Becoming Nicole: The Transformation of an American Family (16 page)

Diversity is not disease.

—GEORGES CANGUILHEM

S
cientists studying gender have recently been able to build upon the burgeoning research into the genetic and neurophysiological underpinnings of homosexuality. Researchers have found, for instance, that a son born to a woman who undergoes stress early in her pregnancy is more likely to grow up being gay than a son born to a nonstressed mother. The reason: Stressed pregnant mothers release a hormone called androstenedione, which mimics testosterone but is, in fact, much weaker. This stress hormone disrupts the timing and amount of the release of testosterone into the fetal brain, which, in turn, interferes with the development of the part of the brain linked to sexual orientation.

But where is the physiological evidence for being transgender? Beginning in the mid-1990s, multiple studies looked at the brains of transgender individuals postmortem and when researchers compared brain anatomy between males and females they found a profound difference where the amygdala, the brain’s emotional center, begins to send projections into the hypothalamus, the source of many of the body’s essential hormones. This area, called the central region of the bed nucleus of the stria terminalis, or BNST, is responsible for, among other things, sex and anxiety responses. On average it is twice the size in males as in females. Likewise, the BNST in the brains of transgender females—individuals with male external anatomy, but who have lifelong female gender identification—look exactly like the BNST in the brains of those with female genitalia and reproductive organs, that is, smaller than a man’s. Interestingly, these differences hold whether the transgender individual has undergone sex reassignment surgery, hormonal treatment, both, or neither. Likewise, when scientists autopsied the brains of patients whose testicular cancer was treated with heavy doses of the feminizing hormone estrogen, they found no shrinkage of these men’s BNST.

In 2008, Australian researchers discovered a genetic variation in transgender women: Their receptor gene for the male sex hormone testosterone was longer than in gender-conforming males and appeared to be less efficient at signaling the uptake of male hormones in utero, resulting in a more “feminized” brain. The number and size of neurons in the hypothalamus of male-to-female transgender adults is similar to females, and the number and size of hypothalamic neurons in female-to-male transgender adults is similar to males. The size of the deep brain structure called the putamen, which forms part of the basal ganglia, is also different in transgender individuals, corresponding to a person’s gender identity, not biological or sexual status.

If further evidence is needed that gender identity rests not in anatomy but in the brain, take the cases of men whose penile cancer forced them to have their genitals removed. In one study, 60 percent of these men experienced feelings of pain where their genitals used to be, similar to those who have lost a limb. In elective male-to-female sex reassignment surgery, however, where the genitals are removed and refashioned into a vagina and clitoris, there have been no reported cases of “phantom penis” syndrome.

What never felt like it belonged is never missed. “I’m a girl,” Nicole would say growing up. “I don’t think I
could
be a boy.” She didn’t think she could be a boy because she’d never known what that felt like. Similarly, Jonas didn’t know what it was like to have a brother because he claimed he always knew Wyatt, now Nicole, was his sister. Sometimes it all made Kelly and Wayne’s heads spin. But just because they didn’t understand it all didn’t make it any less true. What remained such a puzzle to them both was how identical twin boys, who developed out of the same egg and with the same DNA, could be so very different. Why wasn’t Jonas also telling them he was really a girl?

The relatively new field of epigenetics looks at the external modifications to DNA that turn certain genes “on” or “off.” Researchers in epigenetics seek to explain the no-man’s-land between nature and nurture where environment influences a person’s genetic makeup. This happens when changes in the environment trigger some genes to activate and others to deactivate. Identical twins may have the exact same DNA, but not the exact same molecular switches. Those switches often depend not only on environmental influences outside the womb—what the mother does, how she feels, what she eats, drinks, or smokes—but inside the womb as well. Identical twins, developing from a single egg, usually share the same placenta, but each fetus floats in its own amniotic sac and each has its own umbilical cord. Scientists have found that fetal position in the womb can cause differing amounts of hormones to reach each developing embryo. Every molecule affects every other molecule, and even in close proximity to each other, identical twins will be affected differently, which is why they also have unique fingerprints.

Even after birth, gender identity may not be completely set in stone. In March 2015, researchers at the University of Maryland School of Medicine reported they were able to change the gender behavior of newborn female rats simply by injecting a form of testosterone into the preoptic area of the hypothalamus. Despite being a week old, the female rat brains were masculinized by this testosterone derivative, and the females displayed sexual behavior typical of male rats. Physically the rats were female, but their reproductive behavior was male-like. The scientists believe that injections of the testosterone-like substance triggered a mechanism by which certain virilization genes in the brain that had been deactivated in utero were suddenly turned back on.

Unquestionably, there are multiple factors that affect gender identity, from the biological to the sociological, and while there are still many questions to be answered, what we know now is that the interaction of genes with prenatal exposure to hormones in the second half of pregnancy affects brain development in such a way that it significantly influences gender identification. Recognizing that the sexual differentiation of a fetus’s brain happens later in pregnancy than genital differentiation and that both are complex biological processes, the fact that variations in gender identity exist should ultimately come as no surprise.

If anything, these variations have reinforced the idea that gender identity itself is not a fixed target. Rather, it is only one ingredient of a person’s sense of self, and for some the sense of being male or female is simply not as central as it may be for others. Studies have shown that even those whose gender identity aligns with their birth sex vary in their levels of contentment with their gender identity. Gender variance, it seems, is the norm not the exception, and yet the binary view of male/female and the pathologizing of anything that doesn’t conform to these expectations is stubbornly entrenched.

Epigenetics has also caused researchers to question the Darwinian principle of sexual selection—the rule that there are just two genders, male and female. The theory of evolution states that most characteristics of the human species, including gender, are adaptive insofar as they increase the chances of survival of the species. In this way certain physical and psychological traits evolved to create competition for the best mates and therefore the best chance of survival. Having two genders, Darwin believed, aided competition, increased survival, and hence was adaptive. Under Darwinian rules, sexual aberrations, such as homosexuality, are just that—outliers—decreasing survival because they are maladaptive for reproduction.

Nature itself, however, appears to contradict this. At the beginning of time, life was asexual. More than a billion years ago two cells simply got together, knocked against each other’s nuclei, and swapped DNA. Single-cell blobs eventually gave rise to amphibians, then to reptiles, mammals, and humans. But why and when did male and female sexes originate? To the question of how two different organisms became necessary for reproduction, science has theories but no definitive answers. Darwinians believe the chromosomes of two organisms probably promoted better genetic diversity, and diversity, on the face of it, would seem to increase survivability. The problem with sexual selection theory, however, is that there are so many exceptions to the binary rule.

In nature, gender is fluid, dynamic, and even interchangeable. Sex change, in fact, is a normal process in many fish species, including moray eels, gobies, and clown fish. In the hierarchy of a school of clown fish, the female occupies the top rank. When she dies, the most dominant male switches genders to take her place. When the sole male in a school of reef fish dies, the largest female begins acting more aggressive and within ten days produces sperm. In Tanzania, in a species of hyena, all the females have distinctly male-like external genitalia. There are intersex deer and male kangaroos with pouches. In 2015 researchers discovered that the males of a species of Australian lizard, called the central bearded dragon, change sex when the temperature rises, at which time they become super-fecund females. Like humans, the lizards have two sex chromosomes, Z and W. A male carries the ZZ chromosome, a female the ZW. But when male eggs are exposed to temperatures above eighty-nine degrees Fahrenheit, the ZZ male embryos grow up female. It’s important to remember that all this complexity of sexual reproduction among species is not an argument against sexual reproductive success, just further evidence of variation, which some scientists believe carries over to humans.

Some human societies do embrace the reality of multiple genders. In the Eastern Highlands of Papua New Guinea, a third gender is recognized. Some of these third-gender babies are born with a condition known as 5-alpha-reductase deficiency, in which an infant’s ambiguous genitalia makes it appear mostly female at birth but at puberty, masculinization occurs: the testes descend, the voice deepens, and facial hair appears. These “third-gender” people are called
kwolu-aatmwol
by the Papua New Guineans, meaning “changing from a female ‘thing’ to a male ‘thing.’ ” In the Dominican Republic, children born with this same condition are called
guevedoche
(vulgar translation: “balls at twelve”) or
machihembras
(“first woman, then man”). In India, Pakistan, Nepal, and Bangladesh, millions belong to a transgender group known as
hijra,
which dates back at least four thousand years. According to ancient Asian myths, the
hijra
were accorded special powers that could confer luck and fertility on others. In Indonesia, the Bugis people believe there aren’t two or even three genders, but rather five: male, female, those who are physically male but take on the role of female, those who are physically female but take on the role of male, and those who take on the aspects of both male and female. Without all five genders represented in their culture, the Bugis believe the world would cease to exist. Gender is necessary, in other words, but not necessarily binary.

T
he definitions, the descriptive behaviors, the look and feel and experience of gender have all changed over time. Certainly, how we define a person’s gender has become increasingly more difficult the more science reveals gender’s complexity. Recently, a few gender-bending situations have ended up in court where judges are not only trying to understand the biology of being transgender, but what constitutional protections apply to transgender individuals.

Sorting out legal rights in cases involving transgender people is made that much more difficult when you consider that some of society’s ideas about gender and gender expression are still firmly rooted in antiquated beliefs and stereotypes. In 2013, Timberlake Christian School in Lynchburg, Virginia, sent a letter home with student Sunnie Kahle, informing her grandparents (her legal guardians) that she would no longer be welcome at Timberlake if she didn’t start dressing more like a girl. Her short hair, sneakers, and T-shirts made other students uncomfortable, according to the school official, because they weren’t sure if Sunnie was a boy or a girl. “We believe that unless Sunnie and her family clearly understand that God has made her female and that her dress and behavior need to follow suit with her God-ordained identity, that TCS is not the best place for her future education,” the letter read.

In the fall of 2013, a thirteen-year-old eighth-grade boy in Kansas was suspended from his public school for carrying a flowered purse on his shoulder. Although the school dress code did not address purses, school administrators nonetheless claimed they were not allowed in certain classes, so when the eighth grader refused to ditch the bag, the school ditched him. When the incident hit the news, it garnered so much attention the designer of the handbag offered to send more to the male student.

And in 2015, school administrators in North Carolina told a nine-year-old boy he needed to leave his My Little Pony lunch box at home because other students teased him. The school said the container was a “trigger for bullying.” The student’s mother said, “Saying a lunch box is a trigger for bullying is like saying a short skirt is a trigger for rape.”

There are also, on occasion, unexpected positive stories. In March 2015, in Michigan, the owner of a Planet Fitness franchise rescinded the membership of a woman who repeatedly complained about a transgender woman using the female locker room and facilities. In terminating the woman’s membership, Planet Fitness said her behavior had been “inappropriate and disruptive to other members.” Days later, the woman filed suit against Planet Fitness arguing she’d been “wrongfully denied the benefits of her contract” as well as public accommodations at Planet Fitness, because of the gym’s policy, which favored the rights of the transgender woman over hers. The suit is still being litigated.

Not all gender controversies end up in court, of course. Some are debated in the classrooms, dorm rooms, and administrative offices of this country’s finest institutions of higher learning. There remain dozens of all-women’s colleges in the United States, most of them founded in the late nineteenth and early twentieth centuries, when women were discouraged from pursuing higher education and were shut out of male colleges and universities. The feminist movement of the 1960s and ’70s helped secure a future for many women’s colleges, though many have subsequently decided to accept men. Of the traditional Seven Sisters colleges, five remain all-female entities: Smith, Mount Holyoke, Wellesley, Barnard, and Bryn Mawr. All are struggling with how to handle women who identify as men, especially those who transition to being trans men while at school. Most women’s colleges still consider for admittance only those who identify themselves as female on their applications, although Mount Holyoke in Massachusetts and Mills College in California recently decided to admit those who described themselves as trans men. In April 2015, Smith joined Mount Holyoke and Wellesley in reversing its policy on trans women. Anyone who identifies herself as female, regardless of birth sex, is eligible for admission. Generally, the reason cited by trans men for attending women’s colleges is that they feel both physically and psychologically safer there. Some women’s colleges have changed their charters to include gender-neutral pronouns; others encourage use of the word “siblinghood,” instead of “sisterhood.”

If there is no one test for gender, if it rests somewhere in that illimitable space between nature and nurture, then gender truly is less about biology and more about what we tell ourselves—and others—about who we are.

“The only dependable test for gender is the truth of a person’s life, the lives we live each day,” Jennifer Finney Boylan once wrote. “Surely the best judge of a person’s gender is not a degrading, questionable examination. The best judge of a person’s gender is what lies within her, or his, heart. How do we test for the gender of the heart, then?”