T R A N S G E N D E R I S M

WHAT IS TRANSGERNDERISM? HOW IS IT DIAGNOSED? IS IT A CONDITION, A SEXUAL DISORDER OR A DISEASE? SHOULD IT BE TREATED BY ALL MEDICAL MEANS?

As a gastroenterologist with many years of clinical practice experience, I have always been fascinated with brain-and-body communication and miscommunication, and its role in development of mental and  organic diseases.

To me, one of the most curious brain-and-body miscommunication disorders is being transgender. I believe there is lack of scientific knowledge and understanding among research scientists, the general public, and among LGBTQ+ people themselves. In this essay, I would like to discuss my opinions and understanding about being transgender.

First, let us try to define what is being transgender means. Trans is a prefix from Latin origin, meaning across, over, on the other side. Gender means one’s internal feelings about their gender identity. Then, the word transgender simply means having a different gender identity than their genetically assigned anatomical birth sex. So, the constant clash between brain and body is the root cause of being transgender.

As we know, the anatomical sex of a person is genetically determined by X and Y sex chromosomes right at the time of fertilization (XX is female, XY is male), long before brain’s development and specialization are completed, to a level that the brain could create mind, thinking and cognition. A newborn child cannot think about his/her gender identity, neither can he/she walk or talk, because the brain’s development is not yet completed to enable a child to have these abilities.

According to neuroscientists, the brain’s development and its basic architecture is constructed through an ongoing process that begins before birth, accelerates during the first few years after birth, and continues into adulthood.

It has been shown by research scientists that a child can only express his/her gender identity after the age of four. So, it appears that the gender identity is acquired after birth with the further development and various internal and external stimulus depended on specialization of the brain.

Scientific studies have shown that the gonadal hormones testosterone and estrogen have special effects on the brain development and its sexual differentiation in experimental animals. These studies strongly suggest thar same processes happen in the human brain as well.

Lack of hormonal effects on the brain or variations in the differentiations of the brain may also explain how being transgender could occur.

Since I am neither a psychotherapist nor a sex therapist, I would like to raise few central questions about   being transgender, without elaborating on them, with the hope that it will initiate more thinking and understanding about transgenderism in hopes that some experts would answer my questions.

1 – Are there sex chromosomes abnormalities in transgender people?

2 – Have gonadal hormones levels ever been investigated by researchers on the newborns?

3 - Could it be appropriate to give exceptionally low dose, could anatomical sex associated gonadal hormones to the newborn, prophylactically, to send gender appropriate signal to the brain for appropriate development and specialization?

4 – Could changes in microbiome populations in the newborn play a role in brain’s development, since natural vaginal birth babies have different microbiome population in their gut, compared to C section born babies?

5 – Why are there only two sex forms (binary), while there are so many gender identities like cisgender, transgender men or women, bisexual, asexual, or genderqueer?

6 – Why does gender identity in some trans people remains fluid and keep changing while it remains stable in others?

 7- Why do some trans gender people not feel restricted by societal norms and expectations in their dress code and behaviors, knowing that this is the primary cause of societal stigma, prejudice and discrimination?

8 – Could gender dysphoria, which is a feeling constant discomfort, distress, anxiety and depression play a role in trans people behaviors?

 9 – Are there objective criteria to diagnose trans people, or does the diagnosis depend on only feelings trans people express?

10 – Could a diagnosis solely dependent on feeling tend to be wrong and treatments for a wrong diagnosis end up with disasters?