by Dana Beven
I am reading two books about hormones and genetics that provide more background on the Prenatal Testosterone Theory of Being Transgender (PTTT). In previous posts, I have told you about this theory and you hear about it almost every day on television and the Internet. Essentially, this theory says that if you are a trans man that you were exposed to too much testosterone in your mama’s womb and conversely that if you are a trans woman, that were not exposed to enough testosterone prenatally. It is a theory that is talked about a lot but, as I have said in previous posts, the evidence just does not support the theory.
I have always been intrigued as to how this theory got started and why. There is one trail that leads from eugenics, practiced in Western countries in the first half of the 20th Century, which provided Nazi Germany with a delusional rationale for wholesale murder of homosexuals and transgender people. Continuing the eugenic thread, after the war, the East Germans with support from the Soviets were looking for ideas for the “humane extinction” of these groups. At the time, the East Germans were also dabbling in the use of testosterone to improve their Olympics and international team performances. So using the results of a few animal experiments in the late 1950s with sex hormones on sexual behavior, the East Germans developed the PTTT. The idea was to manipulate prenatal testosterone level as a tool to prevent homosexuality and being transgender. Never mind that the only evidence was about sexual behavior in rodents, not about complex human sexual orientation and human gender behavior.
But the books I am reading provide further scientific background which might have inspired the PTTT and the actual words of the principal East German scientist that developed the PTTT. The background stories will curl your hair and I am only telling you about two of them.
sex_itselfThe first book is “Sex Itself: The Search for Male and Female in the Human Genome, by Sara Richardson (2013: The University of Chicago Press). The book starts out by providing background on sex hormone research in the 1910’s and 1920’s. This was a wild and wooly time for testosterone research. Testosterone would not be isolated and synthesized as a chemical until 1935. All the doctors knew is that there was some sort of secretion from male testes that supposedly had dramatic effects on the body and behavior of animals. The only way they could manipulate testosterone levels was through transplants from one animal to another which was successfully accomplished early in this era by Dr. Eugen Steinach, an Austrian physiologist. The male organ transplant was from male to female guinea pigs that seemed to Steinach to exhibit uncharacteristic male sex mounting behavior. Like many other mammals male guinea pigs “mount” the female from behind. That is probably all you want to know about guinea pig sexual behavior. (don’t even think about how elephants manage it; hint—they prefer river banks). Steinach believed that such transplants to humans could prolong life, increase vigor and prevent homosexual behavior.
After Steinach’s suggestion, sure enough, a French surgeon, Serge Voronoff tried transplanting male sex organs from monkeys to humans. He also tried transplanting monkey ovaries into human females. Enough to make an antivivisectionist or an ethicist cry! Eventually, the operations were discredited by the French academy and he died in disgrace. Maybe we can forgive him because of the long vivisectionist tradition in Europe and England; but we should not forget.
Both Steinach and Voronoff were ardent eugenicists as many European and American doctors were at the time. The eugenics movements not only fed into the holocaust murders, it stimulated hormone research. The goal was to rid the population of people like homosexuals and transgender people who were “undesirables.” The eugenics movement actually inspired the research of these doctors because it offered the possibility to eliminate undesirable behavior through the “miracle drug” of hormones, in particular, testosterone. We will come back to the topic of using testosterone postnatally.
Hormones_and_brain_differentiationThe other book I am reading is by Gunter Dorner: Hormones and Brain Differentiation, 1979, Elsevier. Dorner was the mastermind behind the PTTT in East Germany and in this book we find his own words about it. He termed homosexuality and being transgender as “psychic differentiation disturbances” and believed that homosexuality formed the basis for being transgender. He continued “ an important preventative therapy of sexual differentiation disturbances might become possible in the future by administration of androgens in… male fetuses during the critical differential periods of the genital organs….and the brain.” He also pointed out that homosexual behavior had been found to be reduced and heterosexual behavior restored by lesions of the hypothalamus and cited some research papers that I need to find. Of course, current evidence indicates that homosexuality and being transgender are independent phenomena undermining the notion that you first have to be homosexual to be transgender. No current ethicist that I know of would approve of either testosterone administration or making holes in people’s brains to rid them of homosexuality or being transgender.
I am just beginning to understand the full historical scope of the belief in PTTT and related theories. I have heard rumors that in the 1940s male homosexuals were made to take testosterone as a form of reparative therapy and likewise female lesbians were made to take estrogens. I will be looking for reports on this because they would provide continuity with today’s version of the PTTT. A related issue is the use of drugs prenatally to block high fetal testosterone levels in females with congenital adrenal hyperplasia to prevent behavior not deemed to be feminine. As I have written in previous posts, administration of such drugs currently continues without adequate scientific reporting.
The PTTT is not dead but seems to be morphing into a postnatal version. Recently Keith Ablow suggested that transgender children be given hormones that correspond to their birth sex to “go with nature” and make the children feel “more comfortable.” This, in spite of the lack of evidence suggesting that transgender children have no deficits in birth sex hormones. This is his alternative to social transition and puberty blocking drugs for transgender children. There actually is some initial science to show that these latter approaches are effective and safe. Scientists are waiting to see how they work in the long run. Ablow should read the cautionary story of Voronoff before he advocates administration of birth sex hormones in transgender people.
Because of medical problems that I had, and not because of my being transgender, I actually took testosterone by patch for about 3 years. It did not change my transgender behavior but it did leave scar tissue on my thighs where the metal in the patches had burned my skin. On the other had, I have been taking female hormones and blockers for about 9 years with very positive effects on my mood and body. I would not go back.
Sex hormones are powerful technologies. Like other technologies we need to be sure that they are used wisely. Since we have administered sex hormones to people for nearly 100 years, it is vital for medical science that we do not forget about both the successes and failures. It is also important to recognize when doctors have flirted with using them recklessly. I am personally concerned because the science about hormones is integral to understanding and treating transgender people.
Today, in an historic moment in the movement toward transgender equality, Secretary of Defense Ash Carter announced the lifting of the ban on transgender service members in the United States Armed Forces. This momentous decision comes a year after the Department of Defense began studying the issue, determining that the former exclusions were outdated, unscientific, and contrary to the success of openly serving transgender soldiers, sailors, and air force personnel in militaries from other countries.
“Allowing anyone who is willing and able to serve to do so without lying about who they are is a sound policy that reflects American values,” National Center for Transgender Equality Executive Director Mara Keisling said. “Like other institutions, including allied militaries, the Defense Department has found straightforward answers for all the questions that have come up. This is the right decision for the military and brings much needed certainty for thousands of currently serving soldiers who have put their lives on the line for their country, as well as for their units.”
The Department of Defense working group assigned to study the issue evaluated the success of transgender service members in allied militaries and among major employers in the United States and around the world. Initially given six months to conduct the study, the Pentagon extended the time to ensure the decision would not adversely impact military readiness. The Department of Defense will allow the armed services time to develop policies and education plans for their respective service members. Following that, transgender people will be able to serve openly in the military, enjoying the benefits of any other service member including access to medical care based on individual needs and subject to the same rules applied to other medical and personnel issues.
Though the announcement is a momentous victory, NCTE expresses concern about one aspect of the new policy: the eighteen month delay for individuals to join the military after a gender transition. Eighteen months is much longer than delays associated with other comparable medical treatments.
“This is a lingering piece of transgender exceptionalism that we expect will change as the military see that it is simply an unnecessary barrier to getting the best talent,” Keisling said.
The announcement of inclusive military service is a huge step in the right direction for the recognition of merit among all people who wish to serve in the United States Armed Services, but it is only a step toward full lived equality. Transgender people still face the sting of discrimination in employment, housing, and health care throughout the United States.
“We still have further to go to ensure that no one is denied the opportunity to earn a living, get an education, or put a roof over their heads because of who they are,” Keisling said. “If the military can do it – and they can and will – then the rest of society can do the same. That means updating our state statutes and federal laws to make completely clear that every person is treated equally and fairly.”
NCTE thanks all of our partners in advocating for this change, in particular SPART*A and the Palm Center for their long-standing leadership