Research

Neuroscience

• Alternating gender incongruity: A new neuropsychiatric syndrome providing insight into the dynamic plasticity of brain-sex - Case, L.K. & Ramachandran, V.S., 2012.

Summary

An online survey of 32 bigender individuals was conducted. Questions concerned whether they had ever been diagnosed with a psychiatric disorder, whether or not they could predict their cycles in gender, how often they switched between genders, and whether or not they experienced the sensation of 'phantom' breasts or genitalia that cycled along with gender.

Key Findings

• A higher than expected rate of bipolar disorder was found among participants; however, this was not sufficient to explain experiences of cycling gender, nor was any other psychiatric disorder.
• 10 of 32 participants reported that their switches were predictable.
• Of those surveyed, 14 switched daily, or multiple times a day; 9 switched weekly or several times a week; 6 switched monthly or several times a month; and 3 switched several times a year.
• 21 of 32 participants reported experiencing phantom body parts that matched their current gender state.

Limitations

• There is currently no evidence for or against the theories proposed here; this paper appears to be the first formal scientific investigation of bigender identity, and as a result, the discussion section is highly speculative.

Implications for Future Research

• The authors propose several speculative theories of a neurological basis for bigender identity (or 'alternating gender incongruity', as they refer to it):

• Bigender people may have unusually amplified functional hemispheric dominance patterns; cycling of dominance between hemispheres may lead to the alternate expression of cognitions and emotions that are traditionally considered to be 'male' or 'female'.
• Alternatively, these alternating patterns of hemispheric dominance may lead to different patterns of sympathetic and parasympathetic nervous system control, which in turn could result in different patterns of emotional reactivity.
• Bigender people may have atypical somatosensory body maps, resulting in two or more differently gendered body maps that vie for sensory input.
• Bigender identity could also be a result of a combination of these causes.

• More broadly speaking, they acknowledge that there are many levels at which gender and sex can differ - including chromosomes, physical morphology, body image, and "sense of being a man or woman in society" - and that differences in any one of these could underlie a trans* or nonbinary gender identity.
• The authors also wonder whether alternation of gender states might reflect changes in hormone profiles.

Published In: Medical Hypotheses

Access: Institutional login available

Content Note: Contains some problematic language (medicalisation of bigender indentity).

• Current Thinking on the Etiology of Gender Dysphoria - Vitale, A., 2011.

Summary

A very brief review of the evidence for a neurological basis for gender dysphoria, and some informed but speculative discussion of how this neurological basis might emerge during fetal development. The specific findings discussed involve binary trans* participants, but they are potentially relevant to anyone who experiences gender dysphoria.

Key Points

• There is evidence to suggest that, in the brains of transsexual women, thebed nucleus of the stria terminalis (aka BSTc; a region which differs in size between cisgender males and females) is sized within the range typically found in cisgender females.
• Evidence also shows that, for transsexual women, the number of somatostatin-expressing neurons in this region of the brain is within the range expected of cisgender females. Conversely, for transsexual men, the number of somatostatin-expressing neurons in this area was more similar to the range found in cisgender males.
• These findings support the idea that, in people who experience gender dysphoria, the sex characteristics of the brain may be incongruent with other sex characteristics.
• The development of sexual dimorphism in utero is highly complex, and there are many stages at which one or many aspects of an individual's sex may become incongruent with the rest:

"Once in the fetal brain, testosterone is either metabolized into dihydrotestosterone by an enzyme named 5 alpha reductase or converted to estradiol by an enzyme called aromatase. Counterintuitively, increased estrogen receptor activation is responsible for defeminization while increased androgen receptor activation seems to be responsible for masculinization. All this makes clear that there is nothing straightforward about an individual being born with a gender identity that matches their biological sex."

• For an individual's brain to develop with a representation of their body as predominantly male, they must not only be exposed to sufficient testosterone, but this testosterone must also be released with the correct timing, as there is a relatively short time frame in which the brain is susceptible to defeminisation. If this does not occur, the gender map may be "partially imprinted as male". Possible causes of disruption include disorder in the mother's endocrine system, maternal stress, medication, or potentially other substances and/or adverse events. Female gender is less complex to produce, but still potentially vulnerable to disruption.
• "Gender identity, far from being absolute, appears to occur on a continuum, with most people gathered at either end, the rest being somewhere in between. Feelings of discomfort or complete inappropriateness about one's assigned sex do not mean the individual is wrong or ill. It simply means that the assignment made at birth almost universally on the shape of one's genitals can, on occasion, differ from the unseen brain imprint."

Limitations

• Only two studies were cited in support of points relating to the BSTc.
• The samples used in these studies were very small, and there was considerable overlap in the participants used in the two studies.
• Both studies examined postmortem brains, and the majority of trans* participants had been on hormone replacement therapy during their lifetimes. Findings relating to the BSTc may, therefore, have been due to hormone use rather than an innate marker of gender dysphoria.

• The authors did attempt to control for this by including a control group of cisgender males with hormonal disorders; however, this control sample was also very small, consisting of only two brains.

• Only a single transsexual man was studied, so firm conclusions about the brains of transsexual men cannot be drawn from the study described.
• The discussion of fetal development is purely speculative; no research is cited to support the idea that a neural correlate of gender identity develops in the womb.

Published In: The Gendered Self by Anne Vitale

Access: Introduction available as a free download; full book available for purchase in physical and ebook formats.

Law

United States

• Contesting Sex Classification: The Need for Genderqueers as a Cognizable Class - Meerkamper, S.T., 2013.

Summary

A discussion of the need for genderqueer people to be recognised as a distinct, legally protected class, and the possible benefits this could yield for society in general. First-person accounts from genderqueer individuals are used to illustrate what it means to be genderqueer. The paper goes on to outline definitions of 'genderqueer', statistics that highlight unique challenges faced by genderqueer people with regard to discrimination, and arguments that could be used to refute the perceived need for classification based on binary sex.

Key Points

• Genderqueer identity has largely been ignored by U.S. law; the word 'genderqueer' is often instead used to refer to a political movement to challenge gender roles. Genderqueer people are sometimes included under the wider definition of 'transgender', but this can serve to erase genderqueer identity from consideration.
• Two definitions of genderqueer should be considered:

• The Practicing Law Institute's existing definition of 'genderqueer' as a “term for people who challenge the binary gender system of femininity/masculinity; often used because of its subversiveness/overtly political/activist aspects; incorporates ideas from gender theory into personal identity.”
• A definition of 'genderqueer' as a distinct identity:

  ““Genderqueer” refers to those who do not (or do not always) identify as either a woman or a man. Some who consider themselves genderqueer may identify as a man one day and a woman the next. Others identify as neither man nor woman, seeing themselves as between or beyond genders. Some reject gendered pronouns, preferring to be referred to as “they,” or “ze” (a recently created, gender-neutral pronoun) or simply by their name.”

• Legal protection for genderqueer people would likely make it easier for binary trans* people to seek legal protection, as a system that is already accustomed to removing a gender marker should also have little changing one from 'M' to 'F' or vice versa.
• Accepting genderqueer people under the law would also be an admittance that gender is fluid and constructed, which may lead to the reduced medicalisation of trans* identities and wider acceptance of less rigid attitudes toward gender.
• Genderqueer people may face bias in the courts due to their (statistically) younger age, which may contribute to a perception of them being 'confused', 'going through a phase', or threatening the status quo with radical views.
• 90% of genderqueer people surveyed report an experience of verbal harassment in the workplace, barriers to advancement, and pervasive fear of these outcomes.
• US federal law likely already protects genderqueer people, due to language that focuses on 'gender identity' and 'gender expression', rather than transition.

• For example, the latest proposed version (at the time of the paper's publication) of the federal Employment Non-Discrimination Act (ENDA) defines gender identity as “the gender-related identity, appearance, or mannerisms or other gender-related characteristics of an individual, with or without regard to the individual’s designated sex at birth.”
• However, employers are often unaware of this, and may discriminate despite the law. This may mean that employers who do discriminate against genderqueer people will take fewer precautions to cover themselves, making it easier for plaintiffs to build a case against them.

• Most state laws also implicitly include genderqueer people, by protecting “gender-related identity, appearance, expression, or behavior of an individual, regardless of the individual’s assigned sex at birth.”

• Exceptions:

• New Mexico's definition of gender identity as "a person's self-perception, or perception of that person by another, of the person's identity as a male or female based upon the person's appearance, behaviour or physical characteristics that are in accord with or opposed to the person's physical anatomy, chromosomal sex or sex at birth"
• Minnesota's state laws describe being trans* as " “having or being perceived as having a self-image or identity not traditionally associated with one’s biological maleness or femaleness”.
• Colorado makes the distinction between gender identity (“an innate sense of one’s own gender”) and gender expression (“external appearance, characteristics or behaviors typically associated with a specific gender”). Laws concerning "sexual orientation harassment" include deliberate misuse of pronouns and names.

• At the time this paper was published, the latest proposed version of the ENDA defined gender identity as “the gender-related identity, appearance, or mannerisms or other gender-related characteristics of an individual, with or without regard to the individual’s designated sex at birth.” This further clarifies the inclusion of genderqueers under the law, though it may be unintentional.
• Arguments for genderqueer inclusion from the standpoint of equal protection:

• Gender classifications are reviewed under the Equal Protection Clause using the 'intermediate scrutiny' standard - any act of discrimination based on gender by the state must be justified with benefits to an important state interest.
• There is precedent to show that laws based on gender stereotypes should not be upheld - see the case of Craig v. Boren, in which law would have allowed women to legally buy beer at a younger age than men, as men were caught drunk driving more often. The law was not upheld, as it was felt that differential treatment of the genders played a role in women having fewer opportunities to drive when drunk.
• There is also precedent that perceived 'inherent differences' between genders are not enough to justify discriminatory law - see the case of United States v. Virginia, in which the Virginia Military Institute banned female students, as they were not considered physically or mentally tough enough to withstand training. The law was not upheld.
• It could be argued that the idea that there are only 'men' and 'women', and that gender does not differ from sex assigned at birth, is in itself a stereotype and a presumed inherent difference between sexes. Therefore, this idea alone should not be enough to justify a binary sex classification system.
• Binary sex classification is also arguably irrelevant to important state interests, as sex classification does not affect a person's privileges for travel in the US and often does not relate to their gender expression for the purposes of identification.

• Arguments from due process:

• The Due Process Clause protects “personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education.” There is a precedent for this clause being used to affirm the right to an abortion and undermine ant-gay sodomy laws.
• Since US family life is still much defined by traditional gender roles, and the right to marry is based on the genders of the partners who wish to marry, gender is clearly linked to these personal decisions. The clause has also been described by the Supreme Court as protecting 'the right to define one's own concept of existence', and gender could arguably be included in that concept.
• Genderqueer people could, therefore, make the case that they should be free to define their own gender without intervention by the state in the form of binary classification.

• First Amendement arguments:

• The First Amendment prohibits 'state-compelled speech', particularly that which conveys an 'ideological message'. There is a precedent for this being used to justify refusal to display passive, state-issued messages (e.g. citizens removing the New Hampshire state motto, "Live Free or Die", from their license plate, because they disagreed with said motto).
• To some extent, presenting and/or identifying as genderqueer is an ideological decision, and genderqueer people should not be forced to affirm the idea that gender is binary and tied to sex every time they present documentation.

Published in: The Dukeminier Awards Journal

Access: Open Access.

Policy/Statistics

United States

• A Gender Not Listed Here: Genderqueers, Gender Rebels, and OtherWise in the National Transgender Discrimination Survey - Harrison, J., Grant, J., & Herman, J.L., 2012.

Summary

An analysis of data from the 2008 National Transgender Discrimination Survey (NTDS), by the National LGBTQ Task Force and the National Center for Transgender Equality in the US, which surveyed 6450 trans and gender non-conforming participants over the course of six months. The study included two questions about gender identity, one of which provided an 'A gender not listed here' (GNL) option, with an open text field to specify. This analysis focuses on respondents who described their gender identity as GNL (a total of 860 participants, 13% of the sample), and their experiences of discrimination, harassment and abuse compared to non-GNL respondents and the total sample.

Introductory Note

Since this paper is freely available at the link above, in the interest of brevity I will not be reporting all exact statistics here; please refer to the original paper for specifics.

Key Findings

• A variety of gender identity labels were submitted by GNL respondents, including:

• 'Genderqueer' or 'queer' (42% of GNLs; 6% of the total sample)
• 'Both', 'either', 'neither', 'in-between', or 'non-binary' (9% of GNLs)
• 'Androgynous' or 'blended' (8% of GNLs)
• 'Non-gendered', 'gender is a performance', or 'gender does not exist' (3% of GNLs)
• 'Fluid' (2% of GNLs)
• 'Two-spirit' (2% of GNLs)
• 'Bi-gender', 'Tri-gender', or 'third gender' (2% of GNLs)
• 'Genderfuck', 'rebel', or 'radical' (1% of GNLs)
• A variety of unique responses, including: 'Birl'; 'Jest me';'Skaneelog'; 'Twidget'; 'Neutrois'; 'OtherWise'; 'gendertreyf'; 'trannydyke'; 'genderqueer wombat fantastica'; 'Best of Both'; 'gender blur'; and 'transgenderist'.
• Some responses for which the frequency was not reported, including: 'Pangender'; 'Hybrid'; 'Mahuwahine'; and 'Aggressive'. It is unclear from the report whether these were folded into other categories above for the purpose of producing statistics.

• GNLs were more likely than non-GNLs to be FAAB. They were also more likely, to be under 45, and/or to be multiracial, Black, or Asian. They were less likely than non-GNLs to be White or Latinx. In addition, GNLs were more likely than non-GNLs to live in California, the Northeast, the Mid-Atlantic states, and the West (including Alaska and Hawaii), and less likely to live in the Midwest and South.
• GNLs had higher educational attainment than non-GNLs, but were more likely to live in extreme poverty - though this may be because they were, on the whole, younger than non-GNLs.
• GNLs were more likely than non-GNLs to have experienced harassment and sexual assault at school; they were also more likely to have experienced physical and/or sexual assault as adults. In addition, GNLs were more likely to have worked in an underground economy, postponed medical treatment for fear of discrimination, and/or attempted suicide, and were more likely to be uncomfortable with going to the police for help. Finally, they were also more likely to be HIV positive or of unknown HIV status, and more likely to be unemployed. To summarise, contrary to common perception, GNLs had experienced abuse, harassment, and discrimination at higher rates than non-GNLs.
• GNLs were less likely than non-GNLs to have lost their job, and/or had medical treatment denied, as a result of transphobia.

Implications for Future Research

• Including non-binary gender options in future surveys may be necessary in order to observe the "unique demographic patterns" and "distinct experiences of discrimination" present in non-binary/GNL people.
• Future researchers should further explore the identities and experiences of genderqueer people, both by examining these data more closely and by designing novel studies.
• In addition to the gender question focused on by this study, the survey included an additional question asking participants to choose as many identity labels as applied to them from a list, including 'Transgender', 'FTM', 'MTF', 'Genderqueer', and many others. Answers to this question have not yet (at time of publication) been investigated in detail, but appear to differ considerably from those given by GNLs; more research is required to explore the answers to this question.
• Further research is needed to make up for the statistical limitations of this study (see below).

Limitations

• In addition to the 'GNL' option and binary male and female answers, the gender question examined here also provided an option for "Part time as one gender, part time as another", which was chosen by 20% of respondents. This wording could conceivably cover genderfluid and bigender identities, meaning that there have been more non-binary respondents to the survey than were examined by this study.
• The statistical test used - Pearson's chi-squared - only produces generalisable results when applied to a random population, which this was not. In addition, the non-random nature of the study may have compromised the test's ability to find statistical significance. The findings of this study should therefore not be taken as read, but instead, be used to provide hypotheses for more in-depth research.

Published in

The LGBTQ Policy Journal at the Harvard Kennedy School

Access

Open Access

Content Note

Contains mention of sexual and physical assault and suicide.