Born This Way – The Neurological Basis of Transsexuality

Given that an impulse to identify with and adopt the signs and symbols of the opposite sex requires exposure to (and imitation of) those signs and symbols, it is tempting to assume that transgenderism is socially conditioned. It is an interesting thought experiment to consider whether someone who was born on a desert island, who grew up with no knowledge of their mother (let’s assume she disappeared immediately after the birth), and who never encountered, read about nor saw pictures of another human being throughout their entire life, could grow up transgender. With no exposure whatsoever to anyone other than themselves (including, obviously, members of the opposite sex), would it be possible for that person to want to change from male to female (or vice versa)? To be (or become) transgender, does one need to experience what the opposite sex looks like, and how it dresses and behaves, in order to identify with it and desire to emulate it? Is concrete experience of something necessary in order for desire of it to flourish? Maybe not, as I found out when I read ‘We Are Our Brains’ by Dick Swaab. Not only is this book chock-full of eye-popping scientific tid-bits you can trot out to impress (or annoy) at dinner parties, it contains a chapter on the neurological bases of transsexualism that may prove that the poet, philosopher and ambulant camel-toe Lady Gaga was absolutely right when she observed, “Whether life’s disabilities left you outcast, bullied or teased/ Rejoice and love yourself today, ’cause baby, you were born this way.”


Dick Swaab’s book, ‘We Are Our Brains’ (Penguin, 2014), contains the startling assertion that transsexuality is something we are born with: it is as much a product of our development in the womb as the colour of our eyes or the shape of our feet, and is, crucially, not something that can be changed, ‘treated’ via aversion therapy, or socially conditioned. Swaab was a founding member of the Netherlands Brain Bank – a repository for donor brains that has facilitated work on the mapping and cataloguing of grey matter from a diverse and revealing cross-section of society. Through post-mortem studies of donated brain tissue, Swaab established that, while the differentiation of a foetus’ sex organs occurs in the first half of pregnancy, the development of sex differences in the brain does not take place until towards the end of the second trimester. Because the physical and the neurological development of sexuality occurs at different times in the womb, Swaab thought it was possible for them to happen independently of one another.

In 1995, Swaab’s team published a report in ‘Nature’ of findings that confirmed this hypothesis. The bed nucleus of the stria terminalis (or BST for short – an area of the brain involved in many aspects of sexual behaviour) is twice as large in women than it is in men. Even taking the effects of hormones taken by adult transsexuals into account, Swaab found that the BST of male-to-female transsexuals had a female structure, whilst female-to-male transsexuals had a ‘male’ BST.

The bed nucleus of the stria terminalis: it’s in there somewhere

In 2008, a group of Stockholm neuro-scientists led by Ivanka Savic were able to study the functioning brain scans of living male-to-female transsexuals who had neither had surgery nor started hormone treatment. During Savic’s experiments, subjects were given male and female pheromones in order to measure the resulting stimulation in their hypothalami. The hypothalamus (amongst other things) regulates the response of the body’s endocrine system to stimuli from the nervous system. (It instructs the pituitary gland to release hormones, in other words.) The effects of pheromones on the brain differs markedly between men and women, and the responses of Savic’s transsexual patients were found to fall between those of non-transgender subjects of both sexes.

The implication of Swaab’s and Savic’s research is that the basis of an individual’s gender identity is neurological, not social. It can be argued, therefore, that our personal sense of our own gender is developmental; that the origins of transgenderism are down to nature rather than nurture, and the role played by environment is in our subsequent construal and enactment of that identity. Swaab further speculates that the neural body map of male-to-female transsexuals lacks a penis, whilst that of female-to-male transsexuals lacks breasts. It is this neural map that gives us a sense of our physical presence and a concept of our physical integrity. Body Identity Integrity Disorder is a syndrome whereby patients become convinced that a part of their body does not belong to them (even though it may function perfectly normally), and they become desperate to get rid of it. In cases of transsexuality, it is possible that, instead of an arm or a leg, subjects do not recognise their penis or breasts as their own, and look for a surgeon willing to remove them.

We Are Our Brains
‘We Are Our Brians’: a coherent and convincing argument for the genetic causes of dyslexia

Coming out is the landmark act of making sure the world around you knows something crucial about you that has heretofore remained secret – or, at the very least, unconfirmed; what TS Eliot might have meant when he wrote “this dedication is for others to read:/ These are private words addressed to you in public.” Coming out isn’t just a rite of passage, though: it is a test of society at large; of the love and understanding of your colleagues, friends and family; of the ability of the world to shift to accommodate you; and of your capacity for finding your own place in communities that might reject you. Coming out requires courage, resilience, patience, and an unerring capacity not to worry what other people think. It increases many people’s affection and respect for you; it alarms and alienates others. It can necessitate enormous sacrifice, but, ultimately, it is the best favour you can ever do yourself.

If you fear that you may be the victim of prejudice at work because someone suspects you have a secret you haven’t told them yet, then coming out is the wisest thing you can do in Europe to gain legal protection from discrimination on the grounds of gender orientation. Under European law, a person becomes transgender when they declare their intention to identify as such, and redress against iniquity is thus enshrined even before an individual has started taking hormones, changed their name on their passport, or begun living full-time in their preferred gender role. A declaration of intent (taken with full appreciation of the consequences of such a declaration) is all it takes for the legal mechanisms of Article 21 of the 2009 Charter of Fundamental Rights of the European Union to safeguard the individual from discrimination by their government and institutions within their country, seizure of their assets and property, and ill-treatment at work, on the grounds of their gender orientation. In order to ensure legal protection in Europe from gender discrimination, therefore, the decision to come out should be made as soon as you’re ready.

If you accept Dick Swaab’s claims about the development of gender identity in the brain, then the act of coming out as transgender is more than a public and ceremonial declaration of self-identification: it’s a diagnosis. It isn’t a transformation as such (although it may feel that way for people who knew the old you): it’s a confirmation and affirmation of a truth that has existed, if Swaab is right, since before you were born.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s