Scientifically Speaking, People Who Are Transgender are Just Another Beautiful Variety of Human

The Human species is bursting with diversity

Hiya!

This week, I want to talk a little about the science of biological sex and being transgender — but there are a couple of things I want to be clear about before I do. Firstly, the transgender community is not a science project to be dissected. They are full and complete human beings sharing this planet with the rest of us and deserve to be treated with respect and accepted for who they are — no different than you or I.

Second, science continues to show that being transgender is entirely natural and that the transgender community is simply another beautiful example of the diversity that makes up our species. So, rather than fearing this lovely group of people, let’s educate ourselves.

A Closer Look

Let’s make sure we’re all on the same page. When I use the term “transgender,” I’m referring to a person whose gender identity (aka their psychological sense of gender) does not align with the sex they were assigned at birth (which is based on their external genitalia.)

Some people who are transgender experience something called “gender dysphoria,” which is psychological distress stemming from the contradictions between their assigned sex and their gender identity. Gender dysphoria often presents in childhood, before the onset of puberty, but some adults experience it much later.

We shouldn’t need an accredited institution to tell us this, but according to the American Psychological Association, not all people who are transgender are alike. People within this community “may pursue multiple domains of gender affirmation.”

This includes social affirmations, such as changing their pronouns or their name to better reflect their gender identity. Some may choose legal affirmation, like changing their gender markers on official documents like their driver’s license or passport. For others, medical affirmations are pursued, such as hormone treatments. Lastly, surgical affirmations encompass various surgeries, such as facial feminization surgery, breast augmentation, masculine chest reconstruction, vaginoplasty, and more, with the goal of changing their physical appearance to better reflect their gender identity.

That said, the APA is quick to note that “not all people who are transgender will desire all domains of gender affirmation, as these are highly personal and individual decisions.” They also highlight the distinction between a person’s gender identity and their gender expression. To clarify, the former refers to a person’s psychological sense of their gender, while the latter is how someone presents themselves to the world.

Gender expression is the reflection of social expectations when it comes to what’s considered to be masculine or feminine. For instance, wearing the color pink is culturally considered a “feminine” gender expression, whereas suits are considered a “masculine” gender expression.

Neurologically

Unfortunately, similar to the incorrect presumption that people choose to be gay or that people who are bisexual “can’t make up their minds” about who they are attracted to. Some people believe that people who are transgender or experiencing gender dysmorphia are making everything up.

In our not-to-distant past, being transgender was considered “gender incongruence” and classified as a mental health disorder by the World Health Organization (WHO) until 2019. A WHO reproductive health expert, Dr. Lale Say, said:

"It was taken out from mental health disorders because we had a better understanding that [being transgender] was not actually a mental health condition, and leaving it there was causing stigma.”

So, to be clear, being transgender is not a mental health condition any more than being gay or showing strong emotions as a female. In fact, research from 2018 shows that the brain structure and activity of transgender youth are more similar to the typical brain activations of their gender identity than their assigned sex.

The study — led by Dr. Julie Bakker from the University of Liège, Belgium, and her colleagues from the Center of Expertise on Gender Dysphoria at the VU University Medical Center, the Netherlands — analyzed the sex differences in brain activation patterns of transgender boys and girls experiencing gender dysphoria using magnetic resonance imaging (MRI).

While in the MRI scanner, the participants were exposed to a pheromone known to stimulate gender-specific brain activity. The researchers discovered that brain activation patterns in transgender boys more closely resembled the brain activity of non-transgender boys. The same occurred when comparing the brain activations of transgender girls and the patterns in non-transgender girls.

These findings help show that people who are transgender are not making up their experiences. Further, it suggests that these differences in brain functions occur early in development. So you know, maybe we shouldn’t ignore trans youth when they try to tell us what they’re experiencing.

Sex Chromosomes

You might assume this part is simple, but the truth is far more complicated than what you might recall from school — if you were fortunate enough to have sex education. The common consensus is that if a person has XX chromosomes, then they are a female, and they are male if they have XY chromosomes.

As Humans, it’s in our nature to simplify as much as possible, but in this case, limiting sex to our external genitalia or chromosomal makeup is a vast oversimplification describing the true nature of biological sex. According to Scientific American,

The truth is, your biological sex isn’t carved in stone, but a living system with the potential for change.

Chromosomes are intrinsically complex, and biological sex is far more than XX or XY (or XXY, or just X). Fun fact: People with XX chromosomes can have male testes and people with XY chromosomes can have ovaries.

How everything turns out mostly depends on a small group of cells called the bipotential primordium and a gene called SRY, which is the sex-determining region Y gene and initiates the processes that cause a fetus to develop male testes while preventing the development of female sex organs like ovaries or a uterus.

Even still, that doesn’t even come close to painting a complete picture of how complex a role chromosomes play. The SRY gene is still not fully understood, and it’s just one of many delicate factors that can influence the sex of a person.

Hormones

Beyond our chromosomes, our hormones are also major factors in how our gender or sex comes about — specifically, the hormones estrogen, progesterone, and testosterone — which all humans possess.

During infancy and prepubescence, these three hormones have no sex differences. It’s not until puberty that they become weighted toward one end of the gender spectrum — and yes, gender is a spectrum, not a binary.

Research over the last couple of years indicates that sex differences between testosterone, estrogen, and progesterone aren’t as prominent as many assume.

In fact, in grown adults, research shows that, on average, estrogen and progesterone levels are similar between nonpregnant females and males. Of the three hormones, testosterone displays the largest difference between females and males. However, even still, studies found that our sex chromosomes only explain around 56 percent of a person’s testosterone levels — suggesting there are other influences on our hormone levels than just our sex chromosomes.

Lastly, individual sex hormone levels vary wildly within a broad range of “average” values within a single individual. The unpredictability adds to the argument that sex and gender are a spectrum, not a binary. Scientific American points out:

“The binary sex model not only insufficiently predicts the presence of hormones but is useless in describing factors that influence them.”

Believe it or not, environmental, behavioral, and social factors all influence our hormone levels — both male and female alike — which further complicates the idea that hormones or sex chromosomes alone determine a person’s sex.

Outside Influence

Of the three sex hormones I mentioned earlier, testosterone varies perhaps the most, but even testosterone is influenced by external factors. Studies have found that fluctuations in testosterone levels can even predict certain parenting behaviors.

Meanwhile, estrogen levels play a role in social scenarios that involve male-typical power and dominance. Researchers found that estrogen increased in “power-motivated winners” but decreased in “power-motivated losers.”

Lastly, studies also show that progesterone levels change in response to social situations involving competition and dominance. The point is, our behaviors and cultural gender norms influence our sex-related hormones and the biology of the body and brain.

Trans Youth

I mentioned before that we shouldn’t ignore what youth say about how they feel or their personal experiences. For centuries, adults have hushed, dismissed, and excused when children try to communicate their needs. We adults always think we know better, and many people today use this argument to fight against gender-affirming care for youth.

Denying trans youth necessary healthcare is a hot topic in the culture wars ostracizing the trans community, and it’s accompanied by weak justifications of “protecting the children.”

But the truth is, study after study (after study, after study, after study) and a growing list of major medical organizations all show that access to gender-affirming care is linked to better mental health outcomes and saves lives — while a lack of access is associated with higher rates of depression, self-harming behavior, and suicide.

Without gender-affirming care, such as hormone therapy, a trans youth’s body will be forced to go through puberty and undergo changes that can be permanent and distressing. A 2020 study involving 300 trans youth found that mental distress, including depression, self-harm, and suicidal thoughts, increased when they were forced to experience puberty according to their assigned sex.

Of the study’s participants, 184 were considered “older teens” with a median age of 16. By the stage of puberty, when transgender girls started growing facial hair and their voices dropped, and when transgender boys started their periods and developed breasts, 40 percent of them engaged in self-harming behavior, 46 percent were diagnosed with depression, 52 percent seriously considered suicide, and 17 percent of them actually attempted suicide.

In addition to the mountain of studies, organizations including but not limited to the American Academy of Pediatrics (AAP), the Endocrine Society, the American Academy of Child and Adolescent Psychiatry, the American Medical Association, the American Psychiatric Association, and the American Psychological Association, have all issued policy statements and guidelines about providing age-appropriate gender-affirming care. And every single one of them finds such care to be scientifically based and medically necessary.

Perspective Shift

The rise of hatred and discrimination against minority groups has been going on for a while now, and the transgender community is the latest group to be attacked for simply existing. But discrimination serves no one. It only feeds fears and misunderstandings. It distracts us from what’s actually important and blinds people to the fact that our species is bursting with diversity and that diversity is perhaps our single greatest survival skill.

Everything advances when we embrace inclusion and diversity. The scientific field is measurably better when it includes scientists from different backgrounds. Diversity makes us smarter and more creative. It’s better for our communities, businesses, and our health.

If anything, we should celebrate diversity when and where we find it, and that includes the trans experience, which provides essential insights into the science of sex and can help us understand ourselves — our minds, biology, and even life itself — a little better. So can we please stop hating other people for being who they are? Especially when other things need our attention.

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Photo by Rita Vicari on Unsplash