Midlife crisis? 1


Looking towards a bright future?Leaving no avenue unexplored and no stone unturned, my wife cleverly suggested an alternative explanation to what has been provisionally diagnosed as ‘gender dysphoria’ in my case. And, as usual, her ideas and concepts tend to make me think.

Suspicious symptoms

So let’s start with some of the typical phrases and thoughts expressed by those who are usually labeled late onset MtF transexuals.

First they feel that there is something completely wrong about their lives. They have felt, for a while, that they somehow have ‘failed’ — and because of their crossdressing dreams, they tend to believe that they have ‘failed at being men’. This makes their desire to ‘become women’ incredibly intense — they feel that, even though they have wasted so much time in their lives, they are still young enough to enjoy spending the rest of their lives as women. Because this desire becomes overwhelmingly intense, it can become utterly despairing — and the urges to ‘become a woman’, or to stop being a ‘man’, become the main (or even only!) focus in their lives: they start to have difficulty in concentrating on their work or family life; they might either become easily fatigued, or, conversely, spend blank nights, unable to sleep, considering all what lies ahead for them: a life trapped in the wrong body, in the wrong social role? Or the possibility of starting their life from scratch, get rid of their annoying past, enjoy the next decades doing something completely different? Maybe even regretting that they haven’t made the decision to transition earlier, but that it’s better to do it now than regret it even later? Or, well, the opposite might also become true: realizing that there will be no way to go through transition, and, therefore, life stops being interesting for them — thus engaging, perhaps for the first time in their lives, into suicidal thoughts.

Sooh-yeahunds familiar? Well, it should. Most, if not all, of the above symptoms are commonly experienced by people suffering from gender dysphoria, at least when they reach a relatively serious stage (and has been ‘repressed’ or ‘suppressed’ for a long, long time).

But some of those symptoms are also common to depression and anxiety. Again, this should not be very surprising: most people who suffer from gender dysphoria will also suffer from depression, anxiety, compulsive/obsessive disorder, or any consequence of (childhood) trauma. In fact, it’s often because of the need to treat their depression and/or anxiety that someone with gender dysphoria finally decides to talk to a doctor — which is especially true with late onset transexuals (that being one of the reasons for them being late and not early onset transexuals…).

Now this will surprise you: the symptoms I’ve described are also pretty much the same as those connected to midlife crisis. With a twist, of course: I deliberately included as the ‘object of desire’ — so common to male midlife crisis — the desire to transition and becoming a woman.

So what’s going on here??

Midlife crisis — myth or fact?

Doctors, these days, wince when they hear the term ‘midlife crisis’. The problem is that it’s so often misused (and wrongly applied) to shrug away certain unusual behaviour. Oh, so he went and bought that sports car? Well, it’s the midlife crisis. He’s cheating his wife with a secretary twenty years younger? Well, it’s the midlife crisis, it will pass. He’s becoming rather obsessed with sports, going to the gym, personal appearance? Don’t worry, he’s just worrying about aging and trying to delay it because he still feels ‘young inside’. That’s all part of the midlife crisis.

As a consequence, society in general tend to ‘excuse’ men in their midlife crisis far more than what’s healthy for them. Abandoning their job and career, divorcing the wife, and starting from scratch their lives as safari guides in the middle of Kenya should not be shrugged off so lightly; after all, such a decision will carry a huge amount of consequences (namely, for the family… but also for the man himself, since he might bankrupt himself in the pursue of an insane goal).

Therefore, in medical science, ‘midlife crisis’ might not be a ‘diagnostic’ — instead, doctors will steer the conversation towards the real symptoms, those of depression, anxiety, and so forth. In many cases, men in their middle age who consider themselves to be going through a ‘midlife crisis’ are basically just depressed. That can be easily treated, so long as you realise that it’s not your age that provokes the depression, but rather the way your mind is thinking about ‘aging’. Depression can be cured with medication and therapy; ‘age’ cannot. Oh, and by the way, don’t think that ‘midlife crisis’ is something that happens when you’re 50+; it can happen as early as 35, and as late as 60 (especially these days, when we have not only a greater expectancy of life, but this life will be more problem-free than what our parents and grandparents went through). Depression, of course, can hit any age.

It’s therefore also important to pay attention to those symptoms in friends and familiars, and not simply shrug them off. In our society, males are supposed not to talk much about their illnesses and diseases, but even less so about their feelings. A real man does not have ‘feelings’ — their only acceptable emotion is ‘aggressivity’ — and therefore it’s quite likely that they will hide their depression/anxiety for a long, long time, until something in their behaviour betrays them. It can be the new sports car parked in front of the house. It can be the bombshell blonde discovered in the bedroom by a wife that comes home earlier than usual. But it can also be the female clothes, heels, wigs, and corsets found on an ark in the garage. These, of course, are extreme cases — sometimes the signs are much more subtle.

For instance, a man might start complaining about their job, but not about something specific (say, an annoying colleague, an overdemanding boss, a stupid client…), but more generic and vague — hinting that have taken the ‘wrong’ career, that their abilities lie elsewhere, but that they have spent the past decades doing their best at a job that really is nothing they wanted — there was simply no other choice to bring in the paycheck every month. While in many cases there might be a genuine wish for a change of career, it can also be a symptom of the ‘midlife crisis’.

The next step comes when the man drops a hint that they felt that their lives, up to now, was a ‘total waste of time and effort’, or, even worse, that they feel ‘worthless’ even after working so hard and for so long — they basically haven’t ‘succeeded’ (as determined by what others define as ‘success’) and are a real failure as men (and as human beings).

Among crossdressers, of course, these feelings will also trigger an unquenchable urge to crossdress more and more, and, sure, why not, start to entertain the idea of transitioning.

So… while ‘midlife crisis’ is not really a ‘disease’, the many symptoms associated with it can be easily confused with those of depression — and gender dysphoria. In fact, ‘getting older’ can be one trigger for depression — and in someone who already has a light case of gender dysphoria, it can suddenly become an obsessive desire, the only important thing to do in one’s life, and that means excluding everything else (and possibly even everyone else as well). Such ‘triggers’ should be considered carefully, to see where exactly they arise, and in what context. We can label them all as ‘midlife crisis’ if that makes it more bearable, so long as we don’t forget that you cannot ‘cure’ aging, but you can certainly cure depression, anxiety, and so forth (and, yes, there is a solution for gender dysphoria as well, albeit a rather drastic one!).

‘Midlife crisis’ is not a ‘myth’ in the sense that it’s something imaginary or unreal. It’s also not something that should be lightly discarded, ignored, or, worse, suppressed. In fact, what the layperson calls ‘midlife crisis’ is most likely a combination of other issues, all coming together under the same umbrella term. But we should also not look at ‘midlife crisis’ as being a ‘fact’ (a scientifical fact, that is), much less as ‘something all men go through in their lives’. That’s not true — most definitely not all men will experience any depression/anxiety disorder in their middle ageSome will, and even then, it might be so mild that it won’t really make much of a difference. Others, of course, will suffer much more, and, yes, they ought to seek medical advice — not simply shrug it away as ‘something all men go through’.

And even if it were true for all men — like, say, all women go through menopause! — it still doesn’t mean that you should endure it and suffer in silence ‘just because you’re a man’. Instead, you should be aware that most of the symptoms of what we call ‘midlife crisis’ can be ‘cured’, since they really are symptoms of mental conditions that are treatable.

Wait… do you mean that there are no late onset transexuals?

We come now to the really problematic issue, and that is to try to understand better what a late onset transexual actually is. Because this particular kind of transexual was thoroughl studied by Blanchard, we still tend to get influenced by Blanchard’s theories — even if they get debunked over and over again. It’s also true that in science you tend to go ahead on a specific track, nudging it here and there to make the train run more smoothly, but switching tracks — what we would call ‘paradigm shifts’ — is not that common. Relativity, for instance, forced astrophysics to get out of the neat track laid out by Isaac Newton, which could explain pretty much everything we observed except for some nitty-gritty, teeny-tiny ‘details’ that one would quickly dismiss as ‘calculation errors’. Accepting it as the best theory that explains the macrocosm was not peaceful, nor was it immediate — it took years, at least until a few empirical results finally showed that Relativity had to be correct (while clearly Newton was not — or at least, was not able to account for a lot of things). Quantum mechanics, incidentally also ‘kicked off’ by one of Einstein’s theories, is so counter-intuitive and absurd that Einstein himself couldn’t be persuaded to ‘accept’ it — even though, today, it’s the theory of the microcosmos that has been most validated.

What this means is that every time someone proposes a ‘new’ theory of physics, they will have first to show how their theory ‘fits’ into Relativity and Quantum mechanics; similarly, any ‘new’ theory in biology must to comply to Darwin’s evolutionary theories first. This is how it works in science: you need to show first how you fit into existing theories; then you may be able to formulate something new and revolutionary — a problem that many pseudo-scientists have (even though they might argue logically or even show reasonably sound experiments to ‘prove’ their theories). Einstein had to show that Relativity, for instance, was pretty much identical to Newton’s gravitation laws at relatively short distances (i.e. at the human scale); in other words, while it’s true that, if you are running, time gets to pass ever so slightly slower for you, from a perspective of a static observer, in reality the difference is so minimal that we haven’t found a device that is sufficiently precise to measure it. However, when we are measuring properties of objects moving close to the speed of light, then very interesting things start to happen — and here is where Einstein’s theories drastically depart from the ‘common sense’ laws of Newton.

So… after this short interlude on the way science works, let’s get back to late onset transexuals, shall we? 🙂

Before Blanchard, it was hard to understand the concept of ‘late onset transexuals’ because you had basically two categories: transexuals and transvestites. The first group wanted to go through surgery to make their body look like the gender they identified with; while the second group didn’t. This was pretty simple and rather easy to explain and understand. The second group, very likely, was just a harmless fetish, hobby, way of life, whatever; the first group would require attention from medical specialists and helped through transition.

Doctors were baffled with those who didn’t fit either profile. This would take the form of a middle-aged man exhibiting what seemed to be the same symptoms the ‘transexuals’ had (we call this gender dysphoria today: the conviction that one’s gender is not really the one assigned at birth, and the suffering that this causes constantly). However, transexuals would have those symptoms practically from birth, or, well, from as early as they could remember; these new kind of people tried very hard for decades to ‘fit’ to the gender assigned at birth — while secretly crossdressing, or at least dreaming about the idea — but, at some point, the urge to transition became overwhelming. And yes, they wanted to go through the same kind of transition that transexuals also demanded.

Scientific thought before the 1980s simply had no clear classification for that kind of people; doctors could, at best, use Benjamin’s Sex Orientation Scale to assign a degree of transexuality to the patient (or a variation of that), but such people would really not ‘fit’ in the scale. Benjamin, due to prejudice at the time he designed that scale, also included sexual orientation together with transexuality; in other words, a MtF transexual had to be attracted to men only. If they had the slightest attraction towards women then they would be considered ‘false transexuals’ (in other words, they would be lying to their doctors) and simply labeled ‘transvestites’ — which were not really worthy of medical attention. And these people had, in most cases, gotten married and established families with kids — clearly the sign that they would, at best, be bisexual. Many had no problems in admitting that they were attracted to women only; nevertheless, they still wanted to go through transition, which was absolutely shocking at that time.

Needless to say, when they were refused transition, many committed suicide. Others simply tried to cope as best as they could, developing chronic depression, and finding no joy in the life ahead, but going on nevertheless, for the sake of their families. Others still simply disappeared and went to Morocco or Thailand or other exotic countries to get their surgeries from doctors who had no qualms and no problems in doing what they wanted.

Blanchard took a special (one might even say perverse) interest in these so-called ‘late onset transexuals’. Although he should have known better, he was still attached to the idea that gender somehow defines sexual orientation, and like the generation of doctors before him, he still considered the so-called ‘true’ transexuals to be homosexual (i.e. he saw them as males wanting to be females and wishing to have sex with males) — and that was how the ‘true’ transexuals could be distinguished from the others (he called them ‘homosexual transexuals’, a very dubious and confusing term). The ‘others’ were not clearly homosexual nor heterosexual (although most admitted feeling attraction towards women, many also were attracted to men), but they seemed to have something in common: they entertained sexual fantasies imagining themselves as women. That’s where the odious ‘autogynephilia’ theory comes from.

Now, to be honest, I haven’t read all the articles published by Blanchard, and, even if I had, I’m not really qualified to properly discuss them. All I have read, to be honest, were the many, many articles and papers debunking Blanchard’s theories using his own data. As it was repeated often enough, the conclusions that Blanchard draws aren’t even supported by the data he presents — we’re talking about serious bias here! Nevertheless, Blanchard remains a ‘reputable source’, or an ‘authoritative source’, especially for the more religious/conservative folks who research this area with the purpose of labeling us all as ‘freaks’.

Therefore we have a ‘problem’ if we start coming up with issues that look very much like the kind of things that Blanchard has researched. We know he observed those things and came to the wrong conclusion. So how ought we proceed, if we want to analyse the same kind of issues?

MtF Crossdreaming + midlife crisis/depression = urge to transition?

All right, so there are a few theories out there that explain what Blanchard has observed. Jack Molay’s crossdreaming is perhaps the most solid of them, even though there are few more (which often are even more bigoted than Blanchard’s). Jack’s theory merely observes that some people respond erotically to imagining themselves as a different gender than the other assigned at birth. While this is more common in MtF trans* individuals (as Blanchard has observed), it also happens in FtM trans* people, as well as on other non-binary possibilities. It’s just that the MtF case is either more frequent or more ‘vocal’ about their experiences (and when doing those informal studies, we always stumble upon the problem of the sample — is it statistically significant to be representative?).

According to the theory, therefore, some people simply imagine themselves — dream — as members of a different gender, and this ‘imagination’ can have erotic undertones (or not — it’s not really a requirement). This is not quite the same as saying that such people are of a ‘different gender’. It just means that they have different ways of experience certain kinds of pleasure. And it’s not just sexual pleasure, either.

The typical crossdreamer — and it’s really impossible to estimate how many they are! — might never go beyond the ‘imagining’ stage. And note that ‘stage’ is not really a good word, because it implies some sort of progressi0n, but this is not required by Jack’s theory. So it all starts with imagination, and for many people, that’s all it will ever be: it’s just what crossdreamers like to imagine. They can construct complex imaginary settings in their minds and never really allow such thoughts to ‘escape’ to the ‘real life’ — because that’s truly not necessary, all that is needed is a working brain with the ability to dream, something that can be done at any time, at any place, even though, obviously, it makes a lot of sense of dreaming during the night, in bed 🙂

Crossdreamers who also derive erotic pleasure from such imagined dreams may, in fact, never have any other kinds of dreams whatsoever. Indeed, they might fully perform as members of the gender they have been assigned at birth, and even derive great sexual pleasure while engaging in heterosexual intercourse, but… in their minds, they might be imagining the reverse role, i.e. a MtF crossdreamer might have sex with his girlfriend, but in his mind, he’s imagining how it would feel if his body and his girlfriend’s bodies were exchanged — or if he simply had a female body while still having sex with his girlfriend — and so on. Such imagined scenarios are perfectly possible during intercourse, and, in fact, many MtF crossdreamers report that this is the only way they can achieve an orgasm. Several MtF crossdreamers have also expressed the idea that they cannot have any sort of orgasm otherwise (Felix Conrad is aware of such cases, and writes about them in his own books — something that I can perfectly confirm to be true, since I’m definitely one of those cases!).

Such cases, of course, might never be revealed in public; such crossdreamers might somehow feel ‘ashamed’ that this is the only way they can feel pleasure during intercourse. They might become confused, and they are aware that they’re ‘different’ — they know that other people of the same gender assigned at birth will not have the same dreams. MtF crossdreamers might be confused by porn videos, since they will identify with the women being penetrated, and not with the men, unlike their male cisgender heterosexual friends. Because of that — an inherent sense of ‘shame’ for ‘imagining things differently’ — such crossdreamers may never tell anyone about their dreams, and we have no way to figure out how many there are out there.

The next group (I’ll avoid ‘stage’ for now) requires a medium of expression — in other words, merely ‘dreaming’ is not enough for them. These days, we know that many of them will adopt nicknames, or noms de plume, according to a different gender than the one assigned at birth, and express themselves creatively. The oldest form of this expression, of course, is writing books with a pen name of a different gender; we have tons of historical examples of men signing books under a female name, and women writing books under a male name. Such cases are so frequent and familiar that most people don’t even associate that activity with ‘trans* issues’. We cannot, of course, claim that all those people were (or still are) crossdreamers; what we can say is that many crossdreamers use exactly that. Anonymous words can be a great way to express yourself as the gender you dream to be (or that you identify with; or that you wish to become). But of course there are plenty of other ways to express oneself creatively, and these days we have lots of very talented crossdreaming artists doing all sorts of images, web comics, music, even movies.

On the Internet, nobody knows you're a dog. Image from The New Yorker cartoon by Peter Steiner, 1993.

“On the Internet, nobody knows you’re a dog.” Image from The New Yorker cartoon by Peter Steiner, 1993.

The Internet has brought us even more ways of self-expression. From the early days of anonymity on popular newsgroups found on USENET, to discussion forums, to Facebook and Instagram profiles, crossdreamers have managed to ‘hide’ their gender assigned at birth and easily forged a ‘new identity’ with which they could identify with. Because the Internet is still largely based on text, it means that crossdreamers can much more easily ‘pass’ for the gender they identify with. This is especially true on popular virtual worlds or games, where one can design one’s avatar — and pick one’s gender at will. So-called gender-benders (a borrowed term which has become popular on the Internet) may, indeed, ‘hide’ their ‘true gender’ relatively easily — and therefore freely express the gender they identify with, with little fear of being found out. The popularity of YouTube and of video communications using the Internet has slowly been ‘intruding’ on the ability to ‘pass’ as a gender-bender, even though, these days, audio can be easily masked to sound as a different gender.

But with video, things are much harder: it implies crossdressing. So, in Jack’s classification, many crossdreamers manifest physically their attunement with a different gender by crossdressing. You might have noticed that I’ve deliberately dropped the erotic overtones from imagination-only crossdressers to replace it by ‘gender identification’ as the manifestations become more ‘physical’. But the truth is that crossdressing, as an act, may be very exciting to a crossdreamer, even in the erotic context of the word. And here is where we cross — again — Blanchard’s domain.

Blanchard, unfortunately, got into contact into the most extreme cases of crossdreaming: when crossdreamers’ urges, requiring physical manifestation, become so intense that those people wish literally to become ‘the woman of their dreams’ (or, for FtM crossdreamers — which Blanchard did not study! — they wish to become ‘the man of their dreams’). Because this requires transition, of course, Blanchard fit that group into the ‘transexual’ box and allowed them to transition; nevertheless, they had to endure Blanchard’s chauvinistic classification of ‘perversity’, implied in the very polite and scientific word ‘paraphilia’. They had to ‘learn’ that what they are going through was an abnormal desire to ‘have sex with their own self-image as a woman’, and that this kind of thinking was a mental disease, associated to gender dysphoria, whichm, however, could be cured via transition. One wonders how many late onset transexuals had to endure all this verbal abuse in order to get their transition.

Instead, I shall suggest a different mechanism to explain some cases of late onset MtF transexuality. I cannot fully take credit for the idea; to be perfectly honest, it came from my wife. Also, with a slight modification, it might also explain some cases of late onset FtM transexuality.

First, of course, we will need to posit that at least some cases of late onset MtF transexuals are crossdreamers with a ‘female gender core’ (or feminine essence, as some authors put it). For the moment, I will not go deeper into what that ‘gender core’ actually is; you can read about my suspicions (and assumptions) on my previous articles. I’m just going to assume, for the sake of the argument, that this ‘gender core’ exists and is at the root of crossdreaming.

Let’s also similarly assume that such people have, in general, keep their urges and desires in check. Before the widespread of transgender information through the Internet, they might not even have had the opportunity to figure out what ‘transgender’ means and in what way it refers to them, personally. Instead, they will just believe that they are perfectly normal cisgender heterosexual males, with weird dreams, and nothing more. A few will indulge in casual crossdressing, with or without sexual intercourse with a partner. In some cases, they might even reveal to their wives that they get turned on by wearing women’s clothes; both partners will therefore assume that the husband simply has a fetish, and that’s all it is.

During moments of crisis – a job lost, a deceased loved one, etc. – our crossdreaming friend will be particularly vulnerable to his crossdreaming urges. The fantasizing will become more urgent, take more time; if there is some crossdressing, it will increase in intensity; there will be some confusion as well (e.g. ‘why should my desire to crossdress increase just now that I need a bit of peace of mind to deal with this situation?? I have enough problems, I don’t need another one…’).

One might ask – why? Why does this happen? Why do crossdreamers’ urges and desires increase during times of stress and/or depression?

The answer, of course, is hormones. It’s no secret that stress, in general (and depressive states as well), decrease the libido, i.e. the levels of testosterone are reduced through the release of other hormones (like cortisol). You can read an article on the subject which also links to several published studies – the correlation between stress and testosterone productions seems to be well-established. To make things even worse, stress inhibits testosterone production, which leads to lower libido, which – in most males – will possibly induce depression or even more stress, which in turn decreases testosterone even more, and so forth: it becomes a vicious circle, and one that is hard to escape from, although obviously there are medical treatments and therapies to deal with all that.

Now, what happens when you lower testosterone in a perfectly healthy male? Well, the answer is pretty obvious: he feels ‘less male’, especially because males are so conditioned to think and believe that ‘maleness’ is connected to ‘sexual prowess’. Start losing the ability of sustaining an erection, or even getting an orgasm, and the male becomes insecure about himself. It stresses him even more to ‘feel less being a man’.

If our perfectly healthy male is a crossdreamer, however, a slightly different mechanism takes place. Because no matter how hard we try, our society still behaves as if there are just two binarily opposed genders, it’s hard to shake off the feeling that if you are ‘less male’ you probably are ‘more female’. We know, of course, that this is not the case (check the Genderbread Person again, if you have some doubts about this). However, we have been so much conditioned by society to think that way that it’s very, very hard to break out of the binary gender. Therefore, when testosterone levels are reduced in our male-to-female crossdreamer, what happens? He will crossdream more. And more. And, incidentally, he might figure out that, in spite of not being able to reach an orgasm ‘normally’, he has no trouble doing so when imagining himself as a woman. And there is no contradiction here: while testosterone levels most certainly influence the libido levels of a healthy male, it is not the only reason for ‘performing well’ (or our species would have died out unless we were all overpumped with testosterone — which is clearly not the case). In fact, in spite of so many allusions to the contrary, sex happens almost entirely in the mind. Crossdreamers know that better than anybody else, but any person will have experienced that during ‘wet dreams’: you really don’t need anything else but your mind to get an orgasm. All the chemical stuff, the visual stimulation, the physical contact, and so forth, they are just triggers, enhancers, secondary conditions, or whatever you prefer to call them. In other words: even without any sensory perception, ‘sex happens’ — in your mind. However, obviously, it can happen more or less easier depending on all those ‘extra goodies’ that might be active.

When a MtF crossdreamer has, for some reason, their testosterone levels diminished, this might lower the libido (which is a perfectly established scientific correlation), but, at the same time, the mind may compensate for the lack of testosterone and potentiate a more erotic crossdreaming. In other words: taken a binary gender approach, which is still held by the majority of people, the MtF crossdreamer feels ‘less of a man’ and ‘more of a woman’. He can simply point out to his own dreams. Dreams, after all, are supposed to somehow (in a Freudian/Jungian sense) give us some hints on our subconscious thoughts and feelings. Even if we don’t ‘believe’ in Freud/Jung, our society as a whole still takes that approach as a valid one (after all, we still have many practitioning psychoanalysts who follow Freud, Jung, and those who have been inspired by them to continue to research the field). In other words, MtF crossdreamers will ‘believe’ that their dreams — which happen spontaneously most of the time — will point out the existence of a ‘female gender core’ or ‘feminine essence’ deep within their minds. The more they crossdream — the less they are under the influence of testosterone — the more they become convinced of this ‘feminine essence’.

Again, there are several ways to deal with this feeling. One, of course, is continue to suppress it — but at one point, it will become impossible to do so. Why? There are both psychological and physical reasons for that; for instance, an increase in anxiety due to stress — or of clinical depression — which lower testosterone production in biological males. Unless you have a special training in ‘mind taming’ (an expression used by certain Hindu and Buddhist meditation schools), and a lot of practice, it’s very unlikely that you will be able to handle the increased stress of suppressing such feelings more and more. Something is going burst, sooner or later. And you don’t want to be around to pick up the shards…

In short: as a male ages, its testosterone levels will diminish over time. Unlike what happens with women’s menopauses, however, the reduction over time is much, much less pronounced. However, testosterone production, like many similar hormones, is subject to variations — most notably, when one is going through prolonged periods of stress. In crossdreamers who require dressing up as women to satisfy their urges, increased suppression of those urges will increase stress — at the same time, of course, that other external sources of stress will also affect the person (e.g. family issues, financial issues, issues at work, and so forth). By reducing testosterone levels in a MtF crossdreamer, this will not only reduce their libido, but very likely also increase the feeling that their ‘inner feminine essence’ is demanding attention. This mechanism feeds back on itself: more stress means less testosterone means more intense urges to crossdream/crossdress/assume one’s inner feminine essence means more suppression means more stress… and that goes on and on, until something has to give way.

Sometimes what ‘gives way’ is just entering a severe depressive phase, which, however, can often be shrugged away as part of the ‘midlife crisis’. That means paying no attention to the symptoms, and they will only get worse. Stress also affects depression (and vice-versa), so that means another variable in the feedback loop.

At some point — and this can go on for many, many years — a phenomenon amusingly called ‘Glamourpuss’ by Felix Conrad, and similarly identified by Ana Cristina García, becomes more and more stronger, and, if unchecked, it will even ‘take over’: this is the very strong belief, very deeply rooted in one’s inner self, that a MtF crossdreamer is a ‘woman inside’ and therefore has to start to behave as they imagine a woman ought to behave, and that, of course, does not merely include the more futile aspects (starting to waste money on makeup, clothes, shoes, wigs, breast forms…), but also an increased desire of ‘coming out’ — or, if already ‘out’, to go out more and more in public, and start getting used to the idea of ‘being’ a woman. This is when thoughts of transition really start to become very intense. And in some cases, such crossdreamers really start taking their first steps towards ‘becoming women’, or, as they would describe it, to ‘align their physical bodies to their inner essence, which is feminine’.

Where Blanchard has gone totally wrong

Currently we have two major theories explaining late onset transexualism. One, of course, is Blanchard’s. He’s very surgical and precise in his classifications: if you claim to be a MtF transexual, either you’re attracted to males only, and then you will have been a woman since your birth; you will also have a reasonably feminine body, even after years of dealing with male hormones during puberty. But very likely you’ve been one of the ‘lucky ones’: for some reason or other, you’re not particularly male-looking. With Blanchard’s blessing, you will be labeled ‘homosexual transexual’ and pushed into transition. It’s very likely that you also are an early onset transexual.

Any other case — thinking about transition during your adult age (or even during midlife or later); not being especially feminine-looking, nor even behaving adequately like one; feeling attracted to other genders and not exclusively to males; then, well, Blanchard is very harsh with his classification. He will argue that you have always had an erotic attraction to yourself as a woman, i.e. autogynephilia — even if you argue otherwise, Blanchard will tell you that you’re lying with all your teeth. So basically you just have a very complex fetish, produced because somehow your brain is incorrectly wired to locate the target of your erotic attraction inside yourself, instead of outside, where every other sensible person has it. You’re an ‘autogynephilic transexual’, and there is nothing you can do about it. Rejoice, though, because the good news is that Blanchard, although believing you to be a sexual pervert of the worst species, also believes that transition is the best thing you can do to feel better about your gender dysphoria.

There is no ‘third’ case. Blanchard’s classification of transexualism is purely binary — all-or-nothing. A few of his followers, namely Lawrence, have attempted to adapt Blanchard’s theories to a spectrum, but I have no idea about how widespread those derivative theories are. All I can see are mostly pure Blanchardians publicly discussing his theories more and more, deliberately making sure that everybody searching for ‘transexualism’ or ‘gender dysphoria’ come into touch with Blanchard’s theories, and, yes, understand that they are filthy perverts and ought to die. Well. Perhaps not ‘die’. But get used to the idea that they are filthy perverts. This, naturally enough, leads several people to terrible frustration (because transgenderism is common across all societies, imagine how a religious fundamentalist will feel if they come across Blanchard’s theories, in a desperate attempt to figure out what’s wrong with them…); in many cases I can believe that people, instead of getting treatment, will walk out the office of a Blanchardian, terribly disappointed that there is no hope for them (even though there is), and because they cannot live with the idea that they are nothing else but sexual perverts, they commit suicide. Or, if not, they are doomed to chronic depression, possibly lasting the remainder of their lives. Or anything else, really; the trauma of being exposed to Blanchard’s theories can run very deep.

Blanchard’s theories go so far as to say that ‘autogynephilic transexuality’ is something typical of the Western world, and does not even exist in other parts of the world, where every transexual is either an early onset transexual — or is simply lying, and is a ‘transvestic fetishist’. Apparently, autogynephilia is the ‘privilege’ of the West; and before you ask, yes, this is ‘science’ too, because Blanchard’s minions have, indeed, published their results in peer-reviewed journals. The fact that they are also constantly being debunked is irrelevant for a Blanchardian: it just shows that autogynephilia, being ‘truly scientific’, is proud to be subject to discussion and argumentation — through which, Blanchardians say, we might be able to create better models.

This is naturally very arguable.

Now, the alternative scientific explanation is the ‘gender core’ or ‘gender essence’ theory. It has a problem in terms of purely scientific answer: it has to posit something new, something which is invisible and cannot be really measured objectively — although it can be measured indirectly — to give the theory explanatory power. The ‘feminine essence’ theory allows a much wider range of transgenderity to be explained; it also explains why certain ‘urges’ can be suppressed or repressed, and how they can come back to haunt us in situations of stress. Because it posits a gradation of the intensity of those urges, methods and procedures can be employed to allow people to feel better — and transition, unlike what the Blanchardians claim, might not be the only option, but merely one option among many. In essence — pun intended! — every individual MtF crossdreamer will have a different ‘relationship’ — if I can use that word — with their ‘feminine essence’, and, by establishing the degree of intensity of that relationship — and how it affects one’s mental health — several different approaches can be used to deal with gender dysphoria.

I wonder if I'm overthinking all this...

Feminine essence? Well, maybe.

Note that the ‘feminine essence’/’gender core’ theory does not reject the crossdreamer idea that one can feel attracted to one’s self as a different gender than the one assigned at birth. In other words: such ‘fantasies’ emerge in one’s mind because there is a ‘feminine essence’ behind it all. Many Blanchardians argue that ‘cisgender women do not have erotic dreams of themselves, but rather of having sex with their preferred partner’. This is a gross oversimplification; in fact, cisgender women can have erotic dreams of themselves, without needing to conjure a partner, or having a ‘generic partner’ to perform the sexual act — in fact, this is not much different from what a MtF crossdreamer experiences. Cisgender women are also quite keen to point out that they do, indeed, have a ‘gender core’: they are always ‘women inside’, no matter how they look, how they dress, and how they behave and interact with others (my wife is a very good example, and she’s not the only one; I have met several cisgender women who do not really ‘fit’ in the stereotypical female gender role, and even thoroughly reject it, but strongly identify as women). Some of them will get ‘turned on’ by their own bodies, the things they wear, and so forth; others don’t. Therefore, the ‘gender core’ theory does not give so much importance to what a person dreams, but much more about how they feel about it, and how the ‘feminine essence’ affects a MtF crossdreamer, especially during times of crisis.

This theory also allows for the explanation I gave before: why someone who has been quite comfortable with their crossdreaming all of a sudden start to get anxious about it and begin experiencing symptoms of gender dysphoria — my reasoning is that hormonal changes (and, mind you, I’m not limiting myself to sexual hormones), combined with a lot of external triggers (most of which induce stress, anxiety, or eventually depression), will ultimately lead to some form of gender dysphoria — or at least, questioning one’s gender. Note that, like Felix Conrad — and most certainly not like Blanchard! — I’m assuming there is a ‘feminine essence’ somewhere inside the crossdreamer. My own reasoning for that — and unlike what some of the Blanchardians claim — is that the ‘feminine essence’ theory does, indeed, provide much stronger explanatory power. In other words: Blanchardians believe that fetichism is at the root of late onset transexuality, arguing mostly that we can have any kind of fetish, so why not have an autogynephilic fetish? The major flaw with this line of argument, in my opinion, is that having ‘any kind’ of fetishism does not explain why so-called ‘autogynephilia’ appears in the first place. I mean, there are all sorts of paraphilias, but not all of them have any explanation for their cause — they ‘just happen’, or, in other words, people have, somehow, a predisposition (genetic, biological, traumatic…) for certain kinds of paraphilias and fetishes, and that’s why they have them. The problem with most of these theories is that they fail to account for an evolutionary reason for their existence. Let’s see a typical example: why should someone with apotemnophilia (the desire for amputation of a specific limb) have an evolutionary advantage? We can assume it’s just a ‘genetic error’, but in that case, why hasn’t this genetic error been weeded out by natural selection, if apotemnophilia does not provide an evolutionary advantage?

We can always reason that in all those cases we simply don’t know how to answer that; this is fine, it’s still good science, we just observe and record, and leave the explanation for a later stage. But in good science, theories ought to be falsified; in other words, it’s up to the ones making up the theory to provide a method (an empirical experiment, or at least a form of logical argumentation) through which one can validate or refute the theory. That’s good science. A typical example: many forms of Intelligent Design are refuted for not being falsifiable, since ultimately the proposers of those theories can always say, ‘God wished it so’, and since we cannot ask God to tell us His wishes, we cannot prove or disprove such theories. That’s why Intelligent Design theories (or at least most of those theories) aren’t ‘good science’ — we simply cannot set up an experiment to validate or falsify the theory.

The ‘feminine essence’ theory, however, is falsifiable. Because it posits that somehow inside the brain there are some structures that either directly, or most likely indirectly, create a so-called ‘gender core’, we know that, sooner or later, with more advanced technology, we might be able to prove or disprove the existence of that ‘gender core’. Even if we are unable to make a physical validation (maybe because the workings of the brain are far too complex for our understanding), we can make observations and deduce the existence of such a ‘gender core’. As I gave in my example before: my wife, who is a cisgender heterosexual female, no matter how she’s dressed or how she looks like, no matter what job she has or what role she plays, will always feel ‘feminine inside’, and claims, very emphatically, that her own ‘feminine essence’ exists beyond mere biology — in other words, her gender identity is not limited to her body (and her appearance). She’ll always feel ‘to be a woman’, even if she gets third-degree burns and surgically removes all secondary and primary sexual attributes. And although I haven’t asked a sufficiently large group of people, I’m pretty sure that if we get a sample of thousands and thousands of cisgender men and women, all of them will give explanations similar to my wife’s. Then we have to ask ourselves: if all cisgender people feel like that, isn’t is much more plausible to assume the existence of a ‘gender core’, since all these people behave as if that ‘gender core’ truly exists?

We might also argue that people ‘feel’ their ‘gender essence’ or ‘gender core’ because they have been socially conditioned to feel so, but we have very good evidence that this is not the case. Boys, even if they don’t get told anything, will at some age start to feel attracted to participating in groups of other boys and emulate their actions and behaviour — and games — while girls will do the same. This happens irrelevantly of what parents or educators tell them. As I said in a previous article, kids will understand by themselves, with no need for external input, that they ‘belong’ to a certain gender, and will naturally group together with people of the ‘same’ gender. I have also argued (following a lot of Felix Conrad’s own explanations) that such a natural grouping must have strong evolutionary purposes: to survive, the human species (as well as all sexed animals…) will need to recognise their own gender and the gender of others, in order to reproduce. This is what leads so many people in the fields of sexology and gender studies to postulate a mechanism that is behind all that, and that we label ‘gender core’ or ‘essence’.

When we come to transgender people, then the assumption is that this ‘gender core/essence’ is not perfectly aligned with one’s body. In other words, transgender people question their ‘gender core’ — something that does not happen with cisgender people. My own definition of ‘transgender’ is, therefore, ‘someone who questions their gender core’. Blanchardians might prefer, as an alternative explanation, to postulate that such questioning is a mental illness. But they fail to explain the evolutionary reasoning behind it. As I’ve written on previous articles — not my own theories, mind you, but what has been established by researchers and thinkers in the field — there are good reasons why transgenderity has been preserved by natural selection (you can read them on my previous articles, I will not repeat everything!). Perhaps the best example is the existence of a ‘non-binary gender role’, present on all hunter-gatherer societies, which is the shaman/medicine man/wise woman. I think this is so fundamental from the anthropological view that it deserves a full article on this subject. In essence, the theory is that such ‘non-gendered’ social roles were crucial to maintain a society’s culture and customs, and, as we so well know, creating a common identity for a tribe or clan (and later for a city or nation) is what allowed humans to cooperate (benefitting from being gregarious — ‘stronger together’, as Hillary Clinton would say 🙂 ) while at the same time compete for resources with the ‘other’ tribes or clans. It’s by creating a common identity that such cooperation/competition behaviours have been preserved — for hundreds of thousands of years, and dozens of thousands of generations. It’s only very recently — namely, with the advent of cities (‘civilization’) and written language, something we just have for six thousand years or so — that we could ‘abandon’ the source of lore (or culture, if you prefer) that was embodied in the shaman/medicine man/wise woman. And as we all know, there are still a lot of humans living as hunter-gatherers, or direct descents of such societies (like almost all Native Americans, for instance), and who still respect, or at least remember, the importance of the shaman and their role in society. And, as I have claimed before, such roles were ‘outside’ the binary gender.

So to conclude this argument: the ‘gender essence’ theory may have physical roots or not, and we may or not find out ways of detecting such physical clues (e.g. MRI scans of the brain). But what we know tends to point that it exists in some form. At the same time, we are aware that transgender people serve (or served) a very specific evolutionary purpose, even if not many transgender people were needed for such purpose, which means that natural selection would not ‘weed out’ transgenderity from the hereditary legacy of the human species. If we posit transgenderity as merely a questioning (in the sense of ‘not being sure’) of one’s ‘gender core’, then we have a much stronger explanatory power than other theories, namely all those that label transgenderity either as a perversion, a fetish or paraphilia, a mental illness, or even a genetic/biological ‘error’ — because for all such cases, we would have no good explanation about why natural selection kept them around, since they seem not to have any practical purpose (from an evolutionary point of view) except to make one’s life a hellish nightmare — and even if we can accept ‘genetic errors’ as part of what makes natural selection work, we have also to understand that ‘genetic errors’ are far less likely to appear (we have reasonably good statistics showing the rate of genetic errors appearing on human DNA; it’s a really well-researched field!) than the ratio of transgender people to cisgender people — there is simply no way it can happen due to ‘genetic errors’. Also, very, very few genetic errors are somehow beneficial (compared to those which aren’t!) and even less are actually passed from generation to generation.

What we can argue instead is that transgenderity, because it fulfills a fundamental evolutionary advantage (because it was directly linked to the survival of the clan/tribe through medicine men who preserved the ‘lore’, thus giving ‘identity’ to the clan/tribe), very likely has been preserved by natural selection. In the early days of the human species, those clans/tribes who had a stronger cultural identity would be much more likely to survive — and reproduce faster — than those who hadn’t a medicine man to tell them what their identity ought to be. As said, I will develop this thought further; for now, it shall suffice to explain why I personally believe that the ‘gender essence’ or ‘gender core’ theory is much more powerful to explain a lot of things related to transgenderity than any other alternative proposed by Blanchardians and other groups (who might refute Blanchard, not even accept autogynephilia as a valid reason for transition, and just believe that ‘transgenderity’ is a mental illness).

What is missing, therefore, is an explanation of the mechanism which triggers ‘transgenderity’, at least in the classic sense of a MtF transgender saying that he feels to be ‘a woman trapped in a man’s body’ and therefore wishes to transition. I propose that such feelings are produced by a complex combination of hormonal imbalances and external triggers — but the person must have a ‘gender essence’ not aligned with their physical body in the first place. Note that I’m not even assuming that it’s just ‘sexual hormones’ that trigger the urge to transition; in fact, because we have so many recorded observations where injecting people with sexual hormones will not change either their sexuality or gender identity, it’s safe to say that they’re not the cause for transgenderity. But we cannot forget that what we call ‘hormones’ are a vast variety of messaging chemicals that also go through the brain’s blood barrier — they are part of our second information network in our bodies, the first being, of course, the central nervous system. But this chemical messaging system (of which ‘hormones’ are a part) is also rather efficient — while it doesn’t work in the millisecond range, it works in the single-digit second range (yep, it’s that fast!), and it has the further advantage that, unlike the central nervous system, hormones can re-wire the brain and make it work differently. It’s actually quite hard to figure this out — because we usually do not feel our brain ‘working differently’ — until we remember that we drink coffee to wake up, drink alcohol to change our mood, or use all sorts of chemicals to induce hallucinations, or a sense of calmness, or to make us more aware and focused on our work… and so forth. So, yes, chemicals change the way the brain works. We know that quite well — because we behave so differently when drunk, even though we can afterwards claim ‘that was not me, that was the alcohol talking’. Sure thing! The point here is that alcohol is also able to re-wire the brain and make it work differently, and that’s why it’s such an interesting (but dangerous!) drug.

Other hormones will also change the way the brain works, and I’m always fond of bringing up adrenaline into the discussion, because that’s another case where we are quite aware of the differences in our brain (but also in the body itself!); and, of course, if you have been through depression and anxiety, you will be familiar with how the brain works when the serotonin levels are not at their normal values. In short: yes, all those chemicals ‘conspire’ to make the brain work differently, and all of them are fundamental in the way they act upon the brain. Sexual hormones are just one particular brand of hormones that also have an effect on the brain, although not quite in the way that people in the 1950s thought they had.

Because when people talk about ‘trans-anything’ they usually think about sexuality — which is supposed to be just another aspect of one’s identity — there is always this ‘jump to conclusions’ that, if you ‘feel’ your gender core is different from your body’s biological gender, then something must be wrong with your sexual hormonal levels. While sometimes this is the case (and apparently it’s more frequent than I thought!), there might be a lot of hormonal levels that are ‘different’ from the standard — and not all might be related to sexual hormones. And last but not least — there are a lot of things that can ‘go wrong’ with your organism. It’s not just hormones!

Does this sound a bit like an apologetic explanation for ‘crossdreaming’? ‘Blame it on the hormones’… But no, as you will see, there is a good reason for this argumentation.

The development model

One thing that always bothered me on the many explanations I’ve read about transgenderism was the ‘implication’ that there is somehow a ‘progression path’. Twenty years ago, the old joke ‘What is the difference between a crossdresser and a transexual? — Five years’ was actually taken seriously: the idea was that all crossdressers, if they could, would change their gender.

Sociologists like Richard Ekins (even though he has changed a bit his opinions recently) have been particularly eager to follow what they call a ‘career path’ — how transgenderity progresses in an individual’s life. While Ekins most certainly admits that all people are different, and that many will never follow the whole path, he was interested to see how far each person would go, and understand the reasons why they did it — or why they stopped. His book on ‘Male Femaling’, even though limited to MtF transgender persons, and clearly a study made in pre-Internet days, is a wonderful reference about the subject, especially because Ekins, like it is fashionable today, avoids using ‘labels’ when talking about transgender people. He has a sociological approach, of course, but his book also (indirectly) develops a methodology that can aid doctors to help transgender people and give proper advice — by recognising certain ‘phases’ in someone’s life and knowing what the possible outcomes could be, a doctor can probably narrow the choices they can offer to a particular transgender patient, and these choices will be best tailored to what they need to feel better about themselves and allow them to cope better with their lives.

Nevertheless, there are a few cases (which might not be so ‘interesting’…) where ‘nothing changes’, i.e. there is no ‘progression path’. Typical examples are cisgender persons, of course: they identify with their gender, period, end of story. They can blame society once in a while, or lament their gender in certain cases (‘woe to me, as I have to carry this baby for nine months…’), but, in general, there is no ‘career path’ in the sense that Ekins discovers with transgender people. But early onset transexuals also don’t have a ‘career path’ in that sense, either. They already know that something is terribly wrong with the way others look at them; they are sure of their gender, practically since birth; it’s just that they have somehow acquired the wrong body. They do not really ‘question’ their gender, they might just question why their body has not developed according to their gender. Once they go through gender confirmation surgery, then their body is fully aligned with the gender they identify with, and they lead perfectly normal lives — just like cisgender people, in fact; and they will not ‘progress’ further in their gender exploration, simply because that would be as futile for them as it is for cisgender people. And fortunately, these days, we catch early onset transexuals so early that we can even give them a puberty appropriate to the gender they identify with. In one generation or so, there will technically be no more ‘early onset transexuals’ needing to wait for their surgeries and hormones on strange institutions; instead, kids will be screened at school, sent to a pediatrist, who will evaluate them and prescribe to them puberty blockers, while they immediately start presenting themselves as the gender they identify with. Being born ‘in the wrong body’ will just be one of those routine surgeries/medical interventions like fixing a cleft palate or cleft lip; it’s going to become so easy to fix at the earliest date possible that nobody really will care how exactly that person has been born. I can even imagine that some of them will not even remember having been ‘born in the wrong body’ (for instance, I have very, very few memories from my earliest days — while I have a few scattered memories from when I was 4-5 years old, and I’m pretty sure those memories are ‘real’ and not induced by conversations with adults, I cannot say the same about earlier memories — although I know a lot of people that can go really far back in their memories, sometimes up to the first months of life).

While we can argue if assumed transvestic fetishists are part of the transgender spectrum or not, the truth is that they will also not follow a ‘path’. They might indeed learn more and more how to behave like a woman (in the case of MtF transvestic fetishists), and this naturally means learning a lot of new things, and possibly engage in new social interactions, but from the perspective of the mindset, nothing will truly changed. They will only be more experienced, that’s all.

The same actually also applies to a lot of crossdreamers. They are more than willing to explore a certain aspect of crossdreaming — which, indeed, they might follow up and expand and perfect over the years — but not ‘go further’. They will remain happily at the ‘stage’ they are comfortable with (I don’t like the words ‘stage’ or ‘level’ because unfortunately it’s loaded with the idea that there are upper levels, lower stages, and so forth, when in fact they are all equally valid — perhaps ‘type’ is a more neutral word in this context). A few friends of mine, for instance, are ‘merely crossdressers’ — they have fully embraced that part of themselves, and enjoy it fully, without any need to ‘go further’, either. They might explain their crossdressing by ‘being in touch with their feminine essence’ but that’s it — they don’t need anything more than ‘being in touch’.

This is not a rebuttal of Ekins, of course, because Ekins (as well as others) fully recognise that this is what happens to a lot of transgender people — they do not ‘progress along a path’, and that’s more than fine: in fact, being able to reaching a destination with which they are comfortable with provides a degree of happiness.

It’s those transgender people who ‘travel a career path’ that, ultimately, are seeking a form of alleviating their discomfort or even suffering. Sometimes they can find it, and their search is over; sometimes, this is just a temporary respite, until they are pushed to seek another explanation for themselves; sometimes, the destination is transition — or suicide.

Interestingly enough, these are possibly the cases that have been more researched, for some obvious reasons: these are the people that are more likely to seek medical help (or attempt to self-medicate). Also interestingly enough, they are predominantly adults. It’s when I saw a distribution of ages of MtF transgender people seeking help (and being diagnosed with gender dysphoria, i.e. ‘late onset transexuality’) that something caught my attention: the distribution is pretty similar to the distribution of ages connected to the symptoms typically called ‘midlife crisis’.

As I have often repeated, every scientist knows that ‘correlation is not causation’. However, sometimes it’s worth looking at correlations, because they might give us a hint on what is going on.

Now, I haven’t done a rigorous, scientific research, but there are a lot of similarities I find on MtF crossdreamers’ narratives, when they reach the stage of self-labeling themselves as ‘late onset transexuals’ and get a medical confirmation of their gender dysphoria. They all claim that the feeling of ‘being a woman’ started in their early years — i.e. with 3-4 years they would start dressing clothes of their sisters, mothers, or other female familiars. Some would get caught and get a beating; most would be forced to ‘forget all about it’, and, indeed, unlike early onset transexuals, they would obediently comply and try to lead their lives according to the gender role they were told to be.

When they start puberty, they get terribly confused (again). For many, this is the stage where they start crossdressing with a clear intention of ‘feeling well’ — it’s not merely a joke, some kind of play, or merely due to curiosity. The questioning of their gender identity — which is something every teenager goes through — will cause mental anguish and real anxiety. They start to believe that there is something ‘fundamentally wrong’ with them. During moments of crisis, crossdressing — or at least some form of crossdreaming — provides comfort, stress relief, or, in many cases, orgasmic pleasure. It’s the latter that will be misinterpreted first by the Blanchardians, but then also by the mainstream doctors, who still use ‘orgasmic pleasure when dressing as a woman’ as a way to distinguish transexuality from, well, other forms of transgenderity (including fetishism). In other words: no matter how wrong Blanchard is, the truth is that doctors are still conditioned to think that ‘true transexuals’ are purely attracted to members of the opposite gender than the one they are assigned with, and that nothing else will give them pleasure — while we all know that pretty much everybody has sexual fantasies beyond merely having sex with a desired partner.

Once puberty is ‘passed’, entering young adulthood, such MtF crossdreamers will now attempt to live their lives according to the male gender role that was assigned to them. In fact, they will very likely pick a stereotypically male job — from choosing a career in the military to driving lorries to becoming a construction worker. They will attempt to get married and have kids. During this time of early adulthood, they might abandon crossdressing or other forms of crossdreaming (especially once they’re married and get the first child…), or limit it severely. Once in a while, during times of extreme stress, the urge to crossdream/crossdress/somehow express their ‘inner female’ will become overwhelming, not unlike what a drug addict feels when he needs another dose…

One or two decades may pass. At that point, however, their lives start to change. It’s very likely that their marriage collapses, even though almost never due to the crossdressing (in most cases, they will never reveal themselves to their wives). Or things change at the job. In some cases, this leads to stress, then anxiety, then depression; and during that time, the urges become overwhelming. They start to behave irrationally regarding their crossdressing. But such ‘bursts’ might be short-lived: this leads to the many ‘purges’ (throwing out all female clothing and apparel… only to buy it back after some months), and an internal struggle between the need to continue the appearance of a ‘normal’ life, and the urges to crossdress… and eventually even do ‘something more’ beyond crossdressing.

These days, there is another layer of complexity thrown upon this — and it’s called the Internet. Because we can Google for answers, we can also get all the sorts of information about transgenderity, crossdressing, transexuality, and so forth… and this will also mean that this information will influence one’s own ‘choice’ inside the (trans)gender spectrum. I remember that when I first started to search for information on the Web, back in 1995, I was only given two ‘choices’: either transvestite/crossdresser, or transexual. There was just ‘fetishism’ beyond that, and I clearly didn’t ‘fit’ into that group, and ‘transexual’ was way too expensive for me (little did I know, back then, that our National Health Service would cover all the medical costs of transition…).

But as time passed, more and more subtle variations along the transgender spectrum became ‘available’ — pretty much allowing me to pick one of them 🙂 Well, it’s not quite like that, but you know what I mean: if someone in the teens only knows about transvestic fetishism to explain why they have the urge to wear women’s clothes, then they will start to ‘believe’ to be a transvestic fetishism. Then they might stumble upon groups of ladies dressing up to have some tea together, then go out for some shopping and even going to the movies — and ‘sex’ is not involved. So they start to wonder, wow, perhaps that’s more what I am. And afterwards there are all sorts of stories of people just undergoing facial feminisation surgery but letting the rest the body remain exactly as it is; or others who ‘discover’ that they are gender fluid, not really ‘stuck’ to any gender but gently moving from one to the other — or somehow remaining ‘in the middle’ — or even being gender oscillating, i.e. flipping from male to female to male again, sometimes during the course of a single day, and having absolutely no problem with that… so one might wonder, there are so many fantastic options out there, which one will fit me best? And, of course, at the end of the road, there is the example of Caitlyn Jenner shining on top of all of us, showing that you can be all those things, become an Olympic athlete, get married and raise a family, and still end up your life, retired, as the woman you have always been.

What happens is that once we start ‘feeling down’ — that something is not quite right with us — then we turn to the Internet in search for solutions. We want to know that others have felt just as we feel, have traveled the same road, and found their own solution. Maybe it will work for me as well? It might just be a dream at the beginning, but — who knows — dreams can also come true, can’t they?

Then perhaps our busy life intrudes again, and we forget about all our gender identity troubles, focus on work and family, maybe going out dressed once or twice… and not really thinking much about it… life’s good, after all, why worry so much… until — bang! — something happens.

It might be an unexpected divorce, which we hadn’t seen coming. Or the death of a close familiar — possibly a parent. Or suddenly losing the job and getting a notice from the bank regarding our mortgage. Or… you can imagine: something that totally disturbs the regular flow of life.

Our bodies react to that — it’s called stress. And that means releasing a lot of chemicals — hormones! — in our bloodstream. Once again, the idea of getting rid of one’s gender role, starting afresh in a new gender role, becomes more and more enticing. And to deal with the stress — we crossdress more. And we read even more about the subject. And we get in touch with friends, possibly in our own age group, also having to deal with the problems of their daily lives… and naturally enough, we influence each other.

All right. Let’s step out for a while and observe from afar. What is happening here?

Effectively, what I’m pointing at is that, at some time around the 35-60 age interval, certain crossdreamers start to ‘think transgender thoughts’ — and this begins due to something dramatic in their lives (it can also be something positive, of course). But this throws them completely off track — they start behaving and thinking in a way that clearly borders the irrational. Why? There is a good reason: somehow, in the middle of this narrative, our crossdreamers have reached their midlife — that time when we suddenly realise that we don’t have that much time to live more, but still feel quite young inside, even if our own bodies tell otherwise; and somehow we also feel that we have ‘wasted’ too much time already, all in vain. This pushes men during their midlife crisis to do crazy things that they will quickly regret.

As said, not all men go through the symptoms that we attribute to midlife crisis. Also, not all men are crossdreamers — obviously! But among some men who are simultaneously crossdreamers and are going through a midlife crisis, there is an explosive combination — all of a sudden, they might start to believe that, after all, they are women trapped in men’s bodies — and that everything they read, talk, or think about will confirm this.

Even if they start to get blood samples to figure out their hormonal levels… they will see a decrease of their sperm count, of their testosterone levels… suddenly everything makes sense: they have never really been ‘real men’ after all. Sure, that doesn’t mean that they are, in fact, ‘real women’, but… why not give it a try?

Midlife crisis also means… bad decisions

Well, I'm almost 50...

Well, I’m almost 50…

Some kids want to be astronauts, others want to be doctors, others still have just this vague idea that it would be fun to be a cowboy or an Indian. In my own case, I always found it unfair that I couldn’t be what I wanted to be — a girl. So, instead, I studied to become a computer engineer, mostly because computers didn’t bully me, nor make fun of me. At least that was my narrative.

As I approach half a century living on this planet, I look back and see how terribly I have played my ‘gender role’ as a male. In fact, on those moments that people told me that I ought to be ‘more like a men’, and acted accordingly, were among the most ruinous (even at a financial level!) for me. Therefore it’s not surprising that I came to the conclusion that I really suck at ‘being a man’. You read about it on the previous article. This is a typical symptom of the so-called midlife crisis: depression and the feeling that we have wasted our entire life, and the desire to still do something about it while there is still time.

It might make sense, therefore, from the perspective of a crossdreamer, to make a ‘gender change’ at this time of my life. In fact, if you look closely at the statistics, it appears that most ‘late onset transexuals’ make that Big Decision exactly at that time. Some, for instance, use the pretext of a recent divorce to finally ‘become the woman they always wanted to be’. Others simply push for divorce because they want to be a woman more than continuing in a ‘fake’ relationship and suffering all the time. We can see the push to transition as a way to escape suffering; this is attributed to gender dysphoria, and, in fact, it may be in most of the cases.

There is, however, the slight danger that it might not be anything like that at all, as unfortunately many late onset transexuals have found out. In other words: during this strange period of time when we question pretty much everything about ourselves (at least those that do so, of course), we are not known to make good decisions.

This poses a complex problem. People who transition at the time they are going through their midlife crisis (it doesn’t matter if it has been ‘diagnosed’ as such) are already taking a lot of baggage with them. They are not necessarily ‘newbies’ to the whole gender identity issue. They have been reading things about late onset transexualism, and transitioning at a later age. They have looked up at Caitlyn Jenner — if she can transition at 64, so can I! — and know the stakes. And they will be… tired. Tired of living a life ‘for others’. Tired at having constantly worked, mostly to survive and make their family thrive, but there is still a long, long time to go until they are allowed to retire — and they’re not sure that their career is the right one, either. So… they want change. And because they have read all there is to read about transgenderity and transition, and talked to people (either online or in person) who have really gone through it — it’s so much easier to reach out these days! — it’s very likely that they may have a pretty good idea about what to expect. And the decision to ‘start afresh’ becomes more and more attractive.

Men’s Health gives a pretty good description of what men feel during their midlife crisis on an old 2003 article:

The midlife stew often starts with some garden-variety boredom. If you’ve been hoeing the same row for 20 years, only an idiot wouldn’t wonder if there aren’t some more interesting rows somewhere else. On top of tedium, we often get our first bolt of serious bad news: the death of a parent, trouble in a marriage, a career setback, the transformation of the 8-year-old who thought you were God into the adolescent who thinks you’re the devil. Crushing chest pain and the word “biopsy” can set a fellow to thinking about what he’s done with this life.

Often, come our 40s, some undeniable facts start eroding the dubious pillars on which we’ve built our notion of a man.

Indeed. And some of us come to the conclusion that they never really were a ‘man’, and looking back in perspective at one’s life, clearly there have been tell-tale signs that should have told us that we were really not performing at our best in our ‘male role’. The problem, of course, is that this happens to all men; but it’s just the crossdreamers that suffer from a gender identity crisis. Cisgender males will simply feel ‘less of a man’ and overcompensate — by starting to date younger girls, by buying a sports car, and so forth. Ironically, the author of that article on Men’s Health goes on to say:

6. Become a Girlie Man
Listen for a second. No need to develop an obsession with shoes, but take a second look at some virtues normally associated with our mothers, sisters, and wives. It’s a psycho-truism that, as we age, women and men get more like each other. They get more assertive; we get more interested in relationships. Pardon the expression, but go with that flow.

Now, I have no idea who the author is (he quotes Tolstoy and Thoreau…), but isn’t he actually hitting the nail? I mean, what a transgender/crossdreamer ‘man’ wants during their midlife crisis is, literally, to become girly 🙂 Well, the author of that article didn’t want that to be meant literally. What he is saying is that there is a change going on — a change where we start acquiring what usually are seen as female traits (and vice-versa, they acquire male traits — and believe me, I’m quite familiar with women becoming far more assertive during their own midlife crisis!!!). Not necessarily because ‘men become more girly’ but I would claim that, after decades of ‘playing the male role’, they have nothing to prove any more. They can pretty well do what they want — nobody will ‘deny’ their maleness. Not if they have a family, kids, a career, financial success. Just because their levels of testosterone are slowly dropping — allowing men to express other feelings beside assertiveness and aggressiveness! — it doesn’t really matter anymore: they have proven their worth. And that’s why most men who go through their midlife crisis will quickly go through it, sometimes without anyone noticing (except perhaps for their wives, who always know them better than they know themselves).

But if you have reached none of those ‘landmarks of male success’, and always were in touch with your ‘inner feminine essence’ (even if you suppressed it all the way), then the midlife crisis will make you question your whole life as a ‘man’.

Think about it. Look up the so-called ‘symptoms’ of a midlife crisis, and how it is caused or triggered by dramatically bad news that you will need to cope with. Take a look at clinical depression, at anxiety. Put it all together, and mix it with that feminine essence that you know that has always been a part of you. What is the result?

If even the most macho of the men will question their maleness during a midlife crisis… how much more will crossdreamers question theirs?

If all men who exhibit some symptoms of the midlife crisis will ‘become more feminine’ (in the sense that they will slowly start to adopt certain feminine traits), what should we think that happens to a crossdreamer?

Put that crossdreamer in the middle of a community, or a group, of similar-aged people, all of which are expressing precisely the same symptoms. They will exchange their ideas, their feelings, their emotions — and, not surprisingly, they will find out that they are pretty much the same. This will only encourage us to think that we’re right about our feelings. Right?

In other words: our feeling that ‘it’s time’ for our feminine essence to ‘come out’, and that we need to do a big change in our lives to allow ourselves to express our female self, will be reinforced in several ways:

  • The feeling of ‘not being good’ at the male role, by looking back at what we might have achieved; this will include a questioning of our own career so far, and how we ‘failed’ so badly to achieve the expectations that ‘everybody’ had about us;
  • The lowering of the testosterone levels, the difficulty in ‘performing’, the lowering of libido — all that will reinforce the idea that we never were ‘fully men’;
  • The depression/anxiety caused by dramatic bad news, showing us that everything we have believed in is probably not true (or will not become true… ever);
  • Our wives who start to stress us out;
  • Our own crossdressing/crossdreaming/transgender friends, who are going through the same issues, and seem to be the only ones understanding us and giving us support;
  • And, of course, for those who crossdress, the absolute sense of freedom and happiness (or even euphoria) that we get every time we go out — which make us feel like we haven’t felt for decades.

Put that all together and… well, the result may be ‘gender dysphoria’, or at least something in the spectrum of gender dysphoria, and a sincere questioning if we haven’t been really lying to ourselves and everybody for so many decades.

The trouble is that it’s very hard for someone who is undergoing physical changes (lowering of testosterone levels, as well as other hormones, not necessarily sexual hormones) and mental changes (which can also include stress/anxiety and depression) to make a unbiased, objective decision about their lives. There is simply so many emotionally charged inputs, all of them pushing and poking at us, ‘forcing’ us to make a decision — and we will make it, based on emotional and not rational reasons. But how can we be ‘rational’ at the face of such an ’emotional overload’? To make things even worse, our society, for the past two hundred years, has ‘conditioned’ males to conceal their emotions — which is contrary to our nature (no, expressing emotions is not the prerogative of the female gender role — males used to freely express their emotions before 1800) — and so, we assigned-male-at-birthers, have no mechanisms to deal with this emotional overload, because we are not supposed to have it, or to be forced to deal with it.

So we sort of break apart. We start making bad decisions. If we’re cisgender and heterosexual, well, those bad decisions might be throwing all money out of the window, getting a divorce and a lover half our age, and possibly change city and job — all bad things which we will quickly regret, but at least some of the harm might be reverted (well, our ex-wife will probably not accept us back…). If we’re transgender in some sort — we might simply plunge into transition for the ‘wrong reasons’, inadequately counseled by therapists who truly just want us to feel better about ourselves, but… maybe that wasn’t exactly what we should have done. Transition will, of course, provide a lot of relief for a few years. But after the effects of the midlife crisis start to fade, one will start questioning if this was, after all, the best decision we could have made, under the circumstances.

Beware of the midlife crisis and its consequences: they might not be trivial

So are all late onset transexuals actually just confused males in their midlife crisis?

To put it bluntly: no, of course not. That would be stupid to claim. In fact, I would believe that most, if not all, late onset transexuals who actually transition with good medical support are, indeed, transexuals, and transitioning is exactly the right answer to all their problems.

I also think that others are really just ‘confused’ transgender people (mostly, people like myself!). There is no question that they are part of the transgender spectrum. There is no question that they do have something like a ‘feminine essence’ — and always had — simply because, no matter how strong a cisgender male is affected by their midlife crisis, they will never think of ‘changing sex’ as part of their (bad) choices! Remember what I always say: only a transgender person will question their gender identity; but the thought will not even cross the mind of a cisgender person.

This ‘confusion’ is described by many authors (I mean serious authors, scientific researchers in the field, and not silly bloggers like yours truly 😉 ) as being part of the ‘discovery path’ of a transgender person, who will attempt to provide an explanation for what they feel. Such an explanation might be revised over time — it is usually fluid, not fixed, and is dependent on time and events — and as Ekins explains it so well in his book, many transgender people will spend a considerable amount of time finding an explanation or a ‘label’/’category’ for what they feel that best describes them. At some points in this journey of self-discovery, they might even accept certain narratives as applying to themselves; thus, the old ‘I’m a woman trapped in a man’s body’ story, a narrative with which so many MtF transgender persons identify with and make it their own — even though, on late onset transexuals, most of them will not ‘really’ have lived their lives as ‘women trapped in a man’s body’ but rather as persons in touch with their feminine essence and trying desperately fit into society’s stereotyped male role that they were assigned at birth. Note that I’m not saying that late onset transexuals are not ‘women’! From a clinical perspective, having their gender dysphoria confirmed — and the gender dysphoria just gets aggravated by the midlife crisis — they are ‘women’ who just need transition to affirm themselves fully as one. My point is that they never truly were ‘women’ in the sense that many of them did never even try to attempt to fulfill a female gender role in their lives (except for some eventual periods of occasional crossdressing — even if it’s done regularly, it’s not the same thing as fulfilling a female gender role all the time).

I’m aware that this will make some people frown upon my words. But I have been patiently trying to read a lot of information coming from antagonist fields — both from Blanchardians and so-called ‘masochistic emasculation theorists’, but of course also from people of the transgender community (transitioned, transitioning, or non-transitioning) as well as catching up on what de-transitioners tell about their own stories. It seems now clear to me that both the Blanchardians as well as the mainstream are ‘wrong’ in one regard: transition is not the only ‘cure’ for gender dysphoria, because there are different reasons for gender dysphoria to manifest itself, and some of those reasons can be treated differently.

In particular, because there is such an overlap in ages for late onset transexuality and the so-called midlife crisis, it is definitely worth to research this correlation further. I’m not really the first, or the only person, who has figured this out. In fact, and unfortunately, it’s the anti-mainstream theorists, as well as the transphobic groups, who are on a rampage trying to persuade the public that ‘transgenderity’ (or more precisely: a ‘gender identity’) does not exist at all, i.e., there are only ‘sane’ people (those who are cisgender) and deluded or insane people (those who claim to be transgender), sometimes even those who are sexual criminals in search of a pretext to invade women’s toilets (yeah, you know how these people argue)…

While we have to completely disregard what the transphobic groups are saying — except, of course, to learn how we can better present our cases, by using their own arguments against them — we should also keep a sufficiently open mind to listen to what kind of arguments have been presented. Blanchardians, METs (that’s ‘masochistic emasculation theory’), and transphobic groups all seem to believe that so-called late onset transexuals are, in essence, sexual perverts — although they might feel some compassion towards them. Blanchardians, in particular, believe that transition can ‘cure’ the symptoms of gender dysphoria of late onset transexuals; METs think that late onset transexuals are merely deluded and mentally ill, mostly due to childhood trauma, but trauma is a well-researched field and can easily be ‘cured’; while transphobic groups, of course, just want to burn all of us and spread the ashes to the wind, and strike the words ‘gender identity’ from all dictionaries.

Even though thankfully the mainstream scientists and doctors do not give credit to any of these ideas (even when they propose new studies, they are usually easily debunked), I’m not so sure that all of what they say should be simply swept under the carpet. In spite of what Blanchardians say, the ‘gender essence/core’ theory does have more explanatory power than autogynephilia — for several reasons, one of which, of course, that it also explains FtM late onset transexuality (which Blanchard does not acknowledge to exist, although her follower Lawrence sort of accepts); the other is that there are many more differences between types of transexuals, and limiting them to just two based on their sexual preferences not only is discriminating and unfair to the community, but it’s also intellectually dishonest — especially when their own data does not validate their theories. It’s true that the ‘female essence’ theory relies of an ‘unknown’ mechanism somehow wired in the brain, which we cannot see but only speculate about, but it nevertheless has a huge advantage: it explains why ‘gender dysphoria’ cannot rely only upon psychiatric issues (therefore debunking the METs and transphobics), but it also establishes. very clearly, that ‘gender’ is not tied to ‘sex’ in the way that Blanchard wants it to be, but is an independent variable (although obviously a correlated one). Therefore, late onset transexuality cannot be simply a paraphilia like Blanchard (and the transphobics) claims, but is a more complex issue.

However, I still think that there is a strong correlation between what we would call late onset transexuality, gender dysphoria, and mental health issues (i.e. stress, anxiety/irritation, depression, compulsive/obsessive behaviour, etc.). In other words, if we define ‘gender dysphoria’ merely as ‘the distress a person experiences as a result of the sex and gender they were assigned at birth’, then it is clear that this distress can progress to become anxiety, depression, and so on. There is always a ‘mental reason’ for the gender dysphoria; and I believe it’s safe to claim that all transexuals, early onset or late onset, will feel that gender dysphoria — although not all transgender people will feel it, of course.

Some of these ‘mental reasons’ are mostly internal, in the sense that they are an amplification of the distress which is acutely felt, which has remained untreated usually for a long time, and a consequence of repressing feelings and emotions related to that distress. But there are also a few external reasons (i.e. not related to the mind of the individual), and some of those might include a change of the hormonal levels in the bloodstream which happens during midlife. Again, I’m not talking only about sexual hormones, but hormones in general.

A good way to see this at work is when certain MtF individuals start taking hormones as part of their therapy. As they begin taking testosterone blockers, their mood improves, and their distress experienced due to gender dysphoria diminishes in intensity. In fact, the distress might diminish so much that the individual suddenly does not feel the usual ‘urge’ to crossdress! This, in turn, leads them to believe that, after all, they should not transition — because they don’t feel the desire to ‘become a woman’ any longer — and they drop their medication. As testosterone levels return to again to the values previous to hormone therapy, the individual will feel their urges to crossdress returning again! This poses a dilemma to the medical team: it’s clear that gender dysphoria, in that individual, is correlated to testosterone levels in the blood — the lower they are, the less distress is felt. However, when the gender dysphoria is ‘suppressed’, then naturally that individual does not wish to continue their transition. Today, therefore, certain doctors recommend the therapeutic use of hormonal therapy to give those individuals a relief from their gender dysphoria, while not requiring them to go through transition.

This is one example where there are alternatives to transition, and which do not require a change of the mainstream model of the ‘feminine essence’. In the example above, does that mean that the person, once on testosterone blockers, realises that they have no feminine essence at all? No, not at all; they are aware that it is still there; the difference is that they do not feel the urge to crossdress as part of their gender dysphoria. In other words: the distress was suppressed, not the gender identity at its core or essence. And from a clinical point of view, of course, this is a ‘desired’ result. In some of those cases, it also means giving the person much lower doses of testosterone blockers just to see how much has an effect to dispel the distress, although technically we don’t know the result of long-term usage of testosterone blockers, because traditionally, transgender people in transition will, eventually, either go through gender confirmation surgery, or at least a orchiectomy, which will obviously stop the production testosterone (and other androgens), without the need of further T-blockers. In any case, at least in my country, doctor frown upon the idea of using hormone therapy to ‘cure’ side-effects from depression/anxiety/midlife crisis, even though hormonal treatment is one possible treatment for the so-called midlife crisis — even if, in the case of birth-assigned males, the usual treatment is to pump them up with testosterone, not testosterone blockers.

So, my conclusion here is that there are correlations worth exploring, and, even beyond mere scientific research, they should be disseminated around the community — and the doctors to which they go for help. Even though the so-called ‘midlife crisis’ is frowned upon the medical community (because there are other, better explanations for what’s going on), it’s undeniable that there are some changes — some of which traceable to hormonal imbalances, and not necessarily only so-called sexual hormones — that happen to males during a certain time of their lives, which can be as early as, say 35 years, and as late as 60 years. Those who are diagnosed with gender dysphoria during that period may have felt an intensity of their dysphoria due to the external factors that are known to trigger the midlife crisis (or, more precisely, some behaviours associated with that particular period of their lives). Even for cisgender males, this is a time in their lives when their own ‘maleness’ (as defined by social stereotypes) is often questioned — much more so for those who have always recognised and identified with their ‘inner feminine essence’. While cisgender males might engage, during this period, in reckless, nonsensical, irrational activities to ‘affirm’ their maleness and their residual youth — just to ‘feel’ that they’re not ‘old men’ yet! — it’s reasonable to assume that those transgender males, who might have, so far, been able to suppress/repress their inner feelings, suddenly feel themselves bursting from the inside, not being able to handle their ‘lies’ to society any more, and fully embracing their inner feminine essence — in short, ‘coming out’ and eventually even transitioning, if the gender dysphoria becomes insufferable. Interestingly enough, this strategy actually seems to work rather well: such individuals that go through hormone therapy and start a new life are, perhaps surprisingly (or not, depending on your perspective), able to live a much happier life afterwards — and all symptoms of the so-called midlife crisis, as well as gender dysphoria, are basically eliminated through transition.

It is therefore highly questionable that Blanchard’s original theories are right about late onset transexuals. While he focused solely on the sexuality aspect — which is such a limiting view, considering that in the past hundred and thirty years of modern psychology we are supposed to be able to come up with much better answers than a Freudian one! — Blanchard completely ignored all other possible reasons for triggering gender dysphoria at a ‘late’ age (‘late’, of course, when compared with the early onset transexuals). While his proposed ‘treatment’ — transition — has shown to provide excellent results in most cases, clearly it’s not because ‘transition’ somehow allows ‘autogynephilic transexuals’ to live their sexual fantasies ‘in the flesh’, so to speak; but merely because the urge to ‘free’ one’s feminine essence becomes overwhelming, and transition will almost always restore the balance. But in some cases it’s important to figure out alternatives first: even if ‘midlife crisis’ is not a clinical term any more, it still refers to a common group of symptoms and mental issues that can be treated, and, sometimes, with that treatment, the urge to ‘become the woman that one always was’ might subside — and in those cases transition is not really advisable, since it comes from the wrong reasons: not a true desire to join the inner essence with the outer gender role, but rather an escape mechanism to overcome the so-called ‘midlife crisis’.

  • David Aaron

    First I want to say wow, it felt to some extent you were in my head on some of these issues.

    I have been more concerned with the neuroplaticity that a treatment for recalcitrant hypertension might afford at the risk of my male hormones. I been spending a lot of time look over information, demographics .. definitions of dysphoria. I have been through the divorce, the depression, anxiety ..

    I will make one significant disagreement about depression- In my case depression is a byproduct of a brain trauma and is unresponsive to treatment. I had treatable dyspeptic times which responded to normal treatment. Imbalances in hormones aside some brain problems are measurably neurological.