Thursday, 30 June 2011

Asimov on Political Statements

From Isaac Asimov's Foundation:
"But then," interposed Sutt, "how would Mayor Hardin account for Lord Dorwin's assurances of Empire support? They seemed –" He shrugged. "Well, they seemed satisfactory."

Hardin threw himself back in the chair. "You know, that's the most interesting part of the whole business. I'll admit I had thought his Lordship a most consummate donkey when I first met him – but it turned out that he was actually an accomplished diplomat and a most clever man. I took the liberty of recording all his statements."

There was a flurry, and Pirenne opened his mouth in horror.

"What of it?" demanded Hardin. "I realize it was a gross breach of hospitality and a thing no so-called gentleman would do. Also, that if his lordship had caught on, things might have been unpleasant; but he didn't, and I have the record, and that's that. I took that record, had it copied out and sent that to Holk for analysis, also."

Lundin Crast said, "And where is the analysis?"

"That," replied Hardin, "is the interesting thing. The analysis was the most difficult of the three by all odds. When Holk, after two days of steady work, succeeded in eliminating meaningless statements, vague gibberish, useless qualifications – in short, all the goo and dribble – he found he had nothing left. Everything canceled out."

"Lord Dorwin, gentlemen, in five days of discussion didn't say one damned thing, and said it so you never noticed. There are the assurances you had from your precious Empire."
Bear that in mind, the next time you hear a political speech. Lay aside the platitudes, the vagaries, the abstract statements of principle, and see what's actually been promised.

There's also this little dig at the Humanities:
Hardin remained silent for a short while. Then he said, "When did Lameth write his book?"

"Oh I should say about eight hundwed yeahs ago. Of cohse, he has based it lahgely on the pwevious wuhk of Gleen."

"Then why rely on him? Why not go to Arcturus and study the remains for yourself?"

Lord Dorwin raised his eyebrows and took a pinch of snuff hurriedly. "Why, whatevah foah, my deah fellow?"

"To get the information firsthand, of course."

"But wheah's the necessity? It seems an uncommonly woundabout and hopelessly wigmawolish method of getting anywheahs. Look heah, now, I've got the wuhks of all the old mastahs the gweat ahchaeologists of the past. I wigh them against each othah, balance the disagweements, analyze the conflicting statements, decide which is pwobably cowwect, and come to a conclusion. That is the scientific method. At least" patronizingly "as I see it. How insuffewably cwude it would be to go to Ahctuwus, oah to Sol, foah instance, and blundah about, when the old mastahs have covahed the gwound so much moah effectually than we could possibly hope to do."
While Meta-studies have their place - it's what I'm engaged in in when it comes to the whole "science of sex and gender" thing - my PhD work is nothing but "insufferably crude" experimentation, plus some analysis.

In the Humanities, Lord Dorwin's "scientific method" appears the norm.

Wednesday, 29 June 2011

America's Next Great Civil Rights Struggle

That's the title of an article appearing in the right-wing magazine, The New Republic:
Transgender people are some of the least protected, most persecuted people in the United States.
Transgender people are regularly evicted from their homes, fired from their jobs, and denied medical treatment. Last July, emergency room staff in an Indiana hospital refused to help a trans woman who was coughing up blood, referring to her as “it.” More than a quarter of transgender people surveyed say they have lost a job because of discrimination. Transgender people are more likely to become homeless (at an average age of 13, in New York City). And then there is the obstacle course of inconveniences that reminds transgender people every day that they don’t belong. One trans woman told me her company requires her to lock herself in when she uses the restroom—even though it’s multi-occupancy—so she is acutely aware of making other women wait. In some states, a court order is required to change a person’s gender on a driver’s license. Many health insurance plans only cover procedures for one gender, so a person born male who transitions to female can’t get both a prostate check and a mammogram.

For some, these challenges prove insurmountable. Four years ago, Mike Penner, a longtime sports columnist for the Los Angeles Times, came out to the world as Christine Daniels. But, after a year and a half, unable to cope with the scrutiny, she changed her name back to Mike and returned to living as a man. A year later, she killed herself. Daniels’s story was tragically typical: More than one in three transgender people attempt suicide at some point in their lives.

But these are statistics, and people are rarely moved by statistics. In this country, civil rights movements have prevailed when they have convinced enough people that a minority is being treated in a way that is fundamentally un-American. For this to happen, people need to see members of a disadvantaged group as human beings before anything else.
As they say, Read The Whole Thing. The author gets it.

Tuesday, 28 June 2011

Intersex in the House

A post in three parts:

Part I: Confronting the Issues:

While this video is fictional, from the TV series "House Private Practice" - yes, this happens. In the USA, in England, and in Australia.

When I saw it for the first time, I teared up. Not from my personal experience as a baby, for I looked unambiguously male at birth.

My son... had to have genital reconstruction at 18 months. He was in increasing pain. He's Intersex too, very mildly.

Part II - endocrinology for dummies

11-beta-hydroxylase deficiency is a rare form of Congenital Adrenal Hyperplasia.

I'll try to explain things as best I understand them, given that I'm no enocrinologist. You really need to see this diagram first:

That shows the chains by which cholesterol is changed into various hormones, and their precursors. The green and red horizontal and vertical bars show the enzymes necessary to help along the conversion.

To simplify, only cortisol, testosterone (the main male sex hormone), dihydrotestosterone (the super-virilising hormone that causes male-pattern baldness), estrone (a mild female hormone), and both estrodiol and estriol, (main female sex hormones) will be looked at.

For example: 17-beta-hydroxysteroid-dehydrogenase (17BHD) - the long green horizontal bar near the bottom - is needed to convert dehydroepiandrosterone into androstendiol (which then in turn gets converted to testosterone), androstenedione into testosterone, and estrone into estrodiol.

Total 17BHD deficiency means "you can't get there from here" as regards testosterone production. Mildly feminising estrone is the only sex hormone being produced. However, most cases are partial, and once you get some testosterone being produced, as happens in puberty, some gets changed to the super-virilising dihydrotestosterone. So 46XY people born looking like girls because they didn't have much testosterone exposure in the womb virilise to look somewhat male.

5-alpha-reductase deficiency (5ARD) is even more "targeted" if you like, and explains the subtle differences between 5ARD and 17BHDD. Both can cause a "natural sex change" from female looking at birth to male looking later, but the change in 5ARD people is more complete, as it's only the production of dihydrotestosterone that's blocked.

Now see the red vertical bar on the far right. 11-beta-hydroxylase. It's needed to produce corticosterone from deoxycorticosterone, and cortisol from 11-deoxycortisol.

Low cortisol is a life-threatening condition, so in foetal development, the adrenal glands enlarge to compensate by producing more of the precursors to cortisol.
Because 11╬▓-hydroxylase activity is not necessary in the production of sex steroids (androgens and estrogens), the hyperplastic adrenal cortex produces excessive amounts of DHEA, androstenedione, and especially testosterone.

These androgens produce effects that are similar to those of 21-hydroxylase deficient CAH. In the severe forms, XX (genetically female) fetuses can be markedly virilized, with ambiguous genitalia that look more male than female, though internal female organs, including ovaries and uterus develop normally.

If the leftmost vertical bar, 3-beta-hydroxysteroid-dehydrogenase (3BHD), is deficient... pretty much any darn thing can happen, the whole system's out of whack. Mild 3BHD deficiency can cause all sorts of effects. Trust me on that. But I digress...

The point is, 11-beta-hydroxylase deficiency causes virilisation of 46XX people. Some - about 10% - end up with male gender identities.

Part III - Some advice for parents in this position.

1. Pick a sex, any sex. Socially (not surgically) assign your child to that for now. It won't do any harm if it's wrong, sex is in the brain, sex of rearing doesn't matter.

2. Be prepared at any time from age 2 onwards (median is 5) for your child to say that a silly mistake has been made, that she's really a boy, or he's really a girl. Change sex of rearing accordingly.

3. Many people with ambiguous genitalia are happy with things that way. More are not, and desire corrective surgery, one way or the other. Your duty as parents is to bow to the inevitable, and supply resources and options so your child can have, or not have, surgery as they choose.

Monday, 27 June 2011

Docs surgically change baby girls to look like boys in India

From the Hindustan Times
Girls are being 'converted' into boys in Indore - by the hundreds every year - at ages where they cannot give their consent for this life-changing operation.

This shocking, unprecedented trend, catering to the fetish for a son, is unfolding at conservative Indore's well-known clinics and hospitals on children who are 1-5 years old. The process being used to 'produce' a male child from a female is known as genitoplasty. Each surgery costs Rs 1.5 lakh.

Moreover, these children are pumped with hormonal treatment as part of the sex change procedure that may be irreversible.

The low cost of surgery and the relatively easy and unobtrusive way of getting it done in this city attracts parents from Delhi and Mumbai to get their child surgically 'corrected'.

About 7-8% cases come from the metros, say doctors.

While genitoplasty is relatively common - it is used to correct genital abnormality in fully-grown patients - the procedure is allegedly being misused rampantly to promise parents a male child even though they have a female child.
When there is an Intersex condition involving hormonal anomalies in the womb, about 1 in 3 such children would be mis-assigned - defined as "unable to live with their surgically altered body". But as they're Intersex, "defective", "mis-shapen", then that's considered acceptable. Who cares what the result is, as long as society isn't troubled by the existence of someone "in between"?

When no such condition exists, it's more like 9 in 10 who can't live with it. But that's not the cause of the outrage, for few know those figures. It's because these girls are not mis-shapen, defective, Intersex, but normal. Unlike us, they count as being full humans.

Surgery without consent, absent genuine medical need, is wrong. It's wrong on girls, it's wrong on boys, and it's wrong on those few intersex people who identify as neither and are quite happy that way, thanks very much.

Just wait a few years - and they'll tell you what sex they are!

Friday, 24 June 2011

Fukushima Dai Ichi RADHAZ Update

Since the Japanese Government has been less than forthcoming about the radioactive contamination from the TEPCO Dai Ichi reactor disaster, and since TEPCO has been somewhat coy about the issue, here's a graphic that details measurements by the public in the affected areas.

Red means 5+ microsieverts per hour. Yellow-Green 1, Yellow 1.5 to 2.

These levels are not dangerous themselves, though long-term exposure would cause just-detectable increases in cancer rates. But they're indicative of where the cesium has gone to, and that, if ingested, really does pose definite increases in cancer.

TLDR version: do not eat any green leafy vegetables from the red area for 120 years, unless the topsoil's been replaced. Yellow - not in the next 30 years. Blues are safe, the rest, not for a few years, and make sure everything's been checked.

Thursday, 23 June 2011

Every Home Should Have One

From UniverseToday : Build Your Own Apollo 11 Landing Computer

Remember the computer on the Apollo 11 Eagle lander that kept reporting “1201″ and “1202″ alarms as Neil Armstrong and Buzz Aldrin approached landing on the Moon?
Well, yes, I can. But people under 40 cannot. That's most of the people on the planet...
Well, now you can have one of your very own. Software engineer John Pultorak worked 4 years to build a replica of the Apollo Guidance Computer (AGC), just so he could have one. And then he wrote a complete manual and put it online so that anyone else with similar aspirations wouldn’t have to go through the same painstaking research as he did. The manual is available free, but Pultorak says he spent about $3,000 for the hardware.

The 1,000 page documentation includes detailed descriptions and all schematics of the computer. You can find them all posted on Galaxiki, downloadable in pdf. format (the files are large).
The original Apollo AGC cost over $150,000. It didn’t have a disk drive to store any software, and only 74 kilobytes of memory that had been literally hard-wired, and all of 4 Kb of something that is sort of like RAM.

It was developed by the MIT Instrumentation Laboratory and it a pretty piece of hardware in the 1960s, as it was the first computer to use integrated circuits. The AGC mutlitasking operating system was called the EXEC, it was capable of executing up to 8 jobs at a time. The user interface unit was called the DSKY (display/keyboard, pronounced “disky”); an array of numerals and a calculator-style keyboard used by the astronauts to communicate with the computer.

Each Apollo mission featured two AGC computers – one in the Apollo Command Module and one in the Apollo Lunar Module.

And to feed your inner Space Administrator Geek... there's Race Into Space, a freeware port for Windows of BARIS - "Buzz Aldrin's Race Into Space" (1993), itself a port of the Dead-Tree Game "Liftoff" (1989).

Looking at the specs... you could port this onto most mobile phones today.
640k RAM
12 MHz processor
32Mb for the videos
320 x 200 pixel resolution

That's about 500 times as powerful as the actual computers used in the Apollo spacecraft, 24 years earlier.

Wednesday, 22 June 2011

Australia's Most Trusted Professions

From the Age : Australia's Most Trusted Professions

This shows both ingrained cynicism, and a touching naivety.

12. Police

15. Scientists

21. Judges

26. Weather forecasters

30. Religious ministers

33. Lawyers

39. Sex workers

42. Real estate agents
43. Car salesmen
44. Politicians
45. Tele-marketers

Tuesday, 21 June 2011

Nearly a Virgin Birth

From Nature Genetics, A human parthenogenetic chimaera by Strain et al, Nature Genetics 11, 164 - 169 (1995)
In mice, parthenogenetic embryos die at the early postimplantation stage as a result of developmental requirements for paternally imprinted genes, particularly for formation of extraembryonic tissues. Chimaeric parthenogenetic & normal mice are viable, however, due to non−random differences in distribution of their two cell types. Species differences in imprinting patterns in embryo and extra−embryonic tissues mean that there are uncertainties in extrapolating these experimental studies to humans. Here, however, we demonstrate that parthenogenetic chimaerism can indeed result in viable human offspring, and suggest possible mechanisms of origin for this presumably rare event.
I'll leave it to Melinda Wenner of Slate Magazine to explain:
An egg will only start dividing once it senses a spike in cellular calcium. This normally occurs as a result of a sperm's entry during fertilization. But if the egg happens to experience a spontaneous calcium spike, it will start reacting as if it's been fertilized. A defective sperm that lacks DNA can produce a spurious calcium spike. In the lab, scientists can coax unfertilized eggs into beginning the post-fertilization process by simply injecting them with calcium.

Once fertilization—or faux fertilization—occurs, an egg can complete the final stage of a cell division known as meiosis II, during which it loses half of its genetic material to make room for the sperm's DNA. But if there's no sperm, each half of the divided egg cell will end up short, and both will die. In order for our virgin birth to proceed, the faux-fertilized egg must, therefore, not complete meiosis.

Both of these events—the calcium spike and the division mistake—could occur as the result of random dysfunctions or genetic defects. Assuming they do, the egg cell may then begin the process of "parthenogenesis," or virginal development. When this happens to an egg-precursor cell, it can give rise to a tumor made up of many different types of tissue—liver, teeth, eye, and hair, for example.

Parthenogenesis in humans never produces viable embryos, though, because unfertilized eggs lack specific instructions about gene expression from the sperm.
Are there any case reports of virgin births in the medical literature? Sort of. According to a 1995 report in the journal Nature Genetics, a mother brought her infant boy to the doctor after noticing that his head was developing abnormally. When doctors analyzed his blood, they found something truly bizarre: Despite his anatomically male features, the boy's blood cells were entirely female, consisting only of genetic material from his mother. Some of his other cells—such as those found in his urine—were normal, consisting of a combination of both maternal and paternal DNA. No one knows exactly how this occurred, but the best guess is that immediately after being fertilized, one of his mother's eggs fused with a neighboring unfertilized egg that was dividing parthogenetically. This gave rise to a boy who was considered half-parthenogenetic, since approximately half of his cells were derived from a "faux" conception, containing no remnants of his father's DNA.
When it comes to reproduction, genetics, the very definition of sex..It's not that simple. It's complicated. And these are not experimental animals - they're people. We're people.

"Nature loves diversity, society hates it.” (M. Diamond).

Exactly. So we try to educate society about things like this. That often clashes with religious belief, just as did the concept of a round Earth, a Heliocentric Solar System, Evolution...

Monday, 20 June 2011

Passports - The Final Chapter?

From The Scavenger:
A transsexual woman has won the right to a full, 10-year passport in her transitioned identity, without the need for undergoing sex realignment surgery first.
In November 2010 after transitioning full time for just on one month, I consulted with my sex and gender therapist about how I could adjust my passport as I was required to travel overseas for business.

After receiving a letter from her indicating my change, I put together two statutory declarations, one from my business partner indicating my change and that was accepted by all our customers, and the other from myself indicating I was indeed transitioned full time. I then arranged for an appointment with the Passport Office to work with them to make the change.

I was warned ahead of time there might be issues and there were.

I live in Canberra and have been here most of my life. I have spent five years working in the public service and most of the other time contracting or consulting to them. I have friends who work in the public service. What one needs to note is that this isn't a game of chess when dealing with them, it’s much different, and I knew from the beginning that I had to ensure I was tackling their procedures and not the people working there.

As I discovered from my first meeting with them, they were polite, helpful and sincere in their dealings, it was just they were not trained or had any knowledge in what sex and/or gender identity is and how to understand transsexuals and why this was so important to us. What was missing and it was very obvious, was a lack of training and knowledge in anything sex and/or gender diverse.
It took her 7 months. It took me 20. But at least now we've gotten rid of the anomaly that some of those born overseas could qualify for Australian Passports, while those in exactly the same situation but born in Australia could not.

The case only lasted 7 months, about a third of mine. But it involved considerable expense, more even than mine. And the APO fought every step of the way. Count the number of knock-backs:
After my first meeting with the Passport Office, I was given a verbal decline for a full passport stating female in just 30 minutes because I was not booked for and showed no intention of having genital surgery.
That's one.
At this point I started on the paperwork. I knew it was important to keep a paper trail and I ensured everything said and done was documented, catalogued and tracked.

My history of events was going to be more accurate than theirs. So I requested another formal meeting. This time attending with three official letters of procedural complaint and one commendation to the original staff member who was legitimately sincere and polite in her dealings with me. There were two officials in attendance and it was a formal meeting.

The letters of complaint about their procedures related to the Passports Office’s website, which was incorrect and misleading and how my initial dealings with them were incorrectly handled. A couple of weeks later I received an official response denying my request, citing reference to the Passport Act and my birth certificate not matching my passport.
That's two.
I also didn't satisfy the “rare and unique circumstances of a compelling humanitarian nature”, which they said gave them discretion in such decisions on case by case basis.

I appealed the decision immediately citing prior cases and concerns about my safety in having to travel on a passport that did not reflect my gender identity and presentation. I requested an impartial mediator because I didn't believe my case was being heard fairly.

I also pointed out their obvious lack of knowledge and requested information about how I was judged on humanitarian guidelines. I felt confident with the appeal....
My appeal was rejected on the same grounds as before.
That's three.
I rang their legal counsel regarding the appeal and realised very quickly that their level of knowledge regarding the sex and/or gender diversity was non-existent. Yet they had made these decisions. They refused to acknowledge risks to my safety when travelling on a passport that did not reflect my gender identity and presentation and insisted I use a Document of Identity (DOI) like other transsexual and transgendered people.
A document that amongst other things, does not allow travel to the USA, and does not guarantee a right of return back to Australia. You can leave the country.... but it could be a one-way trip, and there aren't many places you can go to.
It was then agreed during a phone call that they would answer any further questions I have in writing. Within two hours I submitted four pages, requesting information about their skill set, training and knowledge, what methods they used for determining humanitarian guidelines. I requested detailed reasoning why I needed answers before my appeal.

My questions were never answered and with one week to go I put in the appeal request to the Federal Government Administrative Appeals Tribunal (AAT). I had to pay a large fee up front and I requested a skilled and impartial person to handle it.
I had the same experience - formal letters requesting reasons for the decision not being answered. They're supposed to, to be compliance with the Administrative Appeals (Judicial Review) Act, if you write a letter like this:

Dear Sir/Madam,

In accordance with ADMINISTRATIVE DECISIONS (JUDICIAL REVIEW) ACT 1977 - SECT 13, please furnish a statement in writing setting out the findings on material questions of fact, referring to the evidence or other material on which those findings were based, and giving the reasons for the decision not to grant my passport application.

Yours Sincerely, etc etc

Getting back to the case in hand:
Realising that if I didn't do this, others would share a similar fate because the precedent was currently in the negative, I lodged the appeal and caught the Passport Office off guard as they referred to me in paperwork as female. I did succeed in getting a further small victory in that the Passport Office admitted in writing they had no procedures for determining what humanitarian guidelines one can be judged against.
Actually... I think that's a pretty big victory, and likely to have considerable legal weight.. but to continue:
At my preliminary hearing there were two lawyers, one a partner, representing the Passport Office. Intimidating – yes, but it worked well for me. I realised my case was more important and warranted more attention than I was led to believe. The Department didn't want to lose and they were using excessive legal muscle to ensure it.

The case went from a simple one of wanting to change one letter on my passport to ensure my safety when I travelled, into one now which looked absurd. Here I was, no legal skill, just fighting for my safety when I travelled, up against a government department sending in two lawyers to push their case.
I felt at all times that this case was not about winning or showing up the Passport Office. That wasn't my goal. My aim was to help them understand that the implementation of procedures and guidelines were causing harm to those transitioning.
Eventually after the preliminary hearing Passport Office conceded the case and it was settled with them issuing me with my 10-year female passport.
And some advice:
In cases such as mine, I advise people to follow their procedures to the letter, document what happens and let them know when the procedures fail. Focus on the procedures and guidelines, not the individuals. Always look for win/win situations and understand who you are dealing with. Be open and honest, do not be deceitful. Do your best not be bullied by bureaucratic procedures and stay strong because you are not alone.
And don't take "No" for an answer.

Trans women who transition late tend to have a certain stick-to-it-iveness. A certain persistence, sometimes taking that to extraordinary lengths. If they didn't, then they wouldn't have transitioned late, they would have transitioned early or died. That even applies to certain women who are technically Intersex rather than Transsexual...

It's not that it doesn't hurt. Here's what I wrote at the time things like this were happening to me:
It's important to step back, and think about what this whole situation is about.

It's about simply getting a Passport, something that by the Australian Passport Act, every Australian has a right to. I'm no Criminal, nor someone with dodgy citizenship, nor a Passport Trafficker or Terrorist. I already had a UK passport with the same correct details in. I needed to go overseas for surgery, there was a growing risk of cancer. I have a congenital medical problem, nothing particularly unusual, and that's all.

At a time when I was under great stress, when I was most vulnerable, I was treated worse than a Murderer - they can get passports. I was ordered to Divorce before a passport would be granted, something that was a gross abuse of power, and blatantly discriminatory. Had I not recorded it on my blog, as it happened, it would seem unconceivable that anyone could be treated this way.

For many months I faced the possibility that I would not be allowed back in the country to see my little son. The sleepless nights, the vast amounts of time spent writing letters, or waiting (sometimes for hours) at the Passport Office, all that was totally un-necessary. Pain and Suffering is an exact description of what was inflicted on me. I think many in a similar situation would not have coped. I came very close to losing it, as was reflected in my writings.

Now that there may be some light at the end of the tunnel, I can let my outrage at being treated like dirt show. I'm crying now, trying to get rid of the pain, the anguish, the frustration at the unreasonable and unconscionable conduct of some of those who had me at their mercy. HOW DARE THEY DO THIS TO ME? I'm Human.

I'm Human. I'm human. No human being should be treated like that.

I intend to make sure they don't ever do it again. That they never order anyone to Divorce. Victimised, I refuse to be a Victim. They don't have my permission to de-humanise me.
And so thanks to a very brave and persistent woman, who took them to Court - something I didn't have to do - there's been another step forward.

I just hope we don't have to go through this all again. They need some training, this is a systemic problem.

But if we do... then we will, and every single bit of caselaw helps.

Sunday, 19 June 2011

Transgender Health Care - The Reality

From Dallas Voice : Who decides what is "Medically Necessary"?
“Transition-related care” can be divided into two parts, Keisling said: the costs directly related to gender reassignment surgery, and the other treatments and services that are related, things like checking hormone levels, lab tests, and mental health services associated with the transition process.

“Even someone who has fully transitioned probably still needs to get her hormone levels checked on a regular basis. And insurance companies will deny those claims by saying they are ‘transition-related,’” Keisling said.

This is also the issue of sex-specific care, she continued. After transitioning, a trans woman will qualify for regular mammograms, but not for regular prostate exams — which she still needs, too.

And a lot of trans men face similar difficulties, Keisling said. “A trans man might need a pap smear or some other kind of gynecological care, and they are often told no, insurance won’t cover that,” she said.

She described another case in which a trans man was told by his doctors that he was facing serious gynecological problems and needed to have a hysterectomy. Because he was trans, however, insurance wouldn’t pay.

“Insurance said, ‘No. We don’t pay for sex-change operations. The doctors said this is transition surgery. This is a medically-necessary procedure.’ But they wouldn’t pay,” she said.

But in some cases, the discrimination is even more blatant.

“The insurance for federal government employees specifically excludes coverage for the costs of [gender reassignment surgery], but there have been a number of cases where that was used to exclude coverage of any type for transgenders,” Keisling said.

“I know of a federal employee who was told insurance wouldn’t pay for care for her son’s broken arm because she was transgender. Another trans woman who was anemic and needed transfusions was told insurance wouldn’t cover the treatments because she had ‘transsexual blood,’” she said.

“The list goes on and on. I know another trans woman who was playing for a woman’s softball team and broke her arm during a game,” Keisling continued. “She went to the hospital, had the X-rays and got her arm set. Then the insurance company turned around and denied the claim. They said if she weren’t transsexual, she wouldn’t have been out there playing for a women’s team and she wouldn’t have broken her arm.”

When it comes to these “really egregious stories” that are “so clearly wrong,” Keisling said, the victims can hire lawyers and get remedies through the courts. Still, she said, “You have to know what to do, how to get things fixed.” And court cases aren’t cheap, either.
In a car crash and break your leg? That's not covered, as the bones could be weakened from HRT therapy. Or if you don't take hormones, they could be weakened because you don't. In either case, "transition-related" according to some Insurance company's rules. And of course, since the evidence is it's congenital, it's a "pre-existing condition".

That's in the USA. Here in Australia, Medicare just changes the patient's records from M to F and back again as necessary when it comes to Intersexed and Trans people. Yes, it's silly, makes a mockery of the whole system - but a humane work-around to prevent inhuman treatment.

Friday, 17 June 2011

The (Lack of) US Manned Space Program

From SpaceNews: Memo Marks Official End of Constellation:
A senior NASA official has signed the formal death warrant for the Constellation deep space exploration program even as work proceeds on one of Constellation’s legacy development efforts and agency officials continue to ponder the fate of another.

“I have signed the letter to close out the Constellation Program,” Douglas Cooke, associate administrator for NASA’s Exploration Systems Mission Directorate, wrote in a June 10 memo.
I've written about the wastage and fiscal mismanagement before, but maybe this graphic shows the situation best:

From another previous post :
NASA has spent more than $9 billion on development of the Constellation project and the Ares rockets over the last six years. President Obama's fiscal 2011 budget would end funding for the Constellation Systems program, initiated by NASA in 2005 to return astronauts to the Moon by 2020 and later to Mars. The administration says the program is behind schedule and cannot achieve its goals without budget increases. Constellation would need an additional $3 billion annually beyond fiscal 2010.

Now Constellation needed mending with a new one. But now it's clear that to Obama, it's all about "US Pride" and "Showing the Flag". Prestige. Basically, one huge publicity stunt. Not about colonisation. Not about using our disabled twin planet as a testing ground for how to live off-Earth.
Why are all concrete plans for further crewed space exploration now cancelled?
Obama sought to explain why he aborted President George W. Bush's return-to-the moon plan in favor of a complicated system of public-and-private flights that would go elsewhere in space, with details still to be worked out.

"We've been there before," Obama said of the nation's moon landings decades ago.
As reported over a year ago.

Constellation needed killing. It was a product of the pork-barrelling "business as usual" that bedevils Congress's financing of space exploration. Split the work so the pork is spread evenly - thus waking everything vastly inefficient. Listen to what the engineers say regarding how much money they will need - then give them half of that. Then spread the payments out over many years, to increase the costs yet more.. and finally kill the project, as it never stood a chance of working anyway without more funding.

Constellation also needed replacing with something more concrete than Unicorns and Rainbows. In one way, it has been, just not a US program - the next man to step foot on the moon will be speaking Mandarin.

Thursday, 16 June 2011

Note to Self

In my experimentation with meta-genetic algorithms to optimise a Pareto set, be careful that I don't end up with suboptimality in other areas not under consideration.

A lot of my work is based on some research I did in making an artificial intelligence for anti-missile defences over 15 years ago. I guess I was lucky, inasmuch as I used a rules-based system and not a neural net.

On the other hand, the fault-tolerance and self-healing properties I put into FedSat, and helped the MESSENGER spacecraft team with, have proven to be useful in space exploration. I skipped over Terminator-I and went straight to Terminator-II, or as I once wrote, skipped the Battleship approach, armoured but brittle, in favour of "Beware of the Blob".

Wednesday, 15 June 2011

Sexual differentiation of human behavior: Effects of prenatal and pubertal organizational hormones

Sexual differentiation of human behavior: Effects of prenatal and pubertal organizational hormones Sheri A. Berenbaum, Adriene M. Beltz Frontiers in Neuroendocrinology 32 (2011) 183–200
A key question concerns the extent to which sexual differentiation of human behavior is influenced by sex hormones present during sensitive periods of development (organizational effects), as occurs in other mammalian species. The most important sensitive period has been considered to be prenatal, but there is increasing attention to puberty as another organizational period, with the possibility of decreasing sensitivity to sex hormones across the pubertal transition. In this paper, we review evidence that sex hormones present during the prenatal and pubertal periods produce permanent changes to behavior.
There is good evidence that exposure to high levels of androgens during prenatal development results in masculinization of activity and occupational interests, sexual orientation, and some spatial abilities; prenatal androgens have a smaller effect on gender identity, and there is insufficient information about androgen effects on sex-linked behavior problems. There is little good evidence regarding long-lasting behavioral effects of pubertal hormones, but there is some suggestion that they influence gender identity and perhaps some sex-linked forms of psychopathology, and there are many opportunities to study this issue.
TLDR version - it's complicated. Here, let me give an example:
Sex matters for human behavior as it does for behavior in other species. Human males and females differ in many ways, including their appearance, their social identity, their social partners, the activities that interest them, how they present themselves to others, their aspirations and values, the likelihood of experiencing psychological and physical health problems, and the specific form in which those problems are manifested (reviewed in [20]). A key question concerns the causes of those differences, particularly the ways in which they are shaped by genes, physiology, and socialization.
The focus of this paper – in line with the other papers in this special issue of Frontiers of Neuroendocrinology – concerns the extent to which human behavioral sex differences are influenced by sex hormones present during sensitive periods of development acting to organize the brain.
More than 50 years ago, Phoenix et al. [130] provided an experimental demonstration in female guinea pigs that early exposure to androgens masculinized sexual behavior. This revolutionary work opened a new era in understanding sexual differentiation of behavior and led to thousands of studies in many species showing
unequivocally that sex hormones present early in development affect sexual differentiation of behavior as well as reproductive anatomy and function [166]. These hormones are said to have ‘‘organizational’’ effects because they produce permanent changes to brain structures and the behaviors they subserve. They are contrasted with ‘‘activational’’ effects, that is, hormones acting later in life to produce temporary alterations to the brain and behavior (through ongoing changes to neural circuitry) as the hormones circulate in the body throughout adolescence and adulthood. The main distinctions between organizational and activational effects concern timing and permanence, although these distinctions are not absolute [3].
Organizational effects have generally been considered to occur early in life when the brain is undergoing rapid change, but there has always been consideration of potential other sensitive periods of brain development when sex hormones again act to induce permanent changes [166].
Recent work in nonhuman animals has focused attention on other particular periods when there are substantial – and relatively abrupt – changes in levels of sex hormones, and that might serve as additional opportunities for hormones to sculpt brain structure: puberty and pregnancy (e.g., [91,149]). In this paper, we consider how human psychological sex differences are influenced by organizational hormones during prenatal development and again during puberty. We consider the foundations of the work, the methods used to study the question, the evidence that prenatal and pubertal hormones produce longterm behavioral changes, and directions for future research.

[20] J.E.O. Blakemore, S.A. Berenbaum, L.S. Liben, Gender Development, Psychology Press/Taylor & Francis, New York, 2009.
[91] C.H. Kinsley, L. Madonia, G.W. Gifford, K. Tureski, G.R. Griffin, C. Lowry, J. Williams, J. Collins, H. McLearie, K.G. Lambert, Motherhood improves learning and memory: neural activity in rats is enhanced by pregnancy and the demands of rearing offspring, Nature 402 (1999) 137–138.
[130] C.H. Phoenix, R.W. Goy, A.A. Gerall, W.C. Young, Organizing action of prenatally administered testosterone propionate on the tissues mediating mating behavior in the female guinea pig, Endocrinology 65 (1959) 369–382.
[149] C.L. Sisk, J.L. Zehr, Pubertal hormones organize the adolescent brain and behavior, Front. Neuroendocrinol. 26 (2005) 163–174.
[166] K. Wallen, The organizational hypothesis: reflections on the 50th anniversary of the publication of Phoenix, Goy, Gerall, and Young (1959), Horm. Behav. 55
(2009) 561–565.
So far, so good. Relatively simple. But when you get further into it...
Data confirming the importance of pubertal hormones in gender identity comes from outcome studies of children with gender identity disorder, showing that the majority develop gender typical identity in adolescence and adulthood, although many continue to display sex-atypical characteristics. An early study of extremely feminine boys showed that most developed a homosexual orientation without gender dysphoria [64]. Two recent studies confirm that most children with gender dysphoria do not remain dysphoric after puberty. In one follow-up study of girls with gender identity disorder in childhood, only 12% were found to have gender dysphoria in adulthood; most developed a heterosexual orientation without gender dysphoria, although there were elevated rates of nonheterosexual orientation [48]. In another study of boys and girls with gender dysphoria in childhood, 27% of boys and 64% of girls were still gender dysphoric, and most had nonheterosexual orientation [167]. Both studies showed evidence of a ‘‘dosage’’ effect: children with more childhood cross-sex behavior or gender dysphoria were more likely to be gender dysphoric at follow up.
(This may explain why girls were more likely than boys in the second study to persist in dysphoria; they probably had to be more extreme to receive a diagnosis in the first place.) Additional evidence for the importance of puberty in gender identity comes from data showing reduced plasticity with age: individuals diagnosed with gender identity disorder in adolescence are more likely than those diagnosed in childhood to have persistent dysphoria into adulthood [172].
Nevertheless, testosterone at puberty is not essential for male gender identity. There are cases of male gender identity in individuals with male-typical chromosomes and prenatal androgen exposure who were castrated in early life and reared as girls because of genital defects (such as cloacal exstrophy or penile ablation [44,111,133]). Some typical girls develop gender dysphoria or male identity at puberty without any obvious exposure to testosterone [174].

[44] M. Diamond, H.K. Sigmundson, Sex reassignment at birth: long-term review and clinical implications, Arch. Pediatr. Adolesc. Med. 151 (1997) 298–304
[48] K.D. Drummond, S.J. Bradley, M. Peterson-Badali, K.J. Zucker, A follow-up study of girls with gender identity disorder, Dev. Psychol. 44 (2008) 34–45
[64] R. Green, The ‘‘Sissy Boy Syndrome’’ and the Development of Homosexuality, Yale University Press, New Haven, CT, 1987.
[111] H.F.L. Meyer-Bahlburg, Gender identity outcome in female-raised 46,XY persons with penile agenesis, cloacal exstrophy of the bladder, or penile ablation, Arch. Sex. Behav. 34 (2005) 423–438.
[133] W.G. Reiner, J.P. Gearhart, Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth, New Engl. J. Med. 350 (2004) 333–341.
[167] M.S. Wallien, P.T. Cohen-Kettenis, Psychosexual outcome of gender-dysphoric children, J. Am. Acad. Child Adolesc. Psychiat. 47 (2008) 1413–1423.
[172] K.J. Zucker, Gender identity development and issues, Child Adolesc. Psychiat. Clin. N. Am. 13 (2004) 551–568.
[174] K.J. Zucker, S.J. Bradley, Gender Identity Disorder and Psychosexual Problems in Children and Adolescents, Guilford, New York, 1995.
Paper [48] is flawed because the definition of "Gender Dysphoria" was far too relaxed; few met the actual criteria, and many were Intersex. Paper [64] is currently enmeshed in the controversy about the aversion therapy techniques used at UCLA - torturing children, basically - and the revelation that much of George Reckers work there was grossly flawed or even fraudulent. Green seems to have taken a second look at the subject though, to try to report on the actual situation rather than one seen through ultra-conservative fundamentalist eyes.

Doing good Science is hard enough without such complications, especially in an area so complex.

Summary: Post-natal hormones do have an effect on gender identity. Sometimes. Not always. And pre-natal hormones have an effect on gender identity. Sometimes. Possibly always. And it's dosage-dependant, and associated with other neural circuitry (usually) and sexual orientation (sometimes). I'd quote more, but I'm already close to the limits of "fair use" of a copyrighted article.

Yes, I'd like it to be nice and simple, a binary, boy brain or girl brain, always set before birth, not mutable in the slightest afterwards... but that's not what the evidence says.

I suppose this should have been obvious to me. Picking the name "Zoe" at age 10 (establishing gender identity well before puberty). Feeling my brain re-wire, the increased sense of smell, the acquisition of a sexual orientation etc in 2005-2006, some effects long before HRT, and due to a female hormone balance. The male-typical play patterns in my childhood, just to make things even more obscure, I was anything but a "sissy boy" - yet my emotional responses were female, even as a child.

It's complicated.

Tuesday, 14 June 2011

Frontiers in Neuroendocrinology

Frontiers in Neuroendocrinology, Volume 32, Issue 2, Pages 109-264 (April 2011)

Special Issue on Sexual Differentiation of Sexual Behavior and Its Orientation.

This has a wealth of articles on the subject, many dealing with animal experiments, but also dealing with the issues in humans too. From the editorial:
In a seminal 1959 paper, William C. Young and his colleagues at the University of Kansas reported that prenatal administration of testosterone to female guinea pigs masculinized their capacity for sexual behavior in adulthood[17]. They concluded that prenatal androgens have an ‘organizing’ effect on the brain circuitry responsible for sexual behavior: high levels of testosterone, such as are typically seen in male fetuses, promote the establishment of neural elements mediating male-typical behaviors, while low levels of androgens, typically seen in female fetuses, permit the establishment of elements mediating female-typical behaviors. The role of androgens and estrogens in adult life is simply to activate these pre-established circuits.

The ‘organizational hypothesis’ became one of the most fruitful ideas in psychobiology. Subsequent research has confirmed the basic truth of the hypothesis and elucidated many of the anatomical structures and molecular processes that underlie it. Yet this research has also highlighted complexities, limitations, exceptions, and species differences that Young (who died in 1966) could hardly have guessed at. The present set of contributions has been selected to highlight some of these complexities, but also to consider the relevance of the organizational hypothesis to two aspects of human sexuality: sexual orientation and gender identity.

[17] C.H. Phoenix, R.W. Goy, A.A. Gerall, W.C. Young, Organizing action of prenatally administered testosterone propionate on the tissues mediating mating behavior in the female guinea pig, Endocrinology 65 (1959) 369–382.

A greater part of this issue is on sexual orientation, and the biological basis thereof:
Melissa Hines provides a masterful survey of the evidence for an influence of prenatal gonadal steroids on human sexual orientation.
A key observation here is that homosexuality is not an isolated trait; rather, it tends to be associated with other gendervariant cognitive and personality traits, both in childhood and in adult life. This is analogous to what has been observed in rodents and other animals subjected to prenatal manipulations of gonadal steroids, and it suggests that atypical levels of these hormones may affect a constellation of gendered traits, including sexual orientation, because many such traits are mediated by hormone-sensitive brain circuits.

Still, gay men and lesbians are not transexuals or complete gender ‘inverts’; rather, they seem to be a patchwork of gender-conformist and gender-nonconformist traits—a patchwork that varies to some extent from individual to individual. Underlying this patchwork may be differences in developmental timing between different brain systems, differences in their sensitivity to gonadal steroids, or differences in causal mechanisms (e.g., hormonal versus direct genetic effects).
It would be unethical to perform in humans the kind of animal experiments that led to the organizational hypothesis and its many subsequent ramifications, but it is possible to approach the same question in less direct ways. One approach is to take advantage of experiments of nature, such as the genetic condition congenital adrenal hyperplasia (CAH), which exposes female fetuses to higher-than-normal levels of androgens. CAH girls do display several gender-atypical childhood traits, as documented by Hines and others, and are more likely than other girls to develop same-sex attraction in adulthood. Still, even among women with the severest
form of CAH, about half are exclusively heterosexual and only a few are exclusively homosexual. Thus the CAH research supports a significant role for prenatal androgens but also leaves plenty of room for other potential factors to play a role, possibly including social ones.
Gender Identity gets relatively scant mention in the editorial, though there are several good papers in the issue.
Gender identity has been the subject of much less biological research than sexual orientation, but even in the absence of strong evidence there is a widespread supposition that transexuality has some biological basis. There have been reports of brain structural differences between transgendered and non-transgendered individuals of the same sex, as described by Bao and Swaab in this volume.
This area of study is made difficult by the relatively small numbers of transexual individuals, by the hormonal treatments that many of them undergo, and by the fact that male-to-female transexuals who are attracted to males and those who are attracted to females seem to have quite different developmental histories [3].

[3] J.M. Bailey, The Man Who would be Queen: the Science of Gender-bending and Transsexualism, Joseph Henry Press, 2003.
It is... unfortunate... that such a junk-science book, largely composed of fiction and anecdote, without references or any of the hallmarks of a scientific publication, should be used as a source here. As bad as using "Moby Dick" as a textbook on cetacean biology, or one on Homeopathy to explain diabetes.

There's also, for the first time I can remember seeing, a mention of the Elephant in the Living Room: the climate that, in the USA at least, makes such research difficult.
As far as the political and social climate permits, researchers interested in the development of sexual orientation and gender identity would do well to take advantage of some of the large-scale longitudinal studies of childhood development now underway.
As gay people become more accepted and integrated into mainstream society, public interest in the ‘‘why’’ of sexual orientation will likely wane. Yet this may be a good thing, because it will allow the study of this important aspect of human diversity to be studied in a less contentious and more genuinely scientific atmosphere than has typically been the case in the past. The contributions in the current collection point optimistically in that direction.
Referencing Bailey's debunked book doesn't make me quite so optimistic, but the truth will out in the end. Reality always wins eventually.

Monday, 13 June 2011

Legislative Definitions


A nose by any other name would smell, and while in daily life, labels are important, when it comes to legislation, as long as the definitions are provided unambiguously, there's no problem with cats, rabbits, and parrots being dogs (for the purposes of the act). Or "gender identity" being included under "sexual orientation".

Friday, 10 June 2011

Why I Blog

A snippet from Reddit
Willblaze wrote:
So Im suppose to be some mystical mind reader? I dont know shit about any of this stuff, Im just an average hetero guy that has no run-ins with any trannsexuals. I never said it was anyones responsibility to teach me anything, I stated I didnt fucking know, and Im a human and make mistakes just like anyone else. Reread my comment and stop being such a fucking child. It has nothing to do with being sheltered, how the fuck do you know what type of surroundings I've grown up in. I live in the south of USA, so I NEVER see people like this.
ZoeBrain wrote:
Um.. I think you probably do - you just don't realise it.

BTW Congrats on admitting you don't know. That shows intelligence and intellectual honesty, and mere lack of knowledge is easily fixed.

OK, I better back up my statement of "you probably do" with some evidence. I know plenty of trans women in the South. Texas, Alabama, Georgia, North and South Carolina... but that doesn't help much.

To see what Trans women actually look like, some pretty, some pretty dreadful, have a look at these URLs.

There are Trans men too. Quite a few.

OK, now just to expand your horizons a bit... in addition to Trans people, there are some who change sex naturally. In some parts of the world, the mutations that cause that are more common than the CCR1 mutation that causes red hair.


Most such changes are FtoM. Some (not due to 5ARD or 17BHDD but 3BHDD or rarer conditions) are MtoF.

Here's one such woman. No cosmetic surgery. She used to look male.

Now she's not the prettiest - she was 52 when that shot was taken. But I don't think it would have occurred to you that her change from looking male was just 5 years earlier, would it?
WillBlaze wrote:
bannana should take tips from people like you. Thank you for being a mature adult about the situation and also going out of your way to educate me. Im not proud of how I looked and I felt like an asshole about the things I said after they were pointed out to me how it was offensive. I wish I could give you many upvotes. The links really show me how I could see someone and have no idea at all. And the trans-men part? Wow, just wow. If I was talking to one of them at a bar I would have no idea at all, unless maybe the voice gives them away? Another subject I dont know very well... but if I just saw them at a bar I would think "thats a man" without a second thought on the matter.

Again, thank you for helping me understand this whole thing. Its a world I never have had any experience in. So instead of hurling childish insults at me and have the problem unresolved if not worsened, you resolve the problem and educate.
Music to my ears.

Thursday, 9 June 2011

The Neurobiology of Sexual Orientation

A Presentation to the 3rd International Midwifery Conference. One that is all too rare in its approach.

Alas, the slides are not available. Here's the abstract:
Homosexuality is a constantly debated issue as to whether it is determined at birth or a choice (nature vs. nurture). The works of the Kinsey Reports and Dr. Evelyn Hooker published in the 1950s resulted in the removal of homosexuality from the DSM4 in 1973. Since then, it has been mentioned as an illness only in the context of being a putative exacerbating factor in anxiety states. Recent studies reveal a clear cut neurobiology to sexual orientation.

Neurobiologist Simon LeVay conducted a study of brain tissue samples from 41 human autopsies performed at several hospitals in New York and California. He found a significant size difference of the interstitial nuclei of the anterior hypothalamus between homosexual and heterosexual men.

In addition, Dr. Ivanka Savic-Berglund and Dr. Per Lindstr├Âm of the Karolinska Institute, Stockholm, performed fMRI and PET measurements of cerebral blood flow. Using volumetric studies, they found significant cerebral size differences between homosexual and heterosexual subjects; the brains of homosexual men resembled heterosexual women and homosexual women resembled heterosexual men. Extensive controls were performed during testing to exclude analytical variability.

A totally evidence-based medicine presentation will provide current data regarding homosexuality showing differences, or similarities, between the brains of homosexuals and heterosexuals to confirm that sexual orientation is neurobiologic at birth. Scientists and physicians with a keen understanding of the human brain must continue to bring data showing differences- or similarities- between the brains of all sexual orientations- heterosexual, homosexual, bisexual and transgender- to light. Having a good understanding of the natural evolution of sexual orientation is critically important to appropriate and supportive health care and a mature attitude of health care providers in an effort to minimize self blame from parents and to contribute to better patient-care within the lesbian, gay, bisexual, and transgender community.

It's based on evidence and not conjecture.

Wednesday, 8 June 2011

L-5 Dreams

The Space Review: The god that failed
Asimov’s article, “The Next Frontier?” and illustrated by Pierre Mion, was written as a first-person account of a visit to an L-5 colony in the far-distant future of 2026. The account is mostly description: the National Geographic reporter is met by the colony’s director George Fenton, who shows him around and explains how everything works. Asimov experiences the gradual onset of simulated gravity as he travels from the arrival hub down a spoke to the colony’s rim. The colony is nearly 1,800 meters in diameter and houses 10,000 people.

Fenton shows him the farms and the industrial areas. He introduces the reporter to a rabbit meat hot dog and goat milk shake. He explains how the population is majority male, but they do have women, and families, and even a thousand children on the station. He shows the reporter a residential area and explains that the streets curve back and forth so that you cannot see them end and become disoriented. Fenton explains how the six segments of the torus are separated by airlocks in case of emergency. The colony is not completely self-contained but is working on it. They still import things from Earth, but most of their raw materials come from the Moon. And of course they recycle everything that they can; the reporter declines Fenton’s offer to tour the sewage plant.
That seemed possible in 1976. It still seems possible in 2011, but add a century at least before it comes to pass.
At its best, the space colonization vision was sophisticated daydreaming, not a future that a large number of Americans wanted to make happen. The vision had its shot and never caught on, despite appearing in the pages of a highly reputable magazine and gaining the attention of political decision makers. Gravity, weightlessness, radiation, and economics may all have ultimately made this vision untenable, but its biggest problem was that people didn’t like it.

We are living in the future that National Geographic’s experts speculated about. The cities are all right. World War III is no longer looming overhead. But grand visions of space colonization no longer appear in popular media. They no longer gain attention on news programs or in the halls of Congress. The Future, it was wonderful, but now it survives largely in the pages of faded magazines.

Until we lose a few million, or few thousand million, people from a dirty snowball, showing just how bad an idea it is to have all our eggs in one basket.

Of course some of us would dream the dream anyway, and do whatever we could to see our dreams become reality.

Tuesday, 7 June 2011

On Post Modernism

A Post-Modernist critique of itself:Why Has Critique Run out of Steam? From Matters of Fact to Matters of Concern by Bruno Latour
I myself have spent sometimes in the past trying to show the "lack of scientific certainty" inherent in the construction of facts. I too made it a "primary issue." But I did not exactly aim at fooling the public by obscuring the certainty of a closed argument–or did I? After all, I have been accused of just that sin. Still, I'd like to believe that, on the contrary, I intended to emancipate the public from a prematurely naturalized objectified fact. Was I foolishly mistaken? Have things changed so fast?
In which case the danger would no longer be coming from an excessive confidence in ideological arguments posturing as matters of fact–as we have learned to combat so efficiently in the past–but from an excessive distrust of good matters of fact disguised as bad ideological biases! While we spent years trying to detect the real prejudices hidden behind the appearance of objective statements, do we have now to reveal the real objective and incontrovertible facts hidden behind the illusion of prejudices?
Yes. Yes, we do.
And yet entire Ph.D programs are still running to make sure that good American kids are learning the hard way that facts are made up, that there is no such thing as natural, unmediated, unbiased access to truth, that we are always the prisoner of language, that we always speak from one standpoint, and so on, while dangerous extremists are using the very same argument of social construction to destroy hard-won evidence that could save our lives. Was I wrong to participate in the invention of this field known as science studies? Is it enough to say that we did not really mean what we meant?
Yes you were, and no it's not.

No, there's no such thing as "natural, unmediated, unbiased access to truth", but by trying hard enough, we can get arbitrarily close to it. Facts are, whether we like them or not, and just because our vision is imperfect doesn't mean to say that phantoms, illusions and deliberate fabrications are as equally real as imperfectly seen objects. No, the value of an idea does not depend entirely on how well it confirms your ideology, and the value of a fact is inversely proportionate: it's the exceptions, the inconvenient truths, that teach you the most.

Monday, 6 June 2011

BIID and the Body Map

From Neurophilosophy:
In BIID, or apotemnophilia, individuals express a strong desire to have a healthy limb amputated at a very specific location. People with this condition usually describe the affected limb as being "intrusive" or "over-present", and report that they have had the desire to remove since early childhood, but do not understand why. This desire can be so strong that sufferers sometimes resort to damaging the affecting limb irreparably, thus forcing doctors to amputate it. The vast majority of BIID sufferers have no other psychological disturbances, and almost always say that they feel much happier when the limb is eventually amputated.

A growing body of literature suggests that body awareness disorders such as BIID occur as a result of abnormal activity in the right parietal lobe, which is known to be essential for constructing a mental representation of the body. Specifically, this body image is constructed in the superior parietal lobule (SPL), which performs a function referred to as multisensory integration, whereby different types of sensory information entering the brain are brought together. Thus, information from the visual parts of the brain and the primary somatosensory cortex, which processes tactile sensations and proprioceptive information relating to the position of the body within space, is sent to the superior parietal lobule. There, it is combined with information from the motor cortex, which controls movement, and all is processed further to generate an internal model of the body. If these processes are perturbed, the body image is compromised.
In BIID, the situation is apparently reversed: the body image is missing a representation of the affected limb. But the body image distortion seen in BIID is almost certainly congenital. Children born with missing arms or legs sometimes experience phantom limb syndrome, suggesting that there is a representation of the limb in the brain, even though it has never existed. The body image is, therefore, probably "hard wired" during development. The experience of BIID sufferers is consistent with this, as they typically report that they have had the desire to have a limb amputated since early on in their lives. It seems the brains of apotemnophiles fail to generate a representation of the affected limb, because of some aberrant developmental mechanism. The limb has never been a component of the body image, so the afflicted person grows up believing that it feels "wrong", but cannot explain why.
I hypothesise that the difference between non-op and pre- or post-op transsexuals is caused by different degrees of masculinisation or feminisation of the superior parietal lobule.

The trouble is - I have no idea how to test this hypothesis. It fits with everything that we know, but that doesn't mean it's true.

All I can say is that when I was 4 years old, long before I had any concept of the differences between girls and boys, that what was "down there" felt... supernumary. Incorrect. Shouldn't be there. Furthermore, after genital reconstruction in 2006, things felt right. Not completely, there still seems something that should be there, in my abdomen, that isn't. But far, far closer to "natural" than before. Even things like urination are effortless, my instincts take over, whereas before I had to concentrate on what I was doing. I had to think, it was neither instinctive nor natural to have somewhat masculine anatomy, even if it didn't resemble the usual kind thereof.

That matches rather closely the description of BIID: but is normal for a woman, just as having a body image that involves external genitalia (and does not involve womb or cervix) is normal for a man.

I hope that one day, we'll be able to point to the areas of the brain that define gender identity more exactly, rather than "in the lymbic nucleus". That we will be able to do the same for sexual orientation, which is probably a very complex phenomenon, certainly involving sense of smell amongst other things, and be more exact than saying "it's in the hypothalamus and elsewhere". That we can do the same for male-vs-female toy preference, which has a strong correlation with sexual orientation amongst "effeminate" gay men and "butch" lesbian women; and finally, the body map in the superior parietal lobule. The latter appears to be more plastic than the others, but "more" here means "not very much".

Research on the latter might find palliative treatments for men who have been castrated, and women who have had vulvectomies, both of whom suffer the same kind of severe distress found in transsexuals. Distress that goes well beyond the problems caused by sexual incompetence. Reconstruction in conjunction with such treatment is the ideal course, but that may not be possible. The brain might need de-programming afterwards to remove the effects of the palliative treatment once reconstruction has been performed, or the patient gets BIID again.

More work needed. And as always, remembering that we're not dealing with machines here, but people, with feelings, emotions, human rights. I know that some researchers, at least, forget that. Maybe it's necessary not to get too involved in order to help people, but in some cases I think it's just pure lack of empathy towards those who are too different from themselves.

Friday, 3 June 2011

Diskworld Wiki

Time for an "interesting URL". This blog, while it deals with serious matters - even matters of life and death - can get a bit stodgy. We need to live, not just exist.

And so I present : the Main Page - Discworld & Pratchett Wiki

Thursday, 2 June 2011

UCSF Transgender Patient Care

From the University of California, San Francisco: Primary Care Protocol for Transgender Patient Care:
"Published transgender-specific level 1 evidence is essentially non-existent. [...] Long-term, prospective studies for most transgender-specific health issues are lacking, thus resulting in variable preventive care recommendations based primarily on expert opinion. However, by utilizing an increasing body of peer-reviewed, scientific research on transgender health, along with relevant data from the general population, one can develop an evidence-based approach to preventive care for patients who are transgendered or transsexual." -- Jamie Feldman, M.D. (Feldman, J [2007])
So it's not great, but it's the best we've got, and as good (or bad) as many other medical protocols.

Very good in the main, but the hormone dosage of Oestrodiol Valerate is too low by a factor of 2, and should be maintained even after gonadectomy. Otherwise, very good, even if lacking in detail regarding the different options for genital reconstruction procedures, and with nowhere near enough emphasis on checking for Intersex conditions first. An Intersex condition disqualifies a diagnosis of Transsexuality in the ICD-10, and is a significant clinical modifier in the (draft) DSM 5. Doctors should be prepared to deal with the consequences of involuntary genital surgery on Intersexed infants, and cannot rely on the patient to tell them of those. They may not know themselves.

Hmmm.. maybe I should write to them on this...

Wednesday, 1 June 2011

The Face of Evil

A follow-up from a previous post.

From the Grauniad:
The founder of a controversial school that treats severely autistic and emotionally disturbed children by shocking them into submission with the use of electrodes has been forced to quit the institution and serve five years' probation.
The criminal charges brought against Israel relate to an incident in August 2007 at one of the school's residential homes where students sleep at night. A call came in from someone posing as an authorised supervisor, who informed the carers on duty that two teenagers had misbehaved and should be given shock treatment.

At 2am, the boys were strapped on boards and given multiple shocks. One of the boys, aged 18, was shocked 77 times over a three-hour period and the other boy, aged 16, was shocked 29 times. It was later discovered that the initial call had been a hoax.

The Massachusetts attorney general, Martha Coakley, indicted Israel over allegations that he ordered his staff to destroy video evidence that revealed exactly what happened that night. Prosecutors had previously ordered that the video recordings from the home were preserved.
He knows what he's doing is wrong. He knew that what he did could have landed him in trouble - so like any evildoer, he tried to conceal the evidence.

Anyone who gave him the benefit of the doubt as being merely misguided must now admit that there's no doubt any more.
"I am now almost 78 years old, and it is time for me to move over and let others take the reins," he said in a resignation letter.

But his departure will not materially change the way the school operates, crucially its technique of disciplining children by meting out electric shocks as a form of supposedly therapeutic punishment. Of the school's 225 students, 97 are currently on the electric shock regime.

The terms of the plea deal struck between Israel and the prosecutors require the school to introduce additional monitoring to prevent a similar lapse of security happening again. But the shocks themselves can continue.
The Evil that men do lives after them....