Tuesday, February 24, 2009

Book Review: The Riddle of Gender

Yesterday I asked what it was that makes us men and women. Many people believe that women and men have inherent differences, and that those differences define what it is to be a woman versus what it means to be a man. While I am willing to concede that men and women (once we know what those two categories of people are) have inherent biological and anatomical differences from each other, I do not think it is accurate to make that claim about all such people. Sex differences, especially psychological ones, are averages. Data is reflective of trends, not of individual capacity. Unfortunately, generalizations about what all men are like (or all women) have been used for far too long to inappropriately limit human behavior.

Yet, in The Riddle of Gender: Science, Activism, and Transgender Rights, Deborah Rudacille notes that while we go round and round about whether sex differences are inherent or constructed, many of us nonetheless have "the deeply felt and ineradicable sense that one is male or female- or neither" (xv). I think that's a good starting point for a review of Rudacille's book. For, this deeply felt sense of ourselves sometimes conflicts with both other people's perception of us and with the gender that other people think we should sense in ourselves. Many issues with respect to transgender rights result from those two conflicts. (All quotes from The Riddle of Gender unless otherwise indicated).

1. Looking For a Cause

To begin, I am not a scientist, so I appreciate that Rudacille, a science writer, has written a book summarizing a lot of the research regarding gender and sex in an accessible manner. And, just because some people automatically discount as biased any presentation of research by someone who happens to be gay or trans, Rudacille also happens to be a heterosexual cisgendered woman.

In the introduction of the book, Rudacille reminds me of something I learned long ago in Anatomy and Physiology but forgot somewhere between Secured Transactions and Making a Living in the Real World. Namely, that embryos begin androgynously and have the potential to develop either male or female anatomy. It isn't until the 6th week of pregnancy that the process of sex differentiation begins (xvi). Sometime during this time, the brain becomes "sexed as well, though the mechanism by which this process is carried out is less clearly understood" and this process "is completed after birth, as [the human] learns what sorts of attitudes, behavior, and role [our] culture expects of [us] as a female [or a male] (xvi-xvii).

With this anatomy lesson informing me, I don't find it all inconceivable that something could happen to this once-androgynous embryo to produce anatomical males (or female) whose brains have been hormonally sexed as females (or males) in the womb. As Rudacille notes, it does take more than XY chromosomes to make a person male. Yet, within our gender binary, persons with XY chromosomes are considered male and it is a "deeply rooted assumption" that "the sex of the body is always consistent with the sex of the brain" (7-8).

Searching for causes of transgenderism can sometimes imply that there is something "wrong" or pathological about the condition. When a condition is the statistical norm, we do not ask what causes it. For instance, it is rarely asked what causes people to be heterosexual, or what causes people to feel as though the sex of their bodies match the sex of their brains. Yet, even though many of us strongly believe that transgenderism is not evidence of some underlying psychological pathology or confusion, looking for biological causes can dispel the ability that others have to treat transgender persons poorly and to do so with the cocksure approval of their own consciences. As we saw yesterday when Seda recounted her experience with Jose, Jose was saying many things that are deeply hurtful to transgender people- calling her "he" and calling her "confused." Yet, undoutbedly, because he does not understand transgenderism, Jose is sleeping very well at night perhaps believing that he is helping Seda in some way.

Evidence of biological causes of gender dysphoria does exist, however. As Rudacille writes, "The strongest evidence for a biological basis for gender variance comes from research on the effects of the drug diethylstilbestrol (DES)" (16). This synthetic estrogen was given to millions of pregnant women during a span of 25 years. Rudacille goes into considerable detail in her book but to give you a general idea, DES has been found to "affect the development of sex-dimorphic brain structures and behavior in animals" (Ibid.). That is, male animals exposed to it in the womb display female behavior outside of the womb, and vice versa. Furthermore, DES "sons" and "daughters" have higher rates of transgenderism than the general population. Currently, as Rudacille recounts in an entire chapter, "'we find endocrine disruptors all over the place'" and we should be exploring in much greater depth how humans develop in response to such a hormonal environment (243).

2. Experience of Transpeople

One reason that I have always found it relatively easy to accept a transgender person's claim of gender dysphoria is that, like being gay, why would someone choose a path in life that is socially unacceptable? Furthermore, as Rudacille writes, "[t]here are few benefits to adult sex reassignment....[It] is physically and emotionally grueling, and hugely expensive in term of money, time, and lost personal relationships" (xxi). Yet, people undergo the surgery (to whatever extent they can) because for many people it is that or suicide. Like Rudacille, I have been told this by virtually every trans person I know. Seda expressed this sentiment in her coming out story.

Other shared traits have been noted, beginning with the observations of one of the first Western scientists to study transgenderism, Magnus Hirschfeld. Often, the gender dysphoria and/or urge to cross-dress begins at a very young age, increases during puberty, and remains almost unchanged for one's entire life (37). (As an aside, after Hitler assumed power in Germany, the archives in Hirschfeld's Institute for Sexual Science were burned by the Nazis (49)). Unfortunately, children who display gender dysphoria "must come to terms with a gender identity that all of society tells them is 'wrong' or 'bad' or 'sick'" (199). Rudacille includes accounts of transgender youth who were forced by their parents to repress their gender identity and/or sent to counselors who tried to force them to act like real boys or girls.

Yet, many such counselors missed something very important. As one transgender man recounts:

"[T]hey were working on my depression. Well, I was depressed because the world was treating me so poorly, but their plan was to get me to act more feminine so that the world wouldn't treat me so badly-- instead of realizing that if you try to make me be something I'm not, I'm going to be even more depressed" (211).

This is very similar to the experiences of people who have survived ex-gay therapy. The problem is not that we deal poorly with being gay or trans, the problem is that other people deal so poorly with it.

To end here, I'd like to end by talking about the concept of normality. Too often, humans have a tendency to see variation as some sort of pathology. The American Psychological Association initially put homosexuality into the DSM for moral, rather than scientific, reasons and even though it has long since been removed, some people still believe that gay men and lesbians are mentally unwell.

Currently, "gender identity disorder" (GID) is the diagnosis "most frequently assigned to children and adults who fail to conform to socially acceptable norms of female and male identity and behavior" (193). This (oftentimes overboard, subjective, and ambiguous) diagnosis is the subject of much debate within the transgender community. On the one hand, there is a sentiment that the stigma of pathology is unwarranted. Yet, it is this very diagnosis that enables some transgender persons seeking sex reassignment surgery to be reimbursed by their insurance companies. Many insurance companies will not pay for procedures that do not include a DSM-coded diagnosis.

I know that many people believe that the the question of including or excluding gender identity disorder in the DSM is a political question, but what if variation was just simple non-malignant variance? Historian of science Georges Canguilhem writes, "An anomaly is a fact of individual variation which prevents two beings from being able to take the place of each other completely. But diversity is not disease; the anomalous is not the pathological" (19).

Being different does not necessarily mean that one is wrong, bad, or sick. As we saw yesterday, defining maleness and femaleness is not as easy as one might think. What if people realized these complexities and fathomed that maybe they were doing more harm than good when calling transgender people "confused" and mentally unwell?

No comments: