Now Reading: Atypical Gender Development – Nature , Nurture, Diversity, Equality

There’s a mentor around every corner, and thanks to one of mine, Dana Beyer, MD (@danabeyermd), I read this series of pieces on gender development.

Why and what for?

  • Because I have been struck by the similarities between arguments used to challenge equal treatment for the lesbian, gay, bisexual population and those used to do the same for the transgender population. 
  • Because we now know that equality equals health, and science, policy, and care, are now starting to align correctly and conclusively for the LGB population, I thought I’d post what is known about the transgender population.
  • And, as one of my other colleagues once said, “It’s my RSS feed.”

The copyright on the pieces is fairly strict so I am not going to quote them. You can instead go here, where they can be downloaded.

And the answer is…

Applying what I know about biology and medicine, and in reading the multiple cases presented, I interpret the answer to be

  • Nature – while the environment has influences, a person’s gender identity is not chosen by them
  • Nature – a person’s gender identity cannot be overriden by socialization or pscyhotherapy

The pieces further articulate that, based on current science: 

  • Those who transition are aware of what they could lose (vital family and other relationships, livelihood); the impetus to transition is so strong it can become a matter of life or death
  • Treatment, through medically supervised transition, is highly successful* (87% for transwomen, 97% for trans men)

*success is judged by satisfaction with treatment

If people say this is not a valid measure, which ultimately leads to ability to achieve life goals, I would ask what is, and the corollary, what is health care for then?

Would we ask people who are LGB to not express their orientation because it is good for their health to be unsatisfied to the point of depression, harmful behavior or suicide? 


There is an excellent document on the site with the latest information about prevalence and health care seeking behavior.

0.003% of the population commences transition in a given year.

Diversity, Equality, Health

From my reading, there are similarities in the choosability and management of gender identity and sexual orientation (which are two different things).

My generation of physicians, nurses, (and patients), came to health care to end exclusion because we saw and experienced the harm that came with it. Along the way, society discovered that diversity promotes health in people, businesses, and their communities (see: Photo Friday: Diverse communities … | Ted Eytan, MD)

Acceptance and compassion, rather than rejection and attempted conversion (which fails reliably), have brought great strides in health to people who are lesbian, gay, or bisexual. It appears they will do the same for people who are transgender. It’s time.

Ted Eytan, MD