological counseling, careful planning, and a realistic understanding of the likely outcome. Most transsexual people are born and first live as male.
Transsexuals are diagnostically divided into the sub-categories of Primary or Secondary. Primary transsexuals display an unrelenting and high degree of gender dysphoria, usually from an early age (four to six years of age). Secondary transsexuals usually come to a full realization of their condition in their twenties and thirties, and may not act on their feelings until they are much older. Typically, secondary transsexuals first go through phases that would be self-assessed as being a "crossdresser or transgenderist."
The outcomes of transsexuals vary greatly. There seems to be no significance in the outcome differences between primary and secondary transsexuals. Those who complete this gender reassignment process (the process of "transition") and have exercised due diligence throughout generally do very well for themselves and lead happy and fulfilling lives. Unfortunately, others who go through the process on a perfunctory basis may be unprepared to fully and comfortably assimilate into their new gender role. In conclusion, when we think of gender, we need to realize that many combinations in gender exist, and that they are all natural. Although most people are morphologically male or female, those who homogeneously fill all five gender categories as the same gender may be in the minority. The largest minority, but still a minority.
Copyright 1995 Tampa Stress Center, Inc.
Source: Tampa Stress Center, Inc., PO Box 273107,
Tampa, Florida 33688. Telephone (813)884-7835.
Details on Transsexual Studies (www.transsexual.org)
Yahoo Transgendered Links (http://dir.yahoo.com/Society_and_Culture/Cultures_and_Groups/Transgendered/)
Geocities TG Directory (http://www.geocities.com/WestHollywood/6200/)
Global Transgendering (http://tr.webring.org/cgi-bin/webring?ring=tr&id=335&list)
GLBT education "Loads of Links" (http://www.virtualcity.com/youthsuicide/links3a.htm)
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