Statement:

In recent years there has been increasing public awareness of transvestism and transsexuality. The media – press, radio, television, (with programmes such as ’Gender Change’ and ‘reality’ T.V. shows) and in particular the world wide web – are portraying these behaviours as if they were an unavoidable, are therefore a normal and acceptable, variant of human sexuality.

The message being conveyed is that an enlightened society ought to be accepting of such people as they present – as a matter of human right.

In a post modern, ideological driven, era the church is being challenged as never before to develop an appropriate Christian response in matters of human sexuality and confused gender identity.

Special interest groups such as Press for Change, GIRES and others have relied on specifically selected research documents, often without peer review, from scientific publications which they (not necessarily the authors) claim demonstrate an innate or biological determined medical condition which enforces the behaviour – known clinically as Gender Identity Disorder (GID) or – transsexuality.

Of concern is that these same special interest groups promote deliberately misleading information in their literature, and on their web sites, to members of the public and others. (Of particular concern is that such information was widely circulated to politicians in an endeavour to influence them (successfully) to support the then Gender Recognition Bill.)

Vulnerable people visit such web sites and read the literature. Some, possibly already having a disposition to transvestism and transsexuality, can be strongly influenced to believe that the only satisfactory outcome for them is to assume a life – possibly supported by medical intervention – in their preferred self assumed gender role.

Dr. N. Whitehead PhD a Member of the International Society of Twin Studies, comments of the GIRES web site (www.gires.org.uk).

‘The material on the web site is misleading. Although saying the cause of transgender is not known, they present much material which supports to some extent a biological link, and by implication an inescapable progression, while ignoring other interpretations which are more worthy of credence. I note that they ignore the concept of a mistaken idea in a young person, reinforced thousands of times by repeated dwelling on the subject leading to an entrenched idea by adulthood. The authors even present some relevant literature to support this latter idea but do not comment on it.

‘They give an incorrect interpretation of twin studies, which correctly interpreted show that their implication about overwhelming biological origins is wrong.

‘They correctly state that the transgender concordance in identical twins is low, but then argue this shows some presumably strong genetic influence. Not at all. A low concordance means either that genetic (i.e. biological) influence is low, or that environmental effects can counteract genetic influence. This means in fact that their entire biological argumentation is wrong, in so far as it implies a strong influence.

‘The correct interpretation of the twin studies is that factors other than genetic are strong, particularly random factors. An example of a random factor could be one twin but not the other being told by a relative that if he persists in girl-like behaviour he might grow up as a girl. This could permanently influence him, but not his brother who was in another corner of the room.

‘The authors note correctly that many children have GID but only in a very small number of cases do they grow up to become transgendered. This argues that there is much change going on at early ages (in fact it is known from child development studies that gender is only thought unchangeable from about the age of 5-6 on) and GID is not fixed for all time. It argues there is a rather rare thought pattern which gets fixed in the mind, specifically that he is a woman in a man's body.

‘The material on biological origins is highly speculative, but that children take strange ideas into their heads and sometimes let them ferment for years is so well known that it hardly needs scientific support.’ — N.E.W.

At least one medical clinic in the U.K. has openly advertised on the web and has run newspaper advertisements appealing to people confused about their sex and gender identity offering hormone treatment and surgery.

It is possible to buy hormones over the internet without prescription.

Instances are emerging in the U.K., Australia and the U.S. of individuals who have come to regret sex re-assignment surgery and are seeking legal redress from both the doctors and hospitals involved as they struggle to resume their own original biological and gender identity. There are sufficient numbers such of people, once diagnosed with Gender Identity Disorder, to demonstrate sufficiently that the condition is not immutable and therefore predominantly psychological and can be overcome where sufficient motivation is present.

In spite of this, any challenge to the entrenched position of these same special interest groups will be met with vociferous accusations of bigotry, narrow mindedness and an unwillingness to listen to their reasoning and adopt it without question.

Two hypotheses most commonly referred to by these special interest groups are:

1) That the behaviour is determined in a localised area of the brain known as the hypothalamus, and

2) That the behaviour occurs as a result of abnormal hormone surges whilst the fetus still remains unborn in its mothers womb.

Both these hypothesis are highly speculative and are being challenged by mainstream medicine. (See appendix)

In addition, the cortex area of the brain, which separates animals from humans (animals do not have a cortex.) has an overriding or ’executive’ function which can, if there is sufficient motivation, override behaviours that that have been repeated to the point of becoming overwhelming or fixed.

In any event, if any biological pre disposition can be satisfactorily demonstrated to exist it is likely only to be weak. Transsexuality in reality arises from a complex variety of circumstances, predominantly psychological in origin.

These circumstances are likely to have caused immense personal (psychological) pain. Attempts to avoid that pain may eventually result in the development of transsexuality. The transsexual behaviours are pursued defensively as a way inserting themselves into a fantasy existence – with associated perceived social advantages – as a way of anaesthetising serious personal pain.

Problems inevitably arise when transsexuality emerges in a church congregation. With the advent of the Gender Recognition Act and the associated complications, an appropriate Christian response has become immensely more difficult. The self determined human rights of transsexuals are now seen to have priority in determining how Christians should think and act whenever transsexuality is encountered.

For many churches, issues of salvation, baptism and communion will be of immense importance. For the pre or post operative transsexual the question of marriage is also likely be important. Or, even for someone who simply insists on their perceived human right to present and be accepted in their own self determined gender role without having undergone any chemical or surgical intervention.

Notwithstanding the intent of the Gender Recognition Act, there will be serious expressions of concerns in congregations as to the effect that the presence of an all too frequently obvious, transsexual will have, particularly on children. Congregations are similarly sensitive to the use, by transgendered persons, of facilities such as toilets. Concerns are expressed when young children, as is common, use designated women’s toilets – not necessarily accompanied by their mothers.

Most people take for granted that their gender identity and their sexual identity are entirely congruent, that is – consistent. It is therefore often difficult for them to imagine how much personal pain can result in the significant skewing of a gender identity away from biological identity, and, to understand the often obsessive behaviour associated with it.

The roots of transsexuality, though obscure, are considered as being multi-factorial, are most likely to have arisen in response to painful early childhood experiences. A large body of psychiatric and psychological evidence points to the development of gender identity occurring below five years of age.

It is common for transgendered persons to assert that they can recall, earlier than at three years of age, thoughts that they had of: ‘being born into the wrong body’. Psychological studies evidence that such alleged memories are unreliable.

The limited amount of psychological research done into the development of gender identity disorder would suggest that family dysfunction and an inappropriate individual response, are strongly contributing factors.

Given that, church leaders and congregations which are concerned with wholeness in Christ will seek more understanding. Transsexuality, therefore for Christians, needs to be seen as an issue of personal identity in crisis.

The apostle Paul reminds us that all fall short of the glory of God. The Bible indicates that all have deviated in some way from God’s original creative intent. Christians are fallen creatures, who are themselves wounded healers, and ought to be about pursuing wholeness in Christ.

Biblically-based personal wholeness will come about in a measure consistent with one’s willingness to be obedient to the Lordship of Christ in one’s own life.

Adherence to a biblical statute alone will not bring about personal wholeness. Wholeness is not about putting the past behind and ignoring personal pain. All pain is an indicator that something is not as it should be.

Personal pain needs to be seen as the basis from which personal growth and wholeness can develop within a supportive Christian community. Achieving personal growth into the person God planned them to be will be slow, and in itself painful.

For the person with a background of confused gender identity, as further pain is encountered seeking after biblical wholeness, or unexpected crisis occurs, there will be a tendency to resort to former patterns of behaviour. Pain threshold is likely to be low. If despair sets in it is likely to result in an unwillingness to co-operate further in seeking after wholeness in Christ.

Old patterns of behaviour will be cyclical and can be identified. If recognised, and there is sufficient will by all parties concerned to do so, new patterns of behaviour can be established and maintained.

For post operative male to female transsexuals there will need to be an acceptance that surgically removed genitalia cannot be satisfactorily replaced.

Expectation of acceptance into the assumed gender role by members of the biological sex is likely to be limited increasing a sense of isolation and alienation from society.

Pastoral oversight of gender confused patients will be fraught with difficulties for all concerned.

Jesus himself demonstrated an extraordinary willingness to meet people “where they are at”. In the third chapter of John’s gospel we see a picture of Jesus meeting with a Pharisee – a well-educated religious leader. In the next chapter we see Him meeting with a Samaritan woman – Samaritans being despised by the Jews. In the eighth chapter we see Jesus meeting with someone legally condemned by the law for adultery. Rather than run from Jesus they appeared to be drawn to Him. We need to look to His example to guide us in a pastoral response to the gender confused.

Appendix 1.

‘It really deals a death blow to any attempt to say that that structure can be responsible for childhood feelings of being the wrong gender‘…. N E Whitehead Ph D

In Humans, the Central Subdivision of the Bed Nucleus of the Stria Terminalis Does Not Become Sexually Dimorphic Until Adulthood

By Anne A. Lawrence, M.D., Ph.D.

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Two reports from the Netherlands Institute for Brain Research, published in 1995 and 2000, have been widely interpreted as demonstrating a possible neuroanatomic marker for male-to-female (MtF) transsexuality. In 1995, Zhou et al. reported that the central subdivision of the bed nucleus of the stria terminalis (BSTc), a collection of cells in the hypothalamus, was sexually dimorphic in humans. BSTc volume was significantly greater in male brains than in female brains. However, the brains of six MtF transsexuals Zhou et al. studied were found to have BSTc volumes within the typical female range. A follow-up paper by Kruijver et al. (2000) looked at the same six transsexual brains and two additional ones, including one from a female-to-male transsexual. Kruijver et al. reported that the sexual dimorphism in BSTc volume found by Zhou et al. reflected a genuine difference in neuron number, and was not simply an artifact of the measurement technique Zhou et al. used.

These two reports have spawned some truly fantastic extrapolations, including the assertion by some MtF transsexuals that they have the "brain-sex" of females (example: "[I] was born and raised as a boy. It was a terrible mistake, because [I] had the brain-sex . . . of a girl."). Unqualified assertions like this have been made even by persons trained as scientists. Never mind that the papers cited above studied only eight transsexual brains, and have never been replicated in another laboratory. Never mind that, of the dozens of other sexually dimorphic structures in the human brain, not one has been shown to be sex-atypical in transsexuals. Never mind that we have no idea exactly what functions the BSTc might subserve in humans. The true believers in transsexual "brain-sex" had found their biologic marker, and no amount of ordinary scientific skepticism could dissuade them.

Until, perhaps, now. A recent paper by Chung et al. (2002) has demonstrated a most unexpected finding: In humans, unlike the rat and perhaps other species, BSTc volume does not become sexually dimorphic until well into adulthood. However, most MtF transsexuals report that they experienced gender dysphoria beginning in childhood, often from the time of their earliest memories. It is hard to imagine how BSTc volume could be a marker for gender identity if BSTc volume has not yet become sexually dimorphic at a time when gender identity has already been firmly established. As Chung et al. wrote:

"Late sexual differentiation of the human BSTc volume also affects our perception about the relationship between BSTs [sic] volume and transsexuality. Interestingly, transsexuals receive their first consultation between the ages of 20 and 45 years, which coincides with the period of sex-dependent divergence of BSTc volume found in the present study (Van Kesteren et al., 1996). However, epidemiological studies show that the awareness of gender problems is generally present much earlier. Indeed, [about] 67-78% of transsexuals in adulthood report having strong feelings of being born in the wrong body from childhood onward (Van Kesteren et al., 1996)."

Of course, it is still possible to construct explanations of these findings that are consistent with the hypothesis that BSTc volume in adulthood could be a marker for gender identity in MtF transsexuals. Chung et al. conjectured that fetal or neonatal hormone levels could affect gender identity, and could perhaps simultaneously produce changes in BSTc "synaptic density, neuronal activity, or neurochemical content" that might not immediately affect BSTc volume, but that might somehow do so much later, during adulthood. Naturally, they did not propose any specific mechanisms by which such delayed effects might occur. Alternatively, they conjectured, failure to develop a male gender identity might itself somehow affect adult BSTc volume, again by an unspecified mechanism.

These possibilities notwithstanding, it should be apparent that the Chung et al. paper has dealt a serious blow to the hypothesis that BSTc volume is a biologic marker for gender identity in MtF transsexuals. Whether this will diminish the fanciful claims of "female brain-sex" by MtF transsexuals themselves remains to be seen.

Here is the complete citation and abstract for the Chung et al. paper:

ABSTRACT: Gonadal steroids have remarkable developmental effects on sex-dependent brain organization and behavior in animals. Presumably, fetal or neonatal gonadal steroids are also responsible for sexual differentiation of the human brain. A limbic structure of special interest in this regard is the sexually dimorphic central subdivision of the bed nucleus of the stria terminalis (BSTc), because its size has been related to the gender identity disorder transsexuality. To determine at what age the BSTc becomes sexually dimorphic, the BSTc volume in males and females was studied from midgestation into adulthood. Using vasoactive intestinal polypeptide and somatostatin immunocytochemical staining as markers, we found that the BSTc was larger and contains more neurons in men than in women. However, this difference became significant only in adulthood, showing that sexual differentiation of the human brain may extend into the adulthood. The unexpectedly late sexual differentiation of the BSTc is discussed in relation to sex differences in developmental, adolescent, and adult gonadal steroid levels.

References:

Chung WC, De Vries GJ, Swaab DF (2002) Sexual differentiation of the bed nucleus of the stria terminalis in humans may extend into adulthood. J Neurosci 22(3): 1027-1033.

Kruijver FP, Zhou JN, Pool CW, Hofman MA, Gooren LJ, Swaab DF (2000) Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clin Endocrinol Metab 85(5): 2034-2041.

Van Kesteren PJ, Gooren LJ, Megens JA (1996) An epidemiological and demographic study of transsexuals in the Netherlands. Arch Sex Behav 25(6): 589-600.

Zhou JN, Hofman MA, Gooren LJ, Swaab DF (1995) A sex difference in the human brain and its relation to transsexuality. Nature 378(6552): 68-70.

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© 2002 by Anne A. Lawrence, M.D., Ph.D. All rights reserved.
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