Women After All: Sex, Evolution, and the End of Male Supremacy (5 page)

Some would say this story is a tribute to free will—Joan decides to become John (as many thousands of transsexuals have now done, one way or another) and, with a little help from her surgeons and endocrinologists, crosses a boundary that used to be thought impassable. But in this case, a determining, or at least a very influential factor—male hormones affecting Joan/John’s brain before birth—made her uneasy in her assigned role as a girl becoming a woman. The most basic human compassion allows sympathy for her wish to be a man. In another such case—fortunately, they are
rare—the penis was lost at the age of two months, sex reassignment and corrective surgery was done by seven months, and the child was raised as a girl. She retained a secure female identity, although she always leaned toward boy-typical toys and games. Interviewed at age twenty-six, she disclosed that she had had an unsuccessful relationship with a man and was in a successful one with a woman; at this time she described herself as a lesbian. So biology has its influence, but it interacts with experience in complicated ways.

What about the growing number of transsexuals—people seeking surgery and hormonal treatment to make them into the sex that they are not? Today, many thousands have had such surgery. Don’t they show evidence of pure free will, now for the first time in history able to be exercised in this way? Not really. People cannot legitimately be granted the chance to surgically and medically change their sex unless they can show that they deeply feel, and have pretty much always felt, at odds with their own bodies. That is, they have male bodies but feel that they should be women, or they have female bodies but feel they should be men. Free will? In one sense, yes. Medicine and surgery allow them to choose, doctors and counselors help them, and the laws in enlightened countries don’t stop them. But where did their will to change come from? We don’t know the biological history of their profound discomfort, their elemental desire to belong to what we call “the opposite sex.”

Randi Ettner, a psychologist who has devoted her career to helping such people, has written, “Many young children experiment with trying on clothes of the opposite sex. Few, however, express the persistent wish to
be
the opposite sex. These children go to sleep praying that they will awaken and be miraculously transformed.” The response of the environment is typically harsh. “Few things are as devastating to parents as learning that their child is a transsexual. The narcissistic injury in having a child who wants to change genders is beyond description. Parents can accept a child who is a
criminal more easily than a child who is transgendered. Our society reinforces this intolerance.” Neither the many cases Ettner and others describe nor the transsexuals’ own accounts in autobiographies and interviews give credence to the idea that some kind of aberrant child-rearing experience is the key to understanding what makes a person want this.

But what does make sense, as a hypothesis, is that some personal biological history—genetic, neural, hormonal, or pharmacological—made these people wish to be different from what, in their bodies, they had always appeared to be. It’s a hypothesis we can test in the future when we can look in enough detail at brain images of people who want to change sex. A 2011 study by Alicia Garcia-Falgueras, Lisette Ligtenberg, and others found that male-to-female transsexuals who came to autopsy and had their brains examined fell between women and men in the cellular and chemical structure of a part of the hypothalamus involved in sex and reproduction. This needs further study, but such evidence may become part of the case people make for changing gender; objective brain differences could support what they so strongly feel. This should never be a requirement—that would merely be more medical arrogance—but it could very well help them and us to understand. We should have, I strongly believe, the freedom to choose what we want, but that doesn’t mean we have freely chosen to want it, or that we can wish it away because others want us to fit society’s mold.

Finally, consider the wonderfully interesting people who start out as XY but are born with the fairly unambiguous claim “It’s a girl.” Many cluster in a handful of villages in the highlands of the Dominican Republic. They come from inbred families and share a recessive mutation that changes a very simple enzyme. It’s called 5-alpha reductase, and their syndrome is named for that deficiency. There are also cases in New Guinea, Turkey, and elsewhere, but the best studies have been in the DR.

Julianne Imperato-McGinley, an endocrinologist at the Cornell Medical Center in New York, studied eighteen of these remarkable people, publishing the results in the
New England Journal of Medicine
in 1979 and following up for many years after. She found out that they were called
machihembra
(man-woman) or
guevedoce
(testicles-at-twelve), because of what was known about them in retrospect. These children were almost all recognized at birth as girls, assigned to female roles throughout development, and not viewed as special until they
should
have started to go through female puberty. First, they didn’t develop breasts; then their clitorises enlarged and became small penises; finally, they developed broad, muscular shoulders instead of laying down body fat over curved, broadening hips.

In other words, these girls became men. But surely more than a decade of being raised as girls could not allow them a successful transition to masculinity? That guess would be wrong. Of the eighteen
machihembras
closely studied, seventeen made an effective psychological transition.

How is this possible?

First, no known cultural-determinist theory of gender development can explain it. Every strongly cultural theory predicts that these people should have confused identities for life. They do have some difficulties making the transition, but almost all of them succeed. They get married. With a little help from a fertility clinic, most of them have children. They become men of their culture, husbands, and fathers, despite the fact that they were not raised to be that at all.

Our best explanation is biological.

The enzyme they have insufficient quantities of, 5-alpha reductase, converts testosterone to another androgen called dihydrotestosterone (DHT). DHT normally causes a penis and testicles to develop in the fetus; since these fetuses don’t have it, they emerge with female-appearing genitals at birth. But what causes male
puberty
is mainly testosterone, and they do have normal amounts
of that; therefore, despite their very different starting point, they are able to go through something closely resembling male puberty as the usual changes in the brain’s regulation of the sex organs take place in the teenage years.

So why are most of them able to make the transition? Our best guess is that their brains have been exposed to typical male levels of testosterone in the womb. As with the Ahs, Andras, and Clokes, and even the cases of loss of the penis and surgical change to female anatomy, testosterone reaching the brain before birth has prepared the
machihembras
to think and feel like men someday. That day comes when puberty transforms them, and they are surprisingly ready.

What about the more usual range of gender identities and behaviors? Gay men and lesbian women live a broad and intriguing spectrum of different lives, not easily (if at all) classified or labeled. Many if not most of us will have same-sex intimacies if we are completely cut off from members of the other sex, as in prison. Most who turn to this situational same-sex intimacy revert to heterosexuality if and when the opportunity returns. But at the other end of the continuum of same-sex relations (and there are all sorts in between), there are people who will never feel an attraction except to a person of the same sex, no matter the situation.

Among those people, there are men who feel and act in a strongly masculine way and men who feel and act feminine; there are women who love women but feel and act feminine and women who love women but feel more masculine. There are men who cross-dress and like to play football, and these men may be gay or straight. Some women get married in a white gown to the woman they love, become sensitive and devoted mothers, and go off to fight in armed combat in a distant land. All these variations are normal. And, as with transsexuals, people who feel in these varied ways and combinations of ways often do not want to be told that their feelings are simply a matter of choice—that if they accepted certain religious beliefs
or entered into certain kinds of psychotherapy they would cease to have the feelings they have had all their lives and instead have the feelings somebody else thinks they should have. Of course, people can be coerced or persuaded to be celibate and alone, to suppress their true selves, but that doesn’t mean that the misguided people “helping” them have changed their feelings—except for making them miserable. The reasons that they can’t change their feelings are in large part biological—incompletely understood for now, but biological nonetheless.

It helps to see what happens to an XY person who looks and acts female throughout life, as psychologist Melissa Hines and her colleagues did in a 2003 study. This is true of people who, despite the Y, lack androgen receptors or can’t make androgens. If this absence of effective androgens is complete, they show no signs of maleness in their brains, behavior, sexual orientation, or identity. Except for being infertile, they are women, period, and they often adopt babies because they
do
want to be mothers. Hines and her colleagues’ direct comparison of twenty-two women with complete androgen insensitivity syndrome but XY chromosomal types with twenty-two matched ordinary XX women revealed no significant differences in any psychological outcome. These XY women are, again, an exception that proves the rule. If the Y is blocked from doing its thing, if the androgens can’t have their effect, there is no maleness at all, not in body and not in mind.

But what about the variety within the typical range, people who have nothing unusual in their chromosomes and no ambiguity in their genitals? Yet they may be men who love other men but also go hunting, boys who dress up like girls but have crushes only on real girls, girls who beat up boys and who want to grow up to be sexy actresses, women and men who have always been sexually attracted to both women and men, men who love flower arranging and women’s fashions but are intensely heterosexual, women kickboxers who put
on lipstick and bat their eyelashes at a man they meet at a dance, and a thousand other combinations and variations that no one can predict from any external characteristics or physiological measurements.

What causes these variations remains mysterious, but evidence strongly suggests that a lot of the causes lie in as yet unknown genes. Why would I confidently say that if the genes remain hidden?

Although locating a gene and tracing the chemical pathway from it to the physiology—nerves and hormones—is now the gold standard for claiming genetic effects, it is not the only standard. For well over a century, scientists have realized that identical twins (who share almost the same genes) are more similar in many measurable ways than same-sex fraternal twins (who have only as much genetic relatedness as ordinary brothers or ordinary sisters). This is true for height, weight, susceptibility to many specific illnesses, longevity, muscle strength, body fat, nearsightedness, hearing loss in middle age, skin complexion, hair and eye color, nose shape, cheekbone prominence, and many other physical features.

It is also true of most behavioral traits and psychological measures, including IQ, verbal, mathematical, and musical ability, athleticism, extraversion or introversion, nervousness, aggressiveness, susceptibility to many specific mental and emotional illnesses, religiosity, political conservatism or liberalism, and many others. We can argue about this or that method of measurement, we can point out that genes interact with one another and that this complicates the analysis, we can recognize the considerable power of the environment, including the culture, but in the twenty-first century we can no longer ignore the fact that identical twins are more similar than nonidentical twins, even if the identicals were raised in different, separate environments. There is a number for something called “heritability” that is sometimes calculated from the degree of correspondence between the twins of the different types. Arguments rage over the way this calculation can or should be done.

I don’t think it matters, because that number isn’t what matters.
What matters is how similar the twins are. If one of a pair of twins develops schizophrenia, an identical twin will have a fifty-fifty or greater chance of getting the same disease, while if the twin is not identical, the risk will be much lower. In the case of schizophrenia, the difference remains very great even if the twins have been reared apart. This is true of many illnesses, mental and physical, and it is true of many traits, including height, verbal ability, moodiness, and aggression. We don’t need to know the “heritability” number, or even care whether or not it is worth the calculation; we just need to know that identical twins are a lot more similar (even if they grow up in different environments) than same-sex nonidentical twins—that’s how we know that the thing we measured has been influenced significantly by genes.

Twin studies are a good way to find this out, but there are other ways. We have been aware for decades that the biological children of people with schizophrenia who are adopted away from their parents in the first month of life are much more likely to become schizophrenic than the biological children of non-schizophrenic people who are adopted at the same early age by parents with schizophrenia. The same can be said of many different illnesses and many human traits within the normal range. This includes, by most definitions, masculinity and femininity, and it certainly includes lifelong sexual preferences, which are in many ways independent of other aspects of gender psychology and behavior.

The point is that genes matter a lot. Experience, learning, culture, and environment also matter a lot. But we all accept that. Take two identical twins and give just one of them piano lessons, and you will end up with a big difference in piano playing. But give them both the same lessons, and they will likely end up more similar in ability than two nonidentical twins who also both get the same lessons. Six or seven thousand languages are spoken in the world, and the differences among them are all due to learning. Women in New York once thought it was unacceptably sexual to show their ankles,
and millions of women elsewhere today think the same about their hair, while currently on New York’s beaches women wear only the skimpiest of bikinis, and on the Riviera they don’t bother with the tops. Almost all modern women sometimes or often wear pants—unthinkable and even punishable not so long ago.