Thursday 28 July 2011

Falling at the First Hurdle

From the Australian Bureau of Statistics, a Spotlight on the forthcoming census.

Try it for yourself.

Imagine you are Intersex. Remember, complete each question completely and accurately before proceeding to the next one.

I identify as female. Most Intersex people identify as either male or female. But a significant proportion identify as neither.

One of the main problems we face is that we're effectively invisible, and many people think that we're one in a ...few million, exceptions that the current health care system can deal with on an individual basis.

Nothing could be further from the truth, and there are thousands of us who have to travel interstate or internationally for specialist medical care. When we point this out, then we're told that there's no data available about our numbers, that if we were more than a handful, statistics would surely have been kept by the ABS. According to them, we don't exist, so there's no need for any facilities to be provided to us.

Hence I have to travel interstate every few months for a 15 minute endocrinologist appointment, at great expense, and taking a full day to travel there and back. Medications essential to my health can be and have been withdrawn from the market, because there's no perceived need for them.

Trans people have the same problem. We know from stats kept by the passport office that at least 200 people get passports in a new sex every year - which requires that they provide proof of surgery. There are several thousand in Australia. Yet there are no medications approved for Trans people on Australia on the PBS or off it, and many of the best are either unavailable in this country, or availability can literally change from week to week as customs etc regulations are arbitrarily changed. All are supposedly only for other conditions, and if a better medication for those conditions is found, the old one is withdrawn, regardless of the effect on Intersex or Trans people. They don't count because they're not counted.

The ABS is well aware of this. They have a real problem with compliance though. Their research has shown that if any questions about Intersex or Trans status are included, a large number of religious conscientious objectors will refuse to fill out the forms, as the existence of Intersex people is against their religious beliefs. Worse, many Intersex and Trans people dare not answer such questions accurately, as they face losing their marriages, jobs, family etc if their status is revealed.

Tuesday 26 July 2011

It was a Dark and Stormy Night....

Winner of the Bulwer-Lytton Prize for Fiction, 2011:
Cheryl's mind turned like the vanes of a wind-powered turbine, chopping her sparrow-like thoughts into bloody pieces that fell onto a growing pile of forgotten memories.

My favourite is a runner-up in the Bad Pun section:
Monroe Mills' innovative new fabric-dyeing technique was a huge improvement over stone-washing: denim apparel was soaked in color and cured in an 800-degree oven, and the company's valued young dye department supervisor was as skilled as they came; yes, no one could say Marilyn was a normal jean baker.
To which I'd add:

Her personal life she lived like the tarnished container that held the dye, cooled and preserved by icy blasts as frigid as the supervisor was not - a can, dull, in the wind.

Monday 25 July 2011

DMRT1, FOX and SOX

Following on from a previous post, from DMRT1 prevents female reprogramming in the postnatal mammalian testis by Marson et al, Nature (2011)
Sex in mammals is determined in the fetal gonad by the presence or absence of the Y chromosome gene Sry, which controls whether bipotential precursor cells differentiate into testicular Sertoli cells or ovarian granulosa cells [1]. This pivotal decision in a single gonadal cell type ultimately controls sexual differentiation throughout the body. Sex determination can be viewed as a battle for primacy in the fetal gonad between a male regulatory gene network in which Sry activates Sox9 and a female network involving WNT/β-catenin signalling [2]. In females the primary sex-determining decision is not final: loss of the FOXL2 transcription factor in adult granulosa cells can reprogram granulosa cells into Sertoli cells [2]. Here we show that sexual fate is also surprisingly labile in the testis: loss of the DMRT1 transcription factor [3] in mouse Sertoli cells, even in adults, activates Foxl2 and reprograms Sertoli cells into granulosa cells. In this environment, theca cells form, oestrogen is produced and germ cells appear feminized. Thus Dmrt1 is essential to maintain mammalian testis determination, and competing regulatory networks maintain gonadal sex long after the fetal choice between male and female. Dmrt1 and Foxl2 are conserved throughout vertebrates [4,5] and Dmrt1-related sexual regulators are conserved throughout metazoans [3]. Antagonism between Dmrt1 and Foxl2 for control of gonadal sex may therefore extend beyond mammals. Reprogramming due to loss of Dmrt1 also may help explain the aetiology of human syndromes linked to DMRT1, including disorders of sexual differentiation [6] and testicular cancer [7].

[1] Koopman, P., Gubbay, J., Vivian, N., Goodfellow, P. & Lovell-Badge, R. Male development of chromosomally female mice transgenic for Sry. Nature 351, 117–121 (1991)

[2] Uhlenhaut, N. H. et al. Somatic sex reprogramming of adult ovaries to testes by FOXL2 ablation. Cell 139, 1130–1142 (2009)

[3] Raymond, C. S. et al. Evidence for evolutionary conservation of sex-determining genes. Nature 391, 691–695 (1998)

[4] Loffler, K. A., Zarkower, D. & Koopman, P. Etiology of ovarian failure in blepharophimosis ptosis epicanthus inversus syndrome: FOXL2 is a conserved, early-acting gene in vertebrate ovarian development. Endocrinology 144, 3237–3243 (2003)

[5] Raymond, C. S., Kettlewell, J. R., Hirsch, B., Bardwell, V. J. & Zarkower, D. Expression of Dmrt1 in the genital ridge of mouse and chicken embryos suggests a role in vertebrate sexual development. Dev. Biol. 215, 208–220 (1999)

[6] Tannour-Louet, M. et al. Identification of de novo copy number variants associated with human disorders of sexual development. PLoS ONE 5, e15392 (2010)

[7] Turnbull, C. et al. Variants near DMRT1, TERT and ATF7IP are associated with testicular germ cell cancer. Nature Genet. 42, 604–607 (2010)
This diagram from the body of the article might help explain what was done, and what the effects were. For more details, see the full article, available through library sibscription.



I have a personal interest in such matters of course. In my own case, 3BHDD is a really good explanation of everything except for the rapidity of the change. That remains unexplained. This may have something to do with it, or it might not. More data needed, though activation/deactivation of Foxl9/Sox2 seems likely to play a role. DMRT1? No idea, though I don't see how it could. We're still guessing, but every little bit of information helps. There's one case being looked at by the Mayo clinic - a more complete change than mine - where this genuinely might be the cause, even if it's not involved in my own case. Weird stuff happens.

Friday 22 July 2011

MIDDLE SEXES

A Film about Diversity in Sex and Gender. Because of the diversity, it's inevitable that I identify strongly with some, while being bemused and bewildered by others.

If you want to learn something about others, please view this video. I learnt a lot about people very different from myself - while recognising characteristics of my own personality and situation in others. I cried a few tears over some parts, and went "Ewwwwwww" over others. As some people go "Ewwwwww" over me.





















Thursday 21 July 2011

Forty-Two Years Ago....

Apollo 11 was the spaceflight which landed the first humans, Neil Armstrong and Edwin "Buzz" Aldrin, Jr, on Earth's Moon on July 20, 1969, at 20:17:39 UTC.

06:17:39 July 21st, Australian Eastern Standard Time.



And today, courtesy of Russian TV, video of another landing. The End of a program that began just 12 years after the Eagle landed. The last voyage of the Atlantis.

Wednesday 20 July 2011

Neanderthal Genes

From An X-Linked Haplotype of Neandertal Origin Is Present Among All Non-African Populations Yotova et al Mol Biol Evol (2011) 28 (7): 1957-1962.
Recent work on the Neandertal genome has raised the possibility of admixture between Neandertals and the expanding population of Homo sapiens who left Africa between 80 and 50 Kya (thousand years ago) to colonize the rest of the world. Here, we provide evidence of a notable presence (9% overall) of a Neandertal-derived X chromosome segment among all contemporary human populations outside Africa. Our analysis of 6,092 X-chromosomes from all inhabited continents supports earlier contentions that a mosaic of lineages of different time depths and different geographic provenance could have contributed to the genetic constitution of modern humans. It indicates a very early admixture between expanding African migrants and Neandertals prior to or very early on the route of the out-of-Africa expansion that led to the successful colonization of the planet.
The only pure Homo Sapiens are in Sub-Saharan Africa. Everyone else on the planet, from Eskimo to Aborigine, is part Homo Neanderthalis.

I've blogged about this before, the first time in 2006.

Monday 18 July 2011

The Space Shuttle - The Economics

First, the Justification:
The Space Shuttle Decision Revisited
The variation of cost-effectiveness vs. flight rate is shown in Figure 2.312 – ‘break even’ for the TAOS (Thrust Assisted Orbiter Shuttle) Shuttle configuration was/is around 25 flights ... Obviously the case for the Space Shuttle system was better with additional uses in low earth orbits.
...

One problem: it was all a pack of lies, to put it bluntly. Or rather, it made certain assumptions: that the rate of Shuttle launch would be >25 per year, that the solid rocket boosters would be replaced by cheaper (and safer) liquid-fueled ones, that a "space tug" would be developed to service satellites at geosynchronous orbit...

The last two assumptions were not just reasonable, they were essential. The first one was known to be impossible.

That a space-tug wasn't developed, and the initial solid-fuel boosters were retained, meant that there was no case for a Shuttle any more. It was always about enhanced capability, able to do what would be otherwise impossible, not able to do the same things for less.
Also noteworthy in this context was the fairy tale of the “assumed” $5 million cost for each Shuttle launch. The range of launch costs was clearly identified in ALL reports and testimony to Congress and in three separate GAO ‘in-depth’ reviews in the 1970’s – and was stated as shown in Figure A-2.
· For TAOS with Solid Boosters (the configuration ultimately chosen by NASA) these costs ranged anywhere from $15 million to $30 million (in 1970 dollars – or about $60 to $120 millions in today’s dollars) depending on assumed launch rates of up to 24 per year, with a clearly stated launch risk of 2% (98% success rate).
· In contrast, TAOS with Liquid (Pressure Fed) Boosters would reduce these costs and risks by about half – and would permit the possibility of intact abort throughout launch.


Actual number of launches averaged 4 a year, at a cost of $1.5Bn each. Call it $400 million in 1970 dollars.



Anyway it's too late to think about more shuttle launches now. We can't get the parts any more.

Sunday 17 July 2011

To Anacreon in Heaven



A drinking song, written circa 1771.

To Anacreon in heaven where he sat in full glee,
A few sons of harmony sent a petition,
That he their inspirer and patron would be,
When this answer arrived from the jolly old Grecian:
Voice, fiddle aud flute, no longer be mute,
I'll lend you my name and inspire you to boot!
And besides I'll instruct you like me to entwine
The myrtle of Venus and Bacchus's vine.

The news through Olympus immediately flew,
When old Thunder pretended to give himself airs,
If these mortals are suffered their scheme to pursue,
The devil a goddess will stay above stairs,
Hark! already they cry, in transports of joy,
A fig for Parnassus, to Rowley’s we'll fly,
And there my good fellows, we'll learn to entwine
The myrtle of Venus and Bacchus's vine.

The yellow-haired god, and his nine fusty maids,
To the hill of old Lud will incontinent flee,
Idalia will boast but of tenantless shades,
And the biforked hill a mere desert will be,
My thunder, no fear on’t, will soon do its errand,
And, damn me I'll swinge the ringleaders, I warrant
I'll trim the young dogs, for thus daring to twine
The myrtle of Venus with Bacchus's vine.

Apollo rose up and said, “Prythee ne'er quarrel,
Good king of the gods, with my votaries below
Your thunder is useless - then showing his laurel,
Cried, Sic evitabile fulmen, you know!
Then over each head my laurels I'll spread,
So my sons from your crackers no mischief shall dread
Whilst snug in their club-room, they jovially twine
The myrtle of Venus and Bacchus's vine.


Some forty years later, the tune was used for an obscure political song of some kind.

Friday 15 July 2011

Lessons from the Past



Map of the Earth made in 1893 by Orlando Ferguson of Hot Springs, South Dakota. Credit: Don Homuth






Thursday 14 July 2011

AMA Resolution 122

For Reference.

Removing Financial Barriers to Care for Transgender Patients

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

Resolution: 122
(A-08)
Introduced by: Resident and Fellow Section
Massachusetts Delegation
California Delegation
New York Delegation

Subject: Removing Financial Barriers to Care for Transgender Patients

Referred to: Reference Committee A
(Linda B. Ford, MD, Chair)


Whereas, Our American Medical Association opposes discrimination on the basis of gender identity [i]; and

Whereas, Gender Identity Disorder (GID) is a serious medical condition recognized as such in both the Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Text Revision) (DSM-IV-TR) and the International Classification of Diseases (10th Revision) [ii], and is characterized in the DSM-IV-TR as a persistent discomfort with one’s assigned sex and with one’s primary and secondary sex characteristics, which causes intense emotional pain and suffering [iii]; and

Whereas, GID, if left untreated, can result in clinically significant psychological distress, dysfunction, debilitating depression and, for some people without access to appropriate medical care and treatment, suicidality and death [iv]; and

Whereas, The World Professional Association For Transgender Health, Inc. (“WPATH”) is the leading international, interdisciplinary professional organization devoted to the understanding and treatment of gender identity disorders [v], and has established internationally accepted Standards of Carevi for providing medical treatment for people with GID, including mental health care, hormone therapy and sex reassignment surgery, which are designed to promote the health and welfare of persons with GID and are recognized within the medical community to be the standard of care for treating people with GID; and

Whereas, An established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery as forms of therapeutic treatment for many people diagnosed with GID [vi]; and

Whereas, Health experts in GID, including WPATH, have rejected the myth that such treatments are “cosmetic” or “experimental” and have recognized that these treatments can provide safe and effective treatment for a serious health condition [vii]; and

Whereas, Physicians treating persons with GID must be able to provide the correct treatment necessary for a patient in order to achieve genuine and lasting comfort with his or her gender, based on the person’s individual needs and medical history [viii]; and

Whereas, Our AMA opposes limitations placed on patient care by third-party payers when such care is based upon sound scientific evidence and sound medical opinion [ix,x]; and

Whereas, Many health insurance plans categorically exclude coverage of mental health, medical, and surgical treatments for GID, even though many of these same treatments, such as psychotherapy, hormone therapy, breast augmentation and removal, hysterectomy, oophorectomy, orchiectomy, and salpingectomy, are often covered for other medical conditions; and

Whereas, The denial of these otherwise covered benefits for patients suffering from GID represents discrimination based solely on a patient’s gender identity; and

Whereas, Delaying treatment for GID can cause and/or aggravate additional serious and expensive health problems, such as stress-related physical illnesses, depression, and substance abuse problems, which further endanger patients’ health and strain the health care system; therefore be it

RESOLVED, That our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder (New HOD Policy); and be it further

RESOLVED, That our AMA oppose categorical exclusions of coverage for treatment of gender identity disorder when prescribed by a physician. (Directive to Take Action)

Fiscal Note: Staff cost estimated at less than $500 to implement.

Received: 04/18/08


References

[i]. AMA Policy H-65.983, H-65.992, and H-180.980

[ii]. Diagnostic and Statistical Manual of Mental Disorders (4th ed.. Text revision) (2000) (“DSM-IV-TR”), 576-82, American Psychiatric Association; International Classification of Diseases (10th Revision) (“ICD-10”), F64, World Health Organization. The ICD further defines transsexualism as “[a] desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex.” ICD-10, F64.0.

[iii]. DSM-IV-TR, 575-79

[iv]. Id. at 578-79.

[v]. World Professional Association for Transgender Health: http://www.wpath.org. Formerly known as The Harry Benjamin International Gender Dysphoria Association.

[vi]. The Harry Benjamin International Gender Dysphoria Association’s Standards of Care for Gender Identity Disorders, Sixth Version (February, 2001). Available at
http://wpath.org/Documents2/socv6.pdf.

[vii]. Brown G R: A review of clinical approaches to gender dysphoria. J Clin Psychiatry. 51(2):57-64, 1990.
Newfield E, Hart S, Dibble S, Kohler L. Female-to-male transgender quality of life. Qual Life Res. 15(9):1447-57, 2006.
Best L, and Stein K. (1998) “Surgical gender reassignment for male to female transsexual people.” Wessex Institute DEC report 88;
Blanchard R, et al. “Gender dysphoria, gender reorientation, and the clinical management of transsexualism.”J Consulting and
Clinical Psychology
. 53(3):295-304. 1985;
Cole C, et al. “Treatment of gender dysphoria (transsexualism).” Texas Medicine. 90(5):68-72. 1994;
Gordon E. “Transsexual healing: Medicaid funding of sex reassignment surgery.” Archives of Sexual Behavior. 20(1):61-74. 1991;
Hunt D, and Hampton J. “Follow-up of 17 biologic male transsexuals after sex-reassignment surgery.” Am J Psychiatry. 137(4):432-428. 1980;
Kockett G, and Fahrner E. “Transsexuals who have not undergone surgery: A follow-up study.” Arch of Sexual Behav. 16(6):511-522. 1987;
Pfafflin F and Junge A. “Sex Reassignment. Thirty Years of International Follow-Up Studies after Sex Reassignment Surgery: A Comprehensive Review, 1961-1991.” IJT Electronic Books, available at http://www.symposion.com/ijt/pfaefflin/1000.htm;
Selvaggi G, et al. "Gender Identity Disorder: General Overview and Surgical Treatment for Vaginoplasty in Male-to-Female Transsexuals." Plast Reconstr Surg. 2005 Nov;116(6):135e-145e;
Smith Y, et al. “Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals.” Psychol Med. 2005 Jan; 35(1):89-99;
Tangpricha V, et al. “Endocrinologic treatment of gender identity disorders. ” Endocr Pract. 9(1):12-21. 2003;
Tsoi W. “Follow-up study of transsexuals after sex reassignment surgery.” Singapore Med J. 34:515-517. 1993;
van Kesteren P, et al. "Mortality and morbidity in transsexual subjects treated with cross-sex hormones." Clin Endocrinol (Oxf). 1997 Sep;47(3):337-42;
World Professional Association for Transgender Health Standards of Care for the Treatment of Gender Identity Disorders v.6 (2001).

[viii]. The Harry Benjamin International Gender Dysphoria Association’s Standards of Care for Gender Identity Disorders, at 18.

[ix]. Id.

[x]. AMA Policy H-120.988

RELEVANT AMA POLICY
H-65.983 Nondiscrimination Policy
H-65.992 Continued Support of Human Rights and Freedom
H-180.980 Sexual Orientation and/or Gender Identity as Health Insurance Criteria
H-120.988 Patient Access to Treatments Prescribed by Their Physicians

Wednesday 13 July 2011

Intersexion

I identify as female, but biologically I'm Intersex. Atypically so, I looked normally male at birth, didn't develop, and changed to look female with ambiguous genitalia later. Usually such rare changes go the other way when they happen, looking female at birth and looking ambiguous or male later.

Mostly though, the ambuguity is present at birth, and doesn't change. I'm atypical, even for someone IS.

Many of us identify as either male or female. Some identify as neither, others as something of both. And have the bodies to justify that, for those religious fanatics that insist on justification. They - we - are as God made us. Deal with it. Take it up with Him if you have a problem.

Now on to the documentary, in 5 parts: Intersexion.









Tuesday 12 July 2011

De-Stressing

Some women sew, others knit. I paint miniatures to de-stress, though I haven't done so for ages. I recently resumed though, as between medical issues, teaching, and conducting a University course, I needed to give my brain a rest.



That's a 1/144 Sopwith Triplane of "B" flight, No 1 Squadron, Royal Naval Air Service. This Sopwith Triplane, No. N5387 "Peggy", was previously flown by French naval pilots serving with F14 at St. Pol, at one time reportedly being flown by famed French ace Charles Nungesser. It originally had white wheel covers and tailfin (see picture below) as did all of 'B' flight, but a later picture from August 1917 showed the tailfin had been re-painted in olive drab, and squadron markings "II" added. No 17 retained its white fin in this picture.







The coin is an Australian 20c piece, a little larger than a US Quarter, the same size as an old-style UK 10p or 2/- piece.

Model sculptured by Kampfflieger.

Monday 11 July 2011

End of an Era



See live updates on NASA TV. While you can.

Saturday 9 July 2011

Friday 8 July 2011

Mother Nature is a B*tch.

An article from National Geographic : "Sex Puppeteers" Force Sex Change, Virgin Birth in Bugs via Genes
Fast-spreading parasite species force sex changes on their victims, induce virgin births, and turn animals into "gross monsters"—among other horrors.

Now a new study has decoded how the bacteria may be able to wreak their havoc: by shutting down immune systems.

The parasites, of the Wolbachia bacteria genus, cause a gene in wasps to stifle the insect's protein-based "alarms" against the bacterial invaders, say researchers who mapped the genomes of three species of Nasonia wasp for the first time.

As a result, the wasps' antibacterial defenses are never deployed, allowing Wolbachia to begin their dirty work.
...
Males are transgendered into fertile females, or killed. Virgin females give birth—no fathers needed. The sperm of infected males is rendered useless in uninfected females.
...
Males get the shaft because Wolbachia can live in eggs but not sperm—only infected females can pass on the bacteria to offspring.

"For the human world this would be science fiction, but in the insect world, it's very much a reality," said Seth Bordenstein, a professor of biology of Vanderbilt University in Tennessee.
Funny things happen to humans too, Professor. Just rarely.
Which isn't to say Wolbachia's handiwork is always spot-on. Sometimes the bacteria can't finish the job, resulting in "gross monsters"—part male, part female—Bordenstein said.

Bordenstein and colleagues don't know exactly how Wolbachia work their genetic sabotage. But they do know that the bacteria go a step further and actually transfer some of their own genes into the wasp's genome.
Gross Monsters - yes, Intersex people sometimes get called that, and worse. In scientific jargon, it's not perjorative, but in the context it's usually uttered to humans, it is.

Interesting that Wolbachia can interfere with the host's genome... one of Mother Nature's more disquieting phenomena.

Wednesday 6 July 2011

Hormonal contributions to sexually dimorphic behavioral development in humans

From Science Direct, a paper about the organisational effects of hormones on the pre-natal brain, and what it means to be male or female : Hormonal contributions to sexually dimorphic behavioral development in humans Reinich et al, Psychoneuroendocrinology Volume 16, Issues 1-3, 1991, Pages 213-278
Nineteen studies on the behavioral effects of prenatal exposure to hormones administered for the treatment of at-risk human pregnancy are reviewed. Because the role of prenatal exposure to hormones in the development of human behavioral sex differences is potentially confounded by society's differential treatment of the sexes, comparisons between exposed and unexposed subjects were evaluated and summarized separately for male and female subjects. Therefore, this review focuses on data for individuals whose prenatal hormone environments were atypical relative to what is normal for their own sex.

Overall, it appears that prenatal exposure to androgen-based synthetic progestin exerted a masculinizing and/or defeminizing influence on human behavioral development, whereas prenatal exposure to natural progesterone and progesterone-based synthetic progestin had a feminizing and/or demasculinizing influence, particularly among female subjects. The data on prenatal exposure to synthetic estrogen derive primarily from subjects exposed to diethylstilbestrol (DES). DES-exposed male subjects appeared to be feminized and/or demasculinized, and there is some evidence that exposed female subjects were masculinized.

These findings are discussed in the context of prenatal hormonal contributions to sexually dimorphic behavioral development both within and between the sexes. Recommendations for the conduct of future research in developmental behavioral endocrinology are presented.
...
Three issues that qualify research in the area of human behavioral endocrinology must be considered in order to appropriately interpret the findings (see Reinisch & Gandelman, 1978, for a more detailed discussion).

The first qualifier relates to the inability to implement true experimental design (i.e., random assignment to treatment conditions) in research on human behavioral endocrinology. Because this area of human research is subject to strict ethical, moral, and legal constraints, true experimental design is precluded when studying potentially harmful interventions in humans.

Consequently, interpretation of the relationship between prenatal hormones and human behavioral development is limited to correlative rather than causal explanation. It is only through thoughtful comparison of conclusions derived from human "experiments of nature" or of medical treatmems with those derived from carefully controlled experimems with laboratory animals that confidence in the former can be attained. The role of hormones in organizing the neural substrate for behavior in nonhuman animals has been clearly established with two basic
experimental paradigms: perinatal androgen administration to genetic females, resulting in defeminization and/or masculinization, and perinatal androgen deprivation of genetic males, resulting in demasculinization and/or feminization, of sexually dimorphic behaviors and gonadotropin secretion in adolescence and adulthood. Extensive reviews of the nonhuman animal literature are provided by Ellis (1982), Hines (1982), and Reinisch (1974; 1983).

The second qualifier relates to the fact that the behavioral repertoires of males and females are not mutually exclusive, but rather, are overlapping. It is rare for one sex to display a behavior that is never exhibited by the other sex (menstruation, gestation, lactation, and impregnation being the notable exceptions). Typically, differences between males and females occur in the average frequency with which particular behaviors are exhibited by each sex. Thus, behavioral sex differences reflect quantitative, not qualitative, differences (Goy, 1970).

The third qualifier relates to the fact that masculinity and femininity are multidimensional. Masculinity and femininity are no longer conceptualized as opposite ends of a single, unidimensional, bipolar continuum (Fig. 2a), but are now understood to be a multidimensional matrix of independent or semi-independent factors.

The orthogonal or independent model (Fig. 2b: Constantinople, 1973; Bem, 1974; Whalen, 1974; Spence & Helmreich, 1978; Heilbrun, 1976; Berzins et al., 1978) and the oblique or correlated model (Fig. 2c: Reinisch, 1976; Reinisch & Sanders, 1987) suggest that masculinity and femininity are, with regard to many behavioral dimensions, relatively independent.


These models imply that an increase in the frequency or strength of masculine behavior (masculinization) is not necessarily associated with a decrease in feminine behavior (defeminization). Conversely, feminization is not necessarily concomitant with demasculinization. Thus, an individual may exhibit high frequencies of both masculine and feminine behavior (androgynous), low levels of both kinds of behavior (undifferentiated), or high levels of one type of behavior and low levels of the other (masculine or feminine).

The difference between the orthogonal and oblique models resides in the extent to which masculinity and femininity are considered to be independent. Whereas the orthogonal model proposes total independence, the oblique model suggests that there is some degree of correlation between masculinization and defeminization and between feminization and demasculinization.
OK, so what were the conclusions?
Our review suggests that endogenous hormones present prenatally influence at least some aspects of sexually dimorphic behavioral development in normal male and female subjects, perhaps by establishing particular behavioral predispositions. In general, play-related activities and interests, aggression/assertion, and gender identity/role emerged as the behavioral categories most often affected by prenatal exposure to exogenous hormones. These effects are not simple, however. For example, although prenatally DES-exposed male subjects appear to have been demasculinized in terms of interest in active participation in sports, they were masculinized with regard to interest in passive viewing of sports. Prenatal exposure to some of these hormonal treatments was associated with delayed or diminished sexual maturation and behavior, while in other instances these dimensions were enhanced.
Unfortunately, it's behind a paysite firewall, but if your library has access, you should be able to view it. I'm accessing it at home using my ANU library privileges, as both PhD candidate and lecturer.

Another reason why I want a career in academe.

Tuesday 5 July 2011

More Parts of the Puzzle- Grey Matter

Prenatal Exposure to Female Hormones: Effect on Psychosexual Development in Boys Arch Gen Psychiatry, April 1973, Yalom et al. 28 (4): 554 :
Two groups of boys exposed prenatally to exogenously administered estrogen and progesterone were studied on several parameters of psychosexual development. Subjects were twenty 6-year-olds and twenty 16-year-olds whose diabetic mothers received these hormones to prevent pregnancy complication. Hormone-exposed boys were compared with same-aged boys whose mothers had not received exogenous hormones and matched for age and socioeconomic class.

Sixteen-year-olds exposed to estrogen and progesterone were rated lower on several variables related to general "masculinity," assertiveness and athletic ability. Six-year-olds exposed to estrogen and progesterone were rated lower on aggressivity and athletic ability. There were two cases of hypospadias among experimental subjects. While it was not possible to rule out influences other than hormonal which may have influenced results, data suggest that prenatal sex hormone levels may influence some aspects of postnatal psychosexual development in boys.


From mygenes.co.nz, a non-peer-reviewed religious site, that nonetheless at least gives its references:Are transssexual brains different?:
The answer is probably yes, but not because of innateness. The altered brain microstructure is probably due to years of repetitive thinking, fantasy and preoccupation with body image.
Thereby ignoring the work by Yalom above, and others.
However the results of studies on transsexuals may be better established than those on homosexual people showing somewhat more reproducible differences in the brains, though still with large overlap. This note argues these differences can be explained by preoccupied thinking and imagination alone.

Recently a paper by Savic and Arver (Savic and Arver, 2011) has appeared. Their innovation is to take a study group composed only of male-to-female gynephiles (i.e. those attracted sexually to women). Previous male-to-female studies mixed gynephiles and androphiles. The authors find that the brains in their study group were not feminised. There was no evidence for female brains in a male body; the brains were male-typical. This is contrary to many of the previous research studies on mixed groups, but the study is thorough. They also found that there were differences in the brains of their study groups which were not found in either heterosexual male or female brains. These regions have been identified as those possibly associated with bodily self-perception (they are also enlarged in those who do lots of meditation, focusing partly on body state).

The authors say this is a “highly speculative” interpretation, but it’s possible they are actually underestimating how much support it has. It is very clear that repeated patterns of mental exercise alone, as seen for example in navigation (London taxi drivers) and internet addiction (Maguire et al. 2006; Zhou et al. 2009) changes significantly the microstructure of the brain. Thinking, particularly repeated thinking, changes brain microstructure.

OK, let's look at these papers. First the Macguire paper, London taxi drivers and bus drivers: a structural MRI and neuropsychological analysis. Maguire, E.A., Woollett, K. and Spiers, H.J. (2006) Hippocampus 16, 1091-101.
Licensed London taxi drivers show that humans have a remarkable capacity to acquire and use knowledge of a large complex city to navigate within it. Gray matter volume differences in the hippocampus relative to controls have been reported to accompany this expertise. While these gray matter differences could result from using and updating spatial representations, they might instead be influenced by factors such as self-motion, driving experience, and stress. We examined the contribution of these factors by comparing London taxi drivers with London bus drivers, who were matched for driving experience and levels of stress, but differed in that they follow a constrained set of routes. We found that compared with bus drivers, taxi drivers had greater gray matter volume in mid-posterior hippocampi and less volume in anterior hippocampi. Furthermore, years of navigation experience correlated with hippocampal gray matter volume only in taxi drivers, with right posterior gray matter volume increasing and anterior volume decreasing with more navigation experience. This suggests that spatial knowledge, and not stress, driving, or self-motion, is associated with the pattern of hippocampal gray matter volume in taxi drivers. We then tested for functional differences between the groups and found that the ability to acquire new visuo-spatial information was worse in taxi drivers than in bus drivers. We speculate that a complex spatial representation, which facilitates expert navigation and is associated with greater posterior hippocampal gray matter volume, might come at a cost to new spatial memories and gray matter volume in the anterior hippocampus.
OK, so we're talking about the hippocampus, and only the hippocampus. Furyhermore, we're only looking at grey matter distribution within that particular part of the brain.

Now let's look at the Zhou paper : Gray matter abnormalities in Internet addiction: A voxel-based morphometry study. Zhou et al, Eur J Radiol. 2011 Jul;79(1):92-5. :
BACKGROUND:This study aims to investigate brain gray matter density (GMD) changes in adolescents with Internet addiction (IA) using voxel-based morphometry (VBM) analysis on high-resolution T1-weighted structural magnetic resonance images.

METHODS:Eighteen IA adolescents and 15 age- and gender-matched healthy controls took part in this study. High-resolution T1-weighted magnetic resonance imaging scans were performed on the two groups. VBM analysis was used to compare the GMD between the two groups.

RESULTS:Compared with healthy controls, IA adolescents had lower GMD in the left anterior cingulate cortex, left posterior cingulate cortex, left insula, and left lingual gyrus.

CONCLUSIONS: Our findings suggested that brain structural changes were present in IA adolescents, and this finding may provide a new insight into the pathogenesis of IA.
This time, we're looking at other parts of the brain : the left anterior cingulate cortex, left posterior cingulate cortex, left insula, and left lingual gyrus. And again, only grey matter distribution.

I've blogged about the Savic paper before, and that post is worth re-visiting.
MtF-TR displayed also singular features and differed from both control groups by having reduced thalamus and putamen volumes and elevated GM volumes in the right insular and inferior frontal cortex and an area covering the right angular gyrus.


I'll add another paper to the mix : Regional gray matter variation in male-to-female transsexualism. by Luders et al Neuroimage. 2009 Jul 15;46(4):904-7.
Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men.



Altogether, females had the largest gray matter volumes in all but two significant clusters, which were located in the left and right putamen. Here, MTF transsexuals had the largest gray matter volumes (see Fig. 1). For the remaining clusters, MTF transsexuals had the smallest gray matter volumes, but their data spectrum largely overlapped with that of males.


OK, let's put this in a table:\
OrganhippocampusLeft
cingulate
cortex
Left InsulaLeft
lingual
gyrus
thalamusputamenRight insulaInferior
frontal
cortex
Right
angular
gyrus
London
Taxi
Drivers
+ Posterior
- Anterior
no datano datano datano datano datano datano datano data
Japanese
Internet
Addicts
no data---no datano datano datano datano data
MtoF
Luders
no datano datano datano datano data+no datano datano data
MtoF
Savic
no datano datano datano datano datano data+++


What conclusions can we draw from this, in terms of cause and effect? Well, the London Taxi Driver paper is pretty good evidence of neuroplaticity at work. The ratio of grey matter in the hippocampus changes as the result of repeated actions and thoughts. This is only to be expected, as the hippocampus is both one of the simplest neurological structures, and also known to be associated with laying down long-term memory. Total amount doesn't change, but distribution changes.

Regarding the Japanese Intersex Internet Addicts... we can't be sure. Is it that having a particular neurological structure makes one susceptible to Internet Addiction (whatever that may be, the definition isn't agreed upon). Or does Internet Addiction cause neurological changes in distribution of grey matter in specific areas? Moreover, we're talking about a decrease in grey matter, not an increase.

In both these cases, the repetitive physical and mental actions occur for significant periods of the day, totalling half the waking hours or more. It's difficult imagining what repetitive action is involved in being MtoF, male or female for that matter.

In summary, the case for neuroplasticity as regards grey matter distribution is very strong. As regards grey matter total, less strong, but still stronger than I'd thought in certain areas. Regarding the putamen though, very weak or non-existent.

Monday 4 July 2011

Friday 1 July 2011

Fact Checking in Inhore

Since my post a few days ago, a number of newspapers have picked up the story. The UK Telegraph. The Week. Pink News. International Business Times. The Hindu.

One comment (grammatical mistakes and mis-spellings in original) on the Telegraph site though struck me.
Vp Goswami

It is totally a failure of media to go in to detail of the issue.I have talked to all the pediatric surgeons of the city and I am confident to say that Nothing like this is going on in Indore,it is a baseless news.As a resposible office bearers of IAP "Indian Academy of Pediatrics" I would like to say categorically that this is the case of negative journalism on the part of HT. is also shocking and surprise for me.We should condemn it as news paper has opened another areas of discussion and need for the parents who are desirous of son , in-turn which will again confuse our society.
Vp Goswami, according to his FB profile, is a Lecturer in medical services for the Government of Madyah Pradesh, in Indore.

It wouldn't be the first time that a newspaper has published a sensationalist beat-up regarding Intersex issues. It also wouldn't be the first time an Indian state government official with an obvious political agenda has tried a cover-up.

More data needed. We may be getting that soon. From The Hindu :
Taking cognisance of a newspaper report about several hospitals and clinics in Indore performing surgeries on baby girls to change their sex, the National Commission for Protection of Child Rights (NCPCR) has asked the State government to undertake an investigation with a team of doctors, known for high professional competence and ethical standards.

The Commission has sought a detailed report within 15 days, giving facts, figures and circumstances of the cases, list of doctors/hospitals practising genitoplasty and action taken or contemplated against them.
I could only wish that such a report was in preparation in Australia, the US, the UK and elsewhere.

One thing's clear: what might be acceptable treatment for Intersex children is looked on with shock, horror and indignation when non-Intersex children are involved. The double standard is rarely illustrated with such clarity.