The theory that prenatally established brain and CNS structures determine innate gender feelings and gender identity:
Well now, if it isn’t the genes that determine gender identity (cAIS girls disprove that)(XY- genetic male intersex infants who have female genitals and who grow up to have female gender identity), and if it isn’t the genitals and upbringing that determine it (cloacal exstrophy boys disprove that)(boys with “micropenises”), then what the heck does determine a person’s gender identity?
Scientific evidence has been growing that somehow certain brain-structures in the hypothalamus (the BSTc region) determine each person’s core gender feelings and innate gender identity. These structures are “hard-wired” prenatally in the lower brain centers and central nervous system (CNS) during the early stages of pregnancy, during a hormonally-modulated imprinting process in the central nervous system (CNS).
It appears that if those brain and CNS structures are masculinized in early pregnancy by hormones in the fetus, then the child will have male percepts and a male gender identity, independent of whether the genes or genitalia are male. If those structures are not masculinized in early pregnancy, the child will have a female percepts and a female gender identity, again independent of the genes or genitalia. As in the case of intersex infants having ambiguous genitalia, there are undoubtedly many degrees of cross-gendering of brain and CNS structures, so that while some infants are completely cross-gendered others are only partially cross-gendered.
More recent research indicates that the brain begins to differentiate in embryonic males and females even earlier, possibly before embryonic sex hormones come into play, and under mechanisms still not yet understood – with gender identity then becoming a complex effect of the interaction between earlier brain differentiation and later embryonic hormones. For more on this emerging research, see: “Brain development: The most important sexual organ” , in Nature magazine, January 29, 2004 (Nature 427, 390 – 392)
That is why it is possible for some children to have gender identities inconsistent with their genes. In cAIS cases, for example, those girls’ brain structures are likely insensitive to the masculinization effects of fetal testosterone, as were their genitals. Therefore, they develop the brain structures and gender identity of females, even though they are XY genetically.
That is also why it is possible for some children to have gender identities inconsistent with their genitalia and upbringing. In the case of the boys with cloacal exstrophy (“micropenises”), their brain-structures and CNS presumably did masculinize under the influence of fetal testosterone, leading to later male gender identities even though they had been surgically “turned into girls” as infants and raised as girls. (This was a common practice with intersexed babies from the 60’s until the 1990’s.)
Those recent cloacal exstrophy observations are already having a profound impact in the medical research community. They are to the science of gender much like the Galileo’s observations of the moons of Jupiter.
These are dramatic, unprecedented, undeniable observations that shift the previous paradigm of thought, and do so in an area of science that had been subject to much misinformation and taboo. In Galileo’s case, the shift was from an ‘earth-centered universe’ to a ‘sun-centered universe’. In the cases here, the shift is away from a ‘genitals + upbringing’ theory of gender identity to a ‘CNS neurobiological developmental’ theory of gender identity.
The implications of this paradigm shift are far reaching, especially for those who suffer from cross-gender identities. Instead of those gender feelings being considered to be “psychological”, they can now be understood as being “neurological” in nature.
Listen carefully to the conclusions of William Reiner, M.D., a pediatric clinician and researcher at The Johns Hopkins Hospital, based on his work with intersex children (Reiner is now an investigator in the Cloacal Exstrophy follow-up study, which now confirms these conclusions):
| “In the end it is only the children themselves who can and must identify who and what they are. It is for us as clinicians and researchers to listen and to learn. Clinical decisions must ultimately be based not on anatomical predictions, nor on the ‘correctness’ of sexual function, for this is neither a question of morality nor of social consequence, but on that path most appropriate to the likeliest psychosexual developmental pattern of the child. In other words, the organ that appears to be critical to psychosexual development and adaptation is not the external genitalia, but the brain.”
William Reiner, M.D., To Be Male or Female–That is the Question, 151 Arch Pediatr. Adolesc. Med. 225 (1997)].
It is amazing that psychiatrists completely missed all of this in the past, and so long assumed that gender identity was neutral at birth and later established by social interactions. Mis-gendered people themselves have long reported their problem not as one of THOUGHTS, but of cross-gendered percepts and BODY FEELINGS – as a little child the gendered feelings of how your body wants to move, how you respond to being touched, how aggressive or cuddly you are, how you interact with other little children. Then, after puberty, one’s feelings upon being sexually aroused, and whether those deep urges are male (mounting urges) or female (urges of being manipulated and penetrated).
One doesn’t “think up” these CNS-produced male/female gender and sexual feelings, one simply perceives them! The basic perceptual mechanisms involved are hard-wired, and cannot be changed by psychiatric means any more than one could permanently change one’s sense of feeling hot into that of feeling cold and vice-versa.
Whatever in-utero process produces it, a person’s gender feelings and gender identity are at the very core of their being. Gender identity is fixed, immutable and irreversible by any known medical or psychological means. We also now know that there is only one method for determining your gender identity. We have to ask YOU! Your gender is a percept: You are the only one who knows for sure what it is, and no one else can tell you what it is.
For more on the biological basis of Transsexualism with more up to date research see the following links.