On Crossdreamers 2

Crossdreamer Sidebars is a support blog for Crossdreamers.com, a blog devoted to crossdreamer and transgender issues.

Thursday, April 2, 2015

On Anne Vitale's theory on testosterone-poisoning in MTF crossdreamers

Sidebar to the Crossdreamers.com blog post "Does the effects of hormones on transgender prove that crossdreaming has a biological component?"
Anne Vitale presents a theory aimed at explaining dysphoria
in MTF crossdressers and crossdreamers.
Illustration: Jupiterimages


One of the leading experts on crossdreamers  is Dr. Anne Vitale. She is herself a transsexual woman, and has helped a large number of transgender patients, from those who identify fully with their target sex and want to transition (transsexuals), to non-transsexual crossdressers.

She has written one of the best books on transgender conditions that also covers crossdressers and crossdreamers.

I must admit she sometimes appear a bit too essentialist for my taste. She writes, for instance, that the defeminization of the brain in perinatal males experience leaves them "incapable of female behavior and sensibility," (Perinatal refers to the period around childbirth).

I find no support for the idea of a unique "female behavior and sensibility", as no temperaments, interests, abilities  or behaviors are exclusive to one gender. The sense of feeling like a man or a woman cannot be reduced to a function of the way you behave. (More about this here!)

Still, her idea about crossdreamers and male to female transsexuals being poisoned by testosterone is interesting.
Anne Vitale (from her home page)

In her book The Gendered Self, Vitale suggests that the variation we seen between transsexual and non-transsexual male to female transgender is caused by variation in the prenatal androgenization/defeminization processes, leading to different degrees of feminization of the brain, including female like hormone receptors.

In a separate note on hormones she writes:
"It is beyond dispute that there are both androgen and estrogen receptors in the brain. Genetic males normally have more active androgen receptors than women and women have more active estrogen receptors than men. That this normal distribution of estrogen and androgen receptor cells can be different in some individuals appears to be a possibility. It therefore follows that androgenic and estrogenic compounds will result in a modified-to-counter expected behavior in affected individuals. For reasons beyond the scope of this Note and as counterintuitive as it may seem, it can only be assumed that testosterone plays a crucial role in forcing certain male individuals to crossdress and experience femininity to the maximum degree possibly."

Vitale predicts that eventually we will find that as testosterone levels rise above some threshold in the daily lives of male to female crossdreamers the enzyme aromatase becomes active and temporarily converts testosterone into estradiol/estrogen. This is creating a strong desire in them to dress and live, even if only temporarily, as a woman.

She illustrates this theory with stories of MTF transgender who have "detransitioned" back to male, after having lived as women. As soon as their testosterone levels again reaches normal male levels, the desire to become a woman returns.

The idea that the body can turn testosterone into estrogen when it reaches a certain level is definitely correct. (See sidebar on MTF hormone replacement therapy) The body/mind system is supposed to be self-regulating in this respect. It is also true that this function may "fail" leading to too low or too high levels of testosterone in men.

What I find confusing, though, is that turning testosterone into estrogen in MTF crossdreamers should force them to desire to dress and live as women.

My first objection refers to what I have already mentioned above, i.e. that being a woman is reduced to some kind of side-effect of a "female" hormone. As far as I know, pumping a woman full of testosterone will not make her feel like a man (although it may make her extremely horny and even more aggressive and emotionally unstable). Nor have I seen any research that indicates that giving a man strong doses of estrogen will make him feel like a woman. This theory was popular in the early 20th century, but has since been dismissed as too simplistic.

As far as I know, most biological oriented gender researchers now agree that hormones play an important role in gender identity formation during the pre-natal phase, and later during puberty. As soon as a masculinized brain has been developed, however, adding estrogen will not change this  person's gender identity in any way. (Kerukels and Cohen-Kettenis)

Vitale provides a possible explanation for this puzzle in her note, namely that the MTF transgender crossdreamers are differently wired as regards hormone receptors in the brain. This may explain why these male bodied people (and not men in general) feel the urge to crossdress and crossdream when producing their own "overdose" of estrogen.

Still, if that is the case, this production of estrogen should have some of the same calming effect taking estrogen and antiandrogen pills has on MTF crossdreamers; it should reduce their sex drive and therefore also the more obsessive compulsive drive we find in some (but not all) crossdreamers.

This is not what is happening.

However, I admit I might be missing something here. Their own "overproduction" of estrogen may, for instance, not have the same libido-reducing effect as antiandrogens have. I suppose only the excess levels of testosterone are converted into estrogen. There may still be typical male levels of testosterone in the system,  and this may explain why the sex drive remains high. I don't know. Vitale does not say.

I must admit that I find the explanation I am given by local sexologists simpler: The distress and dissonance felt by gender dysphoric MTF crossdressers and crossdreamers is caused by some kind of mismatch between their brain hormone receptor system and the typical male levels of testosterone.

There is simply too much testosterone going around, which not only accentuates the feeling of "wrongness", but may also -- in some cases -- lead to a sex drive that makes the dysphoria obsessive.

Vitale's two type model for MTF transgender

Note also that Vitale is using her theory about testosterone-poisoned MTF crossdreamers as a basis for a three type typology of  transgender. The MTF crossdreamers constitutes Group 3 (G3), who "look and act unambiguously as society expects them to but privately identify as the opposite gender."

They are therefore a completely different category from Group 1 (G1), who "have a high degree of cross-sexed gender identity" and where the prenatal androgenization/defeminization process has been minimal, "leaving the default female identity largely intact." (Vitale 2010, p. 19. Her G2 group consists of FTM transgender. There are no FTM crossdreamers in her world.).

This is simply another variant of the traditional late onset/early onset, primary /secondary and "homosexual transsexual"/"autogynephilic transsexual" that has caused so much misinformation, confusion and suffering in the transgender community.

To sort MTF transgender into groups like these for analytical purposes may be defended, but to say this constitutes some kind of essential difference is not only politically toxic (as all G3 trans women are immediately labelled as inferior trans women), but the divide has also been debunked by other researchers (see for instance my presentation of the recent Veale-study of transgender).

I do not believe in sorting transgender people into simplistic categories based on observed "female expressions of femininity", in the way Vitale does (or Ray Blanchard does in his "autogynephilia" theory, for that matter.)

The reason for this is that the stigma attached to being male to female transgender is so big that it causes all kinds of psychological types of repression of both sexuality and gender identities, making the immediate appearance of a MTF transgender or genderqueer person an unreliable tool for diagnosis.

Most male to female crossdressers, crossdreamers or transsexuals have been conditioned to hide any sign of femininity or female identity. This is why so many of them are so traumatized in the first place.  Vitale writes extensively about this kind of repression, but falls into the trap of dividing trans women into two distinct categories, anyway, and that is unfortunate.

A final note to readers who find this sidenote via search engines: 

Even if I believe that there is a biological component to transgender conditions, crossdreaming and crossdressing included, this does not mean that such identities and experiences can be reduced to a simple biological factor only.

I believe our sense of self is the end result of a complex interplay between biological, psychological, cultural and social factors. This would also partly explain why some MTF crossdreamers are transsexual and identify completely with their target sex, while other continue to identify as men. This would also explain why only a third of MTF crossdreamers and crossdressers seem to suffer from severe gender dysphoria.

If you want to make comments to this sidebar, go to the main blog post over at Crossdreamers.com.

...................

Anne Vitale home page

Anne Vitale: "Testosterone Toxicity Implicated in Male-To-Female Transsexuals? Some thoughts." T-Note 15 2009.

Anne Vitale: The Gendered Self, Flyfisher Press, Point Reyes Station 2010.

Baudewijntje PC Kreukels and Peggy T Cohen-Kettenis: "Male Gender Identity and Masculine Behavior: the Role of Sex Hormones in Brain Development" in  Hormonal Therapy for Male Sexual Dysfunction, First Edition. Edited by Mario Maggi. © 2012 John Wiley & Sons, Ltd. Published 2012 by John Wiley & Sons, Ltd.

More references in main blog post.





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