:A Critique of the Endocrine Society’s Statement on Transgender Health
Last September, the Endocrine Society, an august organization in the field of
hormone research and publisher of the reputable journal, Endocrinology, representing about 17,000 members, issued a position statement on transgender health. Okay, well and good. But on examination, rather than actual scientific analysis, the statement is seen to serve as a steely advance of a worldview.
The statement promises, “Considerable scientific evidence has emerged demonstrating a durable biological element underlying gender identity.” Really? That would be worth learning about. Based primarily on the two survey studies, Saraswat A, et al. “Evidence Supporting the Biologic Nature of Gender Identity.” Endocr Pract. 2015 Feb;21(2): 199-204 and Rosenthal S M. “Approach to the Patient: Transgender Youth: Endocrine Considerations” J Clin Endocrinol Metab. 2014 Dec; 99(12):4379-89, the Society calls insurance companies to cover sex changes operations.
I have gone over these papers (and the ones they reference) carefully and am still waiting to see the “considerable scientific evidence” for a biologically based gender identity apart from one’s biological sex. After all, that is what would justify encouraging sex changes in gender dysphoric people. I invite you to peruse some of the data with me.
Saraswat et. al. is a valuable compendium to read, but their introduction belies the problem of their approach: “Misconceptions which assume that gender identity can be altered still exist.” It is hard for me to believe that a scientific paper would make such a statement. As if, no one ever changes their perception of whether they are a boy or girl? Yet this happens all the time. Longitudinal studies have demonstrated that most gender dysphoric prepubertal youth no longer have gender dysphoria by puberty. And testimonies of real live adults also contradict this.
So it seems that the authors’ preconception about a fixed gender identity prevents them from thinking critically about the experiments supposedly showing a fixed gender identity. This is such a fascinating cultural artifact of culture-led science (Roll over, Thomas Kuhn), that I want to give examples. Their first section is on disorders of sexual development:
Sarswat et. al.’s first reviewed study, (by Meyer-Bahlburg, in 2005), seems to say opposite of what the society claims: If someone has XY (= male) chromosomes, even with birth defects, much fewer problems are caused by raising them as boys. Over 25% of the raised-as-girls XY’s went through the incredible effort to then switch over to being boys but none of the boys switched to girls. What does that say? Certainly not that there is this fixed thing called gender identity that is different from one’s biological sex.
It is the same with the following study, (Reiner and Gearhart, 2004). Again, XY folks tended to identify as men, even if raised as girls. In fact, all these XY folks “reflected strong masculine characteristics.” All this says is that chromosomal men tend to be men.
What would be needed to show a biological basis for gender identity is an identity that is the opposite of chromosomal sex, that is, an independent transgender identity. Or, to put it another way, we need to see a large group of healthy, happy XY-chromosomed, SRY-gene-activated people with a gender identity as women and healthy XX (= female) people w/a gender identity as men. It would also be significant if there were no comorbidity in these people.
A third study is referenced about congenital adrenal hyperplasia (CAH). The result of that study? 95% of XX folks with CAH still 
understand themselves to be women. Again, the result is that XX females are women. Some, with high testosterone, had insecurity about their womanliness. Understandable. I can tell you from my gender ministry that that happens not infrequently. A similar message came through in the other study cited.
I could go on about their other lines of evidence (and maybe I will in the next post), but this is enough to show how the science is not really showing what the Endocrine Society claims that it shows, but rather something they want to see, justification for advocating sex changes for the gender distressed. It gives one a very disoriented feeling if even folks at the Endocrine Society play this way with the data.
As Bob Dylan put it, “Something’s going on here, but you don’t know what it is, do you, Mr. Jones?”