The Riddle of Gender

by Deborah Rudacille

  The emerging picture is far more complex than previously suspected, and most likely involves genetic, epigenetic, and environmental factors. Citing the “complex and constant interaction” between the nervous system of the developing fetus and the intrauterine environment, as well as the interaction of the developing child with his or her family and community, child psychiatrist and urologist William Reiner says that we may never fully understand exactly how gender identity is established. On the other hand, recent studies have shown that the belief that one could alter a child’s gender identity afterbirth through the administration of hormones and surgery has been “an unmitigated disaster,” he says. Scientific opinion is gradually evolving, but some researchers are still clinging to the old point of view, citing insufficient data in support of the hypothesis that gender identity is established before birth. “But they are starting with the premise that the old way had some merit,” Reiner says. “I don’t agree with that. We never had the data to establish the validity of that hypothesis in the first place.”

  As more data supports the view that biology plays a significant role in complex traits like sexual orientation and gender identity, the hypothesis that human sexual differentiation is vulnerable to the influence of endocrine-disrupting chemicals (EDCs) is also gaining support. In an article published in the journal Environmental Health Perspectives in October 2005, science writer Ernie Hood reports on the debate raging among scientists who are convinced that EDCs present a hazard to human health and skeptics who insist that EDCs have not been proven harmful to humans. For the first time a peer-reviewed scientific journal—EHP is the journal of the U. S. National Institute of Environmental Health Sciences—raises the issues of whether prenatal EDC exposures may be a causative factor in transsexualism/ transgenderism.

  I spoke to Hood a few weeks before the article went to press and he told me that even though the EDC/transsexual correlation was mentioned only briefly, the article—which focuses on a range of potential effects—was likely to be controversial. Hood interviewed both Scott Kerlin of the DES Sons Network, and Christine Johnson, the engineer who has been the most vocal advocate for the EDC/trans hypothesis. Hood says that he found the data presented in Kerlin’s paper “surprising and enlightening,” adding that “it certainly points an arrow in a particular direction, which should be investigated.

  “On its face, the concept that EDCs might cause transsexualism sounds a bit lunatic fringe,” he says. “But if you accept that there is or could be a physiological basis for gender identity, and if you believe that prenatal exposure to EDCs can affect neurological development, the concept begins to seem credible.” Whether it can ever be conclusively established is another matter, he says.

  A study published by epidemiologist and biostatistician Shanna Swan in 2005 points to the kind of methodology that may ultimately convince skeptics. Swan found that anogenital distance—the distance between the rectum and the base of the penis—was shorter in baby boys whose mothers’ urine revealed elevated concentrations of phthal-ate metabolites. This evidence of “phthalate syndrome” previously observed in animal models provides compelling evidence that exposure to a class of chemicals used in a wide variety of consumer goods (soft plastics and cosmetics) is having a measurable effect on the reproductive anatomy of baby boys. Many are calling this a “landmark study” says Hood, pointing out that even Steven Safe, a noted critic of EDC fearmongering, has called it an important piece of work and a model for future epidemiological research on the human health effects ofEDCs.

  It will certainly be more difficult to come up with that kind of overwhelmingly convincing evidence when it comes to psychological effects. Still, even in this murkier area, progress has been made. For example, in 2005, Scott Kerlin finally began to make some headway in his herculean efforts to bring the health issues of DES sons to the attention of researchers. After sharing his results with EDC researcher John McLachlan, Kerlin was invited to present his paper, “The Presence of Gender Dysphoria, Transsexualism, and Differentiation in Males Prenatally Exposed to Diethyl-stilbestrol: Initial Evidence from a 5-Year Study,” at the annuale. Hormone conference of endocrine disruption research in October.

  This was Kerlin’s first experience at presenting his research to a scientific audience; I asked about the reaction to his presentation. “People were shocked,” he says. “Some audience members—including Shanna Swan—came up to me after the presentation and said, literally, ‘I’m shocked.’” Kerlin’s talk focused on the invisible harm of DES—things not easy to measure and difficult for people to grasp like gender dysphoria and major depressive disorders. “I basically said, I can’t prove it, but I also can’t discount the information that people have shared with me,’” he says. Contra his fears, the researchers in the audience “were not dismissive of my findings,” Kerlin says. Indeed, in his summary at the close of the conference, McLachlan referred to the work being done by Kerlin and some of the other presenters on the human health effects panel as “guerrilla epidemiology” and said that it was essential given the paucity of formal studies thus far.

  Kerlin is pleased that he is finally able to call attention not only to the hot-button issue of gender variance, but also to broader psychological issues of DES sons. “I’ve documented more cases of major depressive disorders than any condition other than gender variance among members of the network,” he says, “but the whole psychiatric realm has been kept off the radar screen. All of the focus has been on measurable physical conditions. What is missing is long-term research on subtle effects, psychological health, and neurodevelopmental issues. My view is that males were disproportionately affected in ways that are relatively invisible, whereas the harm to females—particularly clear cell cancer—was impossible to ignore.”

  In addition to McLachlan, the DES sons gained another powerful scientific advocate last year in Milton Diamond, the University of Hawaii professor best known for his revelation of the tragic outcome of the David Reimer case. When I spoke to Diamond in 2002, he was cautious in discussing the possible “gender-bending” effects of DES. Kerlin’s data has apparently convinced him that the topic is worth investigating; he nominated Kerlin’s paper for presentation at the International Behavioral Development Symposium held in Minot, North Dakota, in August 2005.

  Kerlin was unable to attend so Dana Beyer, co-moderator of the DES Sons Network, presented the results to an audience that included most of the big guns of gender research, including many who still subscribe to the view that MTF transsexuals are self-hating homosexuals or “autogynephiliacs”—men sexually aroused by the thought of themselves as women. “While I received the usual criticisms from the usual suspects, the junior scientists were very appreciative of the data and were cognizant of its significance,” says Beyer. “The younger researchers seem to be accepting the increasing evidence that transsexu-alism is simply a form of intersex, where brain sex is incongruent with genital sex. It’s a slow process, but it’s picking up steam.”

  Unsurprisingly, evidence that transsexualism may be associated with exposure to DES and environmental chemicals is welcomed by some transsexual and transgendered people, and viewed with alarm by others. Jay Sennett, a trans filmmaker and activist whom I met at my first True Spirit conference and who encouraged me to work on this book at a time when I was doubting my right to do so, expressed both points of view in a recent e-mail conversation. “I don’t want my people used in a fear campaign to reduce EDCs,” he says. On the other hand, given the widespread perception that transsexualism is a mental illness, data pointing to a correlation between transsexualism and EDCs may provide relief from the stigma. “Any proven biological component assuages the ick factor,” he says.

  His major concern is how the media will “manipulate” such information. “Given the science phobia that is part and parcel of U. S. culture,” he says, “combined with ignorance/fear of transsexualism,” a media campaign that stokes fears of transsexualism as a way of calling attention to the problem of env
ironmental degradation is almost inevitable. “Stem the rise of transsexualism by cleaning up the environment—given the utter ignorance of science among popular media, I fear such a campaign might arise as a response to legislate/push for environmental clean-up.”

  Sennett’s concerns about how the media, public, and health care providers will respond to any linkage between EDCs and transsexualism are connected to the larger issue of how biology intersects with culture in the lives of transgendered people. “Biology remains a strenuous dance partner for transsexual people,” he says. “Sometimes she makes us look really good and other times it takes all we can do to keep from stepping on her feet.” He rues the “fix it” mindset he has encountered from some health care professionals, “with all the concomitant patronizing and condescending attitudes,” that go along with it—yet, he admits that he has also received caring and compassionate treatment. The bottom line, he says, is that as a transman “I cannot live without these ‘biological’ artifacts,” like hormone therapy. “Unless the testosterone becomes available over the counter, I’m living with these people for the rest of my life.”

  Sennett is deeply interested in science and technology, and on his blog often discusses provocative issues like the transsexual person as a kind of cyborg, a fusion of nature and technology. Unlike Janice Raymond and other critics of transsexualism, he doesn’t view the technological artifice of the transsexual body as a negative but as something to be celebrated. Even the possibility that EDCs are creating more transsexual and intersex people can be viewed as a “Darwinian positive,” he points out. “Only the most robust humans can continue to survive in the fecal soup that we have made of our environment. Perhaps we represent a positive outcome, or at the very least, we represent one way in which the body responds to its environments.”

  He doubts that most will see things that way, though, either within the trans community or without. “I’ll wager that if a positive correlation is found, it will enter my community through statements like ‘it isn’t our fault!’” he says. Research on possible gender-bending effects of EDCs, just like previous research on sex and gender, is a double-edged sword, he points out. “Sometimes biology dismisses our freedom and sometimes it is a source of healing. Really the issue I think is how our society uses biology and science to control and diminish us. There is nothing inherently good or bad about our biology.”

  Sennett’s comments echo those I’ve heard from others in the trans community following the publication of the hardcover edition of this book. Like Sennett, many people have written to thank me for writing the book. “This is the most in-depth piece on the subject that I have read in many, many years,” one middle-aged transwoman e-mailed me. “I was not able to stop once I began. I learned so much about the transgender movement that I simply did not know. For all of that, and for the stories you related, I thank you. For so many years, I thought there was hardly anyone else in the world like me,” she added. “It is so comforting to know there are so many others like me out there.” At readings and on radio shows, people seemed particularly intrigued by the science; the great majority of questions put to me have been about the biological basis of sex and gender. Clearly, there is a great deal of interest, both within the trans community and without, on this subject.

  I’ve also been cautioned by some trans people about the dangers of biological reductionism, and heard concerns that once again science and medicine are being used to define transgendered people, to pin a label on them, even if the label may ultimately be a less stigmatizing one. “Some folks firmly believe in a biological component while others think their experience remains largely socially constructed,” says Sen-nett. “What is missing from these discussions remains an understanding that scientific ‘facts’ are constructed over time.” This point resonates not only within the trans community, but in the straight community as well, as an acrimonious public debate on sex and gender that broke out the month before the hardcover edition of The Riddle of Gender was published in February 2004 illustrates.

  In January 2005, Lawrence Summers, president of Harvard University, delivered a lecture that touched on the continued under-representation of women in tenured positions in science and engineering at top research universities. Summers proposed three possible explanations—many women may be either unwilling or unable to put in the long hours requisite for high-level achievement; women in general may have less aptitude for high-end achievement in science and engineering; lingering patterns of passive discrimination and stereotyping may prevent women from achieving their full potential. It was the second speculation that ignited a firestorm of controversy, beginning at the actual presentation when an MIT biology professor, Nancy Hopkins, walked out, telling The Boston Globe that if she had remained, “I would’ve either blacked out or thrown up.”

  I had mixed feelings about the Summers controversy. On the one hand, I know plenty of female researchers who exhibit no less aptitude for the practice of high-level scientific achievement than their male peers, though it seems that they often have to work harder to balance the demands of family life and research. On the other hand, the research for this book has convinced me that there are, in fact, differences in male and female ways of perceiving and responding to the world, and that these cognitive differences may help explain why fewer numbers of women seem to be drawn to careers in science and engineering. So I am not one of those who thought that Larry Summers should be metaphorically drawn and quartered for suggesting that biology may play a role in the situation.

  At the same time, I see very clearly the dangers of attributing too much emphasis to biology, of using biological determinism to undermine efforts to keep chipping away at the social and cultural factors that prevent girls and women from pursuing, and succeeding in, careers in science and engineering. Black and Latino men too, are under-represented in science and engineering. I have seen no evidence that they are biologically unsuited to the practice of these disciplines. In fact, it seems self-evident that individuals from various minority groups have the ability to succeed in science, but often lack the educational opportunities to develop the skills and knowledge necessary to pursue a career in science and engineering in the first place. To paraphrase Simone de Beauvoir, scientists and engineers are made, not born. It’s no secret that we are making too few scientists and engineers in the United States these days. Indeed, our long dominance in those fields may be rapidly coming to an end as (among other factors) the supply of foreign-born scientists and engineers dries up in the wake of post—9/11 crackdowns on foreign-born scholars. Our precollegiate educational system is simply not providing American students with the necessary coursework to enable them to succeed in undergraduate and graduate scientific studies. Doesn’t it make more sense at this point to focus on education, rather than biology, as a fix for the problem— and to seek to expand opportunity rather than to limit it to those with a “biological” predisposition for such studies?

  I found the Summers controversy frustrating for another, more personal, reason. When this book was published in February 2005, it was almost universally ignored by reviewers and the media—a common complaint of authors. But I felt that part of the reticence in dealing with the book was related to its topic, and that as its author I was in a very real sense cloaked in the same invisibility that continues to blanket its subjects. The experiences of the transgendered and transsexual people who were the sources for this book directly impinge on the issues generated by the Summers controversy—but no one thought to interview a trans neuroscientist like Ben Barres, for instance, for his unique perspective on this subject. No one considered that transgendered, intersex, and/or transsexual people have anything to contribute to the very heated debate that raged for months in the pages of newspapers and magazines. This astonishes me. But it is part and parcel of the dedicated ignorance that continues to characterize the media and public approach to trans people.

  The past two years have also been notable for the degree to which homophobia (and it
s close cousin transphobia) has crept from its dank closet and begun fulminating in the public square. When I began the research for this book in 2001, gay-bashing had begun to seem as embarrassingly antiquated as overt racism and anti-gay bigots were becoming a (thankfully) endangered species. No more! One of the unfortunate effects of 9/11 seems to have been a sudden ratcheting up of public mistrust and loathing for the Other—and gay others have borne the brunt of the hatred and fear. Unscrupulous politicians and preachers have played on free-floating anxiety about difference and have scapegoated gays as exemplars of decadence and the decline of “American” values. What hogwash! I’ve always felt that the value held dearest by most Americans was the right to be left alone. To deny that right to others while claiming it for oneself is the rankest hypocrisy.

  I’ve found that the most valuable insight that I’ve taken away from the research and writing of this book is the certain knowledge that when one group’s rights are violated or denied, the rights of all are threatened. For that reason, that struggle by LGBT Americans to gain their civil rights is not just a “gay” issue—like the civil rights struggles of African Americans forty years ago, it affects everyone. I’ve read excerpts from Chapter 1 of this book at a few bookstores, and when I do someone in the audience invariably points out the chilling parallels between the German experience during the 1930s and the homophobic backlash in the United States today. Yes, I say, it is true. Just as in Germany, a period of relative liberalism has been succeeded by a vicious reaction, though not yet one in which whole categories of others are being exterminated.

  And yet… as I write this, the killers of Gwen Aruajo are once again using the “gay panic” strategy in their retrial, alleging that they were so sickened upon learning that Aruajo was biologically male that they bludgeoned and strangled her in a passionate rage. (The first trial ended in a hung jury.) A similar argument was used in the murder trial of Estanislao Martinez, who stabbed twenty-nine-year-old Joel Robles more than twenty times when he discovered that Robles was biologically male. The Gender Public Advocacy Commission noted that “ ‘crime of passion’ and ‘gay panic’ arguments have traditionally been at the core of defense cases in murder trials with gay and transgender victims.” Martinez was sentenced to four years in prison for the murder—a telling indication of how little value our legal system assigns to the lives of transgendered people.