Gender: Nature or Nurture?

That is a question that many of us in the trans-community ponder, I do not think that there is a definitive answer, but we are getting closer to an answer.

Last month I wrote about an NPR program, “All Things Considered – ‘Two Families Grapple with Sons' Gender Preferences’” where two doctors took different approaches on how to raise a gender variant child. The first approach was to let the child follow their own path and the other approach was Dr. Zucker method of forcing a child to be their birth gender.

However, there are some studies that can shed some light on the debate. I was reading an article, “Mom accepts transgender Manchester tween” in the Nashua Telegraph which is about a six year old who is transgender and in the article they mention Dr. William G. Reiner,

…A 2000 Johns Hopkins Hospital study suggests that’s possible.

The study followed 27 genetically male infants who were born without p---ses [I am censoring the words so that Google does not use them for search words] and raised as girls, according to an Associated Press report. As the kids grew up, all of them displayed male characteristics and 14 insisted they were boys.

“These studies indicate that with time and age, children may well know what their gender is, regardless of any and all information and child-rearing to the contrary,” Dr. William G. Reiner, a child and adolescent psychiatrist and urologist at the Hopkins Children’s Center, told The Associated Press. “They seem to be quite capable of telling us who they are."

So I googled him and came up with an interesting article in the New York Times…

Declaring With Clarity, When Gender Is Ambiguous

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By CLAUDIA DREIFUS
Published: May 31, 2005

…
Q. How did you begin with your unusual specialty?

A. In the early 1980's, I was a urologist in central California, and this remarkable 14-year-old "girl" came to my office. "I'm a boy, not a girl," this child declared.

The child had an intersex condition. At birth, he didn't have a p---s, but rather something that appeared more like an enlarged c------s. He had a partial testicle on one side. Internally, he was half female, and he looked more female than male. Indeed, since infancy, his parents had raised him female.

Since puberty, however, that one testicle had begun producing enough male hormones to masculinize him. To all he now insisted, "You've got it wrong: I'm a boy!"
…
Until the 1950's, when an intersex child was born, they were let be. But starting in the 1950's, the general approach was to make the child into one sex or another. If it was a partially masculinized female, there was a surgical attempt to turn her into a "normal" female. Structures were created so that she could have intercourse later.

If the child was a genetic male, the question was, Will the adult p---s be large enough for sexual intercourse? The vast majority of the children with severe inadequacy of the p---s were converted to "female" surgically and then raised as girls.
…
Q. So the prescription for the intersex boys was castrate them and put them into a dress?

A. The problem was, In a large number of children, as with my first intersex patient, it never took. Gender has far more to do with other important structures than external genitals.

Q. How do you know what constitutes gender identity?

A. As part of a research study, I've personally seen and assessed 400 children with major anomalies of the genitals. Of those, approximately 100 might be called "intersex." Our findings have been many and complex. The most important is that about 60 percent of the genetic male children raised as female have retransitioned into males.

We also found that of this group there were some genetically male children, who despite genital anomalies were raised as males, and they continued to declare themselves as male.

This is very powerful, what he is saying is that gender is not a social construct but is a part of us, of who we are. If a boy who is raised as a girl with female genital can tell that they are a boy, then it is very possible that a boy can tell that he is transgender.

Q. What conclusions can you draw about the eventual sexual identity of an intersex child?

A. That you can castrate a male at birth, create a female genital structure, raise the child as a girl, and in a majority of the cases, they'll still recognize themselves as male. Now many of the children I've seen are still young. I don't know what will happen as they get older.

The larger point is that it's been a monstrous failure, this idea that you can convert a child's sex by making over the child's genitals in the sex you've chosen. This began in the 1950's, when surgeons who felt helpless when they encountered intersex children thought they were helping them with sexual reassignment. The psychologists were saying, "You can make a boy or a girl or anything you want." It wasn't true. The children often knew it.

And that is what Dr Zucker is still saying that you can force a transgender child to live their live as their birth sex and everything will come out all right.

Q. What conclusions do you draw from your study?

A. That sexual identity is individual, unique and intuitive and that the only person who really knows what it is is the person themselves. If we as physicians or scientists want to know about a person's sexual identity, we have to ask them.