I’ve been tagged in this a lot today, so here goes:
Before we can talk meaningfully about transgender neurology, we first need to understand what the literature says about sex differences in the brain more generally. There are documented sex differences (on average) across various domains including white matter microstructure, cortical thickness, grey matter volume, and both structural and functional connectivity. These differences have been observed in both human and animal studies.
However, it’s critical to understand that these differences stem from a combination of biological and methodological factors. Some are simply due to the overall larger brain volume typically seen in males (which affects certain metrics more than others), while others may reflect social influences or even sexual orientation. Some identified differences maybe age-dependent, while others might not arise until there is damaging pathology. Regardless of the source, these differences are generally small when examined in isolation (i.e., univariate analyses), and the specific brain regions showing sex-related differences can vary from study to study, often due to differing methodological designs.
Importantly, there’s no clear-cut dichotomy here, only general trends, some of which are more consistent than others.
Now, turning to the data on transgender individuals: the so-called “brain-sex hypothesis” is the most frequently cited framework. But the quality of the existing data is, frankly, not great. Many studies include transgender participants who are already on cross-sex hormone therapy (sometimes for years!) or who also identify as homosexual.
Why does this matter?
Because both hormone therapy and sexual orientation are independently known to influence brain structure and function, and, crucially, they’re associated with the same kinds of “cross-sex shifts” that researchers are trying to study. We have direct evidence showing that each of these variables can alter the brain in ways that mimic sex-related patterns.
In fact, when researchers have scanned the brains of heterosexual transgender individuals who have NOT undergone cross-sex hormone therapy, their brains tend to resemble those of their natal sex.
Bottom line: correlation is not causation.
I HATE having to address transgender issues, but the bad-faith ignorance is astounding.🧵
My feed has been filled with conservatives attacking transgenderism as a mental illness with no legit biological basis. Which is medically, demonstrably FALSE. Yes, transgender women are obviously not biologically identical to cis women. However, most also are not biologically identical to cis men either.
Countless, broadly accepted medical studies have found that most transgender individuals have brain anatomy and functioning – and often hormonal, chromosomal, and genetic traits – that more closely match their experienced gender. My Substack post in my pinned tweet links to dozens of these medical studies.
The conservatives yelling “that’s impossible because male and female brains are fully identical in design and function" are not only clearly, biologically, wrong, but also hypocritical. The longstanding conservative belief in “gender essentialism” centers around such brain differences as the basis for male masculine vs. female feminine personalities – as they remind us every time a liberal mom tries to raise her baby boy with barbie dolls to reject masculinity. If conservatives suddenly believe that the brain is genderless, then they are endorsing the more radical leftist idea that male masculinity and female femininity are entirely social constructs that can be erased anytime. Any takers on that theory? I didn’t think so.
Typical male and female brains contain subtle but real differences. And because our genes contain a full blueprint for both male and female development, it is possible even for some people with XX or XY genes to experience chemical changes in the womb that alter some of the gender development signals, particularly to the brain.
This all relates to the assertion that transgender people “live under the delusion that they can change their sex.” No, we don’t. The point is that most transgender people were already born with biological differences relative to cisgender people. They aren’t trying to “change their sex” because, biologically, they never completely developed as the other sex to begin with.
As a trans person, I did not wake up and decide to “change my sex.” I knew from age 4 that something was off with my gender, and later participated in several gender medical studies that confirmed a more female brain chemistry/architecture/functioning, hormone levels, and other biological characteristics. Most people who transition are merely aligning the rest of their body with other observable biological gender aspects (mostly in the brain) that emerged before birth.
So, no, a trans woman is not the same as a cis woman. But she is probably not biologically identical to a cis male either. While the scientific discoveries continue to evolve (particularly in identifying the key genes), it has been firmly, medically established that transgenderism does indeed have an observable, biological basis. So it would be nice if more of the conservatives (and some liberals) who pride themselves on “standing up for truth and basic gender science” actually bothered to read and understand the scientific research.
And if you are too invested in hating trans people to accept that gender science is more complicated than the simplified model you learned in 10th grade biology, well, as conservatives love to remind everyone else, “facts don’t care about your feelings.”