Conversations, conformity and inner conflict...

An article in the 30 May 2016 issue of Time magazine’s European edition, on the “Battle of the bathroom – why the fight for transgender rights has moved into the most intimate of public spaces”, has brought this seemingly “USA local issue” onto the global stage.

In the USA, bills and policies are being drafted to accommodate transgender individuals and to protect their rights. While the Obama Administration is pro the enforcement of the so-called “bathroom policy”, a number of American states have instituted law suits against the implementation of these bills.


What is transgenderism?

Transgenderism is the term used for the state or condition of identifying, behaving or expressing a “gender identity” that does not match a person’s physical/biological sex.

People who experience “gender dysphoria” or who “are transgendered” have an internal experience of “gender identity” that differs from what has been considered to be the norm, namely that a person’s gender is necessarily linked to his/her biological sex (i.e. a biological female person is a woman and a biological male person is a man). Transgenderism also differs from “intersex” conditions. “Intersex” refers to a physical condition of an individual born with a reproductive or sexual anatomy that is not considered typically male or female.

Gender dysphoria/transgenderism is not the same as transvestism or cross-dressing and is not related to sexual orientation. Those who self-identify as transgender may consider themselves to be heterosexual, homosexual, bisexual, pansexual, polysexual, or asexual. In order for someone to be diagnosed with gender dysphoria, the person must present a strong and persistent cross-gender identification.

The Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, has replaced the term “gender identity disorder”, with “gender dysphoria”. The DSM-5 also distinguishes the diagnosis of gender dysphoria for children from that of adolescents and adults. The characteristics of gender dysphoria vary with age and many children with gender dysphoria outgrow it as they age, the manual notes.


Medical and scientific research

Some research suggests that there is a biological explanation for transgenderism. Psycho-biologist Antonio Guillamon, of the National Distance Education University in Madrid and neuro-psychologist Carme Junqué Plaja, of the University of Barcelona used MRI to examine the brains of 24 female-to-males and 18 male-to-females, both before and after treatment with cross-sex hormones. The results showed that even before treatment, the brain structures of the transgender people were more similar in some respects to the brains of their experienced (trans)gender than those of their biological sex. “Transgender people have brains that are different from males and females, a unique kind of brain,” Guillamon says. “It is simplistic to say that a female-to-male transgender person is a female trapped in a male body. It’s not because they have a male brain but a transsexual brain.” Of course, behaviour and experience shape brain anatomy, so it is impossible to say if these subtle differences are inborn.

Another study done in America last year suggests that being transgender has nothing to do with a hormone imbalance. Dr. Johanna Olson, of Children’s Hospital Los Angeles said that transgender youth have sex hormone levels consistent with their biological sex.


Is transgenderism a psychological condition?

There are those who feel that transgenderism can be “cured”. “At the heart of the problem is confusion over the nature of the transgendered”, says Dr Paul McHugh, former psychiatrist in chief at Johns Hopkins Hospital. ‘“’Sex change’ is biologically impossible,” he adds. “People who undergo “sex-reassignment” surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women”.

Vanderbilt University and London’s Portman Clinic kept record of children who reported transgender feelings without giving them any medical or surgical treatment.  70-80% of them spontaneously lost those feelings. Some 25% did have persisting feelings, noted Dr. McHugh, but what differentiates those individuals remains to be discerned. Despite such studies several states in America, including California, New Jersey and Massachusetts, have passed laws barring psychiatrists, from striving to restore “natural gender feelings” to a transgender minor, even though parental permission was given.

A recent statement by the American College of Paediatricians vigorously argues against encouraging young people to question their own biological sexuality, “A person’s belief that he or she is something they are not is, at best, a sign of confused thinking,” the doctors stated. “When an otherwise healthy biological boy believes he is a girl, or an otherwise healthy biological girl believes she is a boy, an objective psychological problem exists that lies in the mind not the body, and it should be treated as such.”

Many studies lean toward a biological basis for transgenderism. But given the variety of transgender people and the difference in the male and female brain, it will probably be a long time, if ever, before a doctor can do a brain scan on a child and say, “Yes, this child is ‘trans’.”


Where does this leave us as a human society?

The reality is unavoidable that certain sections of society have come to the conclusion that gender, as a descriptive indicator of roles fulfilled by males and females in society, also constitutes an independent biological or psychological indicator of human identity that is not necessarily linked to biological sex. Acceptance of this conclusion leads to the assumption that people are either assigned a so-called “gender identity” at birth or develop a particular “gender identity” over time, which may not necessarily be linked to biological sex.

Acceptance of these assumptions has translated into “lived experiences” for some members of society. These are the precious ones around whom the current debate is focussed and all of us in the human community have an obligation towards each other to approach the debate with due regard for our common humanity and human dignity.



Will we be using bathrooms according to our biological sex, going forward, or, according to the gender identified with? This will depend on the outcome of the public debate and the political/policy-making process on government level.

We will be doing a follow-up blog in the coming months on the moral and human rights perspectives in relation to this debate, to look at the factors policy-makers would need to consider in order to implement practically viable solutions to a real issue.


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