New year, new beginnings, new gender …

Hi, and Happy New Year! You will no doubt have noticed a new byline and a new photo with this column. But the brain is the same, the knowledge is the same and the writing style is unchanged. But I am now Rebecca, no longer Keith. I am transgender or transsexual (I have no prob- lem with either term) and am now living permanently as a woman and have started the process of physical transformation (‘transition’).

Actually, I never was Keith, although it took me a long time to realise this. It was like being a character in a science fiction story, with a false but strong identity imposed on top of a real identity that was buried and unacknowledged, disregarded, forgotten – like in the case of Arnold Schwarzenegger’s character in the film Total Recall. But, finally, the false identity disintegrates and the real identity breaks through. I’m a great fan of science fiction, and I now know that it kept me sane throughout my life, and allowed me to avoid many of the psychological problems that too many of my ‘sisters’ suffer from. How I phrase it now is as follows: Keith thought he was real, but he wasn’t.

I must highlight the incredible love and support I have received from friends, family, my colleagues here at Creamer Media and the Aeronautics competence team at the Council for Scientific and Industrial Research (CSIR).

How am I possible? The first point is that we are rare. A 2016 American estimate suggested that transgender people represented 0.6% of the US population. This makes scientific investigation (which I strongly support) rather difficult. But some preliminary work has been done.

Second, it must be pointed out that the biology of gender is more complicated than generally realised. Everyone knows that fertile women have two X chromosomes (XX), while men have one X chromosome and one Y chromosome (XY). While having a Y chromosome is a necessary precondition for a foetus to develop as a male, it is not sufficient. What the Y chromosome does is allow the production of male hormones, known as androgens, and it is these that turn the foetus into a baby boy. But that does not always work. There is a very rare condition, with an incidence in the US estimated at 0.005%, called complete androgen insensitivity syndrome (AIS). I must stress that AIS is totally unrelated to transsexuality; I am citing it as an example to show that the biology of gender is not straightforward.

The US National Library of Medicine (of the National Institutes of Health), Genetics Home Reference website provides an explanation. “Complete androgen insensitivity syndrome occurs when the body cannot use androgens at all. People with this form of the condition have the external sex characteristics of females, but do not have a uterus and therefore do not menstruate and are unable to conceive a child (infertile). They are typically raised as females and have a female gender identity.” So there are (infertile) women with XY chromosomes. (There is also incomplete AIS, which results in males with various physical disorders. Both forms of AIS are caused by genetic defects on the X chromosome, not the Y.)

The limited research that has been done on transsexuality suggests (but does not yet prove, because the samples have been so small) that we are biological in origin. In 1995, Dutch neurobiologist Dick Swaab published a study of postmortem brain tissues from male-to-female transsexuals which showed that we have certain brain structures which are much closer to those in female brains than in male ones. But his study involved just 12 brains and it had taken him 25 years to collect them! A separate study published in 2000 by an independent team used a different approach but came to the same conclusion, but again the sample was very small: 42 people, men and women, including both transgender categories. A 2009 study using magnetic resonance imaging data concluded that there was further evidence that transsexuality is associated with brain structure, but the sample was only 24 male-to-female transsexuals, plus 60 ‘control’ participants, composed equally of men and women.

Separately, genetics research, focused on twins, suggests a genetic origin for us. And endocrinology suggests that prenatal and early postnatal androgens play a role in the development of female-to-male transsexuality.

So, all indications so far are that transsexuality is a biological phenomenon. I do not suffer from a psychological disorder; I am objectively real. I certainly feel very real!