The Science
Dr. William Powers has a great v6 (soon v7) presentation about transgender treatment options. https://www.youtube.com/watch?v=fefu33e8O-0
One of his slides lists various “causes” for transgenderism. The autism/science part of my brain really enjoys this type of thing, but I’m sure for many people they might imagine being trans is more “touchy / feely” than “sciencey”.
Regardless, let’s dive into the science end of it first:
- DES Exposure: https://www.cancer.org/cancer/cancer-causes/medical-treatments/des-exposure.html
- Congenital Adrenal Hyperplasia: https://www.yourhormones.info/endocrine-conditions/congenital-adrenal-hyperplasia/#:~:text=Congenital%20adrenal%20hyperplasia%20is%20an%20inherited%20condition%20caused%20by%20mutations,produced%20by%20the%20adrenal%20glands.
- Aromatase Excess (or deficiency): https://en.wikipedia.org/wiki/Aromatase_excess_syndrome#:~:text=Aromatase%20excess%20syndrome%20(AES%20or,of%20circulating%20estrogens%20and%2C%20accordingly%2C
- Klinefelter Syndrome XXY: https://www.mayoclinic.org/diseases-conditions/klinefelter-syndrome/symptoms-causes/syc-20353949
- De La Chapelle Syndrome (XX, male phenotype, +SRY): https://en.wikipedia.org/wiki/XX_male_syndrome#:~:text=XX%20male%20syndrome%2C%20also%20known,that%20can%20vary%20among%20cases.
- PCOS: https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20is,fail%20to%20regularly%20release%20eggs.
- Androgen Insensitivity Syndrome: https://en.wikipedia.org/wiki/Androgen_insensitivity_syndrome
- Exposure to Prenatal Estrogen/Androgens: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350266/
- Psychological disorders (ASD/Others): https://www.sciencedirect.com/science/article/pii/S1750946719301540
- Endocrine receptor sensitivity variance (CAG repeat): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012646/
- Neuroanatomical structure variants: https://www.nature.com/articles/s41598-017-17352-8
If you’re even asking the question about whether or not you are transgender, there’s a good chance you might be, or are at least outside the normal cis gender spectrum. Does anything in the list above resonate with you? In my family transgender touches multiple generations on my mother’s side along with other overlapping conditions.
As an example, I am ASD/ADHD (Autism Spectrum Disorder / Attention Deficit Hyperactivity Disorder). There is also a mention by Dr. Powers in his presentation about overrepresentation of a 3rd nipple in transgender patients… I can find no further information about this pattern; however, I also have a 3rd nipple.
That said, I do not strongly identify as a man or a woman; but, my brain operates much better on Estradiol (reduced ASD symptoms, reduced depression), which is a transgender pattern. There are things I like about being masculine and things I like about being feminine, but I have no desire to be 100% of either and feel most comfortable as androgynous.
My trans sister was exposed to birth control during fetal development and she strongly identifies as a woman. I don’t think that’s a coincidence.
Schizophrenia also presents in 3 generations on my Mother’s side of the family. With multiple overlaps of correlative conditions, it’s not surprising that transgender also presents.
The Experience
Cool, but despite the scientific correlation, it’s not like everyone with one or more known conditions is transgender, so how can you know?
I did not and still do not feel gender dysphoria – I do strongly feel depersonalization though. This article on Medium.com really spoke to me; matching perhaps 70% of the first hand experiences presented:
Depersonalization in gender dysphoria: widespread and widely unrecognized:
This article is also interesting and may be helpful:
5 Things to Know about Transgender Depersonalization:
https://medium.com/@zinniajones/5-things-to-know-about-transgender-depersonalization-8d0e27d29947
What I find fascinating is that although I overlap on science and depersonalization, I do not have gender dysphoria; yet my trans sister has very strong gender dysphoria and has never struggled with depersonalization like I have. My depersonalization is so severe that I don’t even feel human or like I exist in my body. I often don’t even relate to this planet or timeline very well, and have trouble thinking within a frame of time. Clearly everyone has a different experience.
Some people may not feel depersonalization and may not overlap any of the known correlative conditions of transgenderism – that’s fine and it’s still perfectly valid. Searching the internet you’ll easily find other anecdotal signs of being transgender:
- Wearing opposite gender clothing
- Wishing to be a different gender
- Wanting to be a different gender a child
- Feelings of wanting to be a different gender that escalate during puberty as your body changes
- Depression or depersonalization symptoms that increase as you present less like the gender you’d prefer
- Feeling like you’re not who you’re supposed to be
- Feeling like you don’t like yourself and not being sure why
For many people in the trans spectrum they may feel cis, then non binary, then transgender, or cis then transgender then non binary. There is no right answer and we all change as people over time as part of our life journey.
The reality is that many if not most people don’t identify more specifically when it comes to gender, simply due to a lack of questioning. You can think of it like religion: if you are raised a particular religion and you grow up and still practice it, it doesn’t necessarily mean a lot to you personally… just that it’s what you’ve known and it works fine for your lifestyle and values.
For most people being cis gender works fine and it’s what they know. I suspect many people if they thought hard about it, would land within a gradient. Everyone has some amount of estrogen and testosterone flowing through them and both are needed to function well. As a society we tend to gender things that are not really gendered… clothing, colors, occupations, etc. but the reality is that people and gender are gradients and widely diverse.
I’m certain some things have been overlooked, so feel free to post your own thoughts or experiences in the comments to continue updating this article to be useful to others.