So these are the things that I’m currently struggling with. You will see them mentioned over and over again in my articles, comments, and wherever I participate on online social media. I do that mostly to allow myself to review my current thoughts on the subject, but also to see what kind of feedback I get, to see if someone gets some insight on the various subjects that aid me to get a bet understanding of these complex issues.

As you will see, some are purely philosophical; others have political implications; and others may aid people to figure out where exactly they are in the transgender spectrum and how to deal with it.

‘Transgender’ is changing definition… again!

Here is the dilemma: I started reading about crossdressing and transexuality in the mid-1990s. Back then, we were at the end phase of a ‘tolerant, inclusive’ period: in other words, there was a genuine effort to figure out a new theory — based on feminist theories and queer theories — which found the common points among all people who somehow did not fit in the classical cisgender, heterosexual narrative. By the mid-1990s, it was clear that there weren’t simply ‘fetishist crossdressers’ on one side, and ‘true transexuals’ on the other; we have been influenced by Harry Benjamin’s classifications on the various kinds of people with gender issues (he had six types), made thirty years before, and we had already fought Blanchard and his wacky theories; by this time, the word ‘transgender’ was being used as an umbrella term designating everybody who struggled with all sorts of gender issues.

This was also a time when ‘gender’ started to get a more precise meaning, and when it was assumed that it had three separate components: identity (what every person deeply feels in their intimate to be), role (the social behaviours and place in society), and presentation (the outwards appearance in public). It became quite clear that these three were distinct, different from each other (although they certainly influenced each other, too), and separate from what we would call ‘sex’ (in the physical, biological term, i.e. mostly the outwards genitalia and overall physical look) or ‘sexuality’ (the choice of romantic and/or sexual partners). Cisgender and heteronormative people — the vast, vast majority of human beings — would have a standard ‘template’ where all these variables were perfectly aligned (at least in theory, and certainly ‘imposed’ by society to be so). Non-heterosexuals would have a different sexuality, but the remaining variables would be the same as for heterosexuals (with possibly the appearance variable having some nuances, as in some expressions of gay culture, but that was not necessarily a requirement). And what we used to call ‘transgender’ would have some variance in all gender variables; ‘intersex’ people would of course have some variance in the ‘sex’ variable, and possibly all others as well.

This model was explained with the theory of the ‘gender core’, a non-identified area of the brain conjectured to ‘produce’ gender identity. In cishet (cisgender heterosexual) people, that gender core would be perfectly aligned with one’s (genital) sex. But sometimes this did not happen. The number of people with a discrepancy between their gender core in their brains and their physical sex was far too large to be merely a statistical anomaly or an occasional gene mutation; it was so large that it required an evolutionary explanation (as most important things in biology). The gender core theory had all that, it had the largest possible explanation power with the least amount of requirements, and could be experimentally verified (or falsified), so it was accepted as the current state-of-the-art of scientific thought in this field. It still has a fundamental problem, namely, the lack of precise data to actually locate the ‘gender core’ somewhere in the brain, and/or which genes/biochemical reactions actually affect it. I’ve repeatedly written about the subject and given some pointers on the current research in this area; I won’t do it again, since this is just an introductory summary 🙂

The point is that by the mid-1990s we had a reasonably good and solid theory to explain ‘gender variance’, or departure from the cishet norm; it was really seen as an expression of diversity in the human species; it had evolutionary validation; and it seemed to be consistent with the theoretical models we had to explain what we could observe. And, from the perspective of human rights activists, we had something to fight for, namely, ‘transgender rights’, which were inclusive of all the community — from drag queens to transexual children, including even fetishist crossdressers and intersex individuals, even if they didn’t apply the ‘transgender’ label to themselves.

What was written and published by people in this community reflected the conceptual idea that we all share common points, even if we express them diversely; online forums, for instance, would be open to all, from fetishists to those struggling through transition, and, even if they had separate subforums to address their particular issues, everybody would participate and mutually respect each subgroup. You can still see some of this happening on the forums on Susan’s Place: it’s not uncommon for, say, transitioned trans women to give tips and advice about washing wigs on the crossdresser forum, even though they clearly belong to totally different subgroups. Nevertheless, in this particular case, both struggle with gender presentation, and that means they have at least that in common — enough to mutually respect and help each other.

But — and here comes my own struggle! — things have changed. After two decades, the so-called ‘transgender community’ has been polarised and split; even the meaning of the word transgender changed dramatically, as Cristan Williams has so well documented. Most significantly, as we moved out of the 1990s, what would formerly have been called ‘transexuals’ started actively to replace that classification (which is loaded with negative connotations, originally sprung from the medical community) with simply ‘transgender’, just as Christine Jorgensen used it to describe herself in her later years (the word ‘transexual’, with the meaning that Harry Benjamin assigned to it, was only defined a dozen years after her transition).

While replacing a negatively-connotated word such as ‘transexual’ with something having no such negative connotations (‘transgender’) is certainly understandable, it confuses the issue further: when an activist is demanding gatekeeper-free medically-assisted transition for ‘transgender people’ who want it, are they referring to the very small and tiny subgroup in the enormously vast spectrum of transgender people who are, in fact, transexual (in the clinical sense of the term); or do they mean that all kinds of ‘transgender’ people should be allowed to get free transition if they choose to do so?

As I’ve learned, the issue is more complex than that. Most activists with an ideological agenda that I personally know (and many more which I read about, but of course I cannot say what these really think about the issue!) deliberately ‘confuse’ the meaning of ‘transgender’: on one hand, they defend the notion of ‘transgenderity as a spectrum’; on the other hand, they prefer to consider only giving legal protection (and the right to transition) to those who transition from male to female or vice-versa, and are rather suspicious of those who do not ‘fit’ into the classical description of transexuality. The usage of ‘transgender’ to refer to those who want (and need!) transition just broadens the definition a little more, allowing, for instance, for people to transition irrespectively of their sexual preferences (which is entirely legitimate); and this term also allows a legal transition without requiring a full transition (i.e. hormone replacement therapy and ‘top’ and ‘bottom’ surgeries), as it was necessary a few decades ago. In other words: activists have created a new narrative of ‘transgender’ which includes those who are transexual but do not fit into the 100% classical narrative for transexuality (i.e. that all transexuals exhibit physical characteristics of the gender their identify with; that they are romantically and physically attracted to persons with a gender opposite to the one they identify with; that they want to anatomically change their bodies to match the gender they identify with as closely as medically possible).

All right. So, sure, meanings of words change. The problem here is just one of politics: by subtly changing the meaning of what ‘transgender’ means, it implies that ‘some’ transgender people are included in the Good Fight (the ones who are covered by legislation protecting them and giving them access to medically-assisted transition), while others — the majority, in fact — are confined into the category of ‘gender non-conforming’, who essentially have no rights (except the right to breathe and pay taxes). This is where I wrinkle my nose, and this situation makes me uncomfortable — mostly because I’m not quite sure if this ‘relabeling’ of ‘transgenderity’ is deliberate (as so many things related to politics tend to be) or a sad consequence of the way things change over time. Sometimes, by subtly making some changes, we leave people behind — unintendedly. Was this the case?

Perhaps. Not so long ago (a bit over a year or so, I think) I was amidst a conversation including researchers in social sciences and some activists (most of them transgender, if I recall it). At some point, one of the activists told me that she wanted to have a nice little chat with ‘me and my friends’ because she felt that she ought to establish a bridge to ‘crossdressers’ and hear what they had to say as well. My first impulse was to say, ‘hey, we’re as transgender as you are’ but my good manners refrained me to comment — especially because by then I was already aware that the word ‘transgender’ really meant for activists what ‘transexual’ used to mean. Naturally, at the end, I thanked her for the opportunity and, yes, we did agree to meet afterwards, and keep somehow in touch over time. But it quickly became clear that ‘we crossdressers’ had no ‘interesting’ issues, or had little to contribute, to the overall discussion around gender issues. And this happened on more than one situation, i.e. the notion that ‘we crossdressers’ were essentially good and nice people, but really not part of the serious transgender population, just marginally outside the cisgender heterosexuality (and thus always worth to listen to, briefly), but certainly not enough to warrant us any rights, or public opinions, or the inclusion under the ‘transgender’ umbrella.

I keep getting annoyed at that, and I even remember a more dramatic public discussion around the application of the word ‘transgender’: did it only apply to gender identity, or also to gender role and presentation? During that discussion I was pretty much told to shut up because ‘of course it applies only to gender identity!’; but the more I think about it, the more I believe it applies to all three elements of gender issues — identity, role and presentation — and everyone who is outside the established cisgender heteronormative ‘standard’ in any of those three should be labeled as ‘transgender’.

Is this so important to ‘fight’ for? Well, there are many reasons for doing so, but I can point one good reason: there are far more people who fit under the old classification of ‘transgender’ who are essentially being ignored, or left out, or even deliberately excluded (because they challenge several established assumptions about how a ‘real’ transgender person should feel, act and behave).

And how do I know that? Let’s move to the next point!

Confound those statistics: where are 99.9% of all ‘transgender’ people?

Transgender people are very rare; depending on the estimates, they can be as high as one in 10,000 or one in 100,000. A rough estimate places the number at about 1:30,000. It’s very hard to estimate the overall transgender population, because there is no official census for them. Most of them are still suffering in silence; some very few — a minority among a minority! — actually pop up under the statistics because they officially change their name and gender markers, and this is the only ‘official’ number we have for them. For my country, for instance, the number of people who did a legal transition is about 1 per 28,000 inhabitants, although this number may go up a bit because there are still many who are at the final, bureaucratic stages of their transition and may not have been counted yet; it’s not impossible to believe that if all people who wish to transition did so, the number would go down to 1:10,000; it’s however to be expected that many will not transition even if they have all reasons for doing so. In any case, the 1:10,000 to 1:30,000 interval seems to be a reasonably good estimate based on available country data.

When I first started to read about transgenderity, I actually thought that the transgender population was much, much smaller — in fact, like thousands of others in my country, I imagined I was the only one around here (yes, really). Of course I was aware that there were hundreds, if not thousands, of transgender people worldwide; but I thought that this would vary enormously between countries, and that we were simply too small to have any transgender people. I know this is silly, but that’s how I thought back then in the mid-1990s! And even by the late 1990s, when I was aware that there were, indeed, a lot of crossdressers around, I grossly estimated them to be ‘just a few dozens’ based on the ones I could find online.

My big mistake was to confuse the amount of transgender people with the amount of those who participated in the early forms of social media! On top of that, even in those early days, people were already aware of the danger of sharing pictures of themselves online. So, even though we could postulate that the percentage of transgender people online would be equivalent of those who were not online, I failed to take into account an even bigger mistake: I assumed that transgender people wanted to be found online!

Well, that’s clearly not the case. Even today, in spite of activism promoting the opposite view, most transgender people simply want to be invisible, fade into the background, disappear from sight. Many are still anxiously worrying about their self-image and consciously desiring to ‘pass’. And among those who ‘pass’ to an extent, there is still the fear of discovery – by family, friends, or, even worse, colleagues at their job. As a consequence, the amount of transgender people who had public profiles on social media was far below the expected percentage for them; and this, in turn, simply meant that one could not rely on social media for statistics on the transgender population.

This is still true as of today. Even though current-generation social media allow a much more fine-grained approach to security and privacy, this still requires a bit of knowledge to properly set up, and many transgender people simply do not trust social media enough. To make matters even worse, transphobes can easily flag transgender people’s profiles as being ‘fake’, and in this era of corporate censorship, such profiles are deleted first and questions asked afterwards. The consequence is that transgender people are often forced to switch accounts and create new profiles all the time; that, in turn, means making it hard to track friends and keep in touch with the community.

There is still a further catch. In spite of being advertised as something completely different, most people still look at social media as the ultimate dating site. Transgender people are not different (why should they?). Both cisgender and transgender people often have secondary accounts to join dating groups, using nicknames, and keeping their ‘online social life’ separate from their online dating. Why this should be surprising or underrepresented is really beyond my understanding – except if we take into account that journalists love social media, because it allows them to remain online during working hours and chat around and call it ‘research’; so they praise social media for their, uh, ‘ability to connect with people with similar interests, worldwide’ – something which social media companies are eager to hear and to share with stakeholders, of course, thus feeding the positive feedback cycle, and giving social media more and more praise for certain characteristics that they certainly have, but which the majority of people don’t really use it for. The Internet is all about sex, and while it’s convenient to hide that from decision makers and the mainstream population, when discussing the role of the Internet without the need of being politically correct, we simply must acknowledge that one of the fundamental and most widespread usage of the Internet is related to sex and dating, sometimes at a subconscious (or even unconscious) level, such as taking selfies to show potential partners how cool we look.

But let’s move on. For about a decade, I got my numbers from studies guesstimating the amount of transgender people, based on all sorts of surveys and data that could be gathered. But it was only when ‘gender dysphoria’ became a clinical term with a precise meaning that such data became more reliable; for instance, data from the US Armed Forces, which can force people to answer truthfully to such questions, revealed that the amount of transgender people was incredibly higher than even the most optimistic guesstimates imagined! This was later shrugged off in the belief that way too many transgender people join the military simply to cover up their transgenderity; and, in fact, it’s not uncommon for MtF transgender people to work on ‘very male’ jobs, from construction workers, plumbers and electricians, truck drivers, and, of course, the military. What this does not explain is the high number of FtM transgender people in the military as well – unless they are very open about their transition, in which case the reason is similar (getting a ‘male’ job to ‘prove’ they’re ‘real men’ even if they weren’t born with a penis…).

Statistics from the military encouraged researchers to believe that the amount of transgender people was much, much higher than believed; the problem was that only a tiny fraction would be accounted for, when they contacted doctors for their transition. So there was still no way to accurately guess the numbers of those vast masses of transgender people who were ‘out there’ but invisible to surveys and census. How many were they, and where were they? It’s like the discussion of dark matter and dark energy in astrophysics: it allows scientists to explain a lot about the universe (namely, why its expansion is still accelerating) even though we have no clue if such things actually exist or not, since, by definition, they are invisible (they don’t emit light, nor reflect it, so we cannot know where they are, except by conjectural approximation which happens to ‘just fit the observed data’). We can therefore argue if those ‘invisible’ transgender people exist at all, or if they are as numerous as researchers in social sciences expected them to be.

For many years I had no easy explanation for this. Then I started my own therapy with specialists in clinical sexology – mostly to get rid of a depression – and at some point, when I had to take some blood samples, I decided to ‘come out’ to my family doctor, a GP. It surprised me that she was so knowledgeable about transgenderity; but the explanation was simply that she had come across ‘thousands’ of cases, and her own colleagues had seen as many.

This baffled me completely and I first thought I didn’t hear correctly; but on subsequent visits it was quite clear that I didn’t misunderstand her. GPs ‘routinely’ would come across ‘thousands’ of cases. But how could that be, if the official number for the number of transexuals (a legal/clinical term designating those who had been diagnosed with gender dysphoria and went through transition) was merely ‘a few hundreds’?

I researched further, and, as explained before, based on talks with doctors, I could ascertain the following: there were six official public hospitals with a ward for clinical sexology and a handful of cherry-picked doctors. All of these together produce some 30 new cases every year who are referred to surgery, which is pretty much aligned with what the official statistics show. But what they don’t show is that doctors do not refer all cases to surgery; rather, for every thousand patients or so, only one is diagnosed with gender dysphoria and goes through transition! So we can roughly say that, on average, each of these hospitals have a small team who handle, in total, 30,000 patients every year, 30 of which will fully transition.

Actually, this is a guesstimate; from what I could gather, such statistics are not made public; but sometimes doctors let slip through how many patients they are; and there are plenty of ‘generic’ statistics about the ratio of doctors to patients. In my country, depending on the speciality, this goes from 1:1,000 to 1:5,000. It’s also plausible to admit that not all patients in clinical sexology are transgender; and, last but not least, some of the hospitals have more than one team taking care of transgender people. Because the actual number of patients and diagnostics is not really public, it’s hard to tell exactly how many they are, But the rule of thumb of having about a 1,000 transgender patients at all times, one of which will eventually transition, is a good estimate, and it’s also consistent with the numbers my family doctor told me (there is naturally an overlap, of course).

Now, it has to be understood that the 30,000 people are not the whole transgender community in my country; rather, they only represent a small fraction of the transgender population who, having difficulties dealing with their gender issues, finally talk to a doctor (often their family doctor) who then refers them to a specialist in clinical sexology. So these are the ‘extreme’ cases, i.e. those who finally break their silence and their ‘invisibility’ to get treatment – and this is by no means the norm, so many transgender people, fearing public exposure, rather prefer to attempt self-medication first; or they simply mistrust doctors in general, believing they only will attempt to ‘talk them out’ of their gender dysphoria. And of course there will be a certain amount of transgender people preferring to go through the private health system; here we have no statistics at all, except, of course, for the number of people applying for a change of their gender marker and their first name: the procedure is the same for both the public and private healthcare services, of course.

And obviously there are all other people who are somewhere in the ‘trans-something’ spectrum and who never came across the idea of going to a doctor. Again, from parochial evidence (that is, looking at my group of trans friends) I would guess that only one in ten had talked to a doctor about the issue. This means that the actual number of trans people might number the 300,000 – and that would mean around 3% of our population!

That’s a lot of people! And that also means that politicians have no choice but to address trans issues, if they actually affect so many people. Indeed, instead of endless postponing the discussions around trans issues, with the argument that they are ‘an insignificant minority’ (as portrayed by the media: only a few dozens have gone through surgery…), trans issues should be at the forefront of political discourse, as it’s possibly one of the top ten issues affecting a country’s population!

Fusion and other techniques to cope with gender dysphoria

The last issue that has worried me for quite a while is the attitude towards those who suffer from a degree of gender dysphoria but cannot go through transition for many reasons – the main ones being family and work, as well as the social environment (friends, acquaintances, neighbours, etc.).

The classic narrative is that transgender persons have ‘to be themselves’; in other words, it is expected that trans people ‘come out’ and stop pretending they’re cisgender; at least in Western societies, transgenderity is not only legal but enjoys special protection (i.e. access to clinical transition and laws against transphobic actions), so people are encouraged to transition, and, as recently as 2010 or so, clinical transition was considered the most successful medical procedure, with the highest success rate — close to 100%! — with so few ‘regrets’ or ‘failures’ that they were often misrepresented (today, there is a growing number of very vocal people who detransitioned and explain the reasons why).

Now, the issue is that, thanks to decades of very successful transgender activism, we have come to a stage where the diagnosis of gender dysphoria is equated with the almost-100%-successful clinical transition. Also, it is rare that someone goes to the doctor only due to symptoms of gender dysphoria; these are at the root of the issue, yes, but people with gender dysphoria will almost always also exhibit symptoms of depression, anxiety, obsessive-compulsive disorder, trauma, and so forth. Clinical transition has shown how all of these simply disappear as if they never existed once people are put on hormones and officially start the transition. Why this works so well is not totally understood at the biochemical level. Some like to point out that MtF transgender people will have their testosterone blocked, which will lower not only their libido, but also any aggressivity linked to anxiety, thus producing a ‘calming’ effect, which overall will help out with all other symptoms. Such a hypothesis, however, is easily falsified, because FtM transgender people in transition will get shots of testosterone but also feel the same calming effects of clinical transition. Some doctors and researchers are not eager to label hormone replacement treatment as a placebo for all other non-dysphoria symptoms, but essentially that’s what it ultimately is (as a working hypothesis only, i.e. until someone can fully explain what goes on at a biochemical level which gets changed with HRT). And there are also many cases where HRT might not be possible (due to pre-existing medical conditions, say, hypertension combined with a propensity towards blood clots) but surgery is, and surgically changing one’s body during transition seems to alleviate not only dysphoria (which totally makes sense) but all other issues as well. Again, we cannot explain why ‘getting boobs’ implies ‘no more depression or anxiety’ — there is simply no biochemical mechanism that can explain what is going on. And, finally, some people do not modify their bodies in the least (for whatever reason) but simply go through transition towards the gender they identify with, no matter how they look like beneath their clothing; and in such cases, gender dysphoria is also ‘cured’, or at least controlled, and we have good solid evidence from research showing that the change of gender role and presentation, even without surgery or hormones, can be 100% effective in many cases. Also, there is a mix of all the above — people might start transitioning without any medical treatment, immediately start feeling better; then they get hormones, and their overall mood and attitude improves even more; finally, totally confident that they are doing ‘the right thing’, they go through surgery, and whatever remaining symptoms still existed are dispelled forever.

Doctors look abstractedly at so-called ‘clinical transition’ as a complex therapy involving a mix of counselling, psychological therapy, change of attitude/habits/social role (including presentation), as well as the more ‘physical’ changes produced by hormones and surgery. It’s a full package involving psychological changes, behaviour changes, and physical changes — and they have to go together when the diagnosis is gender dysphoria. Interestingly enough, the physical changes might be the less important ones for doctors, while the psychological changes and behaviour changes matter most. In other words, it would be very strange to prescribe hormones and/or surgery to someone who is not willing to undergo a change of gender role; from the perspective of some doctors, someone who is acutely dysphoric regarding their body but not their social gender role might not be diagnosed with ‘gender dysphoria’ but rather with physical dysmorphia, which is something entirely different and not to be confused.

Or is it? The truth is that the transgender narrative is not necessarily singular; there might be several ‘transgender narratives’ (ultimately, an infinity of them, since every transgender person has their own narrative…); and is a doctor really able to tell the difference between a ‘genuinely trans’ person who needs hormones and surgery to lead a normal life (as a member of the gender they identify with) and one who does not physically identify with their gendered body and wish to change it to conform to the gender they identify with, without, however, having any intention to change their social gender role? And what about those people who simply feel symptoms of gender dysphoria due to completely different issues — from schizophrenia to escapism, to dealing with trauma, etc.?

Now… ‘genuinely trans’ people will usually scorn at all others who do not share the same narrative (more on that later!) and sometimes even be afraid of those ‘unconventional trans narratives’ because they secretly fear that these become widespread and known by the mainstream, cisgender, heteronormative society, and, because such narratives are even stranger than the ‘genuinely trans’ narrative, the fear that everybody is thrown into the same bag and denied access to transition is real. In other words, it’s far better to deny access to clinical transition to anyone who does not fit an ‘acceptable’ narrative (and we may agree that even the mainstream Western societies start to exhibit some tolerance towards those who are ‘true transexuals’) and even exclude them from the ‘transgender’ label in order to protect those so-hard-to-get transgender rights. Thus, everything which does not conform to the ‘acceptable trans narrative’ is scorned, downplayed, or simply ignored — by both activists and doctors alike.

Consider a very, very typical example among MtF crossdressers. A surprisingly high number of them fully identify as male, present themselves as males for most of their time, and, while acknowledging that there is an ‘inner female’ which occasionally has to physically manifest itself (by crossdressing and presenting as a woman) — denying such manifestations for a prolonged time will cause psychological disturbances such as depression and anxiety — they have no wish to transition. They very often are happily married and have children.

But some of them (and the number is by no means small!) have a very specific wish: they want to have boobs. This is not merely ‘wishful thinking’, or an obsession, or something they ‘just wish’, similar to people wishing to win the lottery or getting the perfect romantic partner. It goes really very deep within themselves; they strongly and thoroughly believe that their continued happiness will only be possible in full if they ‘grow’ boobs. And the prevention of any treatment or surgery which will give them breast enhancement causes them symptoms very similar to gender dysphoria.

Now, how would we fit such people in the transgender spectrum? Clearly, they do not want to transition, at least not fully; they do not want to abandon their wives and children, and many are even aware of their male privilege which they do not want to give up. They do have some sort of dysphoria regarding their bodies — or perhaps dysmorphia — which is clearly related to gender: their bodies feel ‘incomplete’ unless they get boobs. Note that having a vagina is rarely expressed by these MtF crossdressers — they might dream of how it would feel like, but, at the end of the day, they’re very happy with their penises and the pleasure it provides them and have no intention to change. Oh, and we cannot even assign a ‘classic’ sexual orientation: such MtF crossdressers might be straight as arrows, others bi-curious, others very openly bisexual, and a few even homosexual (but maintaining some sexual activity with their wives or girlfriends in the name of pretense). From my personal experience I would say that most would be somewhere between the bi-curious and bisexual spectrum, but by no means that is the case with all of them.

From a strictly activist point of view, such people are regarded merely as fetishists with an obsession with boobs, and totally disregarded and excluded from activism discussions. Doctors might agree that they are in a class of fetishists who suffer from their fantasies, and they are more compassionate than activists: such people need some sort of ‘treatment’ because they are suffering, they might exhibit symptoms of gender dysphoria, they might get depressed and anxious just because they are not allowed to grow boobs. The reason why some crossdressers are obsessed with this idea and others are not is most certainly not fully explained — and it involves a relatively large group of people (among my own friends and acquaintances, there are far more crossdressers who want to have boobs than transgender people in transition or wishing to begin transition) which is simply not studied enough.

This has some consequences, namely, if someone is so depressed about lacking boobs that they go to the doctor and admit their inner secret wish, they might be discarded as merely having some delusional behaviour or a complex fetish. It would be hardly reasonable to expect them to find a friendly doctor who would, indeed, ‘give’ them the desired boobs. In fact, it’s hardly illegal to graft some silicone prosthesis to otherwise healthy male individuals — a plastic surgeon might raise a few eyebrows, but they might be willing to do that for a price (it’s also the kind of surgery which is relatively easy to reverse). So it’s not really a complex ethic issue regarding the surgery itself (unlike, say, gender affirmative surgery, which involves a non-reversible procedure). It’s more a question of understanding if such a procedure would, indeed, give that person the ease of mind and happiness they imagine they would get. And that’s something that a common plastic surgeon might not be adequately trained to figure out.

I have brought up this particular example because it’s so common; with very few exceptions (I personally don’t know any), such people rarely get their wishes. Some will take hormones bought over the counter in the expectation that they make their boobs grow a bit; some use herbs with phytoestrogens, which are hundreds or thousands of times less effective than synthetic hormones, but might make some difference (as a side-note: a very effective way to grow boobs in a male is to get more body fat. This is because estrogen is produced in males mostly in fatty tissues; the more fat, the more estrogens; the more estrogens, the more likely there is some breast growth; and because breast growth tends to become more-or-the-less permanent, reducing body fat once the breasts have grown enough might work. Note that this is a health-damaging procedure which has all sorts of negative side-effects associated with gaining huge amounts of body fat and hardly a healthy way of ‘getting boobs’ — and the results vary a lot among different males, of course). In this particular aspect, the behaviour is very similar to what ‘real’ transgender people tend to do before they start consulting with doctors.

But is it really? Just because the conduct might externally be the same (seeking hormones or other drugs and treatments to produce gender-related physical body changes) does it mean that internally such people are transgender? The answer, of course, is complex, and definitely not ‘yes/no’. And the first lesson to be learned is that just because someone exhibits the same symptoms as someone with gender dysphoria, that does not mean that they are gender dysphoric.

This affirmation is perhaps a bit baffling. If we assign the clinical label of ‘gender dysphoria’ to a specific set of symptoms, and conclude that transition is the best (or even the only) way to deal with them, how, then, can we ‘treat’ someone who has the same symptoms but the therapist suspects that they are not gender dysphoric whatsoever? As you can imagine, these issues have plagued activists for decades, as doctors persisted to call gender dysphoria symptoms as merely ‘delusional’ or aspects of schizophrenia or something equally able to produce the same symptoms — thus falsely diagnosing ‘true’ transgender people and giving them the wrong treatment (there has been a recent, sad case in my country where this is happening as I write this article).

But the reverse is also true: many (well, quite a few, but not a huge amount) of people ‘regret’ their transition and figure out that, after all, transition did not help them out with their issues. While such misdiagnosis are rare, they do exist, and they are caused by doctors listing all symptoms as being caused by gender dysphoria when they might actually be related to something else. Perhaps the main reason for so few cases of detransitioning is simply because of what I’ve written in the previous section: there might be a huge amount of transgender people out there that doctors (and activists!) simply have no clue about; only a very few ‘come out’ to their doctors to get treatment; and among those, only one in thousand will go through transition. Thus, the percentage of those having being misdiagnosed with gender dysphoria is really, really very small — so small, in fact, that number only becomes apparent when looking globally at all people who have transitioned. In other words: if the chance of misdiagnosis is, say, one in ten thousand, that means that you need at least to have 10,000 people transitioning to find one who was misdiagnosed (in my country, as an example, we just have a few dozens who have undergone all procedures of clinical transition — none were ever misdiagnosed, but that’s just because the probability is so tiny compared to the actual sample). Note that I’ve just come out with a number out of my head, I have no real data to show how often people get misdiagnosed with gender dysphoria (although I suspect that it’s slightly higher than actually reported, and that is due to what will go into the next section!).

To come to the point: there is a chance of misdiagnosis that doctors have to take into account. There are many ‘transgender narratives’, some of which are anything but classic, and who might also benefit from transition. And there are several conditions producing symptoms exactly like gender dysphoria but which might not be gender dysphoria at all. We also have all sorts of cases of people not fitting any plausible narrative but nevertheless suffering from some issue related to gender identity. And finally there is a large number of people exhibiting symptoms of gender dysphoria to several degrees, from moderate to very intense, but who, for all sorts of reasons (social, work-related, family…) simply cannot transition.

What should we do with all of the above?

While I have my ideas about what kinds of rights and protection such people might need (and that will have its own article… soon… or rather… soon-ish 😉 because I’ve been neglecting my writing…), it’s perhaps even more important to consider what kind of treatment such people need. Consider the following two hypothesis, which are taken for granted by most trans-friendly doctors:

Gender identity issues producing gender dysphoria cannot be treated by any means (drugs, therapy, etc.) because this is not a ‘disease’ or ‘condition’; rather, the only way to alleviate symptoms of gender dysphoria (and usually eliminate them) is through transition; People who suffer are fully entitled to any sort of relief as far as doctors are able to give (this is part of their oath!).

In other words: just because someone does not fit in the ‘classic transgender narrative’, they nevertheless suffer, and their symptoms, identical to those of gender dysphoria, will very likely not be ‘treatable’ in the conventional usage of the term. However, it’s unclear if transition is the only choice for all cases, especially those that do not fit in a classic narrative.

What alternatives are there? We know that so-called ‘aversion therapy’ simply doesn’t work, no matter how often ultra-radical religious and conservatives repeat that it does work (note how they never produce actual data on such ‘miraculous’ claims…). There are ‘coping techniques’ — not unlike what is used to help people deal with things like terminal diseases such as cancer — but these have not shown to be very effective, either. Mental issues are simply different for those who suffer from gender dysphoria, and, like personality traits, you cannot simply wish it away — it doesn’t work like that.

One alleged technique that might bring some results is fusion. There are several different ways of explaining how it works, and I particularly like the way Felix Conrad explains it, but I will focus instead on what my psychologist told me.

Suppose that you’re not 100% sure that you’re transgender (the idea that all transgender people know exactly what gender they are is a fallacy; most will have doubts during most of their lives, but of course there are exceptions). All you know is that when crossdreaming (which may or may not have a physical manifestation such as crossdressing) you feel much better, you feel a complete person, while when facing ‘the real life’ you just feel that you’re pretending to be something you’re not.

Something which is typical of crossdressers is the description of their feelings when crossdressed (note: many crossdreamers who do not crossdress, but engage in creative activities, report the same feelings) is how wonderful it feels to present yourself as a woman. If there is a tendency towards object fetishism, it may be just the feeling of the textures of the clothes, or how a dress or a skirt moves when you move, or simply the light touch of long hair on your bare shoulders. Sometimes it goes way deeper than that, and the best way I have to explain it is that people react and relate to me when crossdressed in a totally (and surprisingly) different way than when I’m in ‘male mode’, and that way actually feels ‘right’. In other words: when in ‘male mode’ I feel like I’m something that the cat has just thrown up and get as much attention as that, while as a woman, I’m treated as a princess (not quite — there is always transphobia to deal with — but the sensation is certainly the total opposite).

What do crossdressers do? While ‘in the closet’, they dress up for themselves in their leisure time, and enjoy this special time they’ve got. In their minds, there is a close association between ‘leisure time’ with ‘crossdressing’, while at the same time the busy, stressful daily routine is associated with ‘male mode’ (I’m taking MtF crossdreamers as an example, but obviously the reverse situation is the same). The more the crossdresser engages in this behaviour, the more it associates crossdressing with something pleasurable, while the ‘male mode’ is connected with everything that is stressful, boring, or troubling.

This goes a few notches up when the crossdresser engages in a busy social life while crossdressing. What do crossdressers when they are together? They party. They go out and have fun. They dine on fine restaurants and drink in bars. Some may even go together to enjoy their vacations. Again, this only reinforces the idea that ‘male mode’ is boring and stressful, while ‘crossdressing’ is all about partying and having fun.

There is a deep split here, and this can become extreme. Some crossdreamers actually have multiple personalities in the psychological sense of the word: they don’t merely act and dress differently, they become different people, with different personalities. This can go all the way down to sexual intercourse and romantic relationships (which is particularly hard when dealing with bi-genderity, or so-called ‘double heterosexuality’, i.e. a transgender person who is attracted to males when dressed as a woman and attracted to women when dressing as a male). But this is the kind of positive biofeedback loop that reinforces itself: the more the MtF crossdreamer engages in this kind of behaviour, the more they feel that they hate being male and love being female because it’s so fun. I can speak for myself: for the past few years, when going out for the night with friends, dressed as a male, I have not even a thousandth of the fun and pleasure I’ve got when dressed as a woman.

Fusion is therefore the process of bringing the two sides together, i.e. not do all the fun stuff as a woman, but also as a man; and do some boring, hateful things as a woman instead of leaving it all for the ‘male side’. Ultimately the goal is to keep both parts in check by realising that there is no ‘perfection’ in either being a male or a woman, both have its pros and cons, and once they’re realised and internalised, a balance is achieved, and that balance will quench the toughest feelings of depression, anxiety… and even the other symptoms of gender dysphoria.

In other words: the trick to cope with feelings of gender dysphoria is by realising that neither ‘male’ or ‘female’ are completely free from disagreeable things; while at the same time recognising that both gender roles also have their ‘fun’ part as well. That way, each gendered aspect checks the other one. Felix Conrad even goes so far as to explain that, for someone being born a male, it’s no problem to groom yourself, get rid of your body hair with laser, or even have some corrective surgery to enhance your features — all of these are totally acceptable for both males and females. It’s just when you start doing things that go too far to one of the extremes that there is a problem, i.e. if you’re a middle-aged, overweight male and decide to get some Triple-D breast prosthesis, that won’t help you in any way — it will make you ridiculous as both a male or a female. But having, say, a tummy tuck or a face lift will benefit you in either gender presentation.

The way therapists deal with fusion is often by giving the patient some homework: list all things they love and hate in either gender, and then think deeply about it to let it sink — are those things that dependent on the gender you present as? If not, well, the idea is to engage in some ‘crossgender’ behaviour: like go out to have some fun and parties as a male and not only as a female; or go for a shopping spree as a male, patiently and thoroughly combining colours, shapes and patterns as you do when shopping as a female; go to a beauty salon as a male and get pampered; and so forth. These days, all of that behaviour is acceptable for males; not to mention that male actors, politicians, and celebrities often use makeup on a daily basis. Metrosexuality in males is not the dirty word it used to be.

The reverse has also to be done, of course: going out for shopping or paying bills as a woman; cleaning up the house in heels and a hot wig during summer; doing all sorts of hateful and boring chores when presenting as a woman. Obviously this requires a certain attitude and the willingness to expose yourself as a crossdresser in public; but the more you do it, the more likely the ‘fusion’ technique is going to work.

Note the difference between fusion and ‘aversion therapy’. With fusion, the goal is not to figure out all the hateful things done when presenting as the ‘wrong’ gender, or to shame you into submission to your assigned gender. Instead, it is a pragmatic technique to realise that there is no ‘perfect’ gender role, that both are equally pleasant and valuable, but both have their nightmares as well. Also, aversion therapy is supposed to stop one’s crossdressing behaviour, while fusion encourages it — the issue here is that crossdressing is to be experienced as just another activity, neither ‘better’ nor ‘worse’ than not-crossdressing. In other words, the goal is to enjoy yourself independently of what you dress; and to do things you hate no matter what clothes you’ve picked up for the day. People who fusion successfully can crossdress all the time they want and they won’t suffer from gender dysphoria; while they can also spend long periods without crossdressing and that doesn’t cause them anxiety in the least. And finally, note that fusion does not necessarily mean that you have to embrace and accept a genderless (or genderfluid…) society, or forfeit gender roles altogether, or ‘blend’ both genders in the way you present yourself. Instead, it won’t affect the way you think about gender polarity; you just accept that you’re free to present yourself as you wish, either fully as a woman or as a man, and either way is fine.

Obviously, fusion should be done under the orientation of a therapist, or you might simply do everything wrong. Doing it with a therapist is also not a 100% sure thing. I can say that I have started to do as many boring and hateful things as possible while presenting as a woman; to the extent that I hardly ever go out with friends to dinners and parties as a woman, but go to the supermarket instead, stay in queues to pay bills, or ask bank clerks for loans — that kind of thing. I was expecting to realise that ‘being Sandra’ when doing boring stuff would, well, also be boring, and give me a fantastic insight in how I’m actually not transgender but just use ‘Sandra’ as a pretext for escapism. Unfortunately for me, the more I do ‘boring stuff’ as Sandra, the more I like ‘being Sandra’ — in other words, ‘boring stuff’ stops being boring because I do it as Sandra. I’m not quite sure if this helps or hurts me, or if it eases the depression or makes it even worse, if it shows that my presentation as a woman is linked to some obscure perversion deep in my subconscious mind or if it’s just the natural consequence of being transgender and enjoying myself all the time I present as the gender I have more affinity to. It’s complex, and certainly it has several nuances, and may not be the only solution and/or alternative to transitioning. In any case, it seems to work for many people.

What is so ironic to me is that, these days, I do tons of things as Sandra which usually ‘crossdressers’ would be absolutely scared to do; and I’m quite aware of several friends of mine, many of which going through transition, who are not yet as ‘bold’ as they think I am (this has nothing to do with ‘being bold’ but rather by caring less and less about what people think of me), even though many have absolutely gorgeous feminine bodies, enhanced through hormones — while I plod along with all my prosthesis, corsets, and makeup tricks, but couldn’t care less about what people actually think of me. And no, I have long ago dropped the illusion that I ‘pass’. Instead, I just try to be nice, polite and friendly — attributes of my personality that come naturally to me, no matter how I’m dressed — and not to scare away others by ‘shocking’ them in some way.

Overseeing my own admittedly complex case, the issue remains: transition is not for everybody. What alternatives are there if someone suffers from gender dysphoria but cannot transition?

The role of social pressure to ‘conform’ to a transgender narrative; the case against the ‘gender identity core’ theory

I have to start with a disclaimer: these are not my original thoughts. This is a theory forwarded by my wife, or, if you prefer, an unproven conjecture which, however, explains a lot of things and it’s far harder to disprove than you might think.

First, some background about the scientific method. When researchers make an affirmation about what they observe, such affirmations can have several levels of ‘scientific truth’ (we’ll come to that soon). Figuring exactly where some affirmations fall — even outside science! — is not always crystal-clear, and it’s easy (for an untrained mind) to reach the wrong conclusions.

Usually, based on the observed data, scientists start affirming a conjecture. This is a statement about what their own experience as researchers intuitively tells them how Nature behaves according to rules. At this stage, the conjecture is unproven — it can be a hint, a suspicion, an insight, or perhaps something eventually leading to solid knowledge. But it’s important to understand that a conjecture is unproven, it’s not ‘scientific truth’ yet, but nevertheless it’s much more than just a guess based on observed data — it is an affirmation with a certain degree of confidence that comes from both the researcher’s training and the data being observed.

The next step is formulating a hypothesis. Here, scientists will include a way to prove or disprove their theories, usually through an experiment or a potential mathematical proof (or disproof). In other words: if a certain affirmation can be proven or disproven by subsequent work, then it is a hypothesis. If there is no known way to prove or disprove it, but, in general, the affirmation ‘makes sense’, then it’s merely a hypothesis.

If a hypothesis gets validated over and over again, and in spite of being always possible to devise a counter-experiment to disprove it, then it becomes a theory. Sometimes it can take a long, long time until that happens. For example, Einstein’s theory of relativity was merely a hypothesis because when he formulated it, there was no easy way to set up an experiment to prove or disprove it. But such experiments existed — like measuring how the Sun bends light during a solar eclipse — and soon many different researchers tested several affirmations of the theory and found them to be correct. One of the last ones was the unquestionable proof that gravity waves existed — long predicted by Einstein, but discovered (or ‘proven’) a century after his predictions. In spite of being called ‘a theory’, it is one of the most proven theories in the domain of science. The next most proven one is the evolution of species through natural selection — formulated a century before we even understood that genes carry hereditary information, and subsequently validated not only at biological levels, but at biochemical levels as well.

Sometimes theories that have been proven again and again are called laws, and this is mostly a matter of semantics, and more typical of previous centuries. Newton’s theory of gravitation is encoded into ‘laws’ because they are validated in all possible domains and experiments — within a certain degree of confidence. If we go towards much more precise measurements, then Newton’s laws do not apply any longer, and we have to resort to Einstein’s relativity equations instead. But within a certain domain, Newton’s laws are universal. The same can be said about the Three Laws of Thermodynamics (amusingly known as ‘you cannot win the game’, ‘you cannot get even’ and ‘you cannot leave the game’ — referring to how entropy always grows in a system, and that no matter how you set up an experiment, you will never get 100% efficiency in terms of energy — some will always be lost due to entropy).

But in scientific terms, what best describes the observed universe (universe meaning ‘all that we can observe’, either directly through our senses, or indirectly through tools designed to enhance our senses, such as microscopes and telescopes) is a proven theory. Technically, if a theory is unproven, or proved to be false, it’s not a theory any longer — it simply gets dropped, such as the theory that the postulated medium for the propagation of light was ‘ether’, something which was disproved by the Michelson–Morley experiment (1887). In other words: the ether theory was a hypothesis turned into a theory because it explained a lot of what was going on with light, but, as in all theories, it ought to be possible to design an experiment that invalidated the theory (this is known as a falsifiable hypothesis and is crucial to science. As a counter-example: science cannot incorporate ‘God’ into its theories, because the existence of God cannot be proven or disproven with an experiment — so such a hypothesis cannot be scientific), and that was exactly what Michelson and Morley did. Figuring out a way to disprove a theory, or to show that a theory does not explain all observations, is what gives scientists a reasonable degree of confidence that some theories represent ‘scientific truth’ (which is always in flux — there is no such thing as an absolute scientific truth) while others have to be rejected.

And here we should also explain how some theories are discarded in favour of others. In essence, when comparing two or more theories, they have to comply to the following rule:

The simplest scientific theory that has the most explanatory power is retained, while all alternatives are discarded (sometimes called Occam’s Razor).

What this means is that, given two theories, if one of them has less entities to deal with and is therefore simpler, that theory should be kept, while the other should be discarded; but both also have to be compared in terms of their explanatory power, which means how well they model, represent, or explain all phenomena in the specific area it addresses. A theory that explains the most is the winning one.

This does not mean that a complex theory that explains little is ‘not scientific’. Rather, such theories are sometimes stepping stones towards something else. Einstein, Hawkings, and so many others, for instance, were searching for a Theory of Everything but so far that has not been possible to discover; nevertheless, we have several potential candidates for such a theory, none of which, however, have acquired the ‘proven’ status, since some of their testable claims require setting up experiments with an amount of energy that we still haven’t got on Earth.

Ok, so let’s focus back again on the issue of gender. Now, I’m not an expert in the field, but I can at least tell you about some pointers. When the notion that transgenderity was dropped as a mental disease — since, unlike mental diseases, gender dysphoria is not susceptible to be ‘treated’ by drugs & therapy — researchers had to figure out how exactly ‘gender’ works, and how they could explain that some people have a deep and profound feeling that they have a body that is incongruent with their gender.

This made them formulate a conjecture — which we know today as the gender identity core theory. The idea was that there was a specific area (or areas) of the brain where the gender identity is developed, and such an area would, in most cases, be influenced by the very complex biochemical balance that defines gender development. Sometimes, however, there would be an imbalance in the biochemical soup and the brain would develop a gender identity core that would not be congruent with the rest of the body. As a conjecture, this had a lot of explanatory power — namely, it explained why the ‘gender experience’ wasn’t affected by drugs or therapy: it was embedded or encoded in the brain in a way that cannot be changed (there are several areas in the brain which we actually know that work that way, so it was plausible to believe that the ‘gender identity core’ was another one of those special areas). The proponents of the conjecture were not really worried if this ‘core’ was not visible, or detectable, or if it was just an epiphenomenon of the brain as a whole and not an actual structure per se, and that meant that the gender identity core, at the beginning, was just a plausible conjecture.

Two things changed its status over time. The first was that there were several ‘competing’ conjectures to explain the same phenomenon (transgenderity); one of them is, of course, Blanchard’s autogynephilia. When confronting the two conjectures, the better candidate for a theory was the gender identity core, basically because it was a simpler explanation (Blanchard had to posit at least two measurably different kinds of transexuals, while the gender identity core theory only needs one kind of transexual — that means that it’s a simpler theory) and it had much vaster explanatory power (Blanchard wanted only to explain so-called secondary MtF transexuals, or late on-set MtF transexuals, which he called autogynephilic transexuals, and separate them from so-called primary MtF transexuals or homosexual transexuals as he labeled them; he totally ignored at first the existence of FtM transexuals or transexuals that did not exhibit any symptoms he associated with autogynephilia). In essence, the two theories could exist side-by-side, just applied to different samples of people — a bit like we can describe the orbit of planets using Newton’s laws of gravitation, but if we want to measure how light is bent by gravity, we have to use Einstein’s relativity because it’s far more accurate; but that doesn’t mean we have totally discarded Newton, we just use it according to the domain of astrophysics we’re studying.

However, Blanchard made several flaws in the statistical analysis of his data — he was trying to prove that there are two and only two types of transexual people, but his analysis was incorrect. In fact, his own data disproves his theory, but he was not aware of it due to miscalculations when he started publishing his theories. Lawrence, one of his followers, still sticks to autogynephilia, but admits that there are not only two different and separate kinds of transexuals, but rather a spectrum. Unfortunately for Blanchardians, by questioning the existence of ‘only two kinds’ of transexuals, Lawrence is indirectly refuting some of the base tenets of Blanchard’s own theories, thus disproving it even further.

The point here is to show a bit how science works. Researchers are not always greedy bastards seeking to undermine a competitor’s theory by showing its flaws; while researchers are also human, and compete with each other for fame and glory, they also know they have to stick to certain rules when affirming the superiority of one theory over another. The reason why we still talk about Blanchard and his followers is that they have subsequently refined their theory more and more, to try to encompass more variants of transgenderity. One peculiar explanation for so-called autogynephilic transexuals is the erotic target location error, proposed in 1993 by Blanchard: his idea is that autogynephiliacs, instead of focusing their erotism on partners, focus it on themselves (as females).

Now, why hasn’t Blanchard’s own theory caught on? From an activist/community perspective, it’s obvious: it labels late on-set transexuals as ‘sick perverts’ (even though Blanchard recommends transition for them as well) and only contributes to discriminate them further. But from a scientific perspective, the problem with Blanchard’s theory is that it simply lacks explanatory power — he has focused on just a very specific kind of individuals (male autogynephilic transgender people) and has no explanation for all the diversity among transgender people — while the gender identity core theory encompasses them all. But Blanchard’s theory also fails the Occam Razor’s test — it posits two different kinds of transexuals (even though his own published data actually disproves that hypothesis), while the gender identity core theory claims that there is just one type of transexuality — it just comes within a very broad spectrum, but it’s not different in kind, just in degree.

In other words: because Blanchard’s theory is more complex and has lesss explanatory power, it ought to be rejected in favour of a better explanation. And here the gender identity core theory is the prime candidate!

But it’s not the only one!…

I’m going to ignore for a moment the many alternative theories and just present my wife’s pretty puzzling one. She, like Blanchard, divides the trans population in two kinds: transexual and transgender.

Transexual is easy to explain: these are people who have a very strong gender identity which is opposite to the one assigned at birth (note that my wife’s theory doesn’t really account for ‘other’ genders; she believes that gender is mostly binary, and the exceptions have an explanation – we’ll see that in a bit). Those cases are so clear-cut that they require no profound diagnosis: such people will even physically look to the gender they identify with (which is easier in this generation where both males and females are skinny and underdeveloped because they spend way too much time indoors in front of a TV or a tablet…) or at least androgynous; they will exhibit all sorts of behavioural traits typical of the gender they identify with; and in general they will be strongly attracted to the opposite gender they identify with.

These are the people that my wife does not hesitate to refer to transition; and she has no qualms in getting them to do the transition as early as possible.

Everybody else in the trans spectrum is ‘transgender’ but with a slight twist. You see, instead of devising a ‘gender identity core’ area of the brain — an area, mind you, that we cannot locate with the current technological means we have (and my wife is aware of that limitation!), although we might have some hints on some brain sections that contribute towards identity in general — my wife simply suggests a process of social positive feedback. Not unlike a cult — or the identification that happens with a sports club (or a city, or a country…) if you prefer something more ‘softer’.

Here is my wife’s proposal for the transgender narrative. It starts with someone who is a crossdreamer — with or without external manifestation. Such a person gets a nagging feeling that something is ‘wrong’ with them, and notices that other people do not have the same ‘dreams’ as they have. This kind of feeling is more likely to occur close to the beginning of puberty, during or immediately after intense traumatic events (note that they don’t even have to be sexually related; it could be the death of a parent, getting fired and realising that now you’re bankrupt, or figuring out you’ve got a terminal disease), or closer to the so-called ‘mid-life crisis’ (a non-medical term to describe certain types of depressive behaviour associated with the realisation of one’s aging, which in women might coincide with menopause, while in men it often comes with the end of the peak sexual behaviour in one’s life). Certainly other major stressful and traumatic events might trigger these ‘strange’ dreams.

At the beginning, a sense of shame settles in — because crossdreaming is unusual and hardly mentioned in the mainstream media. The person tries to avoid to think about what’s going on, and often engages in denial and/or escapist activity (usually, work!) to suppress and repress such feelings and dreams. This will not only not work but eventually ‘burst’ — the crossdreamer will feel almost compelled to manifest somehow their strange dreams, and one possible outcome is crossdressing.

This has one consequence: it triggers an adrenaline rush — a very intense one — which is experienced as extremely pleasant. In some cases, it might be erotic/sexual in nature — i.e. on top of the adrenaline rush comes an orgasm — but in many cases it’s merely what we called ‘exciting’ outside a sexual context. But there might be an erotic undertone as well as the thrill from ‘doing something forbidden’ (this is how it is imagined and perceived, according to one’s social conditioning). Because Western society ‘condemns’ sex in so many stupid ways, it might be often impossible to figure out the difference between an ‘erotic thrill’ and a ‘doing-something-forbidden thrill’ since so often doing erotic things is seen as ‘forbidden’ by society as well (and most certainly in the case of crossdressing!).

There is now a moment of extreme shame and doubt about one’s mental sanity. This experience of the manifestation of crossdreaming multiplies by thousands the mere ‘dreaming’ phase. As said, crossdreaming can involve merely doing consistent gender-bending at games and social networks, just to give a very common kind of manifestation of crossdreaming, and which triggers the same kind of adrenaline rush as in persons who actually crossdress — in other words, this is not dependent on the actual manifestation itself, but rather as a consequence of having manifested the crossdreaming in something ‘physical’ (as opposed to ‘merely thinking about it’); although there are certainly cases where such a manifestation might even be totally mental, in the sense that the person focuses for a long while in their dreams, shutting themselves out from the rest of their activities, and experiences the full adrenaline rush just by imagining a crossdreaming experience with extreme clarity. I’m not going to dwell in this point much, because it will be experienced quite differently from person to person, although what is common to all of them is the degree of intensity. In other words: while crossdreaming might always be close to the surface of conscient thought, it might be easily brushed away through an effort of engaging in denial/escapist strategies; the crossdreamer is conscious that their dreams are ‘unusual’ and feels uncomfortable and shameful about them, but that’s all that happens; while when this crossdreaming experience is suddenly manifested (and many crossdreamers describe that it is something overwhelming in the sense that it seems to happen against their volition — there is no free will involved in that first experience — it’s just something that has to happen no matter what), this causes a minor traumatic event where the person questions their mental sanity and their identity.

Now, in the ancient, pre-Internet days, what would eventually happen is that such a person would by chance come across some transgender person — very likely not in the streets, but possibly by a picture in a magazine of someone crossdressing, or the announcement of a drag queen show, or something in the news. This will suddenly trigger a new thought in that crossdreamer: there are more people than me out there.

The realisation ‘I’m not alone’ is usually a moment of relief (the crossdreamer, after all, is not mentally insane — or at least they are as insane as any other crossdreamer, which means there is a bond between them) accompanied by some curiosity (sometimes, a lot of curiosity). The mere realisation that there are other crossdreaming people can, by itself, trigger a form of excitement (and, yes, it can be of the erotic kind) but also one of loathing (depending mostly on one’s education and social conditioning): because ‘transgender people’ are hardly portrayed in the best light (fortunately things have changed a lot in the past decade or so — and this makes a difference, which I’ll shortly address later), the notion that ‘I’m one of them‘ might not be totally a positive experience. It can be one of fear, of rejection (‘I do not want to be one of them!’), and therefore how this affects the crossdreamer has much more to do with the social conditioning they have received than with the experience itself. Notice, though, that the mere notion that there are more crossdreamers these days implies a change in the crossdreamer’s conceptual self-perception: instead of the fear of being unique, the only one with this ‘problem’, the crossdreamer contextualises their feelings within a group of people who (at least outwardly) seem to ‘be like them’.

The way the mainstream media so often portrays anything related to crossdressing as ‘sexual perversion’ does not help, either — one’s social conditioning might be threatened by the realisation that one is a ‘sexual pervert’ and that has consequences on one’s mental health. Again, following the realisation of being part of a ‘group of people’, the feeling might be one of intense relief (mixed with curiosity in knowing more about the ‘other crossdreamers’) or one of profound loathing and rejection (i.e. refusing to be ‘part of the group’ or even remotely associated with ‘one of those persons’…) which has consequences on one’s behaviour.

Eventually, however, there will be some positive feedback from the realisation of belonging to a group. I haven’t listed all possible cases of what happens, but the two most common — and this is based only on parochial evidence, i.e. my own crossdreaming friends — are the satisfaction of acquiring more knowledge about the subject, either to understand that crossdreaming is ‘not unnatural’ (and thus increasing the sensation of relief and curiosity), or to learn that others have coped with the ‘negativity’ and the association with ‘sexual perversion’, and this increases a certain degree of confidence in the ability to cope with crossdreaming (‘if others managed it, then I’ll manage it, too!’). In other words: crossdreaming is either pictured as something wonderful to possess, or something terrible that society condemns but that we can deal with and evade the social stigma — namely, by ‘entering the closet’ (manifesting crossdreaming in absolute secrecy) while still optionally keeping in touch with others who have done the same. Naturally enough, in these days of the ubiquitous Internet, it’s way easier to keep in touch with crossdreamers across the world.

How the situation progresses naturally depends on the individual, and all I can point to is the work of sociologists such as Richard Ekins (who I’ve thoroughly reviewed seven years ago), who points out several possible ‘paths’ for crossdreamers to follow (the book deals with MtF crossdreamers only, a shortcoming Ekins admits on his later writings). My wife, however, generally speaking, limits those possibilities to one major event (which can encompass several different expressions and/or manifestations) — the realisation of ‘belonging to a group’ motivates getting in touch with that group, either directly and in person, or indirectly, reading about them — and possibly a mixture of both. Depending on the degree of either social affinity (an extroverted way of getting in touch with others) or academic-like curiosity (the desire to read everything about the subject and see how it relates to oneself), this will create an image of how society deals with crossdreaming from the perspective of the crossdreamers themselves.

And now this is where the feedback loop starts to settle in. The crossdreamer meets (or reads about) others like themselves; who, in turn, will encourage them to express or manifest themselves more freely — claiming, very correctly, that ‘there is nothing wrong’ in that — and to explore further their own feelings. Depending on the group, of course, this may push the crossdreamer more towards crossdressing fetishism or its opposite, i.e. late-onset transexuality with little erotic undertones (there will always be some erotism; we humans are erotic animals, after all, and sex is natural for us, in spite of what society says or perceives). In my wife’s theory, it’s really not relevant which group will support and encourage the crossdreamer to do more crossdreaming because all of them will tell them the same — it’s only the motivation or the explanation that will be different. And, in fact, as Ekins and others have remarked, it’s not unusual for the crossdreamer to jump from group to group, rejecting some and accepting others, but always getting positive feedback from them. Eventually, they might settle on a particular group — or label, in the case of those who do not physically meet their counterparts but just read about them — and consider them ‘right’, when comparing what they feel and think about themselves.

My wife posits that all groups in the trans* spectrum behave in the same way, i.e. actively promoting positive feedback on one’s ‘transgenderity’ or ‘crossdreaming’, providing relief against any ‘negative’ ideas about the subject (or even dispelling the fear of any negative consequences) and encouraging to explore one’s ‘identity’ and manifest it more fully and deeply. There are obvious differences between the many groups: many will promote things like ‘the perfect crossdreamer’ or ‘the true crossdresser’ and list a series of attributes that a member of such a group should possess, or else, be excluded from them; this makes the crossdreamer gravitate towards the group which shares the most similarities with them and which therefore reinforces their sense of identity. Groups split and get back together, discussing irrelevant ideas or opinions on certain aspects which are often not even related to transgenderity at all. For instance, at least until recently (I didn’t check, so I’m not naming the group), a large transgender organisation in the UK would expell members if they mentioned ‘sex’ in any of their (many) public events – they had always kept apart from so-called fetishist crossdressers and to gain acceptance from society, they bound their members to an oath of celibacy – at least within the group. Such denial of one’s sexuality might be seen as extreme, but one has to consider that at the very top of the list, clinical sexologists will use ‘erotic pleasure’ as a tell-tale sign that someone is a fetishist and not someone with a gender identity issue, so if a group wishes to be taken seriously, they enforce strict rules (if you ever feel an orgasm while dressed as a woman, you’re a pervert; note that natal women are allowed to get erotically excited while they’re ‘dressing up’ and that is considered perfectly normal…).

But I digress. The point here that I try to make is that, sooner or later, either online or on the physical world, crossdreamers will get in touch with others with similar ideas and concepts about the subject, and tend to gravitate towards those groups which accept them more easily, and, most important, give them positive encouragement; sometimes this comes only after accepting fully the ‘rules of the group’ and incorporating them into one’s own attitude, behaviour, and (very often) outside appearance. The variety of such groups and communities is not different from, say, sports clubs – each cater to the tastes of different individuals, each sets some rules (like what colours to wear when watching the club playing), and radical fanatism to a club is encouraged, often through positive feedback given to those who truly wear the colours. We can argue if the underlying mechanism is very different or if it’s just a coincidence, but at least you will agree with my wife that looking at the issue as an external observer, this seems to be a similar mechanism.

Now, of course my wife has read a lot about the subject, and not necessarily agreed with most of what she read; also, like me, she’s not a sociology expert in trans* issues. Instead, she followed trends in academic or activist publications about the subject, as well as my own ‘progression’ (if I can call it that way) and those of some of my close trans friends. My wife is naturally aware that one does not become a ‘transexual’ but it’s something one has been born into; no amount of ‘social conditioning’ can ‘turn someone into a transexual’, so to speak — such a thing is impossible, and my wife acknowledges it. However, she thinks that there are ways to present an otherwise crossdreaming person that transition is something desirable for them, or, at least, living in the gender they identify with for as long as possible — with the exclusion of all the rest (i.e. ignoring what ‘society’ has to say about the subject — and that means also ignoring what friends, family, and colleagues think about the subject).

You can see why I have described this behaviour as similar to cult behaviour. When examined by someone like my wife, who is not in the transgender spectrum, this is what she sees: someone (a crossdreamer!) questions their own feelings about crossdreaming. They come in contact with a group of similar-minded individuals. These will now strongly encourage them to manifest and express such feelings fully, even by crossdressing and going out in public, to start taking hormones and doing a full transition. They will also strongly contest everybody else who disagrees with such a worldview. In other words: the community closes within itself — a ‘defense’ against the intolerant ‘outside world’ — and gives crossdreamers a ‘safe space’ where to freely manifest themselves, in the middle of not merely an ‘accepting’ or ‘tolerant’ community, but one that actively encourages their members to go further and follow ‘all the rules’ which can include a full transition.

The diversity of the transgender community is seen by my wife as merely a vast variety of expression, which is also tied to a concept of ‘building identity’ – by acquiring a label which includes a set of attributes, a specific group becomes ‘autonomous’ in the sense that it establishes an identity different from other possible identities, in a tribal sense. Now all this is anthropologically and even evolutionarily explained; it has little to do with whatever ‘gender identity’ one really and truly has, but rather an attempt to self-justify a set of attributes, behaviours, etc. – which is not unlike so many other such ‘tribal gatherings’, from sports clubs to religious cults to ideologic political parties and so forth.

Let’s take an analogy. Consider the ‘homosexual community’. Broadly speaking, one could oversimplify the subject (and thus get it totally wrong!) by simply saying that someone is homosexual if they feel sexually attracted to someone of the same gender. But there is so much more to it; in particular, a considerable amount of homosexuals are proud of their sexual preferences and quite willing to externally manifest themselves as a member of a group which is connected to homosexuality. But here we see a similar mechanism in effect. A considerable amount of homosexual people are externally undistinguishable from the mainstream, cisgender, heterosexual community. Some homosexual men prefer to exhibit an effeminate image of masculinity; they form the core of the original ‘gay culture’; but by no means are the only alternative. From drag queens to ultra-masculine ‘bears’, homosexual males gather together in all kinds of groups with their own very specific identity, rules of behaviour, and even external appearance. And of course the same happens among the female homosexuals; from ‘butches’ to ‘lipstick lesbians’, the diverse community adopts all sorts and kinds of appearance and types of behaviour – many of which absolutely unrelated to the actual sexuality itself, but merely as an act of identification with a specific subgroup of the LGBTQI+ community.

I’m aware that this is a gross oversimplification, and one that might be used as an argument by right-wing conservatives to disregard the actual ‘existence’ of the LGBTQI+ community. This is dangerous, because it totally fails to understand what is cause and what is consequence. One does not become an ‘effeminate gay’ by choice and then start engaging in homosexual intercourse; instead, one has been born homosexual, and, among the vast variety of homosexual groups (or ‘tribes’ if you wish), one identifies with a specific one, adopts their rules, their behaviour, their external manifestation… their identity.

It is also wrong to say that these rules, behaviour, appearance, etc. are merely ‘external’ manifestations and as such unworthy of being taken seriously! These go much more deeper to be casually brushed away as if they could simply disappear by sheer willpower. Also, of course, we citizens of Western democracies are entitled to the right of presenting ourselves as we wish while pursuing the expression of our individuality. And, again, we must never forget that such rules, behaviours, and so forth are not just an external cloak over our bodies, but rather a deep expression of our identity. And here is where the analogy with identification with sports clubs, religions, or ideologies breaks apart.

While a sociologist may argue that the trappings of tribal behaviour become our identity by identification with them, LGBTQI+ issues work the other way round: they begin with the identity, and its manifestation is a consequence (not a cause!!) of that identity. In other words: you’re not born as a fan of Manchester United; you just find out about that soccer club at some point during your existence on this planet, and, once found, you wish to belong to the fandom of that soccer club, to the point that it becomes part of your identity. Naturally enough, several conditions may trigger that ‘wish-to-belong’ — education for one thing (if your parents are avid fans of Manchester United, it’s likely you will be, too), and physical location or nearness to the source of the tribal behaviour (while MU fans exist all around the world, it’s far more likely to become one if you live in the UK, especially if you live near Manchester).

But with LGBTQI+ issues, the causation effect is exactly the opposite one. You are born LGBTQI+. You may just find out about yourself at a later stage (or maybe even never, in extreme circumstances), and deal with that ‘discovery’ in many different ways (utter rejection and suppression being, of course, one of them), but the gender identity core theory considers that there is no way to ‘un-become’ LGBTQI+ — you can just pretend you’re not LGBTQI+.

Here is where my wife’s theory contradicts the accepted explanation. She says that the notion that some people have been born transgender (she does not emphasize the issue about sexual orientation) is acceptable for her for an incredibly small number of people — those who are ‘true transexuals’. Everybody else has just incorporated transgenderity in their identity, but it wasn’t something that they have been ‘born’ with.

She even accepts notions such as ‘the urge to crossdress’ (just to take an example). We humans have all sorts of uncontrollable urges, she says; some of which we clearly know that come from a genetic propensity (others we suspect about it, but still haven’t found a definitive explanation). A few typical examples: while IQ properly speaking is not hereditary, the potential to develop a higher-than-average intelligence seems to be genetic, so long as it is properly conditioned and a suitable environment is found for that specific person to thrive in it and thus realise their potential. We have also figured out that different brain wiring leads to people being politically more progressive or more conservative. Similarly, it’s now known that the propensity to take unnecessary risks or even to become addicted to a particular substance is somehow encoded into our DNA; that’s why some people can become social smokers (and give it up any time) while others cannot (once they get ‘addicted’ to tobacco consumption, they are ‘hooked’ for life).

Her argument, therefore, is that there is also a propensity (genetically encoded somehow) for ‘crossdressing’ or at least to engage in gender non-conforming behaviour. In other words: some people are ‘wired’ for sticking to the gender binary (or else, bye-bye reproduction and the survival of the species), while others are not. These ‘others’ may never realise that they are gender non-conforming — all depends on appropriate conditions, triggers, education, opportunity, and so forth. In several societies and environments, they may never ‘come out’ — and they will probably have weird dreams and fantasies, try their best to cope with it, suppress and repress their feelings, possibly develop all kinds of mental issues such as depression and anxiety — but even if they get treatment for those, they will never tell their doctors anything about their ‘weird dreams’, because, well, these are just plain weird and clearly not to be taking seriously.

So what happens when some of these ‘differently wired’ people get in touch with a trigger? This is where my wife’s theory comes in. Experiencing that there are other people ‘wired’ the same way, and most importantly, that they are out there having fun, will ring all sorts of alarm bells in their heads. And, as said, in the past, this could be a picture of a transgender person on a magazine or a transvestite on TV or on a movie. All of the sudden comes this realisation: ‘oh, that’s what my dreams mean!’

And the next step is trying to get in touch with this community. Of course such a process is hardly easy and only rarely done ‘immediately’ – it may be years until they get in touch with them. It has become so much easier these days, thanks to websites and social media. At the same time, there are a gazillion articles about the subject that can be read online: people can prepare for their ‘first encounter’ with the community, even if it is just online.

There is also a lot to learn. As any transgender person ‘newbie’ has experienced, the community has a lot of rules. There is the whole complicated nonsense about pronouns. There is the concept of a nickname, or pen name, or in the case of MtF transgender people, the femme name. There are conventions and even grammar to learn: transgender people are not trangender ed , for instance, and they are globally referred as ‘they’, not as ‘he’ or ‘she’. Grammar rules are bent; and even ortography changes (that’s the case in my own mother language, Portuguese, because Portuguese has far more gendered words than English).

As you can see, entering this ‘transgender community’ is not much different from joining, say, the freemasonry or a secret cult with its strange conventions and rules. There are norms of ‘acceptable behaviour’ once you’re ‘one of us’. Transgender people are expected to behave in a certain way; they’re even expected to subscribe to left-wing identity politics (and preferably be atheist, too). The list goes on and on… and it certainly has little to do with what ‘being transgender’ actually means.

Instead, there is tribal bonding. In order to be accepted as ‘one of us’, there is a lot to be absorbed and incorporated into one’s behaviour. Once you show that you’re a well-behaved member of the community, you earn respect from your peers, and are unconditionally loved, or at least protected, by all of them.

This has a lot of consequences – which, again, have little to do with ‘transgenderity’. However, it certainly has to do with identity. To be ‘part of the community’, it means to be proud of being different from the mainstream, cishet society. And that pride is manifested in many ways: in behaviour, attitudes, the places you go and those you avoid, the friends you make and the people you scorn and reject, and even in the way you dress and present yourself. All that in return for ‘acceptance’.

Tribal acceptance is rewarding in itself – quite a lot, actually. Suddenly you’re surrounded by people who think like you and who supports you and who you are fully and inconditionally. Or, well, almost: you’re accepted if you comply with the rules. But because such rules actually conveys identity, most transgender people will submissively subject themselves to those rules, rarely (if ever!) questioning them. In fact, the more time transgender people are in constant touch with ‘their’ community, the more and more all those rules make sense, and the less they’re questioned. This is a behaviour, again, not unlike what happens in sports clubs – or fanatical religious cults.

Now, I’m not saying that the ‘transgender community’ is some kind of cult! Not even my wife goes that far. Instead, I’m just drawing parallels in behaviour and attitude with tribal behaviour. What happens among the transgender community is similar to what happens with all tribal grouping – and that includes geeks working for Microsoft or Google, as well as rocket scientists, or the military. All these groups have their rules for belonging to them. All of them expect from their members some sort of ‘group loyalty’ which is expressed by sticking to the rules, adopting certain behaviours (or abandoning others), sometimes even clothing (the military wears uniforms!). We can go as far as claiming that this is true for all human groupings and that it’s a hallmark of our species; indeed, homo sapiens started as a gregarious species grouping together along clans or tribes, each of which had distinct ‘rules’, behaviour, even language, to distinguish themselves from the ‘others’. This kind of behaviour is hard-coded in our genes; we might just have access to more sophisticated technology these days, but we still form our tribes, clans, gangs, crews… groups of fellow humans who share something with us and who have a common ‘identity’.

I’m loosely using the word ‘identity’ here, because I’m not a sociologist, and I’m pretty sure they’ve got a very precise definition about ‘group identity’. But even using it in its more loose and informal version, there is something that we can note about ‘group identity’: members share something in common which is somehow unique and distinctive (making them different — even visually! — from ‘other’ groups); there is an ‘admission’ system — call it a ‘rite of passage’ if you wish — which requires displaying some skills, abilities, or at the very least the willingness to conform to the rules and standards of the group. And then the bonding begins — all members influence each other, they develop their own common groupthink, and this, in turn, is what gives the group as a whole its ‘identity’. But there is identity working at the individual level as well: struggling to become a ‘full’ member, be totally and unconditionally accepted, requires working hard at shaping our thoughts to be the same as the thoughts of the group; and this, in turn, will shape how we think — in other words, we become part of the group when we think in the same way as the rest of the members; and at that moment, our own identity is re-forged as being part of the group.

We can see this working very well at all levels of grouping and bonding, and it’s even something that happens at kindergarten. As time passes, our groups just become more complex and sophisticated — ultimately, if you will, this will lead to something we could call ‘patriotism’ on a good day and ‘nationalism’ in a bad mood: the full and total identification as a member of a vast group of people sharing the same country or nation, and which has aan infinitely complex cultural legacy, which we absorb totally and make it our own. We say, ‘I’m American’, and we that we equate our ‘being’ (I am) with the relationship we have with all the millions of human beings happening to live in the same geographic area between arbitrarily set borders. Our identity is ‘American’, in the sense that we have absorbed all that cultural legacy and make it a part of our identity. Of course, we can be both American, and, say, Portuguese; or American and a fan of Manchester United; or Portuguese and a fan of bullfighting, a member of Google, and so forth. We are complex creatures, and what defines us — what makes our identity! — is an amalgamation of tribes, clans, groups, at many different levels, often intertwined (can you be Brazilian and hate samba and soccer? Well… yes, but you will be seen as a lesser Brazilian by your fellow citizens), and, most importantly, rarely clean-cut and black-or-white. Ask 28 different people from each of the countries of the European Union what it means to be ‘European’ and you will get 28 different answers: our world is so complex that there is a vast room for dealing with different ways of identification with a specific grouping.

We draw identity from the group(s) we belong to.

I’m well aware of the difference of ‘being transgender’ versus ‘be a fan of a sports club’: to recap, in the first case, there is no choice – one is transgender (or, as my wife would put it, one has the potential of manifesting themselves as gender non-conforming) due to biological factors, while one becomes a fan of a club by choosing to become one. While both classifications confer identity – and that is undeniable! – this fundamental difference is certainly acknowledged by my wife’s theory. Exactly because it is not a matter of choice, my wife also supports laws to protect the rights of transgender people (which go far beyond the right to dress weirdly and yell the anthemn of your sports club in the middle of the street…). What she does not acknowledge is the notion that the propensity or the potential for being gender non-conforming automatically means that one has to follow one’s biological constrains. In other words: if you have been assigned male as birth, but identify as female, that does not automatically mean that you have to do something about it – the actual decision to go through transition, according to my wife, is a question of personal choice. One can choose to ignore one’s biological urges, and lead a perfectly normal life presenting as a gender with which one does not identify with and even be happy – so goes her theory.

In fact, one might even argue that one major trait of the human species is the agility to ignore their ‘animal urges’ – although I’m personally not very happy about such an argument; after all, our cats also learn how to suppress some of their ‘animal urges’ and behave according to a set of rules established by their human companions; surely even in the animal kingdom such things are not that ‘black & white’ either – and our cats are perfectly aware of a lot of ‘instincts’ they have to overcome in exchange for living with us humans. If cats, not being the most obedient pets domesticated by humans, can learn how to override their basic instincts; if dogs, a much more obediente and trainable species can go way further on doing that; than clearly we as humans should be able to overcome all our animal instincts. And this is certainly true for a lot of small things, such as being able to decide to starve to death or just urinate on designated places – and all sort of artificial rules which condition us against our own basic, animal instincts, in exchange for living in what we call ‘civilisation’.

How far this ‘overriding’ can go is obviously a matter of discussion. But unfortunately we have reports of the most horrifying cases where people were forced to override all their instincts of self-preservation in order to do the most abominable things ever. There is an example that we all know about: the military. Their training includes an objectification of the enemy, so that it becomes ‘less than a person’ and therefore can be killed. Such brainwashing is so well accomplished (or we wouldn’t manage to train professional armies) that it leads to the old saying that anyone can be made to kill a fellow human being, given the right circumstances. In reality (and thankfully so!) most of us are conditioned to empathise (at least to a degree) with fellow human beings so that killing them is abhorrent to all cultures. But we can override that empathy.

This also applies for small stupid things. Smokers, for instance, learn to override the gag reflex which sets in when we inhale smoke. That’s a natural instinct, hard-wired in our genes, because smoke means fire and fire means death, so the gag reflex is something we need to have in order to survive forest fires (namely by coughing in an attempt to keep the lungs clean