#trans brain

By: Colin Wright, Samuel Stagg, Christina Buttons

Published: Mar 14, 2025

Earlier this week, City Journal published the tragic story of Yarden Silveira, a young detransitioner—someone who pursues hormonal and/or surgical “sex change” procedures but then seeks to reverse course—whose life ended abruptly after suffering severe complications from a gender-related genital surgery. What led Yarden to adopt a transgender identity in the first place? In 2014, after encountering the growing wave of pro-trans narratives in popular culture, Yarden told his family that he believed he had a “female brain.” Though initially uncertain, his mother was ultimately convinced by scientific papers that suggested that her son could have a female brain trapped in a male body, and that this mismatch caused him unimaginable distress.

“A trans woman (such as myself) was born with a male body, but she has always had her female brain. Literally born with a female brain,” Yarden wrote in 2016.

This belief was widespread back then—and it still is. On January 31, Wisconsin Public Radio featured an interview with a mother, Carri, concerned about President Trump’s new executive order banning federally funded medical and surgical “sex change” procedures for minors. Carri spoke about her daughter, who identified as transgender at 15 and was allowed to medically transition. She said, “Those hormones really helped match his brain with his body which, to me, that’s just the basic level of care we can provide individuals that identify as trans.”

The power of this narrative in persuading people to pursue, or to allow their children to pursue, irreversible medical procedures cannot be overstated. But the notion that males can have “female brains,” and vice versa, rests on a flawed interpretation of “brain sex” studies that in no way demonstrate or even suggest a definitive biological basis for “gender identity.” Little effort has been made to correct this misleading assertion.

The theory is advanced for relatively straightforward reasons. Civil rights lawyers, activists, and researchers contend that people who identify as transgender possess a “brain sex” misaligned with their physical body, thereby establishing a biological basis for “gender identity” akin to immutable traits like race. This framing carries significant legal weight, as U.S. civil rights law offers strong protections for characteristics considered “innate” or rooted in biology.

In courtrooms, prominent gender clinicians routinely invoke “brain sex” literature to bolster the perceived immutability and innateness of “gender identity.” For example, Daniel Shumer, a pediatric endocrinologist and clinical director of the Child and Adolescent Gender Clinic at Mott Children’s Hospital at Michigan Medicine, provided expert testimony in a case challenging Texas’s prohibition of “gender-affirming care” for minors. He linked “gender identity” to “brain structures,” arguing:

Scientific research and medical literature across disciplines demonstrates that gender identity, like other components of sex, has a strong biological foundation. For example, there are numerous studies detailing the similarities in the brain structures of transgender and non-transgender people with the same gender identity.

Such statements have become standard in legal battles over “gender-affirming care” and other trans-related policies. In Talbott v. Trump, a legal challenge to the president’s executive order barring transgender individuals from military service, Nicolas Talbott—a transgender-identifying female and activist—joined six active-duty service members and two prospective enlistees in arguing that “[s]trong research supports the conclusion that gender identity has a biological basis” and that “transgender women and non-transgender women have similar brain structures, specifically in the volume of the bed nucleus of the stria terminalis.”

Outside the courtroom, the idea of a brain-body mismatch has permeated popular culture, resonating with the “born this way” narrative embraced by many in the LGBT community. Mainstream television and other media have reinforced the concept. For instance, in a 2009 episode of Law & Order: Special Victims Unit, psychiatrist George Huang, played by B.D. Wong, explained that a trans-identified boy had a “female brain”: “For some children, something happens in utero where the brain develops as one gender and the body the other.” Children’s books have reinforced this idea, with the trans-identified protagonist in I Am Jazz declaring, “I have a girl brain but a boy body. This is called transgender. I was born this way!”

There is reason to believe the “brain sex” narrative has influenced many young people’s decisions to pursue medical transition. In a forthcoming survey conducted by coauthor Buttons, 49.2 percent of detransitioner respondents recalled health-care providers framing the respondents’ transgender identity as a brain condition, using phrases like “male brain in a female body,” or vice versa. In total, 85.7 percent of those surveyed said that their providers characterized transgender identity as an inherent, biological trait that required medical intervention.

To bolster these claims, providers often cite a growing body of scientific literature that purportedly validates the brain-body mismatch hypothesis. These studies claim that the neuroanatomy of people identifying as transgender more closely resembles the brain structures typical of the sex with which they identify, relative to non-transgender-identifying controls. Media amplified these findings, often presenting them as definitive proof that trans-identifying people “are who they say they are.” Headlines such as “Science Proves Transgender People Aren’t Making It Up” and “Transgender people are born that way, a new study has found” further entrench the narrative.

Proponents of these studies, however, rarely possess the expertise and background knowledge needed to examine their methods and conclusions critically. And the culturally charged atmosphere surrounding transgender issues means that facts often take a backseat to politically—and legally—expedient narratives.

The central flaw in current research purporting to validate the cross-sex brain hypothesis is an inconsistent—or complete lack of—control for individuals’ sexual orientation. Why does this matter? Because most people who identify as transgender are not exclusively heterosexual, and same-sex attraction has been linked to neuroanatomical differences that reflect a cross-sex shift—or, more broadly, to a reduction in typical sexual dimorphism (i.e., to having more androgynous brain structures). This raises serious methodological concerns about the extent to which sexual orientation might confound or interact with the neurobiological markers that “brain sex” studies routinely attribute to gender dysphoria. It also raises major ethical concerns about the use of “gender-affirming care” as a form of gay conversion therapy or as a maladaptive coping strategy for gay men.

If one properly controls for sexual orientation, the reported neuroanatomical shifts in transgender brain-scan studies diminish greatly or vanish entirely. To illustrate that point, consider three influential studies examining regional gray matter differences between transgender-identifying individuals and controls. These examples, considered together, illustrate a pervasive problem in the “brain sex” literature.

The first study, by Lajos Simon et al. and titled “Regional Grey Matter Structure Differences between Transsexuals and Healthy Controls—A Voxel Based Morphometry Study,” reported that trans-identifying individuals exhibit brain structures more closely resembling those of the opposite sex, relative to controls. This study is frequently cited as evidence supporting the brain-sex hypothesis. However, a different study by Eileen Luders et al. titled “Regional gray matter variation in male-to-female transsexualism,” which used similar neuroimaging techniques, found no significant differences overall in gray-matter volume between male-to-female (MtF) trans-identifying individuals and male controls. In one small brain region, the putamen, the MtFs did exhibit a cross-sex shift, relative to their dataset—i.e., putamen volumes in MtFs were larger and more similar to female controls—but this result is anomalous and incongruent with the findings of large-scale studies and meta-analyses demonstrating that males, not females, have larger putamen gray-matter volumes, on average.

A third study, by Ivanka Savic and Stefan Arver titled “Sex Dimorphism of the Brain in Male-to-Female Transsexuals,” comprehensively analyzed structural brain differences using MRI. While the authors observed some structural differences in the brains of trans-identifying men compared with those of non-trans-identifying male controls, these differences did not align neatly with a feminization pattern. Instead, the variations were distinct from typical male or female brain structures, suggesting a unique neuroanatomical profile rather than a simple cross-sex shift. Importantly, Savic and Arver controlled for participants’ sexual orientation and found that, when they did so, the brain differences attributed to gender dysphoria were much less pronounced.

A clear pattern emerges when comparing these and similar studies: the magnitude of the cross-sex shift reported in trans-identified individuals’ brains correlates with the proportion of homosexuals in the sample. For example, in Simon et al.’s study, all transgender participants were homosexual, potentially amplifying participants’ sex-atypical neuroanatomical features. In contrast, Luders et al.’s cohort had a much lower proportion of homosexual participants, coinciding with null findings overall regarding brain feminization. Savic and Arver’s rigorous control for sexual orientation further demonstrates that some neuroanatomical differences previously attributed to gender dysphoria likely reflect—or are confounded by—sexual orientation-related brain variations.

Popular “transgender brain” studies, in short, often fail to control for sexuality, undermining the claim that people with transgender identities have brains that more closely resemble those of the opposite sex.

What would it mean if the “transgender brain” hypothesis were true, and properly controlled studies did document a statistically significant cross-sex shift in the brains of people who identify as transgender? It would not logically follow that a brain scan can capture a person’s “gender identity”—just as brain scans cannot ascertain a person’s sexuality. Differences in group averages do not mean that every individual within a group shares those characteristics. Populations contain variance; for instance, some straight men exhibit brain structures that skew feminine, while some gay men exhibit brain structures that skew masculine. Brain scans therefore cannot verify whether a person is homosexual; nor could they verify whether a person “is transgender.” Brains, like most physical traits apart from primary sex organs, are not discretely sexed; they simply exhibit average differences between the sexes.

Even if there were compelling evidence for “brain sex,” gender clinicians, though often expressing strong confidence in the hypothesis, would be the last to advocate for the use of objective brain scans to validate their claims. Their hesitancy has roots in the history of sexuality research. When scientists proposed the existence of a “gay brain,” many gay rights advocates strongly objected, citing its potential for eugenic abuse (imagine, for example, a drug company developing a fetal “treatment” to “cure” homosexuality based on such findings). Despite progressives’ deep pessimism about science’s potential for abuse, however, many activists still peddle the “brain sex” narrative.

Notably, even though homosexuality is associated with a cross-sex shift in certain brain structures, activists avoid claiming that gays and lesbians exhibit a brain-body mismatch. This avoidance highlights a striking inconsistency in the application of the “brain sex” narrative. For decades, research has shown that homosexuals exhibit subtle neuroanatomical differences that trend toward patterns typical of the opposite sex. Yet, proponents of LGBT rights have rejected the notion that these differences imply a pathological misalignment requiring medical correction.

The persistence of the “brain sex” narrative has real and sometimes tragic consequences. For individuals like Yarden Silveira, it contributed to life-altering—and ultimately life-ending—medical decisions based on a flawed understanding of the science. The notion that transgender identity is rooted in immutable brain structure has led countless young people to undergo unnecessary and often harmful medical treatments, frequently without fully informed consent or consideration of alternative approaches. Challenging that notion isn’t just an academic exercise—it’s a necessary step toward protecting vulnerable individuals from medical abuse.

Policymakers should mandate rigorous, independent reviews of the scientific claims surrounding transgender identity’s supposedly biological basis. This review should include scrutinizing studies that promote the “transgender brain” hypothesis, and incorporate evidence from desistance and detransition research, which highlight how transgender identities are often transient.

Public-health policies must be grounded in comprehensive and unbiased research. Otherwise, vulnerable young people will continue to face irrevocable and potentially devastating treatments.

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It's funny how there are supposedly no differences between males and females when it comes to sports, and yet there are supposedly MRI-detectable "male brains" and "female brains."

🤔

This ideology is completely incoherent.

Happy Trans Day of Visibility!

Here have my gender HCs of these mice

By: Christina Buttons

Published: Nov 14, 2025

Gender-affirming pediatricians don’t offer uncertainty. They offer the confidence of settled science: the young people who enter their clinics are “transgender,” and medical interventions, such as hormone treatments and genital surgeries, will align their brains with their bodies. While no scan or blood test can verify this diagnosis, treatment begins regardless.

In modern medicine, “being transgender” is often portrayed as a condition with biological underpinnings. This belief endures despite decades of unsuccessful searches for an objective biomarker.

Jonni Skinner, a detransitioner who received “gender-affirming” medical care as a child, shows the human cost of that belief. Jonni grew up in a small Michigan town with his mother and brother, moving from place to place amid an unstable home situation. At the age of four, he was diagnosed with Autism Spectrum Disorder. He was a sensitive and empathetic child, which made him a target for bullies.

Jonni had a devout Christian upbringing and took his faith seriously. As adolescence arrived, his emerging same-sex attraction became a monumental source of stress because he believed being gay was a sin. His anxiety quickly turned into depression.

Online and on television, he encountered a different story about boys like him. YouTube personalities Gigi Gorgeous and Stef Sanjati, and reality TV figure Jazz Jennings, were effeminate, same-sex-attracted boys whose transitions played out in public. They appeared happy, successful, and self-possessed. For Jonni, it was easy to believe that following their path might offer the same relief.

The chance to speak with a specialist came through a family friend who tutored Jonni—a lesbian who had begun identifying as a transgender man and taking testosterone. She referred him to the University of Michigan’s pediatric gender clinic at C. S. Mott Children’s Hospital.

Jonni did not walk in at 13 years old convinced he was transgender; he wanted clarity about the distress he was feeling. The clinic supplied that clarity on its own terms. Jonni claims that after a single three-hour intake interview, a clinical social worker affirmed him as “transgender” and placed him on a medical track.

At the clinic, Jonni was seen by Daniel Shumer, a pediatric endocrinologist. According to Jonni, Shumer told him he had a “neurological intersex condition” and that medical treatment was the only effective way to align his brain with his body. Jonni remembers the conversation in explicit detail, because it was pivotal in deciding the course for him and his mother. (Shumer declined a request to comment for this article.)

In the consultation room, Jonni claimed, Shumer used a whiteboard to sketch a prenatal hormone pathway: in the womb, a mistimed androgen signal in early development had “feminized” his brain, while testosterone had masculinized his body later on. Jonni says that his distress was presented as a brain-body mismatch.

The brain-body mismatch story took shape in the 1960s, when researchers first proposed brain-based explanations for transsexuality. By 1980, psychiatry was pivoting toward a biomedical model, anticipating that neuroimaging would reveal biological signatures of mental disorders. The search for a “transgender brain” followed.

In 1995, a Dutch team published a small postmortem study in Nature of six males who identified as women, reporting that their hypothalamic region more closely resembled the typical female pattern. This was widely considered a landmark finding. But later analyses of this study suggested that long-term cross-sex hormone use, known to alter brain structure, was the more likely explanation for the similarities found between trans-identifying people’s brains and those of the opposite sex.

Clinicians nonetheless proceeded to develop clinical guidelines on the expectation that biological evidence would emerge to validate their proposed medical interventions. Within a few years of the Nature study, Dutch clinicians created the first protocol to alter the sex characteristics of gender-dysphoric adolescents, introducing puberty blockers and cross-sex hormones at the onset of puberty. In 2007, Boston endocrinologist Norman Spack imported the “Dutch protocol,” as it came to be known, to the United States when he opened the nation’s first pediatric gender clinic.

This clinic became ground zero for the gender-affirming model of care in the United States. Spack framed transgender identity as a medical condition and described people identifying as trans as having been “born with brains that didn’t fit their bodies.” Shumer trained under Spack, and in 2015, built a program in Michigan for minors on the same “gender-affirming” template.

Dutch researchers continued to pursue biological explanations for transgender identity, even as clear evidence remained elusive. In 2009, they offered a simple account: transsexualism could result from a mismatch between the differentiation of a fetus’s genitalia (which occurs within the first two months of pregnancy) and the sexual differentiation of the fetus’s brain (which occurs in the second half). They claimed “[t]here is no proof that social environment after birth has an effect on gender identity or sexual orientation.” This became the foundation of the script that Shumer allegedly presented to Jonni.

“So, he explained I wasn’t gay, I simply had a female brain in a boy’s body. And how the inverse happens to create a trans man,” Jonni said. He came away convinced that he “was literally in the wrong body,” and that “[a medical intervention] is the only treatment that would work.”

To reinforce what he allegedly told Jonni, Shumer emailed him a 2014 clinician review by pediatric endocrinologist Stephen M. Rosenthal and colleagues, which devoted pages to the “Current Concepts of the Biology of Gender Identity.” It summarized studies on differences of sex development (DSDs), brain structure and function, genes, and twin concordance, which are often invoked to suggest a biological contribution to transgenderism.

DSD studies examine congenital differences in sex development involving chromosomes, gonads, or genital anatomy, usually in patients with complex medical histories. In the transgender research literature, researchers lean heavily on DSD papers and often present them as the strongest evidence that “gender identity is fixed.”

Yet the people in these studies, who have atypical sexual anatomy, are generally not comparable to those who identify as transgender. While the idea of “gender identity” emerged in DSD research and may have utility in that narrow context, it was later applied to transgender research as the basis for biological inquiry. But gender identity is an unfalsifiable construct—it relies entirely on self-report, based on how people say they feel, with no independent way to observe, measure, or disprove it—making it a weak foundation for biological claims.

Studies of brain structure and function report differences between trans-identified groups and non-trans control groups. But when confounding factors such as same-sex attraction and long-term cross-sex hormone use are controlled for, the effects shrink or disappear.

Genetic studies have found small differences in androgen- and estrogen-receptor genes between trans-identified groups and non-trans control groups. Those same variants also appear in the general population and are linked to sex-atypical traits and interests. In plain terms, they reflect normal variation in traits and interests that are less typical for one’s sex. This variation is more common in trans-identified groups, but it is not unique to them and is not a biological marker of “being transgender.”

Twin research is often cited as the strongest evidence for a genetic role in the development of transgender identity. But since these studies often involve twins who were reared together, they cannot reliably separate heredity from the effects of having been raised in a shared environment. In these studies, concordance—which means, in this context, that both twins identify as transgender—is concentrated among same-sex–attracted identical twin pairs. The results are modest for identical twin pairs, and near-zero among fraternal twins, which is out of step with standard genetic expectations for heritability. Identical twins also have closer social bonds and are more likely to imitate each other than fraternal twins, which means that social influence can help explain their higher concordance rates.

Taken together, none of these lines of evidence demonstrates a biological basis for transgender identities per se. But to Jonni and his mother, who trusted physicians and had only a layman’s grasp of biology, the combination of a clinical explanation and a scholarly paper proved persuasive. Reflecting back, Jonni said it was “a very powerful thing to hear from a doctor.”

Jonni’s pursuit of gender clinic services in 2016 coincided with the cultural rise of transgender stories. The year 2015 is often referred to as the “transgender tipping point,” when transgender identification began rising dramatically. The 2010s were saturated with media coverage of studies claiming to support a biological basis for such identities. Subsequent studies that challenged those claims received little media attention.

Follow-ups on early gender-clinic cohorts who did not socially or medically transition—many of them boys who later grew up to be gay men—received far less coverage because they cut against the prevailing narrative. Jonni fits that profile. As a young boy frightened by his emerging sexual orientation, he was looking for an alternative to being gay. The medical story was a way out.

On that basis, Jonni and his mother signed consent forms. Jonni had accepted the modern transgender framework, which holds that even ordinary sex nonconformity—i.e., being a masculine girl or a feminine boy—is potentially proof that a person “is transgender.” Afterward, he began to understand his feminine temperament and preferences as evidence of a female “gender identity.”

Jonni was medicalized before any social transition—before changing his name, pronouns, or clothing—and before any therapy. Intake notes that he provided to City Journal read: “Psychotherapy is not clinically necessary for Jonathon to move forward with medical intervention.”

Jonni’s treatment began immediately. At thirteen, in 2016, he started spironolactone and estrogen, and soon after received a puberty-blocking implant. Throughout the experience, he developed painful muscle spasms, hot flashes, persistent nausea, blood in his urine, a bladder ulcer, urinary incontinence, and fatigue. The depression, insecurity about his appearance, and social isolation he sought help for only worsened. He remained on hormones until 21, when he finally detransitioned.

Today he reports chronic bone and joint pain, reduced adult height, sexual dysfunction, and arrested psychosocial development. None of these risks, he says, were disclosed prior to treatment. Looking back, Jonni believes his distress stemmed from internalized homophobia. “I was just a kid that needed some therapy,” he says. Now 22, he speaks publicly about what he describes as malpractice and fraud in pediatric gender medicine.

Meantime, Shumer has been called to testify as an expert witness in at least 13 cases on behalf of transgender-identifying plaintiffs. He continues to advance a largely biological account of transgenderism. In sworn statements, he has claimed that “gender identity is properly understood to be a naturally occurring source of human biological diversity,” and that such identities have “biologically-rooted, immutable, and unchangeable determinants.” When pressed in a recent deposition, he said a person’s gender identity is “likely . . . innate.”

As of August, after receiving a federal subpoena, the University of Michigan’s medical center has stopped providing puberty blockers and cross-sex hormones to minors. By his own estimate, Shumer has personally evaluated and treated about 400 patients with gender dysphoria.

Asked for comment, Mary Masson, Michigan Health’s senior director of public relations, said “at University of Michigan Health, our gender services care always involves compassionate, individualized support for each patient. We are committed to comprehensive, multidisciplinary care—including mental health services and support-to ensure patients and families can make informed decisions that are right for them.”

The experience that Jonni described is not unique. In an informal 2023 survey that I conducted of 63 detransitioners, many of whom had transitioned as minors, 85.7 percent said a health-care provider told them that being transgender was a biological condition beyond their control. Nearly half recalled being told they had the brain of the opposite sex.

Biomedical explanations for psychological distress can have iatrogenic effects, that is, harm that results from the medical or clinical process itself (including diagnosis, explanation, or treatment). This has been well documented in studies of depression, addiction, and mental-health disorders more broadly.

When people receive biological explanations for mental illness, it diminishes their sense of agency and influences the choices they make. The “chemical imbalance” theory of depression, for example, was long promoted as scientific fact. Yet systematic reviews have found no consistent, high-quality evidence that depression is caused by low serotonin. Studies show that people given biological explanations for the cause of their depression feel less able to manage their emotions, less hopeful about recovery, more likely to choose antidepressant medication, and less confident that therapy or other non-medicalized approaches could help.

Psychologists call this bias psychological essentialism, the tendency to treat social categories as if they were biological. For many decades, people have described a strong desire to live as the opposite sex. That experience is real, but it does not mean that “transgender people” represent a distinct biological type.

Once the transgender framework gained traction, many individuals began interpreting their distress through that lens. The label did not merely describe a preexisting condition; it helped create one. Ian Hacking, a philosopher and historian of science, called this process “making up people”: once a diagnostic category is named and institutionalized, it reshapes how people understand themselves and how clinicians respond to them.

Activists have played a major role in shaping the popular conception of transgender identity. U.S. opinion data show that people who believe that being “transgender” has a biological basis are significantly more supportive of “transgender rights,” with the largest shift among conservatives. As of 2025, 57 percent of Democrats still hold the view that being transgender is “something a person is born with.” Framing transgender identity as innate has proved an effective political strategy—one that endures because it feels scientifically grounded.

Yet after decades of research, evidence for an innate, biologically determined transgender identity has not materialized. Instead, research has identified other factors—childhood sex nonconformity, homosexuality, and autogynephilia—that more plausibly account for the desires and experiences that have been labeled “transgender.” The recent rise of adolescent-onset gender dysphoria further illustrates how cultural influence and peer contagion, rather than biology, can shape identity and distress.

By: Christina Buttons

Published: Apr 7, 2023

Why do progressives and gender activists fervently believe that “transgender” women are literally women? Why do they believe in the existence of “transgender children” that must be medically transitioned to avoid going through the “wrong puberty”? Why is “gender identity” taking precedence over biological sex in legislation like Title IX? How can they confidently assert that “the science” is on their side?

The answer to all of these questions is due to the belief that being transgender is an innate biological property of human beings. The notion that “gender identity” is brain-based and innate has captured the political left. This is due to a collection of brain studies that purport to show that people who identify as transgender have brain structures that are more similar to the sex with which they “identify” than to their actual sex. Widespread media coverage of these studies lauds them as “proof” that transgender people “are who they say they are.”

Progressive media outlets have glommed onto this narrative and published dozens of articles asserting that “transgender people are born that way” and that “science proves trans people aren’t making it up.” Mainstream media like CNN, the New York Times, Newsweek, the Telegraph and scientific sources like Nature, National Geographic, the Cleveland Clinic and Scientific American have also repeated this misinformation.

To make matters worse, the “brain sex” conjecture is baked into clinical guidelines for medical transition and legislation for employment, healthcare, and education. 

The transgender “brain sex” argument is a load-bearing pillar supporting the belief that people are born transgender and should therefore medically transition as early as possible. Several female detransitioners who were medically transitioned as minors have even discussed how their doctors wrongly informed them that they possessed "a male brain in a female body." This claim is so absurd you’d wonder how the average person, let alone a medical doctor, would believe it.

One major player responsible for perpetuating this myth is Dr. Joshua Safer, an endocrinologist and the executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City. Safer is a leading advocate of  "gender affirming care" and believes that "gender identity" is biologically determined. A review article he published on the topic relies heavily on brain studies and disorders of sexual development (which are often used to argue that the sex binary should be represented as a spectrum).

 A 2016 interview with WBUR gives insights into how the “brain sex” theory shifted Safer’s perspective of the transgender experience from a mental health issue to a medical one.

"Up until a decade or so ago, the view among many providers was that this was probably a mental disorder and the fear was that doing hormone therapy or doing surgery might be abetting a mental disorder and the correct intervention would be to counsel people," Safer said. 

But Safer's research traces the increasing evidence that gender identity is rooted in biology, "which makes it so logical that an option for people in 2016 is to change the external appearance to meet that gender identity," he said. 

Why does it matter? Because Dr. Safer is currently the co-chair of the World Professional Association for Transgender Health (WPATH) and has been involved with the organization for many years, including serving as the first president of USPATH, the United States affiliate of WPATH. Most importantly, he co-authored two sets of clinical guidelines for the medical care of transgender patients: the WPATH's Standards of Care and the Endocrine Society guidelines. These guidelines are considered the gold standard in gender medicine and are used by gender clinics worldwide.

Dr. Safer has testified in numerous legal cases related to "transgender rights," providing expert testimony on the purportedly scientific aspects of “gender identity,” particularly as it relates to "brain sex." He appeared on a panel with comedian Jon Stewart last year and has discussed the concept of "brain sex" in various media outlets, including the New York Times and a PBS documentary.

The assumption that being transgender is an innate property that can be detected by brain scans is central to all of the problems we see today surrounding transgender issues. It is therefore crucial to be aware of and challenge the transgender “brain sex” argument whenever it arises.

The “brain sex” argument

The “brain sex” argument claims that transgender people have regions in the brain that structurally resemble that of the opposite sex. This assertion is based on a number of studies conducted in recent years on people who identify as transgender to gain insight into the potential biological basis of their condition. Some studies have even purported to show that the brain structure of transgender individuals more closely resembles the sex they “identify” as than their natal sex.

The "brain sex" argument is based on the idea that there are differences in brain structure and function between males and females that are influenced by hormones and genetic factors. Advocates of this argument argue that these differences can also be seen in the brains of transgender individuals and that these differences may contribute to the development of a “gender identity” that is different from their natal sex. They believe that a biological male who identifies as a woman has brain structures that more closely resemble that of typical females, and vice versa.

Here’s why it's wrong 

The majority of the studies on the “transgender brain” have a fatal flaw: they didn’t control for confounding variables like cross-sex hormone use and, most importantly, sexual orientation. When a study doesn't control for confounding variables, it means that the researchers did not take into account other factors that could have affected the results of the study, which make it difficult or impossible to determine whether the relationship between the two variables being studied is truly causal or a byproduct of other unrelated factors.

Cross-sex hormone use can have effects on the brain, including changes in brain structure and function. But more importantly, many trans-identifying individuals are same-sex attracted, so the research on the “transgender brain” claiming to find structural regions that resemble the opposite sex are essentially rediscovering findings on the “gay brain” and reinterpreting the results to fit their preferred conclusion. 

In the early nineties, neuroscientist and author Simon LeVay made the breakthrough discovery that the brains of homosexuals had structural differences that resembled that of straight members of the opposite sex. So it seems that while undertaking the hunt for the “transgender brain,” researchers have forgotten all about the discoveries made about the brains of same-sex attracted people. 

The first “brain sex” study that did take into account the participants' sexual orientation found that the brains of transgender individuals were similar to those of people of the same birth sex rather than the opposite sex.

When researchers scan the brains of heterosexual people who identify as transgender, they also find they are typical for their natal sex. Samuel Stagg, a U.K.-based Ph.D. student of neuroimmunology, explains: “The homosexual sub-group show brains skewed along the male-female dimension. However, this is predominantly due to their co-occurring homosexuality. When we scan the brains of the heterosexual type, we find they are more typical for their natal sex.” 

“Gender identity” not gender dysphoria

Gender dysphoria, like other psychiatric conditions, may have some biological underpinnings. There are traits like neuroticism that can predispose people to psychiatric conditions and research suggests that neuroticism has a strong biological basis with both genetic and environmental factors contributing to its development. 

But gender activists are not concerned with gender dysphoria, rather they aim to establish a biological basis for being transgender that ceases to categorize it as a mental illness. Activists have pushed for a more “inclusive” definition of what it means to be transgender that seeks to reduce stigma and perceived barriers to medical transition services.

After the legalization of same-sex marriage in 2015, civil rights and gay rights organizations that may have otherwise had to shutter their doors pivoted to championing “trans rights.” The success of the "born this way" campaign in promoting the idea that sexual orientation is an innate, immutable aspect of identity has prompted activists to also present being transgender as innate and immutable.

Manhattan Institute fellow Leor Sapir wrote his Ph.D. dissertation on the rapid proliferation of the “transgender rights movement” and its efforts to obtain civil rights jurisprudence for “gender identity.” To this end, they have attempted to prove that “gender identity” is an innate, immutable trait called “neurological sex” or “brain sex,” which they say should override natal sex.

“In the American civil rights tradition, if you can convince a judge that being transgender is like being black, then you can tap into this entire body of judicial precedent and civil rights laws that immediately applies and gives you all the policies you want,” Sapir told me. Leor Sapir has written a number of important articles on this topic for City Journal, be sure to read them for further understanding.

More context: the trans community is divided

Interestingly, on the surface the transgender community presents as a unified front, but in reality it is divided into opposing philosophical factions: those propelled by civil rights organizations who seek to prove that being transgender is an “innate, immutable trait” for political and legal reasons, and the queer theorists who question the basis of scientific authority. 

Last December, a transgender rights organization announced they were publishing a “groundbreaking article” that claims “being trans is a biological condition.” But after hundreds of critical comments from transgender people claiming that the search to find a biological basis for being transgender could be exploited, citing “eugenics” as a top concern, the organization spiked the article and issued an apology.

A self-described queer theorist named Eirnin who had early access to the article said it was not peer-reviewed nor written by an expert in the field but was merely a short letter that combined several theories of “brain sex” based on “debunked science.”

Another key point 

If “gender identity” were solely biologically ingrained, it would conflict with the fact that gender dysphoria has been observed to resolve spontaneously or through psychotherapy at various ages. As we know from the growing population of detransitioners and a large body of research on desistance in children, transgender identities are not necessarily fixed. Currently, there is no brain, blood, or other objective test that distinguishes a trans-identified from a non-trans identified person.

Group project

This article is intentionally simplified to convey the main points effectively. It is my hope that it will assist individuals in countering the transgender "brain sex" argument when they encounter it. However, I am collaborating with neuroscientist Sammy Stagg on a group project to publish a paper that highlights the methodological flaws present in current "brain sex" research in a more comprehensive way.

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But wait, we were told that "gender is a social construct," and that "gender is fluid" and "separate from biology." God is real but undetectable, good but mysterious, all-loving but tortures for eternity.

If even they can't make up their minds, how is anyone else supposed to accept their claims?

"People should be able to be trans just because they want to be, regardless of whether they 'biologically' are."

It should come as no surprise that well known anti-gay hate preacher, homophobe and child mutilation enthusiast Colin "Katy" Montgomerie is opposed to anything that would constrain the assertions and demands of the fantasists to objective reality.

Reminder again, the activists removed gender dysphoria from the definition so they could use the term for queer theory activism.

https://www.hrc.org/resources/glossary-of-terms

Transgender | An umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth.

https://www.stonewall.org.uk/list-lgbtq-terms

Trans | An umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth.

Here’s an article touching on the matter but do keep in mind this is all theoretical and NOT solidified through research, but merely the most likely reality of the situation from a handful of studies.

Essentially, women’s sexualities are a lot more likely to fall on the bisexual spectrum rather than straight/gay, it’s also been noted that there are, indeed, factors that affect women’s sexualities beyond their biology and genetics. Culture, religion, upbringing, etc.. This isn’t to say you can change someone’s sexuality, god no. All this means is that women have sexualities that evolve out  of utero for all sorts of reasons (PLUS being genetically/biologically influenced). Men, however, are more likely to be purely straight or purely gay. Not to say there aren’t bisexual men, nor are bisexual men ‘less manly’, the factors that affect male sexuality are just different.