What You Can Change . . . And What You Can't*: The Complete Guide to Successful Self-Improvement (26 page)

The tragic difference between an AGS reared as a male and an FM transsexual is that only one phase—psychological masculinization as a fetus—goes awry for the transsexual. All the other phases go correctly, locked unfortunately to the chromosomal sex and not to sexual identity. For the AGS, all phases—fortunately—go awry, and so everything corresponds not to
her
chromosomal sex, but to
his
sexual identity.

The other disorder is AIS, the androgen-insensitivity syndrome. AISs are chromosomally male: 46XY. They are insensitive to masculinizing hormones, however. So AISs are born with male internal organs (which differentiate before the ineffective masculinizing bath) and with a vagina, though the vagina is actually a dead end. All AISs are declared girls and raised as girls. They all grow up feeling female, pursue men, and have intercourse as women. In my theory, they don’t get masculinized psychologically, and, fortunately, their external organs don’t look masculine. Like AGSs, they have an added piece of good fortune: When puberty arrives, they grow breasts under the influence of the normal male amount of estrogen secreted by the testes (which they have deep inside), and so they look like women.
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AISs are the first cousins of MF transsexuals. Both are 46XY fetuses with male internal organs who are feminized psychologically at the end of the first trimester. But the transsexual has a normal next phase—the external organs get masculinized. Therefore, though he is psychologically female, he is born with a working penis and so is declared and raised as a boy. He is miserable ever after—or until he loses his penis surgically. His AIS cousin is psychologically female, and was fortunate enough to be born with the appearance of a vagina and so is declared a girl. Her life works out because what everyone thinks she is (by virtue of her vagina and, later, her breasts) is the same as she thinks she is—a woman.

Again, the tragic difference between an AIS female and an MF transsexual is that only one phase—psychological feminization—goes awry for the transsexual. All the other phases proceed correctly, locked to the chromosomal sex and not to sexual identity. For the AIS, all phases go awry and wind up corresponding not to
his
chromosomal sex but to
her
sexual identity.

My theory speculates that sexual identity—both normal and abnormal—is so deep because it has its origin in a fundamental hormonal process that occurs around the end of the first trimester of fetal development. Fetal hormones are not the only influence on sexual identity. Rearing, pubertal hormones, sex organs, and being mocked also play a role. But at most, these later influences can reinforce—or disturb—the core identity with which we are stuck from well before the moment of our birth.

Layer II: Sexual Orientation: Do You Love Men or Women?

Sexologists use the term
object choice
to denote how we come to love what we love. Gay activist groups, on the other hand, say we have no choice at all. I think the truth is in between, although much closer to the gay activists than to the sexologists. I therefore call this layer sexual
orientation
rather than sexual
object choice
. The basic sexual orientations are homosexual and heterosexual.
⁸
When does a person become heterosexual or homosexual? How does it happen? Once sexually active, can he or she change?

Exclusive homosexuality
. We must distinguish between
exclusive
homosexuals on the one hand and bisexuals
(optional homosexuals)
on the other. Most men who have sex with other men are bisexuals. About 15 percent of American men report that they have had orgasms with members of both sexes, but the figure may now be lower in the wake of AIDS. A large minority of men who are homosexual, in contrast to bisexuals, are exclusively homosexual. They number between 1 and 5 percent of all men. As far back as they can remember, they have been erotically interested only in males. They have sexual fantasies only about males. They fall in love only with males. When they masturbate or have wet dreams, the objects are always males. The orientation of the exclusive homosexual—and that of the exclusive heterosexual—are firmly made and deep.

Sexual orientation may even have its origin in the anatomy of the brain. In a highly publicized and technically well done study, brain researcher Simon Levay looked at the brains of newly dead homosexual men, heterosexual men, and heterosexual women. Most had died of AIDS. He focused his autopsies on one small area, the middle of the anterior hypothalamus, which is implicated in male sexual behavior and where men have more tissue than do women. He found a remarkably large difference in tissue: Heterosexual men have twice as much as homosexual men, who have about the same small amount of tissue as women. This is fascinating because this is just the area that controls male sexual behavior in rats; this area develops when the brains of male rats are hormonally masculinized before birth.
⁹

So it is possible to speculate that exclusive homosexuality in males is an attenuated form of MF transsexuality, which is in turn an attenuated form of AIS. In this theory, the sexual organs, sexual identity, and sexual orientation for the 46XY male may each have its own separate masculinizer, and so three separate levels of hormonal failure can occur.
¹⁰
It might be three different hormones, or it might be a matter of how much hormone. So, for example, with complete hormonal failure, no masculinization occurs: The baby is a chromosomal male with external female organs, female identity, and whose sexual orientation will be toward men—AIS. With grossly insufficient masculinizing hormone, the baby is a chromosomal male, with male organs, but whose sexual orientation will be toward men and whose sexual identity will be female as well—an MF transsexual. With somewhat insufficient hormone, a chromosomal male results, with male organs and male identity but whose sexual orientation will be toward men—an exclusively homosexual male.

In this speculation, the subsequent hormonal events (as yet undiscovered) occur commonly during gestation: A 46XY (normal) male is insufficiently masculinized. He is masculinized enough, however, to have a male identity and to have male external organs. The main effect is to prevent the growth of the medial anterior hypothalamus and so to change just one aspect of erotic life: Sexual orientation is prevented from ever being toward women.

It is important to note that identical twins are more concordant for homosexuality than fraternal male twins, and that male fraternal twins are more concordant than nontwin brothers: Out of fifty-six pairs of identical twins in which one was established as homosexual, 52 percent turned out both to be homosexual, as opposed to 22 percent of male fraternal twins. Only 9 percent of nontwin brothers were concordant for homosexuality. The difference between the identical twins and the fraternal twins means that there is a genetic component to homosexuality. But nontwin brothers and male fraternal twins share exactly the same percentage (50 percent) of genes. That male fraternal twins, who share the uterine world, are more concordant than nontwin brothers points to fetal hormones as an additional cause. What they all might be concordant for, in any case, is a withered medial anterior hypothalamus.
¹¹

It is tempting to put forward the same theory for female homosexuality, viewing it as slight masculinization of a 46XX female fetus. I will resist the temptation for now. Too little research has been done on lesbians to know. It is possible, but still uncertain, that lesbianism is the mirror image of male homosexuality. There is evidence for a sizable genetic contribution to lesbianism: Out of a sample of more than one hundred female twins, one of whom was lesbian, the second twin was lesbian in 51 percent of the identical twins, but only in 10 percent of the fraternal twins. There is no evidence as yet, however, that the anterior hypothalamus is larger in lesbians than in straight women. No one has looked because lesbians, fortunately, are not dying in great numbers from AIDS. Even the rat evidence is clearer for male than for female rats. Finally, there are no outcome studies of change of sexual orientation in therapy with lesbians.
¹²

Homosexuality and therapy
. Can exclusive male homosexuality change? Many homosexuals are happy with their sexuality and don’t want to change. In contrast, a man who is unhappy with his homosexuality is called an
ego-dystonic
homosexual, and he typically comes to therapy depressed, desperately wanting to change his sexual orientation. He wants to have children, he can’t bear the stigma of being “queer,” and he despises the promiscuity he perceives in the single, homosexual world. Twenty-five years ago, behavior therapists gave this problem their best effort, ignoring the clinical lore declaring that psychotherapy has no effect on homosexuality.

They tried using sexually arousing pictures of naked men flashed on a screen followed by a long, painful electric shock. When the shock went off, the picture of an attractive woman appeared. The idea was to make sex with men aversive and sex with women more attractive by pairing women with relief.

“Hopelessly naive,” you’re probably thinking. Actually, it worked surprisingly well. Around 50 percent of men so treated lost interest in men and began having sex with women. A great burst of enthusiasm about changing homosexuality swept over the therapeutic community. On closer inspection, the findings turned out to be flawed—but revealingly so. When a man was bisexual—sometimes had sexual fantasies about women—therapy usually worked. But when a man was exclusively homosexual, therapy usually failed.
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Exclusive homosexuality and exclusive heterosexuality are very deep. Lack of change in therapy, lifelong fantasies of one sex only, anterior hypothalamus withered, high concordance of identical twins, and fetal development all point to an inflexible process. Homosexuality is not quite as deep and unchangeable as transsexuality, however. MF transsexuals almost never marry women and have natural children, whereas homosexual men sometimes marry and have children. They manage this feat by a trick of fantasy. During sex with their wives, they manage to stay aroused and climax by having fantasies about homosexual sex (just as heterosexual men restricted to homosexual release in prison do). So some measure of flexibility is available to exclusively homosexual men—they can choose whom they perform with sexually, but they cannot choose whom they
want
to perform with.

Layer III: Sexual Preference: Breasts, Buttocks, and Bisexuals

Do you remember the first time you saw an oyster, glistening slimily on half its shell, and somebody suggested that you eat it? “What, put that repulsive thing in my mouth?” you probably thought, and shriveled inwardly. Yet once you were cajoled, pressured, or shamed into trying one, you discovered that oysters taste good. Eating oysters, like many forms of human activity, has on its face a disgusting aspect that prevents most people from indulging too casually—until social pressure, curiosity, or sheer bravado get them to try it out. Once tried, however, all the good things about eating oysters—its reinforcers—become apparent, and you may well become an oyster addict.

This important phenomenon,
inhibitory wrapping
, is not confined to human practices. There are two kinds of rats: mouse-killers and nonkillers. When natural mouse-killers—about half of all rats—see a mouse for the first time, they jump on it and kill it. The other half—the nonkillers—either pay no attention to the mouse or even run away. But an experimenter can induce a reluctant rat to kill, by starving the rat and then parading a mouse in front of him. When this happens, a nonkiller will, out of desperation, kill. Once a nonkiller has killed for the first time, once he loses his mouse-killing virginity, he becomes a habitual killer. Thereafter, whenever he sees a mouse, hungry or not, he will jump on it and kill it.
¹⁴

Now remember when you were a child and you first found out about sexual intercourse or, later, about oral sex. “What a disgusting thing to do,” you probably thought. “My mother and father don’t do that. I know I never will.” But as the hormones of adolescence began to seep through your body, or as peer pressure built, or out of bravado or curiosity or rebellion, you found yourself prodded into such acts. You discovered, in doing them, all the good things about them. You soon sought them out and even began to crave them. Most human sexual preferences are like this: a strong inhibitory wrapping around a delicious core. So too with what we eat, with substance abuse, and—I sadly suspect—with violence.

The oyster-eating and mouse-killing stories warn us that there once might have lurked inside us the potential to become erotically attached to any of a large variety of things. That we are breast men, or willing spankees, or women turned on by cheek-to-cheek dancing and sympathetic listening is, while not wholly an accident, a product of what we happened to sample when we were young. I suspect that if we had sampled peeping or rubber clothes, for example, we might have come to crave these instead.

There are two morals to the oyster tale. The first comes from knowing that the potential for arousal by almost anything in the whole gamut of erotic objects lies in each of us: This moral is sexual tolerance. The second moral is caution: The early sexual decisions we make—or are cajoled, seduced, pressured, or forced into making—are matters of real moment for us; more moment, for example, than whom we marry or where we go to college. For once the inhibitory wrapping is torn open, we want the sweet core again and again. What we start doing sexually as teenagers will, by and large, be what we want for the rest of our lives. Yet we make these decisions almost accidentally. As a young person, you should be armed to answer the question “Why not?” with “Do I really want to live my whole life this way?”