Testosterone metabolization, autism, male brain, and female identity

I began this post intending to write about testosterone metabolization in autism and possible connections with transgender identity, but realized halfway through that I didn’t actually know whether the autist-trans connection was primarily male-to-female or female-to-male. I had assumed that the relevant population is primarily MtF because both autists and trans people are primarily male, but both groups do have female populations that are large enough to contribute significantly. Here’s a sample of the data I’ve found so far:

A study conducted by a team of British scientists in 2012 found that of a pool of individuals not diagnosed on the autism spectrum, female-to-male (FTM) transgender people have higher rates of autistic features than do male-to-female (MTF) transgender people or cisgender males and females. Another study, which looked at children and adolescents admitted to a gender identity clinic in the Netherlands, found that almost 8 percent of subjects were also diagnosed with ASD.

Note that both of these studies are looking at trans people and assessing whether or not they have autism symptoms, not looking at autists and asking if they have trans symptoms. Given the characterization of autism as “extreme male brain” and that autism is diagnosed in males at about 4x the rate of females, the fact that there is some overlap between “women who think they think like men” and “traits associated with male thought patterns” is not surprising.

If the reported connection between autism and trans identity is just “autistic women feel like men,” that’s pretty non-mysterious and I just wasted an afternoon.

Though the data I have found so far still does not look directly at autists and ask how many of them have trans symptoms, the wikipedia page devoted to transgender and transsexual computer programmers lists only MtFs and no FtMs. Whether this is a pattern throughout the wider autism community, it definitely seems to be a thing among programmers. (Relevant discussion.)

So, returning to the original post:

Autism contains an amusing contradiction: on the one hand, autism is sometimes characterized as “extreme male brain,” and on the other hand, (some) autists (may be) more likely than neurotypicals to self-identify as transwomen–that is, biological men who see themselves as women. This seems contradictory: if autists are more masculine, mentally, than the average male, why don’t they identify as football players, army rangers, or something else equally masculine? For that matter, why isn’t a group with “extreme male brains” regarded as more, well, masculine?

(And if autists have extreme male brains, does that mean football players don’t? Do football players have more feminine brains than autists? Do colorless green ideas sleep furiously? DO WORDS MEAN?)


In favor of the “extreme male brain” hypothesis, we have evidence that testosterone is important for certain brain functions, like spacial recognition, we have articles like this one: Testosterone and the brain:

Gender differences in spatial recognition, and age-related declines in cognition and mood, point towards testosterone as an important modulator of cerebral functions. Testosterone appears to activate a distributed cortical network, the ventral processing stream, during spatial cognition tasks, and addition of testosterone improves spatial cognition in younger and older hypogonadal men. In addition, reduced testosterone is associated with depressive disorders.

(Note that women also suffer depression at higher rates than men.)

So people with more testosterone are better at spacial cognition and other tasks that “autistic” brains typically excel at, and brains with less testosterone tend to be moody and depressed.

But hormones are tricky things. Where do they come from? Where do they go? How do we use them?

According to Wikipedia:

During the second trimester [of pregnancy], androgen level is associated with gender formation.[13] This period affects the femininization or masculinization of the fetus and can be a better predictor of feminine or masculine behaviours such as sex typed behaviour than an adult’s own levels. A mother’s testosterone level during pregnancy is correlated with her daughter’s sex-typical behavior as an adult, and the correlation is even stronger than with the daughter’s own adult testosterone level.[14]


(Bold mine.)

Let’s re-read that: the male brain is masculinized by the aromatization of testosterone into estrogen.

If that’s not a weird sentence, I don’t know what is.

Let’s hop over to the scientific literature, eg, Estrogen Actions in the Brain and the Basis for Differential Action in Men and Women: A Case for Sex-Specific Medicines:

Burgeoning evidence now documents profound effects of estrogens on learning, memory, and mood as well as neurodevelopmental and neurodegenerative processes. Most data derive from studies in females, but there is mounting recognition that estrogens play important roles in the male brain, where they can be generated from circulating testosterone by local aromatase enzymes or synthesized de novo by neurons and glia. Estrogen-based therapy therefore holds considerable promise for brain disorders that affect both men and women. However, as investigations are beginning to consider the role of estrogens in the male brain more carefully, it emerges that they have different, even opposite, effects as well as similar effects in male and female brains. This review focuses on these differences, including sex dimorphisms in the ability of estradiol to influence synaptic plasticity, neurotransmission, neurodegeneration, and cognition, which, we argue, are due in a large part to sex differences in the organization of the underlying circuitry.

Hypothesis: the way testosterone works in the brain (where we both do math and “feel” male or female) and the way it works in the muscles might be very different.

Do autists actually differ from other people in testosterone (or other hormone) levels?

In Elevated rates of testosterone-related disorders in women with autism spectrum conditions, researchers surveyed autistic women and mothers of autistic children about various testosterone-related medical conditions:

Compared to controls, significantly more women with ASC [Autism Spectrum Conditions] reported (a) hirsutism, (b) bisexuality or asexuality, (c) irregular menstrual cycle, (d) dysmenorrhea, (e) polycystic ovary syndrome, (f) severe acne, (g) epilepsy, (h) tomboyism, and (i) family history of ovarian, uterine, and prostate cancers, tumors, or growths. Compared to controls, significantly more mothers of ASC children reported (a) severe acne, (b) breast and uterine cancers, tumors, or growths, and (c) family history of ovarian and uterine cancers, tumors, or growths.

Androgenic Activity in Autism has an unfortunately low number of subjects (N=9) but their results are nonetheless intriguing:

Three of the children had exhibited explosive aggression against others (anger, broken objects, violence toward others). Three engaged in self-mutilations, and three demonstrated no aggression and were in a severe state of autistic withdrawal. The appearance of aggression against others was associated with having fewer of the main symptoms of autism (autistic withdrawal, stereotypies, language dysfunctions).

Three of their subjects (they don’t say which, but presumably from the first group,) had abnormally high testosterone levels (including one of the girls in the study.) The other six subjects had normal androgen levels.

This is the first report of an association between abnormally high androgenic activity and aggression in subjects with autism. Although a previously reported study did not find group mean elevations in plasma testosterone in prepubertal autistic subjects (4), it appears here that in certain autistic individuals, especially those in puberty, hyperandrogeny may play a role in aggressive behaviors. Also, there appear to be distinct clinical forms of autism that are based on aggressive behaviors and are not classified in DSM-IV. Our preliminary findings suggest that abnormally high plasma testosterone concentration is associated with aggression against others and having fewer of the main autistic symptoms.

So, some autists have do have abnormally high testosterone levels, but those same autists are less autistic, overall, than other autists. More autistic behavior, aggression aside, is associated with normal hormone levels. Probably.

But of course that’s not fetal or early infancy testosterone levels. Unfortunately, it’s rather difficult to study fetal testosterone levels in autists, as few autists were diagnosed as fetuses. However, Foetal testosterone and autistic traits in 18 to 24-month-old children comes close:

Levels of FT [Fetal Testosterone] were analysed in amniotic fluid and compared with autistic traits, measured using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in 129 typically developing toddlers aged between 18 and 24 months (mean ± SD 19.25 ± 1.52 months). …

Sex differences were observed in Q-CHAT scores, with boys scoring significantly higher (indicating more autistic traits) than girls. In addition, we confirmed a significant positive relationship between FT levels and autistic traits.

I feel like this is veering into “we found that boys score higher on a test of male traits than girls did” territory, though.

In Polymorphisms in Genes Involved in Testosterone Metabolism in Slovak Autistic Boys, researchers found:

The present study evaluates androgen and estrogen levels in saliva as well as polymorphisms in genes for androgen receptor (AR), 5-alpha reductase (SRD5A2), and estrogen receptor alpha (ESR1) in the Slovak population of prepubertal (under 10 years) and pubertal (over 10 years) children with autism spectrum disorders. The examined prepubertal patients with autism, pubertal patients with autism, and prepubertal patients with Asperger syndrome had significantly increased levels of salivary testosterone (P < 0.05, P < 0.01, and P < 0.05, respectively) in comparison with control subjects. We found a lower number of (CAG)n repeats in the AR gene in boys with Asperger syndrome (P < 0.001). Autistic boys had an increased frequency of the T allele in the SRD5A2 gene in comparison with the control group. The frequencies of T and C alleles in ESR1 gene were comparable in all assessed groups.

What’s the significance of CAG repeats in the AR gene? Apparently they vary inversely with sensitivity to androgens:

Individuals with a lower number of CAG repeats exhibit higher AR gene expression levels and generate more functional AR receptors increasing their sensitivity to testosterone…

Fewer repeats, more sensitivity to androgens. The SRD5A2 gene is also involved in testosterone metabolization, though I’m not sure exactly what the T allele does relative to the other variants.

But just because there’s a lot of something in the blood (or saliva) doesn’t mean the body is using it. Diabetics can have high blood sugar because their bodies lack the necessary insulin to move the sugar from the blood, into their cells. Fewer androgen receptors could mean the body is metabolizing testosterone less effectively, which in turn leaves more of it floating in the blood… Biology is complicated.

What about estrogen and the autistic brain? That gets really complicated. According to Sex Hormones in Autism: Androgens and Estrogens Differentially and Reciprocally Regulate RORA, a Novel Candidate Gene for Autism:

Here, we show that male and female hormones differentially regulate the expression of a novel autism candidate gene, retinoic acid-related orphan receptor-alpha (RORA) in a neuronal cell line, SH-SY5Y. In addition, we demonstrate that RORA transcriptionally regulates aromatase, an enzyme that converts testosterone to estrogen. We further show that aromatase protein is significantly reduced in the frontal cortex of autistic subjects relative to sex- and age-matched controls, and is strongly correlated with RORA protein levels in the brain.

If autists are bad at converting testosterone to estrogen, this could leave extra testosterone floating around in their blood… but doens’t explain their supposed “extreme male brain.” Here’s another study on the same subject, since it’s confusing:

Comparing the brains of 13 children with and 13 children without autism spectrum disorder, the researchers found a 35 percent decrease in estrogen receptor beta expression as well as a 38 percent reduction in the amount of aromatase, the enzyme that converts testosterone to estrogen.

Levels of estrogen receptor beta proteins, the active molecules that result from gene expression and enable functions like brain protection, were similarly low. There was no discernable change in expression levels of estrogen receptor alpha, which mediates sexual behavior.

I don’t know if anyone has tried injecting RORA-deficient mice with estrogen, but here is a study about the effects of injecting reelin-deficient mice with estrogen:

The animals in the new studies, called ‘reeler’ mice, have one defective copy of the reelin gene and make about half the amount of reelin compared with controls. …

Reeler mice with one faulty copy serve as a model of one of the most well-established neuro-anatomical abnormalities in autism. Since the mid-1980s, scientists have known that people with autism have fewer Purkinje cells in the cerebellum than normal. These cells integrate information from throughout the cerebellum and relay it to other parts of the brain, particularly the cerebral cortex.

But there’s a twist: both male and female reeler mice have less reelin than control mice, but only the males lose Purkinje cells. …

In one of the studies, the researchers found that five days after birth, reeler mice have higher levels of testosterone in the cerebellum compared with genetically normal males3.

Keller’s team then injected estradiol — a form of the female sex hormone estrogen — into the brains of 5-day-old mice. In the male reeler mice, this treatment increases reelin levels in the cerebellum and partially blocks Purkinje cell loss. Giving more estrogen to female reeler mice has no effect — but females injected with tamoxifen, an estrogen blocker, lose Purkinje cells. …

In another study, the researchers investigated the effects of reelin deficiency and estrogen treatment on cognitive flexibility — the ability to switch strategies to solve a problem4. …

“And we saw indeed that the reeler mice are slower to switch. They tend to persevere in the old strategy,” Keller says. However, male reeler mice treated with estrogen at 5 days old show improved cognitive flexibility as adults, suggesting that the estrogen has a long-term effect.

This still doesn’t explain why autists would self-identify as transgender women (mtf) at higher rates than average, but it does suggest that any who do start hormone therapy might receive benefits completely independent of gender identity.

Let’s stop and step back a moment.

Autism is, unfortunately, badly defined. As the saying goes, if you’ve met one autist, you’ve met one autist. There are probably a variety of different, complicated things going on in the brains of different autists simply because a variety of different, complicated conditions are all being lumped together under a single label. Any mental disability that can include both non-verbal people who can barely dress and feed themselves and require lifetime care and billionaires like Bill Gates is a very badly defined condition.

(Unfortunately, people diagnose autism with questionnaires that include questions like “Is the child pedantic?” which could be equally true of both an autistic child and a child who is merely very smart and has learned more about a particular subject than their peers and so is responding in more detail than the adult is used to.)

The average autistic person is not a programmer. Autism is a disability, and the average diagnosed autist is pretty darn disabled. Among the people who have jobs and friends but nonetheless share some symptoms with formally diagnosed autists, though, programmer and the like appear to be pretty popular professions.

Back in my day, we just called these folks nerds.

Here’s a theory from a completely different direction: People feel the differences between themselves and a group they are supposed to fit into and associate with a lot more strongly than the differences between themselves and a distant group. Growing up, you probably got into more conflicts with your siblings and parents than with random strangers, even though–or perhaps because–your family is nearly identical to you genetically, culturally, and environmentally. “I am nothing like my brother!” a man declares, while simultaneously affirming that there is a great deal in common between himself and members of a race and culture from the other side of the planet. Your  coworker, someone specifically selected for the fact that they have similar mental and technical aptitudes and training as yourself, has a distinct list of traits that drive you nuts, from the way he staples papers to the way he pronounces his Ts, while the women of an obscure Afghan tribe of goat herders simply don’t enter your consciousness.

Nerds, somewhat by definition, don’t fit in. You don’t worry much about fitting into a group you’re not part of in the fist place–you probably don’t worry much about whether or not you fit in with Melanesian fishermen–but most people work hard at fitting in with their own group.

So if you’re male, but you don’t fit in with other males (say, because you’re a nerd,) and you’re down at the bottom of the highschool totem pole and feel like all of the women you’d like to date are judging you negatively next to the football players, then you might feel, rather strongly, the differences between you and other males. Other males are aggressive, they call you a faggot, they push you out of their spaces and threaten you with violence, and there’s very little you can do to respond besides retreat into your “nerd games.”

By contrast, women are polite to you, not aggressive, and don’t aggressively push you out of their spaces. Your differences with them are much less problematic, so you feel like you “fit in” with them.

(There is probably a similar dynamic at play with American men who are obsessed with anime. It’s not so much that they are truly into Japanese culture–which is mostly about quietly working hard–as they don’t fit in very well with their own culture.) (Note: not intended as a knock on anime, which certainly has some good works.)

And here’s another theory: autists have some interesting difficulties with constructing categories and making inferences from data. They also have trouble going along with the crowd, and may have fewer “mirror neurons” than normal people. So maybe autists just process the categories of “male” and “female” a little differently than everyone else, and in a small subset of autists, this results in trans identity.*

And another: maybe there are certain intersex disorders which result in differences in brain wiring/organization. (Yes, there are real interesx disorders, like Klinefelter’s, in which people have XXY chromosomes instead of XX or XY.) In a small set of cases, these unusually wired brains may be extremely good at doing certain tasks (like programming) resulting people who are both “autism spectrum” and “trans”. This is actually the theory I’ve been running with for years, though it is not incompatible with the hormonal theories discussed above.

But we are talking small: trans people of any sort are extremely rare, probably on the order of <1/1000. Even if autists were trans at 8 times the rates of non-autists, that’s still only 8/1000 or 1/125. Autists themselves are pretty rare (estimates vary, but the vast majority of people are not autistic at all,) so we are talking about a very small subset of a very small population in the first place. We only notice these correlations at all because the total population has gotten so huge.

Sometimes, extremely rare things are random chance.

Should Transgender People be in the Military? An overview of relevant studies

On July 27 (2017,) President Trump tweeted his intention to ban transgender people from serving in the military, a move which would reverse President Obama’s decision to allow them to serve. (Prior to Obama, trans people were not allowed to serve.) As of the writing of this post, Trump’s tweet has not become official law or policy, but it has set off a firestorm of internet debate, with everyone picking sides primarily based on whether they like trans people or not, rather than what’s actually best for the military.

So I decided to review whatever studies I could find on the subject:

CLAS (Community Alliance for Cultural and Linguistically Appropriate Services) finds:

On September 20, 2011, the repeal of “Don’t Ask, Don’t Tell” (DADT) went into effect in the U.S. military. The repeal marked the end of discriminatory practices in the military based on sexual orientation, but it did not end the prohibition on transgender military service. The National Transgender Discrimination Survey (NTDS) found that transgender Americans serve in the military at a high rate; 20 percent of NTDS respondents had served in the armed forces as compared to 10 percent of the U.S. general population.

According to 538, about 7.3% of the US population has served in the military (0.4% are active personnel; the rest are veterans.) The majority of those are male: 13.4% of men have served in the military, compared to 1.4% of women. Given the slight discrepancy in the data, I thought I’d check the NTDS numbers as well, but the PDF isn’t opening, but the Williams Institute has an article, Transgender Military Service in the US, which helpfully discusses the NTDS data in depth.

Overall, trans people are less than 1% of the population, and according to the Williams article, 60% MtF (male to female) and 40% FtM. According to 70 U.S. Veterans with Gender Identity Disturbances: A Descriptive Study, 91% of trans vets are MtF:

Retrospective descriptive data were obtained from chart reviews of 70 U.S. veterans who were evaluated by the second author for gender disturbances over a 20-year period (1987 to 2007). The modal veteran with gender identity disturbance was a natal male (91%) identifying as female, >40 years old, Caucasian, employed, with more than 12 years of education. Fifty-seven percent were parents with a history of sexual involvement with opposite sex individuals. Histories of autogynephilia were not elicited in vets interviewed since 1997. Classic “flight into hypermasculinity” was described by a majority of the natal male vets as a retrospective understanding of why they joined the military.

If we break the trans population down by gender, NTDS estimates that 30% of MtFs have served in the military and 5.5% of FtMs. (Williams cites a couple of other studies which found similarly high numbers.)

According to CNN, (which probably got its data from NTDS,) there are about 15,000 active trans troops; NTDS estimates a further 134,000 veterans. Given 1.4 million total people in the armed forces and 22 million vets, that gives us an estimate of a bit over 1% of the military and 0.6% of vets are trans. The discrepancy between current and historical numbers of trans people could be a side effect of younger people being more likely to identify as trans or of volunteer forces being more heavily trans than drafted ones. (Here is an interesting article about a trans WWII veteran; CNN has a couple about active troops.)

According to a RAND Corp study commissioned by the DoD, Assessing the Implications of Allowing Transgender Personnel to Serve Openly:

  1. There Are an Estimated 1,320–6,630 Transgender Service Members in the Active Component
  2. A further 1,510 in the Selected Reserve
  3. Not all will seek gender transition–related treatment (some have already had it and some don’t want it.)
  4. Estimates derived from survey data and private health insurance claims data indicate that, each year, between 29 and 129 service members in the active component will seek transition-related care that could disrupt their ability to deploy.
  5. Even upper-bound estimates indicate that less than 0.1 percent of the total force would seek transition-related care that could disrupt their ability to deploy.
  6. Using private health insurance claims data to estimate the cost of extending gender transition–related health care coverage to transgender personnel indicated that active-component health care costs would increase by between $2.4 million and $8.4 million annually, representing a 0.04- to 0.13-percent increase in active-component health care expenditures.

They further claim that:

  1. The limited research on the effects of foreign military policies indicates little or no impact on unit cohesion, operational effectiveness, or readiness.
  2. Policy changes to open more roles to women and to allow gay and lesbian personnel to serve openly in the U.S. military have similarly had no significant effect on unit cohesion, operational effectiveness, or readiness.

Note that RAND’s estimates of the number of trans military personnel is much lower than NTDS’s, which is kind of odd, given how easy the NTDS data is to find. Forgive me a bit of cynicism, but RAND seems to be trying to minimize projected costs by excluding the very large body of trans veterans who might also qualify for treatment and failing to include non-physical psychological expenses (see discussion below.)

Washington Free Beacon has a much higher estimate of physical costs, but I must warn that their website nearly crashed my computer. Quoting:

The 2014 Williams Institute study found there were 15,500 transgender individuals actively serving, or 0.7 percent of the military population. …

Thirty percent will likely seek surgeries, or 4,473 transgender troops. The average cost per surgery is $132,000, which is a combination of the average cost of male to female ($140,450) and female to male ($124,400) surgeries.

In other words, RAND estimates a small % of a small # will seek surgery–between 29 and 129 people. The Free Beacon study estimates a much higher % of a higher #, for an estimate of 4,473 people. RAND is also calculating about $80,000 per surgery, vs. Free Beacon’s $132,000.

The cost to taxpayers for these surgeries would be $590 million, and $770 million with a 3 percent inflation rate by 2027.

If the first set of numbers they cite are correct, then $590 million is an under-estimate, because it uses the average cost of male and female surgeries, but the majority of trans people in the military are MtF and so want the more expensive surgery.

There are 178,000 new military members per year, and assuming 0.7 percent are transgender, 1,246 new transgender service members each year. Assuming 30 percent get surgeries, there would be an additional 374 surgical transitions per year, or 3,740 over 10 years. Those surgeries would cost $493 million, and with 3 percent inflation a total of $579 million by 2027.

The costs of active duty transgender surgeries and those of new recruits over a 10-year period total $1.349 billion.

And this is still not considering veterans.

What about expenses besides surgical transition? According to Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case–Control Study:

Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups.

Trans people have really high rates of depression (62% for MtFs and 55% for FtMs,) suicide attempts (32%,) and HIV infection (35% for MtFs but only 2% of FtMs.)

I found two other potentially relevant studies, one from the Journal of Homosexuality and one from HEIN Online, but both are paywalled so I can’t read them.

So. Tentative conclusions/discussion:

The military is not a charity, nor is it a means of dealing with pre-existing health issues. The military’s primary–some would say only–purpose is to defeat America’s enemies. The military does not take people with health problems like diabetes or Asperger’s, even though there are many diabetic or aspie people who would be GREAT soldiers. There are jobs in the military that you can’t get if you wear glasses.

Some of these rules may be wrong. Maybe we should let people with high-functioning autism/Asperger’s in the military if they can hack it. The Israeli military has a special division where autists put their skills to good use monitoring surveillance footage; it also allows transgender soldiers. But Israel is a small country surrounded by hostile enemies, so it may feel it cannot afford to turn down any willing soldiers.

I propose that the military may serve a secondary purpose: allowing citizens to feel like productive, contributing members of society. Service in the IDF, for example, may have a beneficial effect on Israeli society as a whole beyond merely insuring its safety. If military service is not appropriate for a group of people, perhaps some other form of service to society is.

Trans folk are a very small percent of the military, but a surprisingly large percent of trans folk are current or former military, especially if we only look at MtFs. It seems that the military is more important to trans folks than they are to it.

It makes sense that a larger percent of FtMs than cis-women would join the military, as they would naturally be drawn to more typically “male” occupations. The MtF preference for military work is harder to explain. One study attributes it to overcompensation–that is, covering up their desire to be female by trying to be as masculine as possible. I propose a second possibility: the military pays, and trans people are disproportionately poor.

I would like to draw here on an anecdotal case study of a single individual I knew in childhood:

This fiend has a rare genetic condition (Klinefelter) in which instead of having a normal set of sex chromosomes (XX for female, XY for male,) they’re XXY. Biologically, “male” and “female” are defined by gamete size–females produce large gametes (eggs) and males produce small gametes (sperm.) XXY people basically look male but don’t develop normal testicles and are often infertile, so I don’t think they really count as “male” in the biological sense.

The current vogue for asserting that “gender is a social construct” is pure nonsense, and IMO, will ultimately be harmful to trans people like my childhood friend, who has a true intersex condition. Even chimpanzees show gender roles similar to humans. There are many observed statistical differences between male and female brains, from better mental rotation (men) to lower rates of retardation (women.) These mental differences are caused by the different amounts of male and female hormones the fetal brain is exposed to at different points in its development, which trigger different aspects of brain development. There are whole books on the subject of fetal brain development if you want to know more.

Exposing a fetal brain to incorrect hormone levels–say, by taking a formerly popular anti-miscarriage medication that contains high levels of artificial estrogens–could trigger the development of a more “female” brain in a male body (or with the right hormones, the opposite.) In my friend’s case, an extra X chromosome rather than medication is to blame.

My friend identifies as “female” despite looking male. Why remains a mystery to me, as their life would be much easier if they identified as male and injected testosterone than identifying as female and injecting estrogen, but I certainly can’t naysay their sense that they “aren’t a proper male.”

But in a perhaps not odd twist, my friend is (or was) absolutely obsessed with everything military, from battleships to rifles to historical re-enactments. (Friend also has a very good memory, rendering them a walking military encyclopedia.)

Look, I acknowledge that “obsessed with the military” and “insists they are female and wants surgery in that direction” is a weird combination and I don’t understand it. Trans identity and stereotypically-male spheres overlap in a few other dimensions. People have lately been discussing an overlap between trans and autism, (which researchers often characterize as extreme male brain,) and of course Kaitlyn Jenner was, pre-transition, an Olympic Athlete. But all of that is getting a bit off topic.

“Transgender” is a vaguely defined term, and I don’t see why, even if trans people were allowed to serve in the military, the military would be required to cover the cost of transitioning. Why not declare that the military doesn’t cover it, that members aren’t allowed to put themselves out of commission by getting surgery, and that people using hormones/medications are ineligible for service (just as diabetics are ineligible,) but allow someone who transitioned decades ago and requires no medication or surgery?

However, the psychological co-morbidities, especially depression, are much more concerning. A group with high levels of depression, suicide, HIV, etc., sounds like a bad match for the military.

None of the studies I found really went into much detail (at least in the parts I could access) about trans soldiers’ ability to cope psychologically with the rigors of war nor their effects on group cohesion or effectiveness.

Allow me to express a bit of doubt: if people think the folks running the study want a particular outcome, they may be reluctant to complain about a fellow squad member. What I really want is a study of squad performance comparing squads with and without trans members, similar to the one highlighted in “The US Marines Tested Mixed-Gender Squads Against all Male ones, and the Results are Pretty Bleak” (which I wrote about here and followed up on here):

All-male squads, teams and crews and gender-integrated squads, teams, and crews had a noticeable difference in their performance of the basic combat tasks of negotiating obstacles and evacuating casualties. For example, when negotiating the wall obstacle, male Marines threw their packs to the top of the wall, whereas female Marines required regular assistance in getting their packs to the top. During casualty evacuation assessments, there were notable differences in execution times between all-male and gender-integrated groups, except in the case where teams conducted a casualty evacuation as a one-Marine fireman’s carry of another (in which case it was most often a male Marine who “evacuated” the casualty.)

The report also says that female Marines had higher rates of injury throughout the experiment.

People often argue that men and women ought to have an equal chance to try to be in the military, but what if even women who meet the military’s standards are more likely to get injured (putting their whole squad at risk) than men? Such vulnerability would call for a blanket exclusion of women from certain parts of the military (though there are many support roles, like military doctors, where they perform admirably.)

I have a gut dislike of sweeping “policies;” they tend to lack flexibility. I tend to think it would be better to let individual officers of appropriate rank decide if the particular trans people serving under them are doing a good job than have a sweeping rule that automatically kicks everyone out or demands that everyone be let in.

And before I say anything sweeping, I want a study of squad cohesion and effectiveness. I’ll let you know if I find one.


Final note: I am not a military expert and don’t normally write about the military, so forgive me if I’ve mixed up some of the terms.

So Cultural Marxism is just a “Conspiracy Theory”

Search for “cultural Marxism” on Wikipedia, and you get redirected to “Frankfurt School Conspiracy Theory“:

‘Cultural Marxism’ in modern political parlance refers to a conspiracy theory which sees the Frankfurt School as part of a movement to take over and destroy Western society.[52][53][54][55]

To clear things up, here’s some Cultural Marxism in action:

 Heterosexualism and the Colonial / Modern Gender System, by Maria Lugones, published by Hypatia Press https://muse.jhu.edu/article/206329



In 1933, the Soviet government, under the leadership of Joseph Stalin, recriminalised homosexual activity with punishments of up to five years’ hard labor. …

During the Soviet regime, Western observers believed that between 800 and 1,000 men were imprisoned each year under Article 121.[14] The precise reason for the new law is still in some dispute.[citation needed] … Whatever the precise reason, homosexuality remained a serious criminal offense until it was repealed in 1993.[16]

In the People’s Republic of China:

Even as late as the early 1980s, there were some Chinese men seeking asylum in other countries reported that they had faced systematic discrimination and harassment from the government because of their sexual orientation as well as similar mistreatment from family members [1]. Likewise, the Chinese government did treat homosexuality as a disease and subjected gay men to electric shock therapy and other attempts to change their sexual orientation [34]

And Palestine:

Lesbian, gay, bisexual, transgender (LGBT) rights in the Palestinian territories are often spoken of in the geopolitical and cultural context of the ongoing Israeli-Palestinian conflict. It remains one of the most taboo human rights issues in the region. Homosexuality is illegal in the Gaza Strip but not in the West Bank, although LGBT rights are not protected in either. …

Gay Palestinians frequently seek refuge in Israel fearing for their lives, especially fearing death from members of their own families.[7] “According to lawyer Shaul Gannon, from the Israeli LGBT organisation Aguda, around 2,000 homosexuals from the Palestinian territories live in Tel Aviv at any one time.”[5]

Oh, I guess I have a few more:


Nelson Mandela and Fidel Castro
Nelson Mandela and Fidel Castro


But sure, Cultural Marxism isn’t real. Nothing to see; move it along.

What are TERFs?

TERF stands for Trans Exclusionary Radical Feminist–feminists who don’t like trans people.


Well, you know how radical feminists have a reputation for being man-hating Nazis?

That’s basically true, except for the Nazi part. Radical feminists don’t like men all that much and don’t want men at their events or in their conversations.

The three abstracts in this post hail from real, peer-reviewed, academic "papers." H/T @RealPeerReview
The three abstracts in this post hail from real, peer-reviewed, academic “papers.” H/T @RealPeerReview

Radfems believe that “gender is a social construct,” by which they mean that the oppressive, patriarchal society made up this idea of “femininity” and then “socialized” young, biologically female people into believing it. (Society also made up the idea of “masculinity” and “socialized” biological males into believing it.) In essence, they think society is gaslighting people into believing that there are personality differences between men and women, with the result that men are taught to be aggressive, rapey assholes, and women are taught to be demure, doormat victims.

I... I am sorry this exists
I… I am sorry this exists

To radfems, “women” have two things in common: their physical bodies and their oppression by men, and their primary focus is on liberating their physical bodies from male control, as manifest in things like abortion restrictions, rape, body shaming, marriage, or any claim that males and females are different in any way besides anatomy.

So what about trans people?

From the TERFs’ POV, most trans people are either oppressive, patriarchal men pretending to be women, or women who think there’s something wrong with being female and so are trying to become patriarchal oppressors. TERFs don’t want men or wannabe men in their spaces. They don’t want to explain, yet again, that you can never understand what it is like to be female because you were not socialized as a child into believing that “femininity” exists and you were never oppressed by society for being female. Male-to-female transsexuals don’t menstruate, can’t get raped, can’t get pregnant, and can’t be denied an abortion. You cannot become “female gendered” because “female gender” is just a thing society made up to oppress women, and buying into it is only going to further oppress women.

The whole idea of being trans doesn’t make sense within a radical feminist framework. There is no reason at all why you can’t just be an “effeminate” person who is biologically male or a “masculine” person who is biologically female–the only reason you think you can’t is because society lied to you and told you that you can’t.

ctosyoiwcacm9dtEven if you are sympathetic to trans people, it remains a fact that women-who-are-biologically-women have different practical concerns than they do. Trans folks have very specific concerns about discrimination, anti-trans violence (especially incarcerated trans people), related medical conditions, and of course hormonal therapies and surgery. (There is of course some overlap–trans people can get raped and some can get pregnant, for example.)

TERFs believe that when trans people enter their spaces, trans issues, instead of women’s issues, begin to dominate the discussion, and the women who originally created these spaces in order to escape male oppression are yet again being oppressed by men. EG: Why we Must Stop Calling Menstruation “A Women’s Issue”:

Ame: People can be more inclusive of trans people who also experience menstruation by talking about the topic in a non-gendered way. Realising that bodies and body parts are not gendered would help to normalise the idea that you do not have to be a woman in order to menstruate, and also that not all women are capable of menstruating. A simple change in language, such as saying “people who menstruate” rather than “women” goes a long way in terms of having inclusive discussions, rather than discussions which isolate certain subgroups of people.

Sapphire: Stop the whole “lady parts” cis feminist discourse.

Teddy: I think better education, and more accessible resources online is going to be the way forward; I think magazines aimed at “men” and “women” should make people aware of health conditions that affect all body types, about health issues in general, and how to deal with them. There would likely be some pushback, but removing strict gendering of health issues is important.

Yes, Men’s Health and Maxim should totally start running articles about male menstruation, and Cosmo can run articles about the importance of getting your prostate checked–I’m sure that’ll send their sales through the roof!

As far as TERFs are concerned, trans people are free to have their own discussions in their own spaces, but they are not having a conversation about how “men menstruate too.”

Note that I have no dog in this fight, as I am neither a radical feminist nor trans. I think radfems are basically wrong–“gender” is primarily a manifestation of genetic differences between men and women–and that most trans folk I’ve met have an actual medical intersex condition. However, I think most trans people would be better off if they believed the radical feminists and declared to themselves that it’s fine to like things culture has traditionally deemed appropriate to the opposite sex instead of going through all the trouble of transition.

Transsexuals Prove That Gender is Real

Don’t stop me if you’ve heard this one: Sex is biological; gender is a social construct.

Well, you should know my response by now: Sex is also a social construct.

X is a social construct does not mean “X is totally made up.” It means, “The word is defined however the hell people feel like using it.” This is true of all language.

200 years ago, people did not define “biological sex” as “has XX or XY chromosomes,” because no one knew about chromosomes, and yet they still had this concept of “biological sex.” For that matter, if you get right down to the nitty gritty of how “biological sex” develops in the fetus/young person, it is not just a matter of “Do you have a Y chromosome?” Biological sex does not work the same for all species, (eg, for crocodiles, the egg’s temperature determines whether the baby inside develops as male or female,) but even within humans, the process is complicated.

Diseases or medical conditions are the easiest way to highlight all the things that come together to determine one’s “biological sex”:

Klinefelter Syndrome: person is born XXY instead of XX or XY. People with KS have tiny genitals. The Y chromosome triggers male development, but the two Xs cause an over-production of female hormones. Most people with KS are infertile. KS occurs in 1:500 to 1:1000 live male births.

Given about 150 million men in the US, that comes out to between 300,000 and 150,000 Americans with Klinefelter Syndrome.

Some other obscure conditions with similar names are XYY, XXXX, and XXYY Syndrome. People with only one X chromosome and nothing else have Turner Syndrome. TS affects about 1 in 2000 to 1 in 5000 females, or about 75,ooo to 30,000 Americans.

Congenital adrenal hyperplasia “are any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands (steroidogenesis).


The Wikipedia  recounts the potential first historical description of a CAH case:


“De Crecchio then described the internal organs, which included a normal vagina, uterus, tubes, and ovaries. … He interviewed many people and satisfied himself that Joseph Marzo “conducted himself within the sexual area exclusively as a male”, even to the point of contracting the “French disease” on two occasions. “

CAH apparently varies in incidence; among the American Indians, 1 in 280; among whites, 1 in 15,000. Given 245.5 million whites and 3 million Indians, that works out to about 27,000 in those two groups. (Wikipedia doesn’t give numbers for blacks or Hispanics.)

Androgen insensitivity syndrome “is a condition that results in the partial or complete inability of the cell to respond to androgens. The unresponsiveness of the cell to the presence of androgenic hormones can impair or prevent the masculinization of male genitalia in the developing fetus, as well as the development of male secondary sexual characteristics at puberty, … these individuals range from a normal male habitus with mild spermatogenic defect or reduced secondary terminal hair, to a full female habitus, despite the presence of a Y-chromosome.”

The people in this picture have XY chromosomes, but developed as females because they have have AIS or related conditions:


The exact incidence is unknown, especially since XX carriers are basically unaffected by the condition, but Wikipedia lists estimates between 1 in 20,400 XY births and one in 130,000, or between about 7,000 and 1,000 affected Americans.

Kallman Syndrome isn’t so much an “intersex” disorder as an “asex” disorder. Kallmann syndrome is a genetic disorder in which, “the hypothalamic neurons that are responsible for releasing gonadotropin-releasing hormone (GnRH neurons) fail to migrate into the hypothalamus during embryonic development.”

The most prominent symptom is a failure to start puberty; oddly, one of the other common symptoms is an inability to smell. It affects both men and women.

Incidence: about 1 in 10,000, or about 32,000 Americans.

True hermaphrodites” are rare, but do exist–perhaps due to improper cell division in developing fraternal twins. See also “human chimeras“:

“The Dutch sprinter Foekje Dillema was expelled from the 1950 national team after she refused a mandatory sex test in July 1950; later investigations revealed a Y-chromosome in her body cells, and the analysis showed that she probably was a 46,XX/46,XY mosaic female. …

“Another report of a human chimera was published in 1998, where a male human had some partially developed female organs due to chimerism. He had been conceived by in-vitro fertilization.

“In 2002, Lydia Fairchild was denied public assistance in Washington state when DNA evidence showed that she was not related to her children. A lawyer for the prosecution heard of a human chimera in New England, Karen Keegan, and suggested the possibility to the defense, who were able to show that Fairchild, too, was a chimera with two sets of DNA.”

And as I have mentioned before, people exposed to Diethylstilbestrol–DES–a synthetic estrogen used as an anti-miscarriage drug between 1940 and 1971, (when they realized its major epigenetic effects included cancer,) seems to have triggered female brain development in male fetuses.

“An estimated 3 million pregnant women in the USA were prescribed DES from 1941 through 1971. … The number of persons exposed to DES during pregnancy or in utero during 1940–1971 is unknown, but may be as high as 2 million in the United States.” Or about 1 million men.

There are others, but I will stop here. It is difficult to give a total for such conditions, but folks estimate incidence of intersex conditions around 1.7% of births, or 5.4 million Americans. (By contrast, identical twins occur in only 0.3% of pregnancies.)

As I have mentioned before, I strongly suspect that the vast majority of “trans” people actually have some form of intersex condition–I base this suspicion on the lives of the trans  people I’ve actually talked to. According to LiveScience, about 700,000 Americans, or 0.2%, are trans–significantly less than the estimated number of people with intersex conditions.

Even though 98.3% of us probably don’t have any kind of intersex (or asex) condition, 5.4 million is a lot of people. In a country where we like to put weirdos on TV so we can laugh and point at them, really obscure conditions can become quite well-known. Like octuplets.

Whether you want to call them “male,” “female,” “intersex,” or something else all has to do with your particular definition of “biological sex.” If you’d lived in 1800, your definition of “biological sex” would probably have something to do with genitals and maybe something to do with behavior, but certainly nothing to do with chromosomes or hormones or anything like that. Ten minutes ago, you probably defined “biological sex” as “has XX or XY chromosomes.” Now you’re probably wondering what the hell is up with crocodiles.

None of this changes reality. Reality doesn’t care what you call it.


On to Gender!

What does it mean when people say, “Gender is a social construct”?

I’m pretty sure the technical answer is, “Gender is the set of behaviors and social roles and things that people expect out of people based on their biological sex, and those expectations vary by society, ie, people in Uganda expect different things out of ‘men’ and ‘women’ than people in Japan. Heck, some societies even have ‘third genders’ and things like that.”

However, most of the time when people say, “Gender is a social construct,” what they actually mean is, “People don’t actually have gender; gender roles are a mass delusion created by the Patriarchy to oppress women that we are taught to hallucinate as little kids.”

Unfortunately, the belief that children are blank gender slates is not only common among many academics and feminists, but was a thing people really believed–leading to the surgical “correction” of intersex children born with incorrect genitalia, followed by attempts at raising them as whatever gender the parents picked. They usually picked female, because it is much easier to lop a bit off than to add on.

Imagine, for a moment, that you born with a small penis, so your parents just decided to have it chopped off, turned the nub into a clitoris, stuck a dress on you, and called you a girl.

No, it doesn’t work.

I don’t have any statistics, but I have read a lot of stories along the lines of, “My parents lied to me all my life that I was a girl and it turned out I was a boy and it was horribly traumatic and I was suicidal for most of puberty, etc., etc.”

Gender is a real thing, and even intersex kids can figure it out.

If the feminist “You learn gender roles from the patriarchical society around you” school of thought were correct, these kids would turn out completely normal members of the gender assigned to them and not have any issues at all.

If gender is a real thing, then trying to raise a kid as the opposite gender should result in exactly what we see: The kids are miserable, and then they assert that they are the gender they were born as.


But what about trans people who don’t have any kind of intersex condition? Given 7 billion people in the world, there are probably some. Again, if gender were nothing more than arbitrary social roles determined by our dumb patriarchical society, why would anyone bother changing their “sex” to match their “gender”? Remember that SRS is very expensive, painful, time consuming, and incurs significant social stigma. If I can just say, “hey, all this business with handbags and football is totally arbitrary; I’m just going to re-define football as a thing “women” like and handbags as something “men” like,”–which is exactly what the feminist theory of gender claims you can do–then why wouldn’t trans people just do that, and save themselves all of the effort?

Because trans people understand that gender is a real thing, not just a made up thing that they can re-define because it happens to suit them.

“But wait,” I hear you saying, “trans people are actually just autogynophiliacs, and so that’s why they transition, not because they’re actually trans.”

To be honest, I consider this a weird story. For starters, half the trans people I know started as “female”, not male. Second, almost all of the trans people I know have really obvious intersex conditions. Third, most people into LGBTQ etc. sorts of things will NOT SHUT UP about their sexual interests. If these people had weird self-fetishes, they’d be talking about it all over the damn place. Like furries. Remember furries? No one was ever confused about furries’ sexual interests.

Now, could some trans people be autogynophiliacs? Sure. There are 700,000 of them in the country. That’s a lot of people. Some of ’em are probably into all kinds of weird things.

But there are about 1 million men who were exposed to DES in the womb. So DES sounds like a more likely cause of biological men who “feel female” than weird sexual fetishes.

However, I am willing to grant a chicken and egg potential: once a “man” starts believing that he really is a woman trapped in a man’s body, then he will of course begin thinking about himself as female, and want other people to treat him as female, and even fantasize about being treated like a normal female, being found attractive as a normal female, etc.

That is, I suspect the autogynophiliac hypothesis has the causation backwards. Believing that one is a female trapped in a man’s body leads to imagining oneself as female, not the other way around. The same probably holds true for trans folks in “female” bodies who decide that they are really men–they desire to be seen as attractive, too.

(I will note that a fair number of people with intersex conditions are asexual.)

Now, does that mean that Jenner or any other high-profile celebrity trans person is actually intersex and not just a weird attention whore? I have no clue, but if Jenner wants to be female, I don’t care.

But I don’t consider Jenner “brave” or “pioneering” or anything like that. Jenner has millions of dollars and a media three-ring circus to praise her every move. Meanwhile, I know people with actual, diagnosed chromosomal abnormalities who live in poverty because their families don’t believe in fucking genetics.


But anyway, why does this whole “Sex != Gender” thing get hauled out every time people start trying to explain transsexuals?

Eh, it’s because they’re gender non-conforming weirdos and so for a long time, the only people who would accept them were other gender non-conformists like radical feminists and gay people, and this whole “gender is a social construct” business has been the dominant catch-phrase of feminists out to re-define femininity for a long time. And I’m sure that for some trans people, it has given them some peace of mind to think that it’s okay, they can redefine gender how they want to include people like themselves.

But that doesn’t change the fact that the reality of gender is what trans people are actually seeking.

Transsexuals are not your enemies

I know this is a sign that I am incredibly dumb, but I am always vaguely surprised by neoreactionaries/Dark Enlightenment types who claim to understand human genetics but are openly hostile to transsexuals, transgender, and otherwise trans- folks.

Look, guys. Every trans person I have met has something medically wrong with them–some sort of genetic or hormonal condition interfering with the production/development of normal sex hormones/characteristics. Don’t get distracted by the “gender is a social construct,” nonsense–it’s totally irrelevant. (More on that later.)

So you now how boys are genetically XY, and girls are XY? I have met trans people who are literally XXY. Like Down’s Syndrome, only your genitalia don’t quite develop right due to your body trying to produce male genitalia with way too many female hormones.

Another condition that appears to affect quite a large % of trans people is exposure to massive levels of artificial sex hormones while still in the womb, due to certain medications pregnant women have taken.

Diethylstilbestrol, (or DES,)  is a synthetic nonsteroidal estrogen, synthesized way back in 1938. Between 1940 and 1971, DES was given in large quantities to pregnant women to prevent miscarriages. Unfortunately, it turns out that pumping babies full of unnaturally high levels of estrogen might be bad for them–DES was discontinued as a medication for pregnant women because it gave their daughters cancer, and the sons appear to have high rates of trans and intersex conditions, which is exactly what you’d expect.

And then there are the people I have met whose health histories I am not privy to, but who quite obviously have something hormonal going on–girls who grow up and sprout beards, for example.

Alas, I don’t have data on what is going on with 100% of trans people, but from everything I’ve seen, it looks like we’re really just talking about a few people with rare medical conditions, prenatal hormonal or toxin exposure, etc., not weirdo degenerates who are trying to destroy civilization.

In fact, every trans person I’ve ever met just wanted to live their life without being harassed and be a contributing member of society, like almost everyone else I know.


In a nation with 320 million people, and a world with even more,  and the technology to find people with <1/million conditions and put them on TV or find each other on an online forum, it is easy to overestimate the commonness of extremely rare conditions. (Homosexuality comes immediately to mind–gay folks number around 3% of the country, but IIRC, people estimate that about 30% of people are gay.)

Trans people are an even smaller % of the population–even on LGBTetc forums, they complain about being left out and forgotten–because there are just so few of them. 0.3% of the population to be exact, according to Wikipedia. (This number seems consistent with “caused by a variety of rare medical conditions.”)

There are more prisoners in this country than trans people, but I don’t hear people complaining that a convicted criminal might use a public bathroom while they’re in there, even though criminals are way more likely to rape, assault, or kill you than some “chick with a beard.”

So even if I can’t convince you not to hate them, remember that trans people are such a tiny % of the overall population that worrying about them is a total waste of your time.



But what about all of this business about gender being a social construct?

Look, people throw around a lot of words without knowing what they really mean. Trans people are really the embodiment of the opposite of this principle. If gender were just a social construct, a woman with a beard could just say, “Well, society is wrong to say that beards are a man-thing; I’m going to declare that beards are a woman thing, too!” instead of feeling like there was something really wrong with her. Trans people would not bother with sex-reassignment-surgery (which is expensive, painful, and a pain in the butt;) they would just declare themselves to be whatever they want.

In fact, experiments have been done in which babies with indeterminate genitalia were just assigned a gender, surgically altered, (usually to female, because it is easier to subtract from working tissue than to add to it,) and then raised as their assigned gender, on the assumption that since gender is just a social construct, you can do this.

These experiments went badly. A lot of these kids grew up confused, hit puberty, and realized that they were in fact not the gender they’d been raised as (and that their parents had removed a good chunk of their genitalia.) Gender, in short, has so far resisted our best efforts to make it malleable.


In  short, trans people aren’t your enemies. They just want to pee in peace.