through-a-scanner-glitteringly

So on Gliske again, came across reviewer comments. Two named, not sure which. I believe first must be Ivanka Savic, she was mostly critical – though not for the eugenics or misgendering – but for not claiming credit of ideas she considers hers. From what I can see she has published a lot of interesting things, including re: how HRT improves sense of body ownership and changes sexed perception of scent. I sort of want to work with her, though I heard from people nearer she is somewhat of a nasty person to collaborate with. These comments if hers would paint a similar picture, less a bigot, more an uncaring asshole. Her papers have not been as bad terminology-wise.

One reviewer, apparently anonymous, is a sexologist, not neuro. They (I suspect he) explicitly asked for the Blanchardianism, claims young transitioners have no body issues (then again, not as sexed bodies then), and that aversion therapy hasn’t been properly tried yet, implying they would like for it to. Claiming it has not because Zucker disputes he has done so. Reviewers overall more accepting than I would like. Then again, this is what happens when we get to suggest reviewers. This is why we do so.

I no longer think this is a side project for Gliske, he spent grant funds to have the time to do it. In initial version there was apparently a lot of reference – removed by reviewer request – to sleep disturbances, which he has worked more on. He claimed based on too little data for reviewers to like it that this would be part of trans pathology. Parents, don’t let your children stay up all night, they might be transed!

But what mostly have me commenting, to get it out of my head, is in reviewer response he gets again onto the concept of gender being encoded as “same” or “different”. I agree on the level that the core gender-constructing brain response is a universal capacity to classify perceived bodies as same or other in sense of sex, which wired one way or the other leads to decisions on desire and competition and model learning. But the way he seems to imply a model for it, he perceives trans modality as wanting to be the bodies one classifies as “other” whereas cis modality is wanting to be the bodies one classifies as “same”. This model evokes body dysmorphia, plastic surgery addiction, continually searching for something new to transform into. It would predict that transition can never be enough, that full body medical and full life social transition would just give a new intolerable state one must escape into something else. This toxic idea, of course, was one of those I worried over, that kept me questioning myself.

Can it hold? It would predict that transition cannot enduringly reduce dysphoria, unless it indirectly leads to a change in the brain so that it comes to 1) wants now to instead embody sameness, not otherness, and 2) self-perception is that one has the gender one transitioned as, or rather, reacts with “same” to oneself. Alternately, one still sees ones self as “opposite”, and continues to crave “opposite”. End result same, only in the latter such idea, our genders would somehow be something qualitatively different than cis people’s genders. It is convoluted that one would continue to regard one’s own body as “opposite” once it has stabilized, and assuming then some virtual AGAB identification one happily feels one’s body is opposite to, also feels convoluted. And dysphoria-inducing, as any other scenario that implies there is some essential true identity as my gender that I could never attain.

Transition is complex though. I keep talking of the synergy between medical, social and internal transition. By internal, I mean the alterations in how one perceives oneself and others, how one reacts, how one feels. Some such are spontaneous, some require effort; transition involves making that effort. Moreover, there are mixtures of worries and memories and insecurities, euphoria and dysphoria and problematic validation, doubt, fears of illegitimacy, and the eventual rise of a new, more relaxed normality. In the end it is important I think for me to recognize I am legitimate by virtue of my subjectivity and agency alone, even had I had not been able to reference anything external.

My simpler same-different model echoes how we classify others as same-sex or different-sex. Additionally, I postulate, we do so to ourselves. Cis people inhabit bodies and lives which they classify spontaneously as same-sex as themselves. Trans people the opposite. Transitioning changes that, but beyond ourselves, does not alter who feels “same” or “opposite” with regards to sex, nor (mostly) how we feel about that. By changing what sex we can see ourselves as, we can go from seeing ourselves as paradoxes, mismatches, to simply normal. This reduces distress, reduces sense of lack of body ownership, and makes us eventually less preoccupied with gender. There probably are direct dysphoria reactions from various aspects of HRT itself acting on the brain, but the changes to our bodies are crucial also, something Gliske appears not to realize. Knowing others can see me as a woman makes me comfortable being seen. This is also why some dysphoria reduction can be achieved already by presentation and social transition alone, which again is not fully recognized by this “model”.

I followed up references made to a 2019 Savic paper where her team put 15 cishetero men and 15 cishetero women in a brain scanner and systematically showed them their own body, that of same and opposite sex others, and morphs between them, assing perception of “me/not-me” by self-declaration and imaging data. This is in principle highly relevant. They show own-body perception to involve mostly same brain regions in these men and women; Gliske references this in support for his same-other brain classifier dichotomy but of course it fits equally well with mine. There are other parts of the paper (Burke et al., 2019: Sex differences in own and other body perception [ https://onlinelibrary.wiley.com/doi/full/10.1002/hbm.24388 ] ) that are interesting; seeming congruent with somewhat (N = 15+15, brain imaging statistics caveats, presumably overlapping distributions) greater salience of own body for women, others’ bodies for men, more possible inspect-for-partner vs inspect-for-rivalry in men, etc. The descriptions the paper makes of women sounds like trans girls honestly – own body critical and focused, identifying other women also as self, etc. But tiny, who knows what can be reproduced and then hardly absolute.

It would be a literature of interest to look into but it also severely scare me, because what if brain imaging gets better and more robust so that it would become emergent that trans women (or just me, the awful impostor…) did not react the way I think we do in terms of perception and response, but like twisted versions of our AGABs. Important to remember then – the subjectivity is what matters in this case, brains are plastic and might not locate functions uniformly, HRT has already been shown to change brain functional connectivity. The latter also supported indirectly by another paper I randomly came across – placing CAIS XY women in brain scanners yield the same responses as for cis XX women when shown nudes, compared to cis XY men. So whatever is there in such activation at least is not chromosomal. It may reflect some organizational effects, not just activational, but over time, who knows what we can become?

And as noted, the real crucial insight is – my agency and my feelings, however they arose, however they are implemented, are what matters for me. I believe strongly my brain has differences from that of a cis man, but whether it does or not, I am changing over time into someone I am much happier being, and my life as a result is better. I will that life into reality, no matter what stands against me.

quack tales

I usually don’t comment publically on new papers outside my main field but have to in this case. This is because Gliske (2019): “A new theory of gender dysphoria incorporating the distress, social behavioral, and body-ownership networks” manages to combine a lot of useful literature (I have to reread it in preparation for future planned work) and make the 180 degree wrong conclusion, in a way clearly motivated by a desire of the author for there not to be trans people.

In absolute brevity this is a literature review summarizing how sparse imaging data indicates trans people are atypical with regards to brain networks linked to the main components of clinical dysphoria: 1) distress, 2) (reduced) sense of body ownership, and 3) perception/awareness of socially gendered behaviour. The author’s hypothesis is that this atypicality causes dysphoria, and consequently suggests treating the brain networks directly could “cure” it, going so far as to urge for ceasing to carry out currently accepted standard affirming care.

The author acknowledges as possible, but never engages with, the far more immediate interpretation that a sense of gender incongruency causes 1) distress, 2) (reduced) sense of body ownership, and 3) (intense) perception/awareness of socially gendered behaviour, reflected over a lifetime in these networks. The author even cites how treatment, including hormone treatment, both alleviates these symptoms and reduces (to the extent it is studied) the signal from these networks. If they were causal, why would transitioning reduce these symptoms? Why would they not remain equally in play with instead good congruence with the target gender?

His (single author, who here can be assumed to be a cis man) only real response to this is the suggestion that both transfeminine and transmasculine HRT increases effective estrogen impact on the brain, and that it simply is that estrogen “cures” this network damage, whether supplied in circulation (in trans women) or through aromatization (in trans men). But if the circulating levels trans women on HRT receive are sufficient to do so, then why would not the same levels do so in pre-HRT trans men? One can construct scenarios but all in all this seems highly to overcomplicate.

The author even gets close to pet theories of mine that both gender and orientation are keyed off assessment of others as “same” vs “different”, but goes off into a speculative Blanchardian rant rather than to explore how own-body-as-“different” would make ample sense as a source of the brain signatures he has just summarized. Discussion on vasopressin receptors as underlying this “same” vs “different” response in sexual orientation is interesting and I must follow that literaure more, but I don’t think it will lead near the conclusions the author wants to draw.

Again, he is arguing to “fix the brain of trans people” and to stop promoting gender affirming care. He does this based a summary of what is known of the neural correlates of dysphoria, but clings to an interpretation of those correlates as causes rather than effects. This is contrasted against a strawman of “male/female brain” theory, with ideas of a subtler network for gender identity glossed over – but if we wanted to find something like that, we should look at that which determines whether a male/female body/person is interpreted as same/different than oneself, which would not be there on the level of large structures, but on connections between other parts which might otherwise look identical between men and women because they are equally used in both, only in different direction.

I am not opposed to studies into this field at all. This paper was useful to me in terms of sources also. But a quack summarizing literature, deciding symptoms must be causes, then advocating and hoping for medical conversion therapy because he does not want there to be people transitioning, is not good science at all.