A Discussion on the Relationship Between Gender Identity And Prenatal Exposure to Diethylstilbestrol (DES) in 46XY Individuals 

   Discussion

 

 

 


Of special interest is a UK symposium mentioned on the first page which produced a short document entitled Synopsis of the Etiology of Adult Gender Identity Disorder and Transsexualism. Based upon modern research, it defines transsexualism as a "neuro-developmental condition of the brain." It also mentions some factors which can potentially cause an "altered hormone environment" of the fetal brain such as genetic influences and/or medication, and environmental influences as well as stress or trauma to the mother during pregnancy.

Many of the signatories of this document, i.e., Professor Richard Green, are respected through out the world and all have impressive credentials. The chairperson of the symposium is Professor Milton Diamond. If Professor Diamond's name sounds familiar it may be because his extreme diligence was crucial in revealing the truth of the now infamous John/Joan case which made headlines a few years ago.

Two of the signatories of this document, Professor Louis Gooren, and Dr. Domenico di Ceglie are among the authors of The Harry Benjamin Standards of Care, Version 6, which is the resource psychiatrists and psychologists around the globe refer to when treating someone who is suffering from gender identity disorder.

 

Another of the signatories is Professor William Reiner, MD. His studies done on children born with cloacal exstrophy (1)  will also be found on the Observations page (John Hopkins public release). These studies are an extremely important part of this discussion because they prove that male gender identity is based primarily upon prenatal exposure to testosterone. Sadly the proof had to be obtained from studies done on children born with a life- threatening deformity. Fortunately people like Professor Reiner and Professor Diamond are working to end the medical professions self-proclaimed right to dictate the gender of helpless babies and put an end to the prevalent theory that children are born with a neutral gender identity.

 

The formulation of this auspicious theory can be traced back to the mid 1950's, only a few years after DES was inappropriately authorized for use during pregnancy. Money J., Hampson JG., Hampson JL 1955. Hermaphroditism : Recommendations concerning assignment of sex, change of sex and psychologic management.

 

From - THE CASE OF JOHN/JOAN 2nd page .

Please  note: David Reimer, the very brave man who chose to reveal his story to the world and overturn an extremely well entrenched theory chose to  leave this world behind during the month of May 2004.

 

"Money’s theory that newborns are psychosexually neutral was both unorthodox and against the current climate of science, which for decades had centered on the critical role of chromosomes and hormones in determining sexual behavior ."


"Current guidelines dictate that to be assigned as a boy, the child must have a penis longer than 2.5 centimeters; a girl’s clitoris is surgically reduced if it exceeds 1 centimeter "
Note: In recent years the attitude has changed so that a small penis alone is not grounds for surgical reassignment 219). Other recommendations: see 111). 149)

 

"By providing a seemingly solid psychological foundation for such surgeries, Money had, in a single stroke, offered physicians a relatively simple solution to one of the most vexing and emotionally fraught conundrums in medicine: how to deal with the birth of an intersexual child " 

I have been told by one medical professional in my community that surgery on intersexed babies has now ceased. However, it is still practiced in other locations.

 

The term intersexed covers a wide range of physical conditions which have a variety of causes. An excellent in-depth discussion of intersexed issues, medical protocols, medical ethics and interesting numbers on frequency can be found at ISNA(Ambiguous Sex" -- or Ambivalent Medicine?). "Intersexuality does not threaten the patient's life; it threatens the patient's culture."

 


 

The 1940's marked the beginning of an era when DES production became highly profitable. Since it was never patented, many  companies marketed it. Not only was it inappropriately prescribed to pregnant moms but large quantities of it were used to promote growth in livestock.

 

From - DES Cancer network (timeline) 

 

1947: DES approved for use during pregnancy. At the prodding of the drug companies reacting to market demand, the FDA approved the use of DES during pregnancy.

 

1952: Some scientists began to publicly question the efficacy of DES. The largest and best publicized controlled study of DES at the University of Chicago in 1953 showed it had "no beneficial effect whatsoever" in the prevention of miscarriage, and, in fact, DES brought about higher rates of premature birth and infant mortality. These findings were supported by several other studies done in the 1950s.

 

1959: DES banned in chicken and lambs. DES was used widely in agriculture beginning in 1941 to fatten livestock and chickens. Exposed male agricultural workers suffered sterility and breast growth as a consequence. When high DES levels in poultry produced similar symptoms in consumers as well, the FDA banned the use of DES in chicken and lambs in 1959.

 

1971: Doctors confirmed the link between clear cell adenocarcinoma of the vagina (CCA) and DES. The findings of the Boston doctors were published in the New England Journal of Medicine, April 22, 1971. Only then did the FDA issue an alert advising against the use of DES during pregnancy.

The Canadian DES timeline is similar to the US DES timeline. As far as how many were exposed to DES, either deliberately or otherwise? The following excerpt leaves the question open to debate.

 

 

 

From - A REVIEW OF PROCEDURES FOR THE DETECTION OF RESIDUAL PENICILLINS IN DRUGS 232)


"FDA became aware in the early 1960's of the potential health hazards associated with one particular contamination problem when reports were received that young males, reportedly being administered a vitamin preparation,were developing female characteristics.FDA inspections revealed manufacturing practices suspected of causing contamination with diethylstilbestrol."

 


 

Given the wide spread acceptance of Money's theories that babies are born psychosexually neutral, it's easy to understand why transsexualism was labeled as a mental disorder by the medical community (Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV). Modern research indicates that gender identity has much more to do with prenatal exposure to hormones than other factors and many of us would like to see Gender Identity Disorder removed from the DSM just as homosexuality was in 1973.  Studies such as the following are lending credibility to the concept that GID is not a mental illness.


From - Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults, IR Haraldsen, AA Dahl, Acta Psychiatrica Scandinavica  264)

"Results: TS patients scored significantly lower than PD patients on the Global Symptom Index and all SCL90 subscales. Although the TS group generally scored slightly higher than the HC group, all scores were within the normal range.


Conclusion: TS patients selected for sex reassignment showed a relatively low level of selfrated psychopathology before and after treatment. This finding casts doubt on the view that transsexualism is a severe mental disorder.
"

Note: PD stands for personality disorder and HC indicates Healthy controls.


From the perspective that a transsexual persons body gender does not match their brain gender, transsexualism is more appropriately defined as a birth defect and not as a mental disorder. In the case of male to female transsexual people, if we insist on labeling them as mentally ill and it turns out that they have brain structures which are typically female as has been shown to be the case in an ongoing study from the Netherlands....... well then half of the human race have similar brain structures. Of course the same argument applies for female to male transsexual people. Perhaps one day a new phrase such as Body/Brain gender disparity disorder or something similar will replace Gender Identity Disorder.


It is becoming apparent that for some of us the disparity between brain and body gender may very well have been caused by the medical community. The effects of thalidomide were readily apparent but the effects of drugs to the neurological development of the fetus are not as easily seen.


A growing number of professional and non professional people are working to have GID removed from the DSM.

GID Reform Advocates



 

How Frequently Does Transsexualism Occur ?

 

The etiology of gender identity disorder is a difficult subject, below are several quotes from  sources which are very different. By far the best discussion on the etiology of Transsexualism can be found in Christine Johnson's new thesis
Transsexualism: An Unacknowledged Endpoint of Developmental Endocrine Disruption?.

In addition she does an excellent analysis of how applicable the numbers from DES-Sons-International relate to the etiology of DES associated  transsexualism. Page 109 (Page 118 on the PDF page counter) .

 

From the Merck Manual "Estimated incidence is about 1 in 30,000 male births and 1 in 100,000 female births."

 

From the DSM-IV-TR, August, 2000, p. 579:  
Prevalence: There are no recent epidemiological studies to provide data on prevalence of Gender Identity Disorder. Data from smaller countries in Europe with access to total population statistics and referrals suggest that roughly 1 per 30,000 adult males and 1 per 100,000 adult females seek sex-reassignment surgery.”


The Harry Benjamin Standards of Care web site indicates the following:  "The earliest estimates of prevalence for transsexualism in adults were 1 in 37,000 males and 1 in 107,000 females .The most recent prevalence information from the Netherlands for the transsexual end of the gender identity disorder spectrum is 1 in 11,900 males and 1 in 30,400 females."


A study undertaken by Professor Lynn Conway based upon estimated surgeries performed in the US: "The result is a rough lower bound on post-op prevalence, which we find to be about 1:2500. In other words, at least one or more in every 2500 adult males in the U.S. has had SRS and become a postop woman."


A UK study estimates 1 in 3752 males have transitioned.

 

A newly release study by Mary Ann Horton, Ph.D. entitled the The Cost of Transgender Health Benefits in the US estimates the number to be close to 1 in 3000. "1 in 3000 have surgery once in their lifetime".


Although transsexual people have existed since the beginning of human history, in recent years our numbers (per capita) have been constantly increasing and the medical community's estimates are not in line with actual surgeries performed. Why?  I've actually asked Health Canada if they knew how many transsexual people there are in Canada and they have no idea. What is odd is that they have absolutely no intention of tracking the numbers. 

 


 

Who and what to believe ??

 

Not only does the medical community have problems with statistics on transsexual people, they also have problems agreeing on the physiological effects DES has on the male human fetus. From NIH 72): "Observations in DES-exposed male offspring (both humans and mice) include subfertility and infertility, decreased sperm counts, hypoplastic cryptorchid testes, epididymal cysts, testicular tumors, anatomical feminization, microphallus, hypospadias, retained Müllerian remnants, and prostatic inflammation." See also 127)130). However there are always studies published which report contradictory results 129).

We know from studies on mice that the effects of DES can be very dramatic (see caller 9, 76)) 125) 29):
"That male mouse will have a prostate seminal vesicle, all the other plumbing to get the sperm from the gonad out, but it will also literally have a functioning set of fallopian tubes, uterus, cervix, and an upper portion of the vagina."
"The penis of this mouse is also feminized to the extent that there is a higher prevalence of a condition called hypospadias."

 

A few people in Dr.Kerlin's group have discovered, usually by accident, that they also have portions of a female reproductive tract, i.e., after receiving an ultrasound for a hernia, or when the parents finally confess after remaining secretive for many years that as a baby their child had corrective surgery.


In relation to intersexed children, Dr. Diamond comments:  "Typically, patients discover their condition from an inadvertent family slip, community gossip or personal investigation into puzzling aspects of their lives. One must expect that the truth will emerge. And when it does, the patient will learn anyway what she or he was never supposed to have found out."


To the best of my knowledge no one has done a comprehensive study on the internal structures of exposed males. See DES Action Canada for a list of DES related effects and issues or check out the very cautious CDC site.
 


 

 

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