A Closer Examination

To clarify, when I refer to "transgender," I mean individuals whose gender identity does not correspond with the sex they were assigned at birth, which is typically based on visible genitalia.

Some transgender individuals experience "gender dysphoria," a psychological distress arising from the mismatch between their assigned sex and their gender identity. This experience often begins in childhood, though some adults may encounter it later in life.

According to the American Psychological Association (APA), it's crucial to recognize that not all transgender individuals share the same experiences. Members of this community may seek various forms of gender affirmation. This can manifest as social changes, such as adopting new pronouns or names that reflect their identity. Others may pursue legal changes, modifying their gender markers on official documents like driver's licenses or passports. For some, medical interventions, including hormone treatments, are sought, while others may opt for surgical procedures such as breast augmentation or gender confirmation surgeries.

The APA emphasizes that not all transgender individuals will pursue every form of affirmation, as these decisions are deeply personal. Furthermore, they distinguish between gender identity, which is an internal understanding of one's gender, and gender expression, which is how one presents themselves outwardly.

For example, wearing pink is often culturally associated with femininity, while suits are typically viewed as masculine attire.

Neurological Insights

Regrettably, misconceptions persist that suggest individuals who are transgender or experiencing gender dysphoria are fabricating their identities. Historically, being transgender was labeled "gender incongruence" and classified as a mental disorder by the World Health Organization (WHO) until 2019. Dr. Lale Say, a reproductive health expert at WHO, stated that the classification was removed once it became clear that being transgender is not a mental health issue, and that retaining it in that category perpetuated stigma.

Research from 2018 indicates that the brain structure and activity of transgender youth align more closely with their identified gender rather than their assigned sex. This groundbreaking study, led by Dr. Julie Bakker from the University of Liège and colleagues, analyzed brain activation patterns in transgender boys and girls using MRI technology while they were exposed to specific pheromones known to trigger gender-related brain activity.

The findings revealed that the brain activation patterns of transgender boys were more similar to those of non-transgender boys, and the same was true for transgender girls when compared to non-transgender girls. This evidence suggests that transgender individuals are not fabricating their experiences, indicating that such neurological differences may develop early in life.

Sex Chromosomes and Their Complexity

While one might think the relationship between chromosomes and sex is straightforward, it’s actually quite intricate. The general belief is that individuals with XX chromosomes are female, while those with XY chromosomes are male. However, biological sex is not solely determined by these chromosomes or external genitalia.

As noted by Scientific American, biological sex is a dynamic system capable of change. Chromosomes are complex, and there are instances where individuals with XX chromosomes can have male reproductive organs, and those with XY chromosomes can possess ovaries.

The development of sexual characteristics largely hinges on a specific group of cells called the bipotential primordium and a gene known as SRY, which triggers the development of male traits while inhibiting female ones. Yet, the SRY gene is just one of many factors influencing biological sex, and its role is not fully understood.

Hormonal Influences

In addition to chromosomes, hormones play a significant role in determining gender and sex, particularly estrogen, progesterone, and testosterone—hormones present in all humans.

During infancy and prepubescence, these hormones do not exhibit gender differences. It is only during puberty that they begin to express greater concentrations toward one end of the gender spectrum. Recent research suggests that the differences in hormone levels are not as pronounced as once believed.

Notably, studies have shown that estrogen and progesterone levels are quite similar in nonpregnant females and males, while testosterone shows the most significant variance. However, around 56% of an individual's testosterone levels can be attributed to sex chromosomes, pointing to other influences on hormone levels.

Environmental, behavioral, and social factors also play a role in shaping hormone levels, complicating the notion that sex and gender can be reduced to a binary system.

The Influence of Environment

Among the three hormones mentioned, testosterone exhibits the most variability and can even influence specific parental behaviors. In social contexts, estrogen has been found to fluctuate based on scenarios involving power dynamics.

Research indicates that estrogen levels increase in individuals who succeed in power-driven situations but decrease for those who do not. Similarly, progesterone levels can change based on competitive social interactions. This illustrates how our behaviors and societal gender expectations influence our hormonal biology.

Trans Youth and Their Experiences

It's vital to listen to what youth communicate about their feelings and experiences. Historically, adults have dismissed or downplayed the voices of children, often believing they know better. This dismissal is evident in current debates surrounding gender-affirming care for young people.

Denying necessary healthcare to transgender youth is a contentious issue, often framed under the guise of "protecting children." However, a plethora of studies and endorsements from major medical organizations indicate that access to gender-affirming care correlates with improved mental health outcomes. Conversely, a lack of such access is associated with increased rates of depression, self-harm, and suicide.

Research conducted in 2020, involving 300 transgender youth, highlighted that mental distress significantly increased when individuals were compelled to undergo puberty according to their assigned sex. Among the participants, 40% engaged in self-harming behaviors, 46% were diagnosed with depression, and 52% considered suicide.

Numerous reputable organizations, including the American Academy of Pediatrics and the American Psychological Association, advocate for age-appropriate gender-affirming care, deeming it scientifically backed and medically necessary.

A Call for Perspective

The rising discrimination against minority groups, particularly the transgender community, has become increasingly prevalent. Discrimination does not serve anyone; it only perpetuates fear and misunderstanding. It distracts from what truly matters and blinds us to the rich diversity of our species, which is perhaps our greatest asset for survival.

Embracing inclusion and diversity fosters progress, enhancing the scientific community and enriching our society. We should celebrate diversity in all its forms, including the transgender experience, which offers valuable insights into our understanding of sex, biology, and life itself. Let's shift our focus away from hatred and towards acceptance and understanding.

This article was initially published in the author's newsletter, Curious Adventure, and has been edited and republished with her consent.

In the first video titled "Science, the Transgender Phenomenon, and the Young," Abigail Shrier explores the intersection of science and transgender identity, aiming to foster understanding and respect for the transgender community.

The second video, “Neuroimaging Studies of Transgender People: A Critical Review” by E. Kale Edmiston, PhD, critically assesses neuroimaging research focused on transgender individuals, contributing to the conversation about the science behind gender identity.