Scientifically Illiterate, Medically Dangerous

The other major piece of anti-trans propaganda that appeared in the media recently is, of course, in the New Statesman. I am fast coming to the conclusion that Helen Lewis and her staff don’t just hate trans women, they want to cause us actual harm. First there was their trolling of Leelah Alcorn, and now this. Let me explain.

For the most part the article is a truly dreadful attempt at Oppression Olympics. It goes on and on about how evil, “McCarthyist” trans women are preventing feminists from saying, well, anything really. The most spectacular part of it is where it tries to insinuate that BlockBot, a tool developed by feminists on Twitter to protect themselves from GamerGate, is in fact a weapon invented by trans women to shut down feminist debate. (And here once again we see the accusation that by refusing to listen to the hate being directed at us we are somehow “censoring” our opponents.)

The reason I am interested in the article, however, is that it makes some specific scientific claims about trans women. (And by the way, you can always tell nonsense articles about trans people because they talk almost exclusively about trans women.) I’d like to take a look at these claims and see how they stand up.

The first thing I did on reading the article was to check the author to see if they had any scientific credentials. The byline is “Terry Macdonald”, which the article freely admits is a pseudonym. I’m guessing that this is an attempt to insinuate that writing about trans women is not safe, and the author has to remain anonymous for their own protection. Goodness only knows how long a New Statesman writer would survive in the shoes of Anita Sarkeesian, Zoe Quinn or Brianna Wu, who are actually risking their lives. But hey, trans women, the greatest threat to civilization the world has ever known and all that.

Or possibly, of course, it is some complicated shell game that will end with Sarah Ditum yelling, “See you misgendered me, you are a transphobe, I WIN!!!” Given that the situation is uncertain, I shall use gender-neutral pronouns for Macdonald.

Anyway, the point is that there is no evidence of scientific credentials. Nevertheless, scientific claims are made. In particular there is this:

The core of the ideology I’m referring to is the assertion that ‘trans women are women’. (We hear a lot less from and about trans men.) Exactly what this statement means depends on whether the speaker is using the word ‘women’ to refer to a social category or a biological one. In the first case there is a discussion to be had (though people may reasonably differ in their conclusions), but in the second case the assertion is patently false. Trans women are not, by definition, biological females. Yet in the most extreme version of the ideology, you cannot say that without being labelled a TERF.

I note in passing that there is a third meaning to the statement ‘trans women are women’, and that is a legal one. The good old Gender Recognition Act might have many flaws, but one thing that it has done is make thousands of trans women legally female. Macdonald conveniently ignores this. As to social categories, TERFS are all over how gender is a social construct, except when it applies to trans women, in which case their right to be socially female is suddenly questionable.

I also note that the reason we don’t hear a lot from trans men is that no one is devoting pages and pages of newsprint to preventing trans men from using men’s bathrooms. It is generally accepted that trans men are men.

The claim I want to look at, however, is this one about trans women not being “biological females”. What does it mean? Macdonald doesn’t say, so I am going to run through a bunch of possibilities to try to work out what this is all about.

The most obvious starting point is physical appearance. I often see people claiming that the breasts of trans women are “fake”, implying that they are the result of silicon implants. I can’t speak for everyone, but I can assure you that mine grew naturally, under the influence of estrogen, just like any other woman’s would. Some people also like to claim, because trans women have had their genitalia reconstructed, that our new genitalia are somehow made of dead flesh, and even that they smell of necrosis. The plastic surgeons are much better than that, I can assure you. Finally it is sometimes claimed that because we have our penises “cut off” we are incapable of enjoying sex, a comment so inaccurate that it tends to make me giggle uncontrollably.

How about internal organs, then? Well, trans women don’t have wombs or ovaries, but some cis women have to have them removed for medical reasons and that doesn’t stop them being women, does it? I think not.

One area in which trans women are often accused of being “biologically male” is sport. There is an assumption that a trans woman will have an unfair advantage over a “real” woman because of her “male” body. Well, as luck would have it, there are parts of the Guardian that do publish socially progressive articles about trans people. Their science and technology section can be quite good, but yesterday it was their sports section that stepped up to the plate by carrying an interview with Fallon Fox.

The article quotes Dr Eric Vilain, director of the Institute for Society and Genetics at UCLA, who helped the Association of Boxing Commissions write its transgender policy, and Dr Marci Bowers, an OB-GYN specialist and a leader in the field of transition-related surgeries. Both of them dismiss the idea that Fox has some sort of unnatural advantage over other female contestants. Dr Vilain is quoted as saying, “male to female transsexuals have significantly less muscle strength and bone density, and higher fat mass, than males”. Obviously there is a range of abilities, because not every woman is the same, but Bowers says of Fox, “There are taller women than her, there are bigger women than her, there are stronger women than her.”

The author of the article, Jos Truit, adds that, “transition could mean a hormonal disadvantage for Fox because of her low testosterone levels.” I’m highlighting that because what the experts say about Fox are not comments on her status as someone who has identified as female from an early age, but on her status as someone who has undergone gender surgery and hormone treatment. That’s important.

Hormones are hugely powerful chemicals responsible for all sorts of systems in the body. There’s a fascinating program about them currently available on iPlayer. Testosterone and estrogen are particularly important. Post-surgery, trans women no longer make testosterone naturally, but they can’t make estrogen either. Because of this, we are put on a lifetime prescription of what is essentially hormone replacement therapy. We are supposed to get regular blood tests too, because the doctors want to be sure that our estrogen levels are typical for adult women. It is a health issue, we are told.

Estrogen, of course, is what causes pre-pubescent girls to turn into adult women; and testosterone turns boys into men. But the hormones don’t suddenly stop working just because you have become an adult. That’s why trans women are able to grow breasts naturally. Estrogen treatment causes other effects as well, including the loss of muscle strength and bone density, and the gain in fat, reported by Dr Vilain.

The upshot of this is that if you were to take a blood sample from a trans woman, or check a whole bunch of characteristics such as those mentioned in connection with Fox, the results you got back would be typical of a woman, not of a man.

So where are we? Trans women appear to be “biologically female” from their external appearance and a whole battery of internal tests. Is there anything else we can look at? Well, Macdonald does admit that some research suggests that trans women have brains that look more like those of women than like those of men. This is fairly contentious stuff, and to be really safe researchers have to be very careful to ensure that what they are measuring is the pre-transition brain, not the brain that has been bathed in estrogen for decades. Up until yesterday I was not prepared to state that a biological basis for gender identity had been discovered.

Then this was published. It is a paper in an academic journal called Endocrine Practice, and it takes the form of a literature review, meaning that it looks at evidence from a wide range of studies. The conclusion of the paper is, “Although the mechanisms remain to determined, there is strong support from the literature that there is a biological basis for gender identity.”

Michael Dillon would be so happy. I don’t suppose that Macdonald has had a chance to read the paper yet, but I’d be interested to know what they make of it.

Finally, of course, we come to chromosomes. That’s the usual last resort of those who wish to “prove” that trans women are “really” men. Women have XX chromosomes, and men have XY, and all trans women are XY, right?

Well, no. Macdonald admits that intersex people exist, but doesn’t seem to know much about them. One of the better known intersex conditions is Klinefelter’s syndrome, which generally involves having XXY chromosomes, though the best known example, Caroline Cossey, has XXXY. The point about Klinefelter’s is that people with that condition are born looking male, and are assigned male at birth. Some of them identify as female, and like Cossey choose to go through gender surgery. They may identify as trans women — Cossey does. I’m interested to know how Macdonald would classify them. Are they “really men”, or do they get a pass because they are also intersex?

One of the most spectacular intersex conditions, however, is androgen insensitivity syndrome. People with this condition have XY chromosomes, but their bodies are unable to process androgens, which are male sex hormones. As a result their bodies develop looking female, and they are assigned female at birth. Their only significant difference from XX people is that they don’t normally have wombs or ovaries.

So if chromosomes trump everything, are people with AIS “biologically male”? Or do they get a pass and count as “biologically female” because they have AIS? And if so, how is a trans woman, whose body doesn’t process androgens because she can’t make them anymore, different?

I suspect that some mumbling about age might be happening in the New Statesman bunker (buried deep underground for fear of nuclear strikes by angry trans women) right now. And there we come to another interesting question: trans kids.

As I mention above, hormones are responsible for the massive changes that humans undergo at puberty. These days, trans kids are able to access treatments that allow them to go through puberty in their preferred gender. A young trans woman today will never have been through male puberty. She will have been through female puberty. How is she not “biologically female”?

But, but… Time for one last throw of the dice. Macdonald says,

Other arguments espoused by some trans activists are entirely lacking in scientific support, since they deny the existence of human sexual dimorphism.

Oh, right humans are a sexually dimorphic species, so males and females must be different. Paging Dr Bowers here:

“Sexual dimorphism refers to the amount of physical difference between the sexes,” Bowers explains. “The fact is, human beings actually differ very little in their sexual dimorphism, much less so than other species.”

That lack of difference is, of course, much less pronounced in children than in adults. And, you know, isn’t that one of the central tenets of feminism: that when it comes down to it men and women are not that different? Why, then, is it so important for some feminists to insist that trans women are, and can only ever be, men?

Basically, I suspect, it is all down to willies. It used to be that TERFs would claim that gender was a social construct, and that trans women were constructed male in childhood and could never change that. As trans girls began to transition at younger and younger ages, it eventually came down to, “but they had willies when they were born, and that makes them men!”

It is the same with the biology. Trans women can be as close as possible, biologically speaking, to cis women — certainly well within the natural range on most tests — and they can transition as young as possible, never going through male puberty. But eventually it will all come down to, “but they had willies when they were born!”

The main point I wanted to make here, though, is not that Macdonald’s argument is scientifically illiterate. I also want to note that it is medically dangerous.

One of the things that modern medical science is discovering is that the health of the body is very much dependent on what gender it is. And that’s not a question of chromosomes, or what gender it was assigned at birth, it is mostly down to hormones. For trans women to remain healthy, it is important for doctors to treat them, in most cases, as biologically female, because their bodies will react like those of other women. By encouraging people to think, against all scientific evidence, that trans women are biologically male, Macdonald and their friends are putting trans women’s health at risk.

Doubtless the argument in the New Statesman bunker is that the thing to do would be to ban gender medicine. Then all of the trans women would commit suicide and the problem would be solved in what they would regard as a humane and civilized manner. Thankfully much of the rest of the world doesn’t seem to share their views.

One thought on “Scientifically Illiterate, Medically Dangerous

  1. Excellent piece (as was your other). Just to note that Greer, for one, does indeed deny that AIS women are women, even though many reach their teens without even realizing that they are intersex. The ensuing discussions with AIS women and their relatives as captured on the AIS society’s website here are pretty enlightening in showing that her ignorance and callousness are reserved for trans women only. Both must be sacrificed in the name of chromosonal purity, apparently.

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