Sparkle

Sparkle19a

Sparkle is the annual UK transgender celebration, held in July in Manchester. 2019 was my 8th Sparkle. I’ve been every year since 2012, with the exception of 2013 – when my wife gave me an ultimatum: give “it” all up or you may lose me.

I remember the devastation I felt a week before Sparkle 2013 as I withdrew from commitments I’d made. It felt like the end of the world: all my things were packed into a large suitcase and put away. My wife’s original demand was to dispose of everything for good; put it all in a bin bag and get shot of it. But as I looked at the pile of my things on the floor, I broke down and sobbed. It was simply too hard to throw everything away, two years after finally accepting myself for who I was. Of course the pile on the floor was just clothes and shoes, but they symbolised the resolution of a lifetime of self-hatred and a hard-won battle for self-acceptance. To go back down the long dark tunnel having once emerged into the light seemed too awful. The photograph below was the last one taken before the fateful day – it felt like Karen’s last outing.Leeds_Jun_13b

The next few months were rather difficult. The photograph of a happy, contented Karen at the top of this post would have seemed inconcievable. The past six years have undoubtedly seen trials, but not only am I a happier, more contented person in the summer of 2019, but my marriage is stronger than ever. This progress, this triumph in the face of adversity, has not been made without sacrifice – some of it painful. Some challenges are unresolved – I don’t want to claim that my life is perfect. But I know what I believe in, and I have remained true to my values. If I was to offer any advice based on my experience it would be always to do what you know is right, and to remain true to those who you love. Much easier said than done.

The photograph at the top of the page was taken in Kendalls in Manchester by my very dear friend Pamela. Pamela was in drab, but it really didn’t matter. She’s the same person whatever she is wearing, and we spent a lovely couple of hours together. I have a few friends who I know “both ways” – we’ve met “dressed” and in drab. In each case, ironically (for a condition that is so strongly connected with external presentation), I have found there to be an underlying unity of self that transcends the clothing that is worn. Perhaps I should not be surprised: if the desire to dress as a woman comes from a strong inner sense of identity, then that sense of identity should come through irrespective of the presentation.

Of course, that begs a question –  can I not manage without dressing like a woman, just by accepting my inner femininity? It’s a question my wife has asked. The answer seems to be no – I simply have to slip on a frock on a regular basis. I can’t rationalise the apparently contradictory statements in the preceding sentences; I can see an inner unity in myself and my trans friends that transcends what we wear, but the freedom to present myself to the world in feminine guise seems to be fundamentally necessary to my sense of self and my well-being. I’m somebody who understands things for a living, but with much that’s associated with being trans I’ve had to admit defeat, and simply accept the way that things are.

But perhaps the peace of mind that has come with self-acceptance is greater than that which comes through understanding. At last the different, apparently contradictory elements of my psyche seem to be woven together to form a coherent pattern. If I don’t understand myself, I can at last make sense of myself.

A Normal Distribution

Many folk who are trans search for some kind of objective legitimation for their sense of gender identity. The internet is awash with tests that promise objective determination of one’s “real” gender. One of the more unlikely such tests is the “digit ratio”: in men and women, the index finger is usually shorter than the ring finger, but an increased difference is associated with high levels of exposure to testosterone in the womb. Thus for males the ratio is 0.947 while for females it is 0.965. On the basis of this simple diagnosis, I’m officially a woman. Or am I?

Measurements are subject to variation, not only because of random errors in measurements (there are limits to the precision of any measurement method) but also because of the intrinsic diversity of biological systems. To understand the meaning of a measurement, therefore, we have to know the spread of measurements. In nature we find that measurements of many properties fit a normal distribution: repeated measurement yields a spread of values that are distributed symmetrically about a mean value. The diagram below shows a normal distribution. The blue vertical line marks the mean, and the two red lines demarcate a region in which 95% of the measurements fall. In statistics, the parameter that is used to quantify the spread of this variation is the standard deviation (SD). The red lines in the diagram lie two standard deviations below and two standard deviations about the mean value.

NormalDistribution

Armed with this statistical information we can consider again the significance of the digit ratio. For males, the digit ratio has a mean value of 0.951 with a standard deviation 0.035, while for females, the mean value is 0.968 and the standard deviation is 0.028. Thus the mean values lie closer together than one standard deviation. If the sample size is large enough (many thousands of measurements) one might be able to claim that the difference in the values of the digit ratios for males and females is statistically significant, particularly if we compare the standard errors in the means. However, the means are closer together than one standard deviation, and in such circumstances it will be impossible to determine whether a single individual is male or female based on their digit ratio.

One often hears trans folk talking about a “spectrum” of behaviour. “Masculine and feminine are not two entirely different things”, people say; “both genders display a spectrum of behaviour and it is wrong to talk about masculine and feminine attributes”. What they mean is that for each sex there is a spread of behaviours or characteristics. Scientists would expect that such characteristics would fit a normal distribution, but the fact that types of behaviour are distributed normally about a mean does not help us to know whether or not the differences between the sexes are significant.

At the opposite extreme to the digit ratio is the blood testosterone concentration (see figure below). The mean testosterone concentration is very different for men and women: values for the vast majority of the male population lie more than two standard deviations from the female mean value. It should therefore be very easy to make an accurate determination of biological sex based upon a blood test, because statistically speaking there is an enormous difference in the spread of values obtained for the two sexes.

NormalDistribution2

Except that…Philosophers of science like to talk about “ceteris paribus clauses”: they argue that many scientific hypotheses depend upon “all other things being equal”. The importance of this becomes clear when one starts to think about transgender athletes. Martina Navratilova recently provoked a storm of controversy by suggesting that transgender athletes benefitted from having had unusually high levels of testosterone in their bodies for a large part of their lives, giving them an unfair advantage after transition. It’s a very persuasive argument; we know that during the Soviet era, female athletes were treated with testosterone to help them build muscle mass. The competitive advantage that comes from achieving such enhanced testosterone levels is clear; it seems obvious that transgender athletes are enjoying a similar “unnatural” advantage.

These kinds of considerations have led some athletes to suggest that a maximum blood testosterone level be defined in order to provide an objective, non-judgemental demarcation of where an athlete’s blood chemistry can be thought to take them outside the normal range. The marathon runner Paula Radcliffe has lent her support to those arguing for an upper threshold of 5 nMol. Now in fact, even at this level, things are problematic: for a random sample of normal women recently described in one study, several subjects displayed testosterone levels above 5 nMol. However, in sport the problem is rather more complex.

Athletes are not “normal” individuals: they are people who have subjected themselves to strict training regimes to achieve exceptional levels of physical performance. Comparing the blood chemistry of elite athletes with normal distributions collected for entire populations is perhaps problematic. To underline this, one study recently reported blood testosterone concentrations for elite athletes from a wide range of sporting disciplines (for a summary, see this web page). There were two really striking findings. First, a quarter of male athletes had low testosterone concentrations – thus among men testosterone is perhaps less well correlated with athletic prowess than might at first be expected. Second, 5% of female athletes were found to have high levels of testosterone, and a slightly larger number would have failed to qualify under the 5 nMol rule proposed by Paula Radcliffe and others.

The women who displayed very high testosterone concentrations were found to be predominantly competing in track and field and rowing, disciplines where muscle mass is of course important. What these data demonstrate is that a small number of women lie outside the “normal range” and these women are found to be disproportionately significant among elite athletes, because of course athletic competitions are designed to discover and to celebrate exceptional, unusual performance and not average behaviour.

What can we conclude from all of this? It is very hard to draw sharp lines. I do not accept the argument that there exists a “spectrum” of masculine and feminine attributes – I believe that ceteris paribus, we find it quite easy to differentiate between a man and a woman. Genuinely ambiguous individuals are unusual. In all my time mixing with other trans-women, I have rarely been uncertain whether they were really men or women. In a very small number of cases it was genuinely very hard to say, but even after careful application of makeup, its comparatively easy to differentiate between the real McCoy and a complete imposter like myself. This raises many questions about gender identity that are uncomfortable for trans people, who would often prefer that it be mandated that society be unable to make that differentiation for fear of prosecution. In the field of elite athletics, one cannot help but agree with Martina Navratilova that mediocre male athletes may, by virtue of a lifetime of testosterone-assisted development, achieve a degree of athletic prowess relative to natal females after they transition that places them at an unfair advantage and denies female athletes a reward they have worked very hard to achieve. But the normal distribution offers a warning – it’s a great way to think about “normal” but not so smart on “exceptional”!

International Women’s Day

Friday was International Women’s Day – an occasion to reflect on the obstacles that prevent women from achieving equality of opportunity and influence with men. As a transwoman, I don’t believe International Women’s Day is for me, because I haven’t routinely experienced the kinds of challenges throughout my life that are so familiar to women. These include paternalistic societal norms, the limitations placed on women’s advancement by the unequal sharing of child rearing with men, and around the world, the problems many millions of women still have due to the lack of safe toilets and the widespread stigmatisation of menstruation.

Transwomen have their own battles to fight. But International Women’s Day is for women. Let’s pay women the respect of recognising the challenges that so many of them still face today, and supporting them in their struggle for equality.

AGP

I mentioned a few posts back that I’d dallied with Twitter recently. I closed my account eventually because I found the aggression associated with much activity on the platform to be upsetting. People who had never met me, or even exchanged messages with me, would assert confidently and aggressively that I was AGP (an autogynephile). The assertion carried an implicit moral judgement – when I’m out and about, or in the ladies changing room trying on a new dress, I’m all aroused and isn’t it disgusting to think about that sort of behaviour? Things spread like a contagion around Twitter, where the vector is the sharing of microscopic and carefully selected snippets of information. These conceptual bacteria are selected because they suit people’s prejudices, and they get tweeted and retweeted, until one rapidly has a group of folk who share a common perspective that is fed by an entirely unbalanced information-gathering system, leading them not to a consensus, but rather, to its inverse.

The concept of autogynephilia provides a convenient heuristic for trans-haters. I’ve written at length about it elsewhere on this site. The idea originates with Canadian psychologist Ray Blanchard, who hypothesised that there were two types of gender dysphoric individual: those who were attracted to men, or androphilic gender dysphorics, and those who were attracted to women. Blanchard hypothesised that the majority of the latter group were autogynephiles. He defined an autogynephile to be somebody who is erotically attracted to the idea of themself as a woman. He calls it an “erotic target location error” – a paraphilia.

In the debate about gender identity, the idea has proved to be dynamite: as trans people have come out and asserted their right to exist and enjoy protections in law, there has been a parallel movement to explain away transgender identities as fetishistic behaviour. Blanchard’s hypothesis of autogynephilia has provided a scientific framework with which to debunk the notion that transwomen are people expressing an inner sense that they have a feminine identity; the autogynephilia hypothesis (it is argued) suggests its just a sexual kink.

“AGP” has metamorphosed into an easy put-down. Are you attracted to men? If the answer is no then you must be AGP, because Blanchard proved it. For some transsexuals the concept has proved attractive. There are those who wish to prove themselves to be “really” trans. Have you had surgery? Maybe you’re AGP. Not had surgery and not gay? You really are AGP. The willingness of those who are also gender dysphoric to be so quick to judge people they have never known is particularly upsetting.

Then there are those transsexuals who are believe that they are best described as autogynephiles. There is Anne Lawrence, whose work I’ve dealt with elsewhere, or Miranda Yardley in the UK. Miranda is outspoken and thoughtful on many issues, and she addresses fearlessly issues that are not addressed honestly by much of the transgender community. However, she also falls prey to the desire to mass-diagnose people she has never met as AGP. On Twitter I also met ex-trans people who assert aggressively the universal origin of gender dysphoria in AGP. These people are uniformly unable to engage in sensible debate, and unable to consider that another person is incapable of experiencing the same desires as them. And then there are feminists. Of course for many feminists the theory of AGP plays to their darkest fears. But I must say that gender critical feminists were actually the group on Twitter most willing to sustain intelligent discourse, and the least hasty to judge.

In the arena of public discourse, the issue appears to be in large measure binary: Blanchard’s theory of AGP states that you’re attracted to men or you’re AGP. Try as I like to claim that I experience no erotic arousal while presenting in my feminine guise, there is no shortage of people who apparently have a much keener sensitivity to what happens between my legs than I do. If I don’t feel aroused, well I’m just not feeling things properly. Or I’m lying. Moreover, it is asserted, the psychologists’ manual, the Diagnostic and Statistical Manual (DSM) recognises AGP, which further proves I’m delusional or lying.

Let’s start with the DSM. DSM-5 includes autogynephilia as a sub-category of “transvestic disorder”, which is defined as “in tense sexual arousal from cross-dressing fantasies, urges or behaviors”; for many of the “haters” on Twitter gender dysphorics are now diagnosed by the DSM as AGP. For Blanchard inclusion of autogynephilia in the DSM was certainly a win because it incorporated his theory into the lexicon of psychological disorders. However, despite the ire that this move has provoked among transgender activists it falls short, to my understanding, of supporting the universal binary labelling of gender dysphorics as either “gay” or “AGP”. Trans activists have produced voluminous and multitudinous entries on blogs and web sites decrying the inclusion of autogynephilia in DSM-5 but I think the move still leaves enormous room for alternative diagnoses. It simply recognises that autogynephilia exists and as I’ve said elsewhere, I believe this is the case and, moreover, that the condition is widespread. My beef is that its not a catch-all diagnosis. The American Psychological Association, publishers of DSM-5, support this perspective, through a very carefully written description of gender dysphoria published on its web site.

Blanchard has a Twitter stream that is provocative and outspoken but also well-reasoned and thoughtful, although there is no doubt that he is the authentic grumpy old man and he displays no intention of dispelling the widely held notion that “AGP” is a universal theory for gender dysphoria that assigns all individuals to one of two precisely defined character types. This feeds the public desire to find a universal put-down for Trans people. I think his apparent unwillingness to inject nuance through this medium – in which he is engaged regularly – is disappointing. However, it should also be noted that he has been an outspoken advocate of surgical solutions for gender dysphorics in extremis during his professional career.

In contrast to his Twitter profile, however, Blanchard’s academic work is much more nuanced. There are plenty of caveats, exceptions are discussed and he admits that more work is needed. One cannot read his academic papers and conclude that his theory of autogynephilia is a universal, binary system for categorising gender dysphorics. Recently there have been forays into public engagement that have demonstrated a transfer of some of this subtlety. Recently, he and Michael Bailey (another psychologist who gave prominence to the concept of autogynephilia) made presented overview of gender dysphoria on the web site 4thWaveNow. In contrast to popular recapitulations of the AGP hypothesis, this piece is thoughtful, and written in more measured tones. The boundaries are fuzzier, and they identify a third category of gender dysphoria – rapid onset gender dysphoria, a type especially associated with adolescent girls..

“The first type—childhood-onset gender dysphoria—definitely occurs in both biological boys and girls. It is highly correlated with homosexuality–the sexual preference for one’s own biological sex–especially in natal males…The second type—autogynephilic gender dysphoria—occurs only in males. It is associated with a tendency to be sexually aroused by the thought or image of oneself as a female. This type of gender dysphoria sometimes starts during adolescence and sometimes during adulthood”.

They go on to say:

“The most obvious feature that distinguishes childhood-onset gender dysphoria from the other types is early appearance of gender nonconformity…A very gender nonconforming boy may dress up as a girl, play with dolls, dislike rough play, show indifference to team sports or contact sports, prefer girl playmates, try to be around adult women rather than adult men, and be known by other children as a “sissy” (a term generally used to ridicule and shame feminine boys).”

This paragraph certainly describes me as a child: I believe I displayed all of these traits. I must admit that I found it surprising to find Blanchard and Bailey agreeing that I do not fit their description of an autogynephile.

“Childhood-onset gender dysphoric boys who desist usually become nonheterosexual men. A smaller percentage have reported that they are heterosexual at follow up. Those who transition become transwomen attracted to men.”

Again, we see that the tone is measured and absolutism is lacking. The language is that of academic discourse – “highly correlated” (not either/or)”; “usually” (not always); “a smaller percentage have reported” (again, not either/or). My own experiences are in fact not categorised by Blanchard as characteristically “AGP”, and neither are they categorised by DSM-5 as fetishistic or autogynephilic. As a child I displayed exactly the kind of behaviour that Blanchard and Bailey describe as characteristically non-gender-conforming. I was bullied mercilessly for being a sissy at primary school, and I always got along much better with girls; in contrast, boys were a mystery to me and I never really knew how to play with them. It was only in adolescence thatI learned to fit in and act like one of the boys. Even now as an adult, I find I get along much better with the women I work with than the men, who in their 50s still betray many of the traits that mystified me as a child.

For me this underlines the importance of speaking out about these issues. There is a large and complicated debate to be had. The concept of autogynephilia is undoubtedly an important contribution to the understanding of gender dysphoria, but we must recognise its complexity and accept the paucity of good academic research.

As a professional scientist I am reminded often to consider the ethics of scientific enquiry and practice. That there is a moral imperative for leading academic scientists engaged in debate about issues that have a real and substatial impact on the life experiences of real human beings to speak carefully, in measured tones that reflect in public discourse the kinds of uncertainties that they readily acknowledge in their academic work. In the desire to speak out in public and translate their academic work into society, it is vital that oversimplification does not lead to misapprehensions that do real harm to real people.