Correlation is not causation

Glass-ceramic cooktop. Source: Wikipedia

Glass-ceramic cooktop. Source: Wikipedia

Let’s imagine you have one of those glass-ceramic cooktops and try to do the following experiment: you see a pot with boiling water, and a red light on display on the cooktop.

Now, which causes which? Is it the cooktop that boils the water, or is it the boiling water that makes the red light turn on?

(We’re assuming that you didn’t see anyone manipulating the controls, or filling the pot with water, etc.)

This is what scientists call the ‘correlation vs. causation’ dilemma. We see two different phenomena — boiling water and a red light — and now we have to figure out: are the two correlated? Does one cause the other?

Let’s imagine, for the sake of our thought experiment, that you have several cooktops, side-by-side, all of them with pots with boiling water, and with a red light turned on. You could successfully induce that the two things are correlated: after all, all show the red light, and all have boiling water.

But now this requires setting up a few more experiments. For example, does water boil when the red light is on? Does the red light turn on by itself when the water is boiling? This means figuring out causation.

Let’s imagine we have an additional cooktop which does not have a red light on (and no water is boiling), and a second one which does but has no pot on top of it either. So now you can experiment. first you take one of the pots with boiling water and put it on top of the cooktopwithout a red light. What happens? The red light does not turn on.

Then you let one of the pots cool down, until it is at room temperature, and put it on top of the cooktop with the red light. What happens? After a few minutes, the water starts to boil.

Eureka‘, you say, ‘I have successfully established causation: it’s the red light that causes water to boil, and not the other way round.’

Of course we all know it’s not as simple as that, but I hope that you appreciate the simple example!

Now, when we turn to psychology, sociology, anthropology, economics, and most of the studies related to human beings — as opposed to physical properties of the universe — things get far more complicated.

A nice example that I have heard on the radio is, for instance, economics. Have you noticed how economists (and politicians who read what economists publish) so often fail their predictions? Is that because of gross incompetence on the part of the economists? No — it’s because the predictions get ‘perverted’ by the market. What this means is that if economists tend to predict, for instance, that economic growth will stagnate, companies around the world will work hard to increase their production and sales (anticipating a period of zero growth), and, as a result, the economy grows! Such things happen all the time, because the system being analysed has a lot of factors and a lot of variables — it’s a very complex system, after all — but the most ‘unpredictable’ element in the system is, of course, human beings. Who can act irrationally if they wish — thus disturbing the science of economics.

When we come to studies of the mind, things get even more complicated.

Let’s take a good example, education. Through education people become more learned; that’s a well-established fact, and it can be tested successfully. So we know that the process of teaching is the cause for acquisition of learning by the students: we know the causation. However, one might wonder: are good students a result of better education — it causes them to become smarter and therefore they learn better, thus becoming good students — or have they always been inherently smarter, and therefore they become good students?

The problem here are the edge cases. In the best of educational systems, there will be always bad students. So we ought to assume that it’s not the education system itself that causes students to become ‘smarter’. There has to be something else, which is somehow innate in some students, but not in others. On the other hand, it’s not always genetics: the children of smart parents are not always smart as well. So when we see those edge cases, it’s clear that, while there is a correlation — smarter kids under a good education system will often become better students — the causation is not so clear.

In fact, a study on the inheritance of intelligence showed that the potential for intelligence seems to be passed from parents to children. A typical example: two learned parents who are very intelligent will produce offspring that have the potential to become intelligent as well. But this potential has to be triggered. What seems to happen is that once the potential is triggered, the child will, on their own, seek environments where they can fulfill that potential better. Therefore, it’s reasonable to assume that they will feel drawn to, say, universities, where they think that the environment might unleash their potential even more. And this does, indeed, happen. Interestingly enough, it helps little if the parents deliberately try to ‘coerce’ their children to ‘become smarter’, by signing them up to zillions of activities and pushing them to limits in their studies (indeed, the Japanese case shows that this leads so often to depression and suicide, for failing to accomplish the parents’ goals and desires). The effect of the parents’ education is limited to triggering the potential in their children, but, once triggered, there seems to be no benefit in going much further: the child will, on their own, seek for better environments to improve themselves. Of course the reverse is also true: a child which might have been lucky to get some good ‘intelligence genes’ will do little to unleash their potential if they are subject to child abuse and other sorts of trauma, instead of getting a proper education.

So these are cases where we can easily see where correlation leads to causation. Let’s try a few more difficult cases.

Mind vs. Brain

What is ‘mind’? If you are a positivist, the answer seems to be straightforward. We cannot have minds without brains, and all human brains (while alive and inside a host body, of course) have minds. So clearly both are correlated. Destroy the brain — kill the person — and the mind disappears. The correlation is well established.

Now what about the causation? Well, a positivist would claim that the brain develops the mind as an epiphenomenon. Epiphenomena are observable secondary occurrences that develop alongside primary occurrences. In the theory of complex systems, the expression ’emergent effect’ is also used. Typical examples are abstract concepts like ‘life’: how much complex much a system be until we classify it as being ‘alive’? As an example: viruses are not technically alive (they are only alive when reproducing), but bacteria (which are huge compared to viruses) are definitely alive. Somewhere along the two, life ’emerged’, as the system became sufficiently complex for us to classify it as ‘being alive’.

‘Mind’ is assumed to be an epiphenomenon, or emergent effect, caused by the complexity of the brain. Therefore, such theories tend to believe that insufficiently complex nervous systems do not have ‘minds’ (amoeba, for instance, are postulated not to have any minds, since they are unicellular organisms…). As nervous systems, and ultimately brains, grow in size and complexity, ‘mind’ emerges, and so-called higher cognitive abilities are an emergent result of more and more sophisticated brain structures.

If you wish to take a simpler example: what makes a ‘hamlet’ become a ‘village’, then a ‘town’, and later a ‘city’ or even a ‘metropolis’? You can look up how your country defines the rules of what is a village, what is a town, and what is a city, but, to simplify, we can say that it’s just a question of its social complexity. That requires, first and foremost, more population; that, in turn, requires more services to support the population, and a more complex form of organisation, as there are many more interpersonal relationships in a city than in a hamlet or village. So, ‘township’ (or, if you wish, ‘civilization’…) is merely an emergent property of the number of human beings living in close proximity and developing far more complex relationships. Seen from afar, a town is not much different than a hamlet: people living in homes near each other. But somehow when we have many people living together, the order of complexity of their relationships ‘produce’ new things that are not merely a sum of the parts. There is more than that.

The theory of complex systems is definitely beyond the limits of my knowledge, but suffice to say that, according to this view of the universe, there are certain concepts that ’emerge’ only if a system is sufficiently complex.

Therefore, in these cases, what such scientists would say is that ‘mind’ and ‘brain’ are correlated; a sufficiently sophisticated brain ‘produces’ — ’emerges’ — a ‘mind’, so it is its cause. The main argument for this is that if you destroy the brain, the mind ceases to exist as well, so the brain has to be the cause.

What about ‘mindless brains’, i.e. people who are clearly alive and all their bodily functions are working well, but they are in a vegetative state, with no apparent conscious mind? This poses a problem, and one has to postulate that the brain has to be working properly to ‘produce’ a mind. Again, this can be easily proven: cut some brain tissues at the right spots, and the mind vanishes, even if the person is technically still alive. So there is not merely correlation, there is causation as well.

Where things start to get tricky is when we see those cases where clearly there are many parts of the brain missing, but the person still has a mind. There was a notable case in 2007 about a French civil servant who, after a brain scan, was shown that his cranial area contained mostly water, and just a thin sheet of brain tissue. The person, however, had merely a slightly-below-average IQ, was married and had two children, and lived a happy and normal life. Since this case, many more have been reported. They are technical ‘impossibilities’ according to the prevalent brain/mind theories, because there is simply not enough brain tissue left to create sufficiently complex interrelationships to produce ‘minds’. At least not human minds.

Neuroscience introduced therefore a new term to explain such issues: ‘brain plasticity’. This is a property of the brain, as a whole, to be able to ‘re-train’ certain areas in order to compensate for the loss of others. I remember in my teens to have been taught that we are pretty much born with all neurons we’d ever need, but, at birth, they were not all yet interconnected; through education we get them to interconnect more and more, and that’s how we acquire all our skills and abilities. As we progress towards old age, more and more neurons die, but the remaining ones are still able to interconnect, often at much higher levels of complexity than before, and that’s why some people never lose any cognitive abilities until their death.

Today, we know this theory is quite wrong. The brain does grow new neurons, and even at old age, new neurons continue to pop up and replace old ones. But the brain can do even better: it can effectively transfer whole cognitive areas to different spots, if some areas get damaged. There is a lot of redundancy in the brain, and it seems to be very adept in transferring ‘knowledge’ and ‘memory’ from some places to others, in order to preserve as many cognitive abilities as possible. We should be happy because our brains are so ‘plastic’, because it explains how we are unusually good at recovering from a stroke — parts of our brain died when there was not enough blood providing them nutrients, and, for a while, we might suffer from debilitating paralysis, but, with some training — always training and education! — we will eventually recover, because the brain will use different areas to replicate the cognitive abilities that were lost.

Of course this doesn’t work always, and doesn’t work forever. Someone getting successive strokes, one after the other, in quick succession, might never give the brain a chance to ‘catch up’ with the missing bits.

But there is more. Benjamin Libet, an experimental neuroscientist, managed in the 1980s to develop an experiment which shows that there allegedly is no ‘free will’ in the brain. Rather, before we make a decision, there is an increase in the potential of the brain — it is subconsciously processing the decision on our behalf — and, at the moment of decision, what we experience consciously is just the awareness that the decision was made. Since we are not aware of that potential increase, we assume that it is what we consciously designate as ‘I’ that made that decision. Libet tried to demonstrate that it is not; the ‘I’ apparently just becomes aware that a decision has been made, but it doesn’t actually trigger the subconscious processes that lead to the decision. These happen autonomously. The Libet experiments have been repeated with many variants and are, of course, the source for intense philosophical debate.  More recent experiments, however, question (at least partially) the interpretations of Libet’s original experiment.

My point here is that it is very easy to show correlation between ‘mind’ and ‘brain’ and this is truly unquestionable. What seems to be harder to prove is causation. Does the brain cause the mind, or, by contrast, is the activity of the mind reflected somehow on the brain patterns? The answer, of course, is mostly a philosophical one, and it depends from which side of the question you’re observing the issue. If you’re a positivist, there is no question that the mind is an epiphenomenon of the brain, and that the brain ’causes’ the mind, and whatever doubts or questions there might be are merely a limitation of our measurement abilities — sooner or later we will be able to ‘prove’ what we right now can only speculate about.

The alternative hypothesis is that the mind causes patterns in the brain to be activated somehow, but such explanations always have the problem of explaining how something insubstantial like ‘mind’ — an abstract concept, after all — have the power to affect physical systems.

And a third hypothesis (known by Buddhists as ‘the Middle Way’) simply states that there is interdependent origination — a fancy philosophical term that just states that we cannot observe minds without brains, but they always happen at the same time, in dependence of each other. Evolutionarily speaking, we have brains because we need minds; we have minds because we have brains that allow minds to ‘originate’. Both things happen at the same time. And, ultimately, ‘mind’ is just an abstract concept describing cognitive processes, but ‘brain’ is also an abstract concept as well (an assembly of neurons and other cells, plus nutrient supply via blood vessels, which we, for convenience’s sake, collectively call ‘brain’).

Whatever your own philosophy might be, the point here is that when we start taking a look at minds, the whole issue of causation becomes way harder to explain than correlation. We can establish correlation relatively easily. Causation, by contrast, is much harder.

Diagnosing transexuality

Now we come to practical issues. The purpose here, for a medical doctor, is to know how to alleviate pain and suffering in a patient. For that, the doctor needs to do a diagnosis. She has to observe the symptoms and figure out their cause. When the cause is known, some sort of therapy or medication can be applied to remove the cause. Remove the cause, and the pain or suffering disappears.

That works relatively well for a considerable amount of physical diseases and even many mental diseases as well, therefore we have a reasonably high degree of confidence that such an approach works well.

When reviewing the issue of transexuality, there seem to be a few problems in establishing the cause. Why is this important? Because when a transgendered individual is unable to bear the constant suffering for much longer, they finally come to a doctor for help. And the doctor needs to understand what is at stake, so that the individual can be effectively cured of their suffering.

Now, we start here with a few assumptions. First of all, the symptoms that transgendered individuals exhibit when finally consulting a doctor are not exactly ’caused’ by transexuality itself. Rather, they come with symptoms of depression, suicidal thoughts, anxiety, compulsive-obsessive disorder, sexual dysfunction, and so forth. These are all symptoms of treatable diseases.

However, all these symptoms are strongly correlated to a single source, which is the transgendered condition. Putting it simply, the individual is not happy with the gender role they’re ‘pushed’ to act due to their physical appearance as a member of one of the genders. In lay terms, we could call this feeling of extreme unhappiness ‘gender dysphoria’.

When diseases (physical or mental) occur in dependence of each other or arise simultaneously, doctors call that comorbidity, currently a (controversial) term. It is the purpose of the doctor, based on the symptoms, to figure out which one is the ‘main’ disease that require priority treatment, and which of the symptoms are part of secondary diseases which can be dealt with at a later stage. Or, in some cases, some symptoms might simply be from secondary diseases ‘triggered’ by the primary one. Treating that one first will make the others disappear.

So when a patient goes to the doctor saying that they feel anxious or depressed, but that crossdressing definitely improves their mood, the question here is what is the chicken, and what is the egg? Is the person depressed or anxious, and crossdressing is just a coping mechanism which allows some mood improvement? If so, by curing the depression and anxiety, the urges to crossdressing might simply disappear.

Or is the individual gender dysphoric, and that’s why they feel depressed and anxious? In that case, ‘curing’ the depression/anxiety will probably provide some relief, but it will be just temporary, because the gender dysphoria will bring those symptoms back, sooner or later. Therefore, the better option is to ‘cure’ gender dysphoria first.

The problem in this case is that, although depression, anxiety, etc. are relatively easy to cure these days (they mostly require a patient willing to strictly follow a regime of medication and therapy), there is no way to cure ‘gender dysphoria’.

So the American Psychological Association developed a protocol to deal with this issue: patients suffering from ‘gender dysphoria’ and other mental diseases shall be treated by dealing with those diseases first. Then a new evaluation is made: did the gender dysphoria disappear or not? In some cases, it does. That’s the typical scenario when someone crossdresses to relieve stress and go to the doctor because they suffer from anxiety. By treating anxiety, the crossdressing urge may fade or even disappear, or, at least, if it doesn’t, it doesn’t cause any further ‘gender dysphoria’.

If ‘gender dysphoria’ persists after treating the other diseases, what next? The only (mainstream) solution to deal with it is, of course, transition.

The problem is when, after transitioning, the person still manifests symptoms of gender dysphoria. In that case, something was very likely misdiagnosed at the start! Obviously, the medical community wants to make sure they do not make any mistakes in the original diagnosis, because in most cases, full transition might be permanent, although sometimes a partial transition can be reverted (‘full’ and ‘partial’ are my own terms, of course; I’m merely thinking that a ‘full transition’ implies surgery plus hormones, which, at least in the MtF case, are not reversible to the original state; a ‘partial transition’ might not even involve hormones, much less surgery, but merely living in the preferred gender role without any physical changes, and that can usually be easily reverted).

The problem with tackling ‘concepts’ and ‘narratives’

People detransitioning, like ThirdWayTrans, are naturally very skeptic about transition as the ‘ultimate cure’ for gender dysphoria. In some of those cases, the actual condition which triggered gender dysphoria was not related to gender at all, but possibly some kind of unresolved childhood trauma. We are generally good at dealing with trauma issues, and once they are dealt with, symptoms of gender dysphoria — in those people that trauma ’caused’ gender dysphoria — will be eliminated, and therefore there is no ‘need’ for those people to actually transition. Of course it’s hardly fun to know all about that after transition, i.e. that there is actually a ‘cure’ for gender dysphoria that does not involve transition.

On the other side of the spectrum, we have activists who reject the notion that ‘gender identity’ is something that a doctor — a ‘gatekeeper’, in their jargon — is allowed to establish. They advocate for the right of every human being to establish their own gender identity, independently of the opinion of the doctors, and they claim that the only role of a doctor, in this case, is to sign paperwork for the required surgeries and hormone replacement therapy.

In countries where government actually pays for the surgeries and HRT (it’s the case of most welfare states, including mine), there is a slight issue here: we’re talking about taxpayers’ money, which is used to solve problems that affect citizens. If the government is going to pay for something, they want to make sure someone is responsible for that payment — ensuring that the public moneys have been correctly employed for the public good. That means mostly that an ‘expert’ has to give a ‘qualified opinion’. Which, in turn, means that doctors have to ultimately decide if it’s worth to spend public money to cure someone suffering from ‘gender dysphoria’ or not, by suggesting transition.

The alternative is simply to allow anyone to pay the surgeries out of their own pockets. This becomes an ideological struggle, as only rich people like Caitlyn Jenner are able to afford transition, while poor people have to continue to suffer in silence. In either case, there are two distinct issues here: one is publicly registering one’s name in the ID card/driver license according to their preferred gender (an administrative issue), the other is to get surgeries and hormone treatments (a clinical issue). The former doesn’t really require a doctor to give an ‘expert opinion’ — activists advocate for the freedom of gender identity. The latter is a bit more problematic, even when someone pays for the medical treatments out of their own pockets: doctors are always responsible for the kind of treatments they administer to their patients, and are held ethically — sometimes even judicially — responsible for what they do.

Therefore, if someone ‘decides’ to do a surgery that might impair their quality of life forever, even if they assume full responsibility, and the doctor goes ahead with the patient’s wish… only for the patient to immediately regret it afterwards, claiming that they had no idea it would be so bad, that they had been mislead due to lack of information to go ahead with the treatment, and so forth… well, what then? Who is held responsible?

These are complex ethical issues, nor merely pragmatic or ideological ones, although certainly the ideology will reflect upon the specific set of ethics being applied.

So the question here is that there are several different proposals to explain what exactly ‘is’ transexuality (or transgenderity, to be more precise), some of which list very specific causes, others which assume there are multiple causes, some of which biological, others environmental, others still conditioned, either socially or through specific education. Which approach is the more correct one?

Perhaps more important than that: why can’t experts agree on a single, universal view of the whole issue? (There is a majority consensus on the subject, but there are many who disagree with the general consensus.)

Again, we need to delve into philosophy a bit, to understand the underlying problem.

Much of what we call science today — ‘natural philosophy’, as it was known before the mid-1800s — was, to a degree, platonic: there was this idea that the universe could be essentially understood because there are universal laws, perhaps in a form that we cannot access directly, but which we can infer from observation. Such universal laws have real, physical existence. By observing the universe, we can always perfect our own description of it in order to come closer and closer to those essential, fundamental laws.

A classical example is the notion of a ‘triangle’. When we draw a triangle, we are just drawing an approximation of it: our pencil will always have a degree of irregularity, seen under a microscope. On a computer screen, diagonals will always be jagged, even on Retina displays — and even if we cannot see the jagged edges with the naked eye, a good magnifying glass will show those ‘imperfections’.

Nevertheless, we can calculate the area of a triangle with utmost perfection, because we assume that there exists an abstract notion of a triangle — a ‘perfect triangle’, if you wish — which correlates with an essential ‘triangleness’ that exists in the universe. While we cannot reproduce the ‘perfect triangle’, we can do maths assuming that such a ‘perfect triangle’ exists.

Most ‘hard sciences’ — maths, physics, etc. — pretend that they are writing universal laws based on ‘perfect’ concepts that are truly existing, even if our observation and reproduction of them is necessarily imperfect (due to our own limitations and of our implements and tools). We can, however, over time, refine results. Newton’s laws of gravity were superceded by Einstein’s, because Einstein’s were much closer to the degree of measurement we could observe. In other words, if Newton had access to the kinds of tools — telescopes — that we had in the early 20th century, he might have figured out that something was not quite right with his equations. So, in a sense, we develop laws that explain the universe according to our level of understanding and the ability to experiment, and the precision of the tools we have at the moment. We might still postulate that our results are not ‘definitive’ — the so-called ‘perfect triangle’ is still beyond our reach — but, iteratively, we can come closer and closer to it, as we develop better tools and a more precise understanding of the observed universe.

This is not the only philosophical idea behind how science works. An alternative approach — by no means the only one! — is simply to discard the platonic concept of ‘perfect forms’. Instead, what we humans do is narratives. We simply tell convincing stories about what we observe. It matters little if those stories are ‘real’ — in the sense that they truly describe our observations of the ‘real’ universe — or merely abstractions to acquire knowledge in a certain field. Narratives can always be improved — we can always tell better stories about the same subject.

Thus, we can say that the Earth orbits our Sun, and explain that with a convincing narrative. That story, as a matter of fact, would be incorrect. In fact, both the Earth and the Sun orbit each other, around the center of mass of the Earth-Sun system. It just happens that the Sun is so much massive than the Earth that the center of mass of the system is deep under the Sun’s heliosphere, very close to its core, so, for all practical purposes, we can ‘simplify’ the narrative by just saying, ‘the Earth orbits the Sun’.

This is not an outrageous lie, but just a simplification, for practical and pragmatical purposes. But it’s still incorrect. By simplifying the narrative, we are losing information. Someone listening to that narrative might think, ‘why does the Sun attract the Earth and the reverse doesn’t happen? What makes the Sun so special that it has an attractive force which the Earth lacks?’ and incorrectly postulate that there is a ‘special’ force that makes the Sun attract the Earth but not the other way round.

Obviously, what happens is that the Sun attracts the Earth, but the Earth also attracts the Sun; the attraction force is gravity; it just happens that the Sun is so much more massive than the Earth that the Sun hardly senses the Earth’s gravity pull. This is a much more elaborated narrative. It conveys more information. It’s also harder to understand. And it would still be incorrect, or at least not precise: we cannot describe the Earth’s orbit around the Sun by isolating merely the Earth and the Sun and do our calculations. Instead, we have to account for all other planets and heavenly bodies, which disturb the Sun-Earth orbits. Well, and while we’re at it, we should also account for people jumping up and down on Earth, which perturbs very slightly its orbit. And so on and so forth.

At some point, of course, this becomes unmanageable, and that’s why we go for ‘simplified’ narratives instead. Will the perturbation by someone jumping up and down on Earth be measurable with our instruments and tools, when we consider Earth’s orbit around the Sun? Answer: no. So it’s worthless to spend time doing the extra calculations. It doesn’t add any new information to the overall narrative, except to, well, be compulsive-obsessive about worthless details 🙂

‘But wait!’ someone is exclaiming at this point. ‘How do scientists invent those narratives? Isn’t that the same thing as prophets and priests do when using religion to explain everything?’

Ah, that would be a good question. Indeed, there is not much difference between telling a story like ‘the Sun’s gravity attracts the Earth’ and ‘God spins the planets around by His Will’. As stories go, both narratives are at the same level. The difference is mostly the purpose of the story. To grossly oversimplify the issue, science is mostly worried about describing the universe in order to predict outcomes. While religion is mostly worried about establishing morals, i.e. ‘all hail the great God who spins planets around the sun!’ So they have different goals in mind. Thus, ‘God spins planets’ has neither explanatory, nor predictive powers, because God can spin planets any way He wants, so we mortals are unable to figure out where planets are going to be next. After all, if God decides to stop planets in their tracks and change position, that’s His Will, and it can happen anytime; who can know what God is thinking? Therefore, religious and superstitious narratives have no predictive power.

By contrast, science can make accurate descriptions. By explaining how the Earth rotates the Sun every 365.25 days (more or the less), we can predict when it will be winter again, and when it will be spring and summer. That means farmers will know when they are supposed to place the seeds in the ground, when to water them, and when to expect them to grow. Science gives us predictability in the universe. And here is where things become more interesting: even an incomplete narrative, done using the scientific method, is always better than no narrative at all. We can always refine it later. Thus, while the Julian calendar, established by the Romans, had a few flaws, it was good enough to predict seasons for almost 1600 years. That’s not too bad. Then it had to be adjusted and corrected, and our current calendar will probably be much better (especially as we have atomic clocks to measure time and are constantly tweaking the measurements so that we can calculate the Earth’s orbit of next year to more and more decimal places of precision).

This is true of all sciences, naturally with higher or lower degrees of precision, and also applies to so-called ‘soft sciences’. The point I wished to make is that it’s all ‘making up stories’ — good, compelling stories, which have predictive ability, and explain the observations.

But we can abandon Plato and his philosophy by assuming that we’re not really describing ‘reality’. There might, in fact, not be anything ‘real’. Our scientific narratives do not need to worry much about what they’re describing. They can simply rely on the degree of precision that observations are made, and on their predictive powers. The ‘existence of reality’ is better left for philosophers (not natural philosophers — i.e. scientists). Science is more concerned about measurable observations and compelling narratives which explain those observations and have predictive powers.

Now it’s time to get back to the issue of transgenderity.

A common narrative, held by the mainstream experts in the field — as well as the community — is that there is something we call ‘gender identity’, which is separate from its manifestation (‘gender expression’), as well as sexual preference, and, on top of everything, it is also independent of the physical body, too.

In about 90% of all humans, all four axis are aligned with each other. Thus, someone born with XY chromosomes will have a biologically male body, feel attracted to females, act a gender role appropriate to males in their society, and, generally, ‘feel male’ (whatever that means). We can say that there is congruence among the four axis.

But each axis is not either/or, positive/negative. It’s a spectrum of possibilities. For instance, sexual preference can move along the axis, from 100% heterosexuality to 100% homosexuality, with bisexuality in the middle (and asexuality outside the scale). Most people are never on either extreme. So, even if 90% of the human population label themselves ‘heterosexual’ (a convenient narrative!), they might have had some homosexual experiences, desires, wishes, or simply dreams. Even if a dream only occurred once in their lifetimes, they might just be 99.9999% heterosexual. That would be a more precise narrative. For all practical purposes, however, we can simplify the narrative, and assume — perhaps wrongly or incorrectly, but at least pragmatically — that most heterosexual individuals will feel attracted to people presenting as the opposite gender, while most homosexual individuals will feel attracted to people presenting as the same gender, most of the time. This is a simplification of the narrative, but it helps much more than saying, ‘well, I’m 75.6% homosexual, but only 37.5% of the time’ — what exactly does that mean?

To make things even more confusing, ‘feminine’ and ‘masculine’ are not even ‘opposites’. You can have both — say, you can have ‘feminine’ traits and still identify with ‘masculine’ ones. Just because you’re ‘more feminine’ doesn’t make you ‘less masculine’ (and the opposite is obviously true). These are different, separate scales. They’re related, yes, but they’re not exclusive. I’ll address this later again.

Those categories are not important because they describe an ultimate reality. Instead, they’re important because they allow a functional society. If we wish to stop people from discriminating homosexuals, we need to know who is a homosexual or not, so that we know to whom those laws apply! Conversely, if we had no idea that homosexuals existed, we couldn’t pass any laws to stop their discrimination.

Similarly, as I’ve said before, human bodies present a vast variety of change, and little sexual dimorphism. My sister-in-law is just 1,50m tall, but she weighs much more than I do, and is far stronger as a woman than I am as a male; she can lift a couch (sometimes with people sitting on it!) with a single hand, to sweep under it, without breaking a sweat; while I might strain a few muscles and remain agonizing with back pain for a day if I attempt to do the same. My own wife, who is much smaller than I am, and weighs much loss, could easily drink four or five times more alcohol than I do without feeling any of its effects. So clearly all these examples show that the typical stereotypes for ‘males’ and ‘females’ are just that — stereotypes — but, in reality, the differences between individuals are huge. As so many crossdresser handbooks say, ‘Don’t worry about your shape not being very feminine. Women come in all sorts of shapes — and so do men, too!’

What we can only talk about — from a scientific perspective — is averages, not specific individuals. On average, women are smaller, weigh less, are weaker, and cannot handle to much alcohol as men do. But that is something we can only understand if we have a large sample and calculate averages. When we look at individuals, they differ so much, that we will be constantly seeing exceptions to the ‘average’ — in the case of humans, the number of exceptions is actually quite large, and, to make matters more complicated, it varies according to place to place, and from time to time. Thus, humans before the mid-1800s had a life expectancy of 40 years and were much smaller on average than today. They were still taller, on average, that pygmies today.

When talking about ‘averages’ we have to be careful to take into account that any narrative that only addresses ‘averages’ and stereotypes built upon those averages will very likely be wrong. But even if they are ‘wrong’ it doesn’t mean it cannot be useful.

Another pragmatic example: it’s fair to allow women to rest after giving birth, being paid by the State (or by the insurance company), and to protect that right in law. On average, most women will give birth and definitely require that time to recover. Of course there will be a lot of exceptions. A lot of women will not have children, either because of medical complications, or simply because they don’t want to. Many women do not really need a long resting period after birth; others, by contrast, due to their weak physical constitution, might need very long periods of resting. So, even though the variation among women is huge, the laws target the ‘average woman’, so that concept — even if it’s not more than that, an invented stereotype for a narrative — is still quite useful for a lawmaker to consider.

When we enter the field of mental diseases, scientists use the same approach. People react to physical and mental diseases quite differently. Some people, for instance, seem to be completely immune to the ‘flu since birth. Others, by contrast, seem to catch it every year. Even though it’s the same virus, it affects people differently; but that doesn’t mean we should give up on developing treatments and vaccines against the ‘flu, just because there are so many exceptions to the rule. Instead, we develop medicine to deal with the ‘average person’.

Mental diseases are the same; some people are prone to chronic depression, while others will never get depressed, no matter what. Most people will very likely never have serious cases of depression, and, if they do, they will react to it differently. Nevertheless, it’s still useful to develop treatments for depression that address the case of the ‘average’ person, but taking into account that not all will react in the same way, and adjust accordingly. The overall narrative that explains how depression is caused and how it can be cured is still valid, even if there are many exceptions and edge cases.

We come to the point where it’s worth discussing ‘gender identity’, always in this context of expressing a narrative which might not be completely correct and address all cases, but is still valid for a majority of cases, on average.

The gender narrative

Sexual reproduction has been such a successful evolutionary move, at least on multicellular organisms, that we have been stuck with it, and it’s unlikely that the human species, before it inevitably gets extinct, will develop any other alternative strategy, at least not by natural means. This is just taking the ‘evolutionary narrative’ and applying it to our case: all our common ancestors in the past billion years or so have successfully used sexual reproduction. Evolution tends to stick with strategies that work well under different situations; in mathematics, these are called ‘local optimums’. It’s conceivable that there might be (on other planets) more successful strategies for reproduction, but on Earth, at least, evolution has just ‘found’ sexual reproduction, and that’s all we have on higher forms of life.

As a consequence, humans have no other choice but to exhibit some sexual dimorphism. As said, in our case, we’re not highly sexually dimorphic. We can only see the differences when we look at averages. As I like to say, we’re much more like cats (where it’s very hard to distinguish between male cats and female cats, at least to a human observer, of course) than chicken (where roosters are clearly completely different than hens!). Nevertheless, there is a difference, and we can notice it by looking at statistics — these are undeniable facts.

Because there is a difference, when we became a gregarious species (very likely because we have descended from an ancestor which was also gregarious), we created societies that had to deal with the different abilities, skills, and needs of the differently-gendered individuals. In a sense, it was through social norms, customs, and rules that we enhanced the difference between the two genders in an artificial way. There is some evolutionary logic in this: males that would look and behave more closely to the ‘average male’ would have better success at reproducing (and the converse would be true for females, of course). Therefore, social conditioning tried to push individuals to conform to those average aspects of gender, and even enhance them to accentuate the differences. ‘Masculine’ behaviour in girls would be discouraged, as well as ‘feminine’ behaviour in boys, because this would lead to lower chances of reproduction.

In gregarious species, it’s usually the alpha males that mate more often (namely with the alpha females), so being ‘more male’ (which usually means being more stronger and have more clearly-defined male characteristics) means having a competitive, evolutionary advantage. In some species, only the alpha males reproduce; the remaining ones will have to fight for the alpha male role. This is something known in evolutionary biology as sexual selection. Charles Darwin’s theory of evolution is more known for natural selection, but Darwin was clear enough that natural selection, by itself, doesn’t explain sexual dimorphism. So he completed his theory by allowing for a different mechanism — sexual selection — to explain such differences. In birds, more even than in mammals, the display of secondary sexual attributes to attract potential mates shows quite clearly how this mechanism works: the better-looking you are (from the perspective of a bird, this means having nice colours or singing well), the more likely you’re going to get a mate. In gregarious mammals, ‘being male’ means the ability to fight better, to hunt better, to be able to beat the rest of the male members of the pack, but also to be able to defend the pack better from competing packs. Males compete for the leading role by displaying those ‘male attributes’, which, in turn, earns them better chances at mating.

Humans, of course, are (were?) not so different. Simple hunter-gatherer societies, even if they were far more complicated than, say, wolf packs, had similar traits. The only difference is in terms of complexity. A shaman, for example, might not need physical strength to be seen as a male worth of being mated with; knowledge and power are also ‘masculine’ traits that would ensure good mating chances.

As the human species developed civilization, and much more complex societies, many of those ritualized behaviours that we brought from our remotest past as hunter-gatherers still persist — while allowing for a wider range of activities for each gender, a tendency that goes on to our days. Darwin, who was incredibly provocative and radical in his days, tended to believe that there would not be further evolutionary pressure on the physical gender attributes to change much more, because our societies had tended to ‘crystallize’ the gender roles according to certain stereotypes and frown upon variance; therefore, successive generations would still try to enforce compliance with such stereotypes, and those who conformed best to them had better chance of getting partners and reproduce. He, however, predicted that giving higher education to women would have a social impact after several generations — a prediction which was entirely correct — but he didn’t believe it would actually happen (where he was, fortunately, entirely wrong in his assumptions).

So we have to ask at this stage where exactly those gender roles come from, and why they tend to ‘crystallize’, even if allow for variation.

Here, it’s simple to explain correlation. A woman that conforms to a stereotypical description of a female in her society has better chances to get a willing partner, and therefore raises her chances to reproduce. Therefore society imposes conformity to gender stereotypes, because, by doing so, it raises the overall chances of all members (at least those who conform to gender stereotypes) to reproduce as a whole.

But causation is not so easy to explain. Are gender roles innate, and therefore the stereotypes have been constructed around them — and then imposed by society? Or did those mental constructs appear in societies, and it was the pressure to conformity that created those ‘gender roles’? Or maybe both things happened simultaneously, i.e. they’re partially innate, and partially imposed?

It’s not easy to tell. All we can do is look at the fossil record of ancient humans, and we can see that there have always been some form of differentiation between genders in prehistoric times. But we cannot know for sure. All we can say is that since homo sapiens became homo sapiens, there were some differences between each gender role from the very beginning. But because homo sapiens didn’t appear ‘out of nothing’, but we can only see that they have always appeared already in gregarious groups — clans, tribes, large families — we can only invent a single narrative to explain those earliest forms of group arrangements: as far as we know, all humans, since they became humans, had some form of gender differentiation in their roles, not merely in their physical attributes.

And if we go further back, we also see that our closest neighbours in the evolutionary tree have similar gender differentiation. Hominids and primates have gender roles, even if they are not as clear-cut as humans. But on gregarious primate species, males hunt while females take care of the kids. This is a very primitive kind of different gender roles.

It is therefore very tempting to postulate that gender roles are innate.

But that might simply be completely wrong. After all, humans have this amazing characteristic of being able to teach others to learn new things. Education is an evolutionary advantage: instead of requiring generations after generations of survivors of encounters with lions to learn how to avoid them, someone who has successfully avoided their first lion can simply tell others what to do (‘run away! as fast as you can!’). Put in other words: because we are able to create narratives, we can sidestep ‘evolution’ as the only mechanism to deal with changing environmental conditions (i.e. because our favourite hunting ground has been infested with lions, we don’t need to go extinct or change species attributes over thousands of generations to be able to deal with the lions; instead, we can tell others of our generation how to deal with the lions).

Therefore, what we can alternatively explain by observing the fossil track of the human species is that we have always had a narrative that separates gender roles. We can see this as a meme that has been perpetuated since the beginning of time. We could also postulate that, for some reason, human societies that carry the ‘gender role’ meme are successful — they didn’t get extinct, after all, since we still have gender roles — so it’s very likely that this ‘gender role meme’ has been handed down by generations of human beings to our very days.

In that alternative explanation, it means that gender roles are not ‘innate’ but merely conveyed through education.

In the late 1950s and 1960s, behaviour theorists were quite adept at this way of looking at things, and, as a consequence, they postulated that human babies, at birth, were genderless. Gender was thought to be purely a mental construct imposed by society. The so-often-quoted case of David Reimer, who, after an accident that smashed his penis shortly after birth, was given a gender reassignment surgery and raised as a girl, shows that those theorists were completely wrong. David always identified as a boy, transitioned in his late teens back to a boy, got married, but finally couldn’t handle it any longer and committed suicide. This seemed to prove, once and for all, that gender is not really ‘conditioned’. This means that the narrative that tries to explain gender roles as being merely social constructs handed over since the beginning of time is, to put it bluntly, completely wrong.

That’s why the mainstream researchers in the field postulate that we humans have something encoded in our biological makeup — possibly encoded in our DNA — that produces what we call, for the sake of a better word, ‘gender identity’. But so far such ‘gender genes’ have eluded researchers — there is some promising work in this area, but it’s still early to be sure of the results so far. Remember that I’m not talking about sex; we have known for quite a long time how biological sex is determined genetically! I’m talking about gender, and this is much more confusing.

To add to the confusion, so far I’ve been talking about the views of evolutionary biology and psychology. But there are more ways to view the gender issue. For example, sociology and anthropology naturally also explore gender and sexuality. And they use a slightly different approach, even though the results are similar. In other words: they use different narratives to tell a different story. And such narratives are very compelling.

Sociologists tend to be less focused on the origin (be it biological or psychological) of ‘gender roles’, except for the historical perspective and the overall framework. Instead, they observe how human beings interact. They certainly ‘behave’ as if they were pushed by a ‘gender identity’, and they present themselves (through attire, conversation, body language, etc.) as if they do, indeed, conform to a ‘gender role’. It is not fundamentally important for them if such abstract concepts do ‘exist’ or not. From a functionalist point of view, what matters is that those concepts are actually very useful to explain human interactions.

Sam Killermann, a sociologist, teacher, and social justice activist, has presented his own narrative using the popular ‘Genderbread Person’:


Explaining it all would require quite a lot of time, but you can go to his site and download the book where he explains everything in excruciatingly detail written in his easy-to-read and funny language 🙂

You can see that Killermann also splits things according to four parameters: identity, expression (or presentation), biological sex, and attraction (or sexual preference). His twist is having two axis on each parameter, and four on attraction. He sees — quite correctly, in my opinion — that male/female are not really ‘opposites’. Instead, they are separate (although correlated!) variables. So by being ‘less male’ that doesn’t automatically make you ‘more female’. I like the example of a female friend of mine, who was simultaneously very feminine (she looked gorgeous, too, and did her best with her image) but also included a lot of very masculine traits, like aggressivity (she was one of the most aggressive persons I ever met), competitiveness, a strong (and ruthless!) business stance, and so forth. So on Killermann’s scale she would be simultaneously ‘very female’ but also ‘very male’.

Now, Killermann is not worried about biological (or psychological) causation of such parameters. His goal is different. He just needs a good narrative to establish social justice. It’s of little importance for him why people have gender identities, or if those exist or not. But our society is based on the assumption that there are two gender roles, and that’s the narrative we have to live with every day — no matter if it’s ‘true’ or not (in the sense of being a scientific fact). Therefore, Killermann (and so many others) simply assume that such characteristics like ‘gender identity’ actually exist and that people who do not conform with the two ‘established’ gender identities feel some dissonance, and this dissonance can cause depression, anxiety, and similar mental disorders.

Here we can see a more complex interaction between correlation and causation. We can say that the reason why such people feel a dissonance with the gender role they’re assigned at birth is caused by living in a society which only establishes two acceptable gender roles to live in. If we lived in a genderless society, it’s plausible to admit that such dissonance would not be ’caused’. We can also see that the dissonance causes certain forms of mental disorders: if such a dissonance weren’t present, those people would not feel any dissonance. Now we could postulate that ‘gender identity’ does not truly exist. But this would not help anyone. Our society would still stick to the narrative about binary gender roles. Some people would still feel uncomfortable about those gender roles, even if they don’t truly exist. They would still get depressed and anxious. Just stating that ‘gender identity does not exist’ will not provide them with any real relief. And that’s just one of the four parameters on the Killermann scale, of course; there are narratives for all of them. All are, to an extent, either social constructs or mental constructs (but heavily influenced by society as well), and may not have any ‘real’ existence. Nevertheless people suffer when they do not ‘conform’ to the established prototypes.

Stop attacking gender identity! Look at evolution!

In my personal opinion, therefore, it makes absolutely no sense in getting rid of the notion that people have a ‘gender identity’ and try to postulate that such a mental construct does not exist and is just a convenient narrative to explain what people feel. One thing is the same as the other: such narratives become ‘truth’ and are ‘believed in’, to the extent that people cannot escape from them. We do not live in genderless societies. Instead, we live in societies where the gender narrative is very well established with archetypes and stereotypes, and that puts a lot of pressure on us since birth to conform with such gender narratives.

‘Gender identity’ might be something just like ‘justice’. There are no ‘justice’ particles in the universe. Justice makes no sense outside the limited sphere of human societies. Nevertheless, all humans seem to have an innate sense of justice, which can also be taught and learned, and which is expected from the society they live in. People that feel ‘injustice’, even if such an abstract concept has no physical existence, can get depressed and anxious — and this is a well-established fact. But just because we don’t have ‘justice genes’ or there aren’t any ‘justice particles’ in the universe, it doesn’t mean we must get rid of ‘justice’ and replace it by a different explanation.

Non-conformity with the mainstream gender narrative produces dissonance, which can manifest in different ways. Again, it makes no sense to replace ‘gender identity’ by a different explanation and shrug it off as being non-existent. Advocates of a genderless society certainly have good arguments to advance their cause, but they have to deal with tens of thousands of years of prejudice and stereotyping — it’s not something that will happen overnight in any case. So we should simply recognize that the vast majority of human beings identifies with the gender narrative that was told them at birth, but there are many who don’t, and suffer because of that. They would still suffer if the law in the country abolished gender — because one thing is the law, the other is the society that embodies the law. Look at the relationship in the United States between Church and State: constitutionally, they’re forbidden to mix and match, but no political candidate for president can claim to be an atheist (or they’ll get zero votes), and will have to be sworn into office by placing their hands on a Christian Bible. So while in theory Church and State are separate in the United States, in practice American society joins them much closer than their constitution allows it.

It’s perhaps not the best example I could come up with 🙂 and makes even less sense on European countries, where Church and State are really separate (except perhaps in countries like Poland or even Greece). But I hope you can appreciate my point: just because some people ‘declare’ that something is supposed to be in a certain way, which runs contrary to the mainstream narratives in the society, it doesn’t ‘make’ it that way.

Even though good correlations can be found that show that there could be alternative explanations — maybe we ought to call them alternative narratives — to ‘explain’ that gender identity (or, more precisely, gender dysphoria, i.e. dissonance with one’s assigned gender) is a consequence of something else than biology & environment, it still doesn’t mean that the correlation automatically becomes causation.

This is what currently nags me with those ‘alternative’ explanations. They have a very compelling narrative, especially when they seem to get a lot of details correct. After re-reading many of Lawrence’s interviews, it looks like most of those people do feel exactly the same way as I do: their narratives definitely sound very similar to what I think and feel, and it’s very easy for me to empathise with them and say, ‘I’m one of you!’ What seems always to be a dead giveaway is how almost all of them start with ‘After having read your article, I’m sure I’m autogynephilic’. So this is basically just identification with a stereotype — because Lawrence defines in her narratives what an autogynephilic person is supposed to think and feel, others, by reading her narratives, identify with them.

If the word ‘autogynephilic’ would only be a descriptive concept to group what all these people think and feel, then it would be alright. It would even be a very thorough description. The problem, of course, is that Lawrence, like Blanchard and Bailey, list ‘autogynephilia’ as a serious mental disease, at the same level as psychopathy and pedophilia, and at least as bad as narcissistic disorder, but for which there is no cure (although transition at least provides some relief). This is the problem here: from the narrative Lawrence postulates a cause. While there is certainly a correlation, nothing in her argumentation is persuasive enough to convince that she has nailed the right cause.

But by spreading Blanchard’s theories and its variants, those people are actually causing more harm than benefitting transgendered individuals.

Blanchard, Bailey, Lawrence (BBL) and followers claim to want to help transgendered individuals, by proposing transition as a solution to ease the suffering from their ‘serious mental disease’. However, this is not much different from those Christian homosexual conversion camps, where people subjected homosexuals to aversion therapy (sometimes with electroshocks) to ‘cure’ them from their terrible disease, homosexuality. BBL might be more humane, but they have the same stance: by defining that gender non-conformity is a mental disease, they propose the only treatment that helps to reduce suffering. At least they don’t suggest that transgendered people get reconditioned through electroshock therapy! Rather the contrary, they urge psychologists and psychiatrists to evaluate the ‘disease’ and consider it very serious, and to propose to their seriously ill patients some form of transition (even if only partial transition) to alleviate their symptoms.

The emasculation trauma theorists are slightly better. They still see autogynephilia as a form of mental disease — at least, as a paraphilia — but propose that childhood trauma issues are addressed first, and only after those are dealt with, should transition be attempted. It’s even more humane than BBL. But not good enough.

All these groups are still stuck with the idea that ‘gender identity’ does not exist, and, as such, gender non-conformity has to be a mental disease and requires a different origin. BBL proposes that it is a paraphilia due to ‘erotic target location error’, a mental disease where one’s object of sexual desire is located in one’s own body, instead of the body of others. It’s a form of narcissism. In any case, it’s basically linked to sexual attraction, lust and desire. The emasculation trauma group are a little more generic. They believe that childhood trauma requires a defense mechanism, and, since in the brain the trauma areas are close to the sexual areas, they postulate that the trauma, in those individuals, is coped with a distorted expression of sexuality — in this case, the sexual desire of one’s own female body — but unlike BBL, they’re not persuaded that transition is the only option. Instead, they propose other, alternative methods to cope with trauma, and once trauma is dealt with, gender dysphoria will disappear.

Such narratives are compelling because they actually apply to some people. In certain cases where transition did not remove gender dysphoria, effectively dealing with childhood trauma worked well, and such individuals could then de-transition back to their original gender and live good, successful lives afterwards — just regretting that they had to go through all that trouble to finally find a correct diagnosis of their condition…

This is really the problem with such black-or-white classifications. The BBL crowd is incredibly restrictive by reducing all kinds of gender dysphoria to basically two types: either as an extension of ‘homosexuality’ (where the individual has little success to attract male partners unless they change their bodies to female) or of ‘deviant heterosexuality’ (where the individual is so obsessed with their own self-image as a woman that they can have no successful romantic/erotic relationships). Well, three: the alternative, which is the vast amount of transgendered individuals that do not fall into either classification, are labeled by BBL as merely being compulsive liars and in denial about their ‘true’ condition.

The emasculation trauma crowd is a bit less harsh in judging people, and they are also not so black-and-white. They postulate that trauma comes in many forms and that it’s not relevant if a certain situation is traumatic or not; all that matters is if the person experiences that situation as traumatic. Similarly, and unlike BBL who seem to be frantically obsessed with this strange new mental disease that they have invented (autogynephilia), they prefer to explain ‘sexuality as a coping mechanism’ by using a very loose definition of sexuality — which can be expressed in so many forms that it might not even be considered ‘sexuality’ by most people. A typical example: most late on-set MtF transexuals report that wearing women’s clothes is not specifically ‘erotic’ or ‘arousing’, it’s just what they need to wear to present themselves as the gender they identify with. BBL says that they are lying. The emasculation trauma crowd would ask them if they find the idea of going out as a woman and being identified as one as exciting, even if not in a sexual way. Many MtF transgendered individuals would probably accept ‘exciting’ as a description, but they would actually consider that it is what they feel to be ‘appropriate’ for the gender role they identify with. Some might consider the experience ‘pleasing’ but not ‘exciting’. Well, ‘pleasure’ is not necessarily ‘sexual’, but the emasculation trauma proponents consider that it is a sort of sexuality, much watered down, but still having its roots in the pleasure/pain areas of the brain, which are also interconnected (correlated?) with the sexual areas.

It’s a convoluted explanation. In both cases — and probably in many more which I haven’t read yet — the issue here is that transgenderity, or more precisely, gender dysphoria, is always seen as a mental disease, or at least as the consequence of a mental disease, and that the manifestation of gender dysphoria requires sexuality as a coping mechanism.

Again, the issue here is the problem of generalisation and context.

If one assumes that there is a conventional concept of ‘gender identity’, even if it’s abstract, though it’s rooted in evolutionary behaviour of gregarious species, then a vast spectrum of possibilities are open. Nobody really conforms to the two archetypes — man and woman — but most people are comfortable enough with their identity and align themselves according to those gender roles, even if they’re not 100% male or 100% female but exhibit a wide range of traits from both types of roles. On average, however, one of the gender roles will be more closely followed or emulated than the other.

A few people — perhaps 10% or less — are uncomfortable with those stereotyped roles, and they exhibit dissonance with it. At some extreme levels, they might simply reject the whole ‘gender’ concept and refuse to abide by social norms — but feel no discomfort in doing so. Others will try to conform to those roles but find them unacceptable — this causes dysphoria, eventually leading to depression and anxiety. Others still might, indeed, develop a form of paraphilia — we cannot simply ignore many of those reports. And I’m sure that many develop coping mechanisms to deal with childhood trauma, even if they are not aware of either the trauma, or the coping mechanism they’re using.

This narrative allows for a far vaster range of possibilities, because it is not so restrictive. It also means — unlike BBL — that not all cases require transition to ease the suffering from gender dysphoria. It also allows psychologists and psychiatrists to explore other mental issues that are correlated with gender dysphoria (comorbid with them) and figure out which causes which. It’s possible that trauma causes gender dysphoria. But gender dysphoria might cause trauma as well. Both alternatives should be explored, since the treatment, in each case, is completely different. Some people are genuinely paraphilic, and there is reason to believe that some sorts of therapy allow people to replace a more extreme form of paraphilia for a more benign one. There are many more cases and possibilities, each requiring some different form of treatment, many not requiring any treatment at all, but all of them are based on the assumption that there is, indeed, something called ‘gender identity’ which can be seen as the ’cause’ of everything — even if we could dissect the brain and not find a single neuron tagged with ‘gender identity’.

But as evolutionary biologists know, we cannot find neurons or areas in the brain for things like ‘justice’ or ‘altruistic behaviour’. Nevertheless, we know that such states and concepts have been carried by generations (even if the manifestation of such states depends not only on the individual, but on the society and culture they have been born in).

It’s reasonable to assume that gender roles, even if stereotyped and changing according to society, country, and epoch, are the end result of a long evolutionary chain that started with the first gregarious species which reproduced sexually. Since we can see in non-human species how gender-specific attributes are ‘enhanced’ or sometimes even ‘faked’ in order to attract mates, we know that strict conformity with such attributes is seen as an evolutionary advantage. As we progress towards more complex organisms with more complex societies, crossing over to the human species where societies have become incredibly complex, we see the same kinds of behaviour as our fellow non-human inhabitants of this planet, but just adapted to our species and its culture.

There are so many typical examples of this. For instance, it’s relevant for males to pick females that are good at bearing offspring. Because humans have such big heads, especially when they’re young, having wide hips is an evolutionary advantage. Therefore, primitive male humans would be attracted to females with wide hips (and big breasts filled with milk). Clearly, ‘faking’ wide hips would be an advantage for those females who did not have such wide hips as the average. And that’s why we invented clothing which enhance the male and the female figure — or hide the unpleasantness in those figures. Because males and females have different requirements in terms of mates, it’s natural that each gender would adopt different types of clothing. It makes no sense, for a male, to ‘fake’ wide hips — wide hips in a male has no biological advantage. Height, by contrast, does (since it equates with more physical strength) — that’s why until recently it would be males, not females, wearing high heels (at least until the 18th century in Europe). Makeup in both genders is a way to simulate youth and health, both of which are secondary sexual characteristics that are favoured by potential mates. So we can actually trace much of the attire and behaviour of each gender to a lot of evolution. It’s not merely a correlation — which might have happened by chance only! It is, indeed, causation, and at the root of that causation is sexual reproduction.

Of course, there are a lot of stereotypes attached to the genders that don’t make sense at all. It’s therefore not unreasonable to assume that many people simply don’t identify with those stereotypes — either by totally rejecting them, or by preferring the stereotypes of the opposite gender than the one assigned at birth. To explain such mechanisms, we will need to postulate that there are stereotypical gender roles, but also an identification (or rejection) with those roles at the individual level. Whatever the mechanism might actually be, it’s hard to avoid calling such process ‘gender identity’. And because it’s rooted in evolution and biology, even though it might be an abstract concept, it certainly is not merely a conditioned form of behaviour, as it was thought in the 1950s and 1960s. It’s much more than that.

It also makes more sense to postulate that a dissonance between one’s identity and the social role assigned to us when we are born creates all sorts of potential issues. Such dissonance might be explained by genetics (not very likely), embryological chemistry (very likely, but we are still at the beginning of the research in that area, and its still controversial) and some social conditioning — very likely, a mix of the three. If that dissonance appears, it ‘feels’ real to the person exhibiting it. In some cases, the person can successfully deal with the dissonance without any problem — most crossdressers, for instance, have no problem in identifying themselves with the gender role assigned at birth, but still present themselves as the opposite gender whenever they wish (or can), and feel no discomfort in either role. Some cases are much more complex and the dissonance creates all sorts of mental issues — from more simpler cases like depression and anxiety (simple, but definitely a huge source of suffering, which can lead to suicide), to complex paraphilias which might be hard to unravel. But the simple truth is that transgendered people present a wide spectrum of possibilities. They cannot be all lying about what they feel and think about themselves! It’s far more reasonable to assume that only a few may be lying (that’s always a possibility) but most are being honest about their feelings. For them, they truly feel that they have a gender identity which is misaligned with the gender role assigned to them at birth.

Rejecting this postulate means discrimination. In our society, we’re not very tolerant towards those who are labeled as compulsive liars. We’re also uncomfortable with serious mental diseases, and some of them produce behaviours which are criminal offenses (extreme psychopathy, pedophilia, etc.). It doesn’t help in the least to consider all transgendered people as mentally ill, and those who reject or deny it get labeled as compulsive liars. Instead, we need to be more inclusive, and give to each the appropriate treatment according to their case. If the issue was produced by childhood trauma, which is a very well-studied field of research, then they should be treated for trauma, and see if the gender dysphoria disappears. If they are depressed or anxious, and expressing a different gender role is a way of coping with depression and anxiety, then they should be treated first for depression and anxiety and observe if the symptoms of gender dysphoria are reduced or even disappear completely. But there are many more alternatives, each of which might be successfully dealt with. And there will eventually be those cases where transition is really the only solution. Not merely to ‘reduce’ stress and anxiety — as the BBL followers claim — but because such people really wish to embrace the gender role they identify with, and become fully functional, healthy, and sane human beings in their preferred gender role.

Anything less than this will just give the transphobes cannon fodder to restrict the rights of transgendered people.