GHQ Letter Sent to USC Neuroscientist Who Wants To Study Transgender Brains

NEWS COMMENTARY

Jonathan Vanhoecke, who has an MA in neuroscience, wants to use neuroimaging to study the brains of transgender people and compile data in ENIGMA (a global research network based at USC).

The article, Researcher explores links between transgender brain and gender identity, explains:

Understanding how their brains develop and change as transgender people grow up could help doctors and other health professionals provide better treatment and support.

There is a lot of evidence showing there is a grey area between gender nonconforming gay and lesbian people and trans people. This is demonstrated in research statistics showing desistance rates from childhood gender dysphoria and its association with adult homosexuality and Increasingly bisexuality. It is also apparent in the increasing numbers of accounts of desisted and detransitioned (underwent medical procedures) lesbian and bisexual females. If neuroimaging could be used to tell a “true trans child/teen” from a minor who could outgrow gender dysphoria, this would be a useful tool in how to best support the young person. It is unlikely to be this simple. There is a lot of evidence on the GHQ website to support the argument that environment and other factors influence gender dysphoria and trans-identification.

The article mentions that there is a mix of information provided by the previous studies:

So far, results from the few existing studies are inconclusive, Vanhoecke said. Some evidence suggests differences in gender identity could be linked to ways the brain develops in childhood and adolescence, and that the observed patterns correspond to gender identity. Other studies have indicated that neural patterns generally match the sex a person is assigned at birth. Yet other studies found evidence that doesn’t seem to support either of these, but rather that there are unique neural patterns in transgender people.

Topic 10 thoroughly covers the research that is available on biological and environmental causes of both transgenderism and homosexuality, and in some cases, the causes may be similar.

The article discusses a brain region that may be involved in gender dysphoria:

Vanhoecke aims to study systems of the brain, including a part of the brain’s white matter that might be involved in differences between sex assigned at birth and gender identity. It’s called the inferior fronto-occipital fasciculus, a bundle of white brain fibers that runs along the lower portion of the brain between the occipital and frontal lobes. Analyzing its structure in greater detail might offer clues about its role in gender identity and guide future studies, he said.

Interestingly, it is the inferior fronto-occipital fasciculus that may be involved in anorexia nervosa, bulimia nervosa, and body dysmorphic disorder. Medical transition used for gender dysphoria appears to be more effective than plastic surgery is for BDD.

One of the goals of this organization is to put pressure on researchers to admit that there is a blurry line between trans and gay and to keep this in mind conducting research:

15) Insist that brain research studies trying to determine the causes of transsexualism, use very gender nonconforming gays and lesbians as controls, before they reach their conclusions. There are likely spectrum effects in the causes of homosexuality and transgenderism. Heterosexuals are not the best controls to determine if transgenderism is completely innate. There is much information that shows that for some individuals it isn’t, and that it’s influenced by culture. In relation to the medical transition of minors, and it’s safety to desisters, comparing gays/lesbians with trans people is more relevant.

Below is a letter written in response to Vanhoecke and the other researchers listed in this article around this subject:

To Mr. Vanhoecke, Ms. Savic, Mr. Thompson,and Mr. Feusner,

This letter is about the article Researcher explores links between transgender brain and gender identityon the USC’s news website about using neuroimaging to study transgender people. 

Gender Health Query is an LGBT organization that was formed as a result of the increasing numbers of LGBT people who have major concerns about the number of minors who are being permanently altered by medical treatments for gender dysphoria. This includes concerns about the hormone blocker protocol, which can begin as young as 10 years old, as well as double mastectomy and vaginoplasty surgeries under the age of 18. 

There are concerns about this for two main reasons. The first is that these medical techniques are very invasive and may cause bone weakening, permanent sexual dysfunction, sterility, possible cognitive effects, and a very large increase in circulatory health risks. The second main reason for concern by our group is that all research, as well as more recently observed examples, shows an association with youth gender dysphoria and adult lesbian, gay, and bisexual identity. And indeed, there appears to be more transition regret, particularly among lesbian and bisexual females, who transitioned before they were cognitively mature (full maturity is not reached until age 25). 

So the worry is, particularly in the gay and lesbian community, that borderline gay, lesbian, and bisexual youth are going to be over-medicalized with the current enthusiasm to socially and medically transition children, teens, and young adults. These fears seem warranted given that five gender clinician professionals in the United Kingdom have quit because of ethics concerns. They cite internalized, as well as parental homophobiaas reasons they believe early medical treatments risk pre-gay and lesbian youth. These fears also seem warranted due to reports from parents, or the young people themselves, that a trans-identification lasted several years in the tweens and teens before desistance. This is long enough to receive an official DSM diagnosis and receive testosterone and doublemastectomy. 

Our website documents many examples of factorsbeyond innate biological gender identity that appear to influence gender dysphoria. These include homophobic bullying, parental instability, mental health issues, and social contagion. There are people who wish to be the opposite sex from a young age and who will choose transition. But it seems unlikely that a brain scan will be enough to determine which minors are “truly trans,” as it appears there is more of a continuum between homosexual and trans, rather than a clear line. Dr. Ray Blanchard’s work on the “older brother effect”on both trans and homosexual identity supportsthis idea.

For these reasons, it seems that using very gender nonconforminghomosexual controls, as well as opposite sexcontrols, in brain imaging studies would provide interesting comparisons. Several studies of homosexuals’ brains also show cross-sex similarities. One of the goals of our organization is to notice when researchers seem uninterested in the blurred line between trans and gay because it worries so many of us when it comes to transitioning children. 

And a brain study will not necessarily be able to answer what causes the differences in areas such as the inferior fronto-occipital fasciculus. This area may be affected in body dysmorphias as well. Could more cultural acceptance mitigate any bodyanxiety in people who are gender outliers? What did the brains of the desisted teens look like during and after their trans-identification lifted? The cultural questions are still interesting.

Another relevant factor in brain imaging studies not mentioned in the article is the difference between males who transition who are attracted to men versus males who are attracted to women. Dr. Ray Blanchard, the researcher mentioned above, is an expert in adult gender dysphoria. He categorized the two groups as homosexual transexuals (HSTS) and autogynephilic (AGP) males. The de-emphasis of this categorization in research is all political, as Blanchard describes AGP as a type of paraphilia, rather than a brain feminization. Despite the fact that some trans activists find this offensive, there is no scientific reason not to pursue this theory and one brain imaging study has already indicated that HSTS and AGP are two different phenomena.

Sexologist Dr. James Cantor:

“[T]he brains of both homosexual and heterosexual male-to-female transsexuals probably differ from the brains of typical heterosexual men, but in different ways. In homosexual male-to-female transsexuals, the difference does involve sex-dimorphic structures, and the nature of the difference is a shift in the female-typical direction. If there is any neuroanatomic intersexuality, it is in the homosexual group. In heterosexual male-to-female transsexuals, the difference may not involve sex-dimorphic structures at all, and the nature of the structural difference is not necessarily along the male–female dimension. (p. 437”)

Many parents are starting to see gender nonconforming children as transgender. This is facilitating large numbers of children being socially transitioned and given hormone blockers before they have experienced any puberty (the time when gnc gay and trans identities often separate out). Some of these children may not be adults who would definitely transition. It would be irrelevant if not for children being put on medical pathways, with serious health consequences, at younger and younger ages. The efforts in brain research should also focus on protecting these grey area children from over-medicalization, not just trans medical treatment. 

Thank you for your time.

REFERENCES:

Buchanan, B.G., Rossell, S.L., Maller J.J., Toh W.L., Brennan S., Castle, D.J. (2013). Brain connectivity in body dysmorphic disorder compared with controls: a diffusion tensor imaging study. Psychology Medicine. 43(12), 2513-2521. doi:10.1017/S0033291713000421

Cantor, J. M. (2011). New MRI Studies Support the Blanchard Typology of Male-to-Female Transsexualism. Archives of Sexual Behavior, 40(5), 863-864. doi:10.1007/s10508-011-9805-6

Cornell University. (2018, March 26). What does the scholarly research say about the effect of gender transition on transgender well-being? Retrieved from https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Dreger, A. (n.d.). Answers to Some Questions about Autogynephilia. Retrieved from http://alicedreger.com/autogyn

Gaudio, S., Carducci, F., Piervincenzi, C., Olivo G., Schiöth H.B. (2019). Altered thalamo–cortical and occipital–parietal– temporal–frontal white matter connections in patients with anorexia and bulimia nervosa: a systematic review of diffusion tensor imaging studies. Psychiatry Neuroscience, 44(3),1-16. doi:10.1503/jpn.180121

Higgins, S., Wysong, A. (2018). Cosmetic Surgery and Body Dysmorphic Disorder – An Update. International Journal of Women's Dermatology, 4(1), 43–48. doi:10.1016/j.ijwd.2017.09.007

Lindberg, E. (2019, July 15). Researcher explores links between transgender brain and gender identity. USC News. Retrieved from https://news.usc.edu/158899/transgender-research-usc-brain-gender-identity/

Travisa, K. Golden, N. Heidi, Feldman, H., Solomon M., Nguyen J., Mezer, A., Yeatman, Dougherty, R. (2015). Abnormal white matter properties in adolescent girls with anorexia nervosa. NeuroImage: Clinical, 9, 648-659. doi:10.1016/j.nicl.2015.10.008

Vanderlaan, D. P., Blanchard, R., Zucker, K. J., Massuda, R., Fontanari, A. M., Borba, A. O., … Lobato, M. I. (2016). Birth order and androphillic mate-to-female transsexualism in Brazil. Journal of Biosocial Science, 49(4), 527-535. doi:10.1017/s0021932016000584