Skip to main content
SpringerLink
Log in

Etiopathogenetic Hypotheses of Transsexualism

  • Chapter
  • First Online:
Management of Gender Dysphoria

Abstract

Although the condition of transsexualism has existed throughout history, the etiology remained obscured and has spawned debate. With the advent of sophisticated new technologies, brain activity and structure can be envisaged, and hormone-related genetic variants can be analyzed. Thus, older psychosocial theories have been largely discarded in light of new and tantalizing clues that point to a biological mechanism in the formation of atypical gender identity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eliot A (1976) Myths. McGraw Hill, New York

    Google Scholar 

  2. Freud S (1946) Totem and taboo. Vintage, New York

    Google Scholar 

  3. Jung CG, Kerenyi C (1949) Essays on a science of mythology. Princeton University Press, Princeton

    Google Scholar 

  4. Taylor T (1996) The prehistory of sex: four million years of human sexual culture. Bantam, New York

    Google Scholar 

  5. Monstrey S, Selvaggi G, Ceulemans P (2007) Surgery: male-to-female patient. In: Ettner R, Monstrey S, Eyler E (eds) Principles of transgender medicine and surgery. Haworth Press, New York

    Google Scholar 

  6. Ettner R (1999) Gender loving care. WW Norton, New York

    Google Scholar 

  7. Lothstein LM (1979) Psychodynamics and sociodynamics of gender-dysphoric states. Am J Psychother 33(2):214–238

    CAS  PubMed  Google Scholar 

  8. Gilpin DC, Raza S, Gipin D (1979) Transsexual symptoms in a male child treated by a female therapist. Am J Psychother 3(3):453–463

    Google Scholar 

  9. Moberly ER (1986) Attachment and separation: the implications for gender identity and for the structuralization of the self: a theoretical model for transsexualism and homosexuality. Psychiatr J Univ Ott 11(4):205–209

    CAS  PubMed  Google Scholar 

  10. Ovesey L, Person E (1976) Transvestism: a disorder of the sense of self. Int J Psychoanal Psychother 5:219–236

    CAS  PubMed  Google Scholar 

  11. Macvicar K (1978) The transsexual wish in a psychotic character. Int J Psychoanal Psychother 7:354–365

    PubMed  Google Scholar 

  12. Socarides CW (1978) Transsexualism and psychosis. Int J Psychoanal Psychother 7:373–384

    PubMed  Google Scholar 

  13. Lothstein LM (1984) Psychological testing with transsexuals: a 30-year review. J Pers Assess 48(5):500–507

    Article  CAS  PubMed  Google Scholar 

  14. Shtasel TF (1979) Behavioral treatment of transsexualism: a case report. J Sex Marital Ther 5(4):362–367

    Article  CAS  PubMed  Google Scholar 

  15. Vogel F (1981) Neurobiological approaches in human behavior genetics. Behav Genet 11(2):87–102

    Article  CAS  PubMed  Google Scholar 

  16. Lundberg PO, Sjovall A, Walinder J (1975) Sella turcica in male-to-female transsexuals. Arch Sex Behav 4(6):657–662

    Article  CAS  PubMed  Google Scholar 

  17. Gooren L (1986) The neuroendocrine response of luteinizing hormone to estrogen administration in heterosexual, homosexual, and transsexual subjects. J Clin Endocrinol Metab 63(3):583–588

    Article  CAS  PubMed  Google Scholar 

  18. Kula K, Dulko S, Pawlikowski M et al (1986) A nonspecific disturbance of the gonadostat in women with transsexualism and isolated hypergonadotropism in the male-to-female disturbance of gender identity. Exp Clin Endocrinol 87(1):8–14

    Article  CAS  PubMed  Google Scholar 

  19. Eicher W, Spoljar M, Richter K et al (1980) Transsexuality and X-Y antigen (abstract). Geburtshilfe Frauenheilkd 40(6):529–540

    Article  CAS  PubMed  Google Scholar 

  20. Spoljar M, Eicher W, Eiermann W et al (1981) H-Y antigen expression in different tissues from transsexuals. Hum Genet 57(1):52–57

    Article  CAS  PubMed  Google Scholar 

  21. Eicher W, Spoljar M, Murken JD et al (1981) Transsexualism and the H-Y antigen (abstract). Fortschr Med 99(1–2):9–12

    CAS  PubMed  Google Scholar 

  22. Engel W, Pfafflin F, Wiedeking C (1980) H-Y antigen in transsexuality, and how to explain testis differentiation in H-Y antigen positive males and ovary differentiation in H-Y antigen positive females. Hum Genet 55(3):315–319

    Article  CAS  PubMed  Google Scholar 

  23. Gooren L (1990) The endocrinology of transsexualism: a review and commentary. Psychoneuroendocrinology 15(1):3–14

    Article  CAS  PubMed  Google Scholar 

  24. Greenberg RP, Laurence L (1981) A comparison of the MMPi results for psychiatric patients and male applicants for transsexual surgery. J Nerv Ment Dis 169(5):320–323

    Article  CAS  PubMed  Google Scholar 

  25. Tsushima WT, Wedding D (1979) MMPI results of male candidates for transsexual surgery. J Pers Assess 43(4):385–387

    Article  CAS  PubMed  Google Scholar 

  26. Leavitt F, Berger JC, Hoeppner JA et al (1980) Presurgical adjustment in male transsexuals with and without hormonal treatment. J Nerv Ment Dis 168(11):693–697

    Article  CAS  PubMed  Google Scholar 

  27. Cole CM, O’Boyle M, Emory LE et al (1997) Comorbidity of gender dysphoria and other major psychiatric diagnoses. Arch Sex Behav 26(1):13–26

    Article  CAS  PubMed  Google Scholar 

  28. Buhrich N, McConaghy N (1978) Parental relationships during childhood in homosexuality, transvestism, and transsexualism. Aust N Z J Psychiatry 12(2):103–108

    Article  CAS  PubMed  Google Scholar 

  29. Wu C (1995) Ancient crocodile chomped on plants. Science News August 1995, 132

    Google Scholar 

  30. Dorner G, Poppe I, Stahl F et al (1991) Gene and environment-dependent neuroendocrine etiogenesis of homosexuality and transsexualism. Exp Clin Endocrinol 98(2):141–150

    Article  CAS  PubMed  Google Scholar 

  31. Elias AN, Valenta LJ (1992) Are all males equal? Anatomic and functional basis for sexual orientation in males. Med Hypotheses 39(1):39–45

    Article  Google Scholar 

  32. Giordano G, Giusti M (1995) Hormones and psychosocial differentiation. Minerva Endocrinol 20(3):165–193

    CAS  PubMed  Google Scholar 

  33. Coleman E, Gooren L, Ross M (1989) Theories of gender transpositions: a critique and suggestions for further research. J Sex Res 26(4):525–538

    Article  Google Scholar 

  34. Dumesic DA, Goldsmith PC, Jaffe RB (1987) Estradiol sensitization of cultural human fetal pituitary cells to gonadotropin-releasing hormone. J Clin Endocrinol Metab 65:1147–1153

    Article  CAS  PubMed  Google Scholar 

  35. Zhou JN, Hofman MA, Gooren LJ et al (1995) A sex difference in the human brain and its relation to transsexuality. Nature 378(6552):68–70

    Article  CAS  PubMed  Google Scholar 

  36. Angier N (1995) Size of region of brain may hold crucial clue to transsexuality, a study finds. The New York Times, November 2

    Google Scholar 

  37. Krujiver FPM, Zhou J, Pool CW et al (2000) Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clin Endocrinol Metab 85:2034–2041

    Article  Google Scholar 

  38. Chung W, De Vries G, Swaab D (2002) Sexual differentiation of the bed nucleus of the stria terminalis in humans may extend into adulthood. J Neurosci 22(3):1027–1033

    CAS  PubMed  Google Scholar 

  39. Pol HE, Cohen-Kettenis P, Van Haren N et al (2006) Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure. Eur J Endocrinol 155:S107–S111

    Article  CAS  Google Scholar 

  40. Garcia-Falgueras A, Swaab DF (2008) A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity. Brain 131:3132–3146

    Article  PubMed  Google Scholar 

  41. Taziaux M, Swaab DF, Bakker J (2012) Sex differences in the neurokinin B system in the human infundibular nucleus. J Clin Endocrininol Metab 97(12):E2210–E2220

    Article  CAS  Google Scholar 

  42. Dessens AB, Cohen-Kettenis PT, Mellenbergh GJ et al (1999) Prenatal exposure to anticonvulsants and psychosexual development. Arch Sex Behav 28:31–44

    Article  CAS  PubMed  Google Scholar 

  43. Swaab DF (2004) Sexual differentiation of the human brain: relevance for gender identity, transsexualism and sexual orientation. Gynecol Endocrinol 19:301–312

    Article  CAS  PubMed  Google Scholar 

  44. Kerlin SP (2004) The presence of gender dysphoria, transsexualism, and disorders of sex differentiation in males prenatally exposed to diethylstilbestrol: initial evidence from a 5-year study. DES Sons International Network. TransAdvocate.org

    Google Scholar 

  45. Colborn T, Dumanoski D, Myers JP (1996) Our stolen future. Penguin, New York

    Google Scholar 

  46. Langston N (2010) Toxic bodies: hormone disruptors and the legacy of DES. Yale University Press, New Haven/London

    Google Scholar 

  47. Phelps VR (1952) Relative index finger length as a sex-influenced trait in man. Am J Hum Genet 4:72–89

    PubMed Central  CAS  PubMed  Google Scholar 

  48. Garn SM, Burdi AR, Babler WJ et al (1975) Early prenatal attainment of adult metacarpal-phalangeal rankings and proportions. Am J Phys Anthropol 43:327–332

    Article  CAS  PubMed  Google Scholar 

  49. Manning JT, Fink B, Neave N et al (1998) The ratio of 2nd to 4th digit length, a predictor of sperm numbers and concentrations of testosterone, leuteinizing hormone and oestrogen. Hum Reprod 13:3000–30004

    Article  CAS  PubMed  Google Scholar 

  50. Galis F, Ten Broek C, Van Dongen S et al (2010) Sexual dimorphism in the prenatal digit ratio (2D:4D). Arch Sex Behav 39(1):57–62

    Article  PubMed Central  PubMed  Google Scholar 

  51. Schneider HJ, Pickel J, Stalla GK (2006) Typical female 2nd-4th finger length (2D:4D) ratios in male-to-female transsexuals-possible implications for prenatal androgen exposure. Psychoneuroendocrinology 31(2):265–269

    Article  CAS  PubMed  Google Scholar 

  52. Green R (2000) Family co-occurrence of “gender dysphoria”: ten sibling or parent-child pairs. Arch Sex Behav 29(5):499–507

    Article  CAS  PubMed  Google Scholar 

  53. Gomez-Gil E, Esteva I, Almaraz MC et al (2010) Familiality of gender identity disorder in non-twin siblings. Arch Sex Behav 39(2):546–552

    Article  PubMed  Google Scholar 

  54. Henningsson S, Westberg L, Nilsson S et al (2005) Sex steroid-related genes and male-to-female transsexualism. Psychoneuroendocrinology 30(7):657–664

    Article  CAS  PubMed  Google Scholar 

  55. Diamond M (2013) Transsexuality among twins: identity concordance, transition, rearing, and orientation. Int J Trans 14:24–28

    Google Scholar 

  56. Bentz EK, Hefler LA, Kaufmann U et al (2008) A polymorphism of the CYP17 gene related to sex steroid metabolism is associated with female-to-male but not male-to-female transsexualism. Fertil Steril 90(1):56–59

    Article  CAS  PubMed  Google Scholar 

  57. Hare L, Bernard P, Sanchez FJ et al (2009) Androgen receptor length polymorphism associated with male-to-female transsexualism. Biol Psychiatry 65(1):93–96

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, New Health Foundation Worldwide, 1214 Lake Street, Evanston, IL, 60201, USA

    Randi Ettner

Authors
  1. Randi Ettner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Randi Ettner .

Editor information

Editors and Affiliations

  1. Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy

    Carlo Trombetta

  2. Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy

    Giovanni Liguori

  3. Department of Radiology, University of Trieste, Cattinara Hospital, Trieste, Italy

    Michele Bertolotto

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Italia

About this chapter

Cite this chapter

Ettner, R. (2015). Etiopathogenetic Hypotheses of Transsexualism. In: Trombetta, C., Liguori, G., Bertolotto, M. (eds) Management of Gender Dysphoria. Springer, Milano. https://doi.org/10.1007/978-88-470-5696-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5696-1_6

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5695-4

  • Online ISBN: 978-88-470-5696-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation