In graduate school I was warned not to touch anything to do with homosexuality or transgenderism. By that time I had learned that graduate school and high end science was not the open-minded inquiry I had expected. I was, however, convinced then that most transexuals were in part biologically female.

Some years after grad school, I wrote a paper about how it can be that an apparent man could have a woman’s brain, and vice versa.

In a nutshell, somewhere around 10%-15% of the population are probably natural chimeras. What that means is that two separate embryos merge into one, and are born as a single person. It’s the opposite of fraternal twins. If you think about it, you realize that half the time, those two embryos should have opposite sex. So, if one embryo forms the brain, then probably the other one will form the gonads. In animals, transplanting the brain bud of the notochord into an opposite sexed embryo causes sex behavior traits of the brain to manifest. There are other ideas about transgender people, and many of them hold water, but I think mine is the strongest.

How confusing and difficult that must be. A transgender person did not choose to be born this way any more than you chose to have feet or hair. I am certain that homosexuality and transgender identity are not a choice. The only thing that is a choice is reconciling with it or not.

Living in a body that feels wrong, growing up feeling different, facing prejudice, bullying, death threats and mockery isn’t easy. Even if a person is quiet and in the closet, it has profound effects to see all that happening. Then, gender reassignments are often late in life and the best years are felt to be past. In addition, gender reassignment surgery is more than a little wanting.

Those who undergo gender reassignment surgery and hormone treatments do not get a sex change. A male to female surgery today will not produce a full biological woman when it is done. A person will likewise not be a full biological man if changing from female to male. This can be very disappointing in a life filled with broken dreams, and people who get surgery can find that their field of potential partners has not expanded, it has narrowed. Transgender people face murder at the hands of both men and women with and without surgery. Some adjust well enough, it is true, but the surgery is far from ideal.

Poor outcomes from gender surgery do not have to remain so. I spoke with Dr. Anthony Atala recently at a conference, advocating for more work on stem cell production of gonads and sex organs. This is no minor matter, don’t misunderstand me. Growing ovaries, follapian tubes, a uterus, vagina, and external genitalia, is an extreme challenge. We are not there yet. We are closer to growing a penis, or at least something penis-like, out of stem cells. For the rest of the male equipment, we are also not there yet.

My wish is that growing complete reproductive systems become a goal and that serious efforts be expended to fund the research. It won’t just help gender reassignment. There are women who have had hysterectomies because of cancer, endometriosis, or accidents who would want to be made whole. Similarly, there are men who have such needs as well. There is no reason why we should not try, regardless of the great difficulty involved.

I hope for a time in the not so far distant future when a person who gets gender surgery comes out of it as the sex that fits their mind. In theory, we can probably do it. In theory, it is possible to make those organs and make that person able to marry, have children, and be what they should have been born as in a more perfect world.