LISE ELIOT: Neuroscientists have been studying transgender people's brains for for
quite a while now maybe twenty years and again there were some splashy early
studies that suggested that this tiny little zone of the hypothalamus or a
structure called the bed nucleus of the Stria terminalis differed in
transgender versus cisgender people however there's now been about 20
studies I think of transgender people's brains and comparing them to cisgender
and by and large because there's very little gender difference to begin with
or sex difference the differences are subtle and and again they're all over
the map with different studies finding different phenomena in male to female
female male and then apparently one sexual orientation also influences to
remember gender and sexual orientation are completely different dimensions you
can be you can be cisgender and be gay or straight you can be transgender and
be gay or straight for the gender that you identify with and so we see
depending on the study subtle differences in all these groups very
little replication from study to study in the last decent review or the only
decent review of this literature I've been reviewing it myself that I haven't
published it but there's one published review of 2015 the basic conclusion from
this was we just need to abandon the idea of binary brain sex period that the
studies of transgender individuals do not support the idea that there is such
a thing as a male brain in a female body and vice versa to me
gender is a spectrum I you know there's no question there is such a thing as
masculinity and femininity and that you know more xx individuals are feminine
and more XY are masculine but it really is a spectrum and you can find any
individual anywhere on the spectrum or some people even refer to it as
mosaic that there are these dimensions of masculanity and feminity my talk
about gender identity and sexual orientation which can be quite different
but we also have things like aggressiveness physicality social
sensitivity I mean we could we could chalk up all kinds of things that we all
know what's the masculine and what's the feminine end of the spectrum and you can
find individuals that are a mosaic of those different things you know so you
can find somebody I mean I I I consider myself very much of a mosaic brain I've
always been a strong and math and science and a pretty pretty physical
athletic but you know get me around a baby very nurturing and socially
sensitive and so I I think I'd end up on the feminine side of the spectrum in in
in in that zone and so for each of us there are many many dimensions of
masculinity and femininity you know cultural stereotypes have portrayed it
as if it's this binary but our brains have to do all of these things and so
our brains have many many circuits that for any individual are gonna fall
towards the male masculine towards the feminine or maybe kind of in-between so
we just really need to abandon this idea of binary brain sex and that applies
equally for cisgender as for transgender people right well
LBW: It's really fascinating that gender identity is not really tied to anything that we can it's
not really tied to brain structure right just like we have discussed so again I
think it leaves it leaves us all in a space of maybe unknowing sorry oh yeah
yeah just unknowing of not exactly fully understanding ourselves very well and
understanding how there is such large variations in human beings and our
identities and what we identify ourselves as it regarding gender
and you can't just reduce it to something biological yeah
LISE ELIOT: No I by the same token you know we don't know the neural circuitry for being a Republican
or a Democrat we don't know the neural circuit for being a Christian versus a
non-believer you know we know that there are there are brain activation
differences in people with different groups but you know we're barely if the
if the task is very discrete if it's like reading words or like I said
identifying facial expression neuroscientists can map out the circuits
for these things but how do you map out a circuit for gender identity I mean
what is gender idea how do you put somebody in a scanner and activate their
sense of gender identity brain activity and it's and so I think
like any of our complex thought processes it involves through life you
know our ability to identify our tendency to identify is going to be
influenced by many factors genetic and environmental and interestingly one
thing about transgenderism which I guess kind of surprised me because I think the
dogma is that you have a child born with the wrong brain for their body or vice
versa but it turns out that people transition at all ages and they don't
necessarily they weren't necessarily just for gender dysphoria as children it
can come on at many stages of life which again tells me it's um it's a it's it's
it's influenced by life experience and culture and and a lot of complex
influences and and frankly we can't study it in animals either because
gender is by definition cultural and animals maybe have a little bit of
culture but I would argue not to the extent that we do
LBW: Right it doesn't get
there not as uh maybe it's not as complex oh yeah yeah yeah
I just think this is a credibly fascinating subject because I don't
know I want people to be respected and I want to respect everybody's decisions in
their life I do have some understandably I think there is some and I don't know
if you have an opinion on this particular element of it but you
describe people who identify as one gender or the other they might this
comes up in different parts of their life which indicates that it might be
cultural in its origin or or something like that but I think that because
people want to be so inclusive of transgender people like for instance if
you have a child that's about maybe 6 or 7 years old and say its a little boy
physically biologically a boy but they say I want to dress and be like my
sister or like a girl and that parent may then think oh well they're just a
transgender who wants to transition into female I've heard of these cases
where children are are basically under go hormone therapy and and so that's
that's the territory that I know it's a bit it gets into a really politically
sensitive very difficult territory to discuss because in no way am i trying to
be insensitive or trying to dismiss or say that people can you know do whatever
they want with themselves and and and identify whatever they whatever they
want regarding their gender but I think we get into this territory of trying to
understand how to deal with say children who are undergoing this process I just
again I don't know if I have an opinion on that but that's really where my my
confusion or interest kind of goes into because it it really concerns me when
people maybe don't have a nuanced perspective or letting that child grow
up and see how it all plays out I guess is maybe the way I would say that
LISE ELIOT: Yeah it's extremely difficult time in for like pediatric psychiatry and
endocrinology trying to understand what to do with kids who are
gender dysphoric that express you know that they're not they they want to be the gender
other than their by gonads but I and it's evolving the good news is there are
protocols in place for a child who is as you know very persistent very insistent
about their gender dysphoria that they you know a genetic boy who says that you
know I am a girl I want to be a girl I've always wanted to be a girl there
are protocols in place that involve delaying puberty and waiting until the
child is at the age of consent or I think maybe at 16 now and allowing them
to choose to initiate hormone therapy and so on but generally a very slow the
advice is to take it very slow because some kids do change their mind and so
many social factors can can influence that and and complex psychological
factors we really don't understand but I can tell you that it's a extremely
challenging for parents and pediatricians these days we want to be
affirming we don't want to shame children and that was always the
standard method for trying to condition children to accept their biological
gender and a lot of kids were seriously traumatized by that so I think we're in
a better space that way in terms of parents and hopefully teachers and
communities affirming children's gender creativity I like that term better than
gender dysphoria kids are being creative about gender but but you know those are
these are major changes to your body that may affect your fertility may
affect your various aspects of your health and so we need to be extremely
cautious and take it slow for how children are treated medically and you
know stay tuned is all I can say that maybe in another 10 or 20
yearss we'll have this sorted out better but I want maybe final thought is that
you know none of this would be an issue if if we did not have binary gender if
we all dress the same if we didn't have different pronouns and different names
and if we didn't line up the boys and girls separately or send them to
different bathrooms if kids sports frankly frankly could be gender
integrated until puberty there's there's no difference in strength or ability
between boys and girls before puberty there's no reason to separate the soccer
teams we just make such a big damn deal about gender that we force kids to
pick a team you know if gender truly is a spectrum and yet we only present them
two teams well what do we do with all those kids that are kind of in the
middle and that maybe a lot of kids you know that are not super
masculine are not super feminine and and and we force them into these narrow
boxes that really constrain the rest of their lives it constrains the kinds of
things they're gonna practice it constrains who they interact with who
they befriend who they talk to who they get close to and you know to me you know
gender is very limiting so the ultimate solution to this would be if we could
live in a truly not gender neutral society but gender free society where it
just wasn't a label that influenced anything in our lives and and then we
wouldn't have kids I people I think as much wanting to change their outward anatomy
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