Archive for December, 2009

Careful with that X, you gene

December 28, 2009

A couple of weeks ago, Cell magazine published an article (Somatic Sex Reprogramming of Adult Ovaries to Testes by FOXL2 Ablation) by a group of scientists confirming that their research on mice has revealed that “the activity of a single gene, FOXL2, is all that prevents adult ovary cells turning into cells found in testes”.

In other words, sex is not determined by chromosomes alone; genes in the autosomes play a significant part in the process.

From the News section of the National Institute of Medical Research (NIMR) website:

The decision as to whether a developing embryo will become a male or a female is taken at an early stage during the formation of the gonads. In an XY embryo, the Y chromosome gene Sry triggers the formation of testes. Substances made by the testes, particularly the hormone testosterone, then cause the development of male characteristics throughout the rest of the embryo. In an XX embryo Sry is not present, so ovaries will develop instead of testes, and female characteristics will develop because the male-promoting substances are absent. However, Sry is only active for a brief period in the early embryonic gonads, and it works by activating a gene that is neither on the X or Y chromosome but on one of the other pairs of chromosomes common to males and females. This gene, termed Sox9, functions to promote and then maintain the formation of Sertoli cells in the testes, cells that support and nourish developing sperm. Sox9 is active in Sertoli cells throughout life. If Sry is absent and Sox9 fails to be activated, then cells of the same original type become follicle cells, which serve to support growing eggs (oocytes) in the ovary. Because Sry, Sox9 and testosterone are all male-promoting, so that in their absence female characteristics will develop, it had been considered that female development happens by default.

Robin Lovell-Badge from NIMR’s Division of Stem Cell Biology and Developmental Genetics, in collaboration with Matthias Treier and colleagues at the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany, have shown that the activity of a single gene, Foxl2, is all that is required to prevent cells typical of an adult ovary from turning into those present in testes. When the gene is deleted from adult female mice, the cells rapidly change and begin to make male-specific factors including the male hormone testosterone. Moreover, these cells organize themselves into structures resembling sperm producing tubules – although these tubules are empty because the eggs cannot change to become sperm. This work shows very clearly that the male pathway needs to be actively suppressed in the adult.

That’s the science, but what of the implications? Assuming that the same findings hold true for humans as they do for mice, then there are potentially several advances in the field of reproductive medicine. From the NIMR report again:

[...] For example, [these findings] may help to understand and treat some of the masculinising effects of menopause seen in some women, and some cases of premature ovarian failure where women lose all their oocytes early. It also offers for the first time the suggestion, although one that is still very speculative, that it might eventually be feasible to help treat some disorders of sex differentiation in children, for example, when XY individuals develop ovaries or perhaps when XX individuals develop testes or in intersex conditions. In some such cases it may be possible to retain fertility, which is otherwise inevitably compromised. Similarly, if it is possible to change adult gonad type from ovary to testes or even the reverse, it may eventually allow individuals with gender dysphoria, who feel they are trapped in the wrong sex, to change their gonads appropriately rather than having them removed surgically as part of their treatment to undergo gender reassignment. In such cases, however, while the new gonads might make the right hormones for their new sex, these individuals will lose their fertility.

To be honest, the only immediate benefit of this discovery that I can see is that, to quote Sophia Siedlberg at Intersex News:

the unholy dictatorship of “XX or XY” is over

I’ve no great wish to get bogged down in another interminable discussion of the nature/nurture dichotomy as applied to transsexual women, even so, it seems obvious that being able to ‘flip the FOXL2 switch’ would not instantly end an individual’s gender dysphoria. Unlike stem cell research, where I can imagine that – eventually – there may be the possibility of a body developing appropriate genitalia, it seems that with any FOXL2 therapy, surgery would still be required. And, of course, it would still not be a matter of ‘taking the blue pill’ and instantly becoming a woman; questions still remain around such factors as socialisation, gender roles and presentation, etc. And it seems likely that gender dissonance will still be invisible to an obstetrician, so the opportunity to activate the FOXL2 gene in utero, when it might, arguably, be most effective, will be lost.

Finally, there’s the ever-present risk that any benefits of such an emerging biotechnology will be co-opted by politicians and other vested interests, to advance the cause of eugenics as a tool for greater enforcement of a heteronormative gender binary whilst simultaneously permitting drug companies to increase their profits still further.

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Cross-posted at Questioning Transphobia

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The belonging kind

December 25, 2009

Sometimes, at dawn, perched on the edge of his unmade bed, drifting into sleep – he never slept lying down, now – he thought about her. Antoinette. And them. The belonging kind. Sometimes he speculated dreamily…Perhaps they were like house mice, the sort of small animal evolved to live only in the walls of man-made structures.

[...] And they can change outwardly, like a chameleon or a rockfish, for protection. So they can live among us. And maybe, Coretti thought, they grow in stages. In the early stages seeming like humans, eating the food humans eat, sensing their difference only in a vague disquiet of being an outsider.

- The Belonging Kind, John Shirley and William Gibson (P)1981 [Text file here]

20081225-240x389For as long as I can remember I’ve been a solitary person, a loner. Not the belonging kind. But I’ve adapted, as one must. I’ve learned to be happy in my own company to the point where I can leave the office on a Friday evening and have no contact with another human being until going back to work on Monday morning – and not be bothered by it. They say hindsight is 20/20, but I believe my gender dissonance was a factor in this: when you know that you don’t belong with the boys, and it’s not possible to hang out with the girls, you learn to make your own entertainment. To be self-sufficient.

But your introversion feeds on your isolation, your self-imposed exile. Time passes, you grow and retreat still further into yourself. You build walls to keep your inner space safe, your rudimentary social skills fall away and you move from enduring to positively embracing the solitude.

Still, I’m only human and yes, sometimes I get lonely, sometimes I think I’d give anything for company, the simple physical presence of another – but my decision was made too long ago now to change, and so it goes.

Perhaps the hardest part of living alone has been – is – living alone. Humans are social creatures and, although the loneliness is usually bearable, still there are times when you just want someone to talk to. To share the good and the bad, the happy and sad. But when that, too, is not an option, you bottle it up inside.

Finally, the pressure of spending a lifetime in denial, of not facing up to the see-sawing of your emotions and the endless sense of not belonging anywhere, of just, somehow, being different, builds to the point where you can no longer contain it. Then one day, you find yourself forced to face your demons. And that’s when your crisis becomes a state of emergency. Mine was eased when I began my transition. It brought an unexpected sense of liberation. When the hormones began to kick in, it felt like coming home. Many things have changed – overwhelmingly for the better – and I’ve been able to leave that life behind and start building mine.

In the process of transitioning, my gains were counterbalanced by losses. I think this happens to many trans people, to some degree. Some lose it all: partners, children, friends, homes, jobs, everything. I was lucky: I “only” lost my family, they do not accept me as the person I am. Bad enough, yes, and it pains me today perhaps more than any – for as long as I can remember, growing up, Christmas was always a time for family. I guess it probably still is even today, but not being mentally or emotionally strong enough to pick up the phone, I can’t say for sure. Estrangement is a… strange… condition.

I’m still not the belonging kind; as much as I might like to be, I don’t believe I ever will, and so the rest of this solitary existence lies before me. But the other side of solitude is loneliness. Usually it’s bearable, but some days it’s less so. Some days it’s about just enduring the empty hours, about getting through it somehow, about hoping that better times will come. Today is one of those days.

Intersex youth in Gaza

December 21, 2009

Via CNN World (also detikHealth and O Globo), a news report about two intersex youths in Gaza.

Nadir Mohammed Saleh and Ahmed Fayiz Abed Rabo are cousins and next-door neighbors. With their gelled hair, buttoned-down shirts and jeans, they look much like any other 16-year-old Palestinian boy. But looks, Ahmed says, can be deceiving.

“Only my appearance, my haircut and clothing, makes me look like a boy,” Ahmed says, gesturing with his hands across his face. “Inside, I am like a female. I am a girl.”

Until last summer, both Nadir and Ahmed were — for all intents and purposes — girls. They wore female headscarves, attended girls’ school and even answered to the female first names Navin and Ola.

Both Nadir and Ahmed were born with a rare birth defect called male pseudohermaphrodism.

In passing, I’m not comfortable with CNN’s use of the phrase birth defect; it seems to me to perpetuate the medicalisation and pathologising of intersex people who simply happen to have been born with a phenotype which differs from that which might more usually be expected.

Even the term pseudohermaphrodism [sic] is problematic, given its origin in the nineteenth century, long before the genetic roles of the X chromosome and Y chromosome and the social components of gender identity were well characterized.

However, whatever my opinion of another piece of lazy journalism in search of a snappy soundbite, this next passage certainly gives pause for thought:

There are an unusually high number of male pseudohermaphrodite births in the Gaza neighborhood of Jabalya, where Nadir and Ahmed live.

Dr. Jehad Abudaia, a Canadian-Palestinian pediatrician and urologist practicing in Gaza, says he has diagnosed nearly 80 cases like Nadir’s and Ahmed’s in the last seven years.

“It is astonishing that we have [so] many cases with this defect, which is very rare all over the world,” Abudaia says. He attributes the high frequency of this birth defect to ‘consanguinity,’ or in-breeding.

“If you want to go to the root of the problem, this problem runs in families in the genes.” Abudaia says. “They want to get married to cousins… they don’t go to another family. This is a problem.”

In Western, more developed countries, doctors typically identify and then operate to correct disorders of sex differentiation at birth. But in war-torn Gaza, which has a lower standard of medical care, the birth defect can go undetected for years.

“Some of them unfortunately will be discovered late, when they are more than 14 years [old]. When they have been living as a female and they don’t have menstruation, then they will go to the gynecologist,” Abudaia says.

Abudaia’s first advice to patients with the disorder is to immediately adopt male clothing and hair cuts, and then to plan for a sex-change operation.

There are a few points here: first, do we know for certain sure that 17-B-hydroxysteroid dehydrogenase (17-B-HSD) is due to consanguinity? Or is it that there’s a higher incidence of its occurence under those conditions? None of the information I’ve been able to find online is clear on this point, saying only that 17-B-HSD is congenital, which – according to Princeton University’s WordNet – means “present at birth but not necessarily hereditary”. Nothing about consanguinity that I could find. I’m not saying it isn’t a factor in this case, just that from my research, the idea that there’s a universal link isn’t clearly stated anywhere. So why make the point of using it as if it is? The cynic in me says it’s just another low-level, almost subliminal, framing of anyone who falls outside the default male/female binary as being someone not “normal”. Othering, much?

Second, yet more lazy journalism: “disorders of sex differentiation”. OII’s stated position about the use of controversial and objectionable phrases like this is well-documented and not hard to find online.

Third, Dr Abudaia’s advice seems more likely to invisibilise (and further stigmatise) an already extremely marginalised and oppressed group of people by reconstructing them as members of another marginalised and oppressed group – transsexual people. Which, to my mind, is a tactic which does nothing to help either intersex or transsexual people, or indeed those who self-identify somewhere along the intersection of the two.

Additionally, it seems to me that the path advocated by Dr Abudaia has other implications as well as those around enforced surgery and medical transition; the following quote from the article reminds us that, like transsexual people, intersex people are also routinely subjected to the linking of pathologisation to legal regulation:

Until the sex-change operation is completed, Palestinian officials won’t change the gender on their identity cards to “male,” thus restricting their access to higher education.

My heart goes out to Nadir and Ahmed; by all accounts life in Gaza is hard enough anyway so it’s reassuring to know that they have the support of their families through their transitions. I only hope that the benefits they may gain will far outweigh any negative aspects that may arise if this normalisation has in any way been imposed on them by mainstream society.

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Curtsey to Richard Köhler on the TGEU listserv for the link

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Previous related posts:

*UPDATE* Turkey: another LGBT rights organization faces closure

December 16, 2009

“Money is the road to justice – and power walks it on crooked legs”

Logo of Siyah Pembe (Black Pink Triangle Association)

A couple of months ago I wrote about the closure threat facing Black Pink Triangle Association in Izmir. An update on the situation has now been published in Bianet. I’m just going to quote it verbatim as it covers all the points I’d raise if I were to take the pink sparklehammer of deconstruction to it:

“Public Morality” Disturbed by LTGB organization…

The governorship filed a closure case against the Black Pink Triangle association in Izmir under charges of “opposing the public morality and the Turkish family structure”. The first hearing is scheduled for February next year.

The Siyah Pembe Üçgen (‘Black Pink Triangle’) LTGB association is facing a closure trial on the grounds of “running contrary to the public morality and the Turkish family structure”. The first hearing will take place on 19 February 2010. The association is the 5th LTGB organization established in Turkey after Kaos GL, Bursa Gökkuşağı (‘Bursa Rainbow’), Pembe Hayat (‘Pink Life’) and Lambdaistanbul.

Siyah Pembe Üçgen member Hülya Sur argued, “The prosecutor’s request to close down our association is a violation of the civic rights of lesbians, gays, bisexuals, transvestites and transsexuals (LGBTT). If the establishment of an association is a constitutional right and if the prosecutor wants to deprive a part of this right from the citizens, then we can speak of constitutional inequality”.

Once more the reason is “public morality”

Association member and joint attorney Elif Ceylan Özsoy talked to bianet about the establishment of the association and the launched court case.

“As the Siyah Pembe Üçgen LGBTT Association we presented our regulatory statute and the necessary documents to the Izmir Provincial Association Directorate on 20 February. The directorate was supposed to examine our regulatory statute and to inform us in written form about the approval or the provision of lacking documents within 60 days. We did not receive any information within this period of time”.

Özsoy continues, “I called the Directorate and they said ‘It was sent to the Ankara Association Office Presidency for examination and we still did not receive an answer from them’. So I called Ankara. They informed me that the request had not reached them yet. We faxed an application to the directorate in Izmir to speed up the process. Another 60 days had passed but there was still no written response”.

An answer was received on 26 May. The directorate requested to amend article 2 from the regulatory statute because it allegedly opposed article 43 on public morality and protection of the family; furthermore, a couple of lacking signatures had to be provided.

Özsoy indicated that their regulatory statute was not any different form the other LGBTT organizations in Turkey. They completed the missing signatures and sent it back without further amendments of the relevant article.

“This article is included in the regulatory statute of the 4 other LGBTT organizations as well and it is entered in their registries accordingly. We stated that this request was opposing the state’s principle of equality. Additionally, we reminded the fact that the Court of Appeals had rejected a closure request in the case of Lambdaistanbul, which had been filed on the grounds of opposing the article on public morality and protection of the family. We declared that we were not going to make the referring modifications”.

According to information from Özsoy, upon this response the governor applied to the Izmir Public Prosecutor’s Office on account of the Izmir Provincial Association Directorate for closing down the Siyah Pembe Üçgen Association. Prosecutor on duty Sami Dündar opened a court case on 16 October on the grounds of completing the deficiencies as notified within 30 days according to article 60/2 of the Anti-Terror Law.

“This case is the result of communication problems of the judiciary”

Hülya Sur claims, “Has somebody got a scale for evaluating citizenship? So let them feel comfortable and exclude LGBTT people from citizenship”.

The association member sees a communication problem within the judiciary since another closure case has been opened against an LGBTT organization despite the fact that the court of appeals decreed against the closure of Lambdaistanbul.

It’s worth restating that this is happening in Izmir, where the current Istanbul Chief of Police, Hüseyin Çapkın, is from (I wrote about this charming man’s totalitarian tactics back in September). With that in mind, it’s hard not to be skeptical that there’s even a gram of political will in government to uphold the human rights of trans people in Turkey to organise themselves in their own defence against the violent oppressors who should in fact be the ones who are on trial.

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Curtsey to Richard Koehler on the TGEU listserv for the heads up.

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Previous related posts:

  • Human rights violations against LGBT individuals in Turkey in 2008 (August 9, 2009)
  • Turkey: trials in connection with the murders of two trans women now under way (July 9, 2009)
  • Unsafe haven: LGBT asylum seekers and refugees in Turkey (July 8, 2009)
  • Turkey – new Chief of Police for Istanbul. Will this bring an end to the “undeclared war” against trans women? (June 15, 2009)
  • Turkish policemen on trial for attack on trans woman (May 29, 2009)
  • Turkey: another trans woman stabbed to death – UPDATE (May 29, 2009)
  • Turkey: another trans woman stabbed to death (May 25, 2009)
  • Turkish parliament questioned on trans safety (May 12, 2009)
  • Lambda Istanbul granted permission to continue operating (May 7, 2009)
  • Suspected murderer of trans rights activist arrested in Turkey (April 21, 2009)
  • Every 15 days, another trans person is murdered in Turkey (April 14, 2009)
  • The undeclared war against LGBTT people in Turkey continues (March 29, 2009)
  • Another trans woman murdered in Turkey (March 14, 2009)
  • Trans woman stabbed to death in Istanbul (March 12, 2009)
  • Lambda Istanbul wins appeal against closure (January 28, 2009)
  • Trans rights abuses in Turkey (November 29, 2008)
  • Normal service will be resumed shortly…

    December 15, 2009

    …in the meantime, here is some music:

    Hmm…

    December 15, 2009

    Thursday December 17th is International Day to End Violence Against Sex Workers

    December 15, 2009

    Via Sex Workers Outreach Project USA:

    December 17th is International Day to End Violence Against Sex Workers.

    This event was created to call attention to hate crimes committed against sex workers all over the globe. Originally thought of by Dr. Annie Sprinkle and started by the Sex Workers Outreach Project USA as a memorial and vigil for the victims of the Green River Killer in Seattle, Washington.

    International Day to End Violence Against Sex Workers has empowered workers from over cities around the world to come together and organize against discrimination and remember victims of violence. During the week of December 17th, sex worker rights organizations will be staging actions and vigils to raise awareness about violence that is commonly committed against sex workers.

    The assault, battery, rape and murder of sex workers must end. Existing laws prevent sex workers from reporting violence. The stigma and discrimination that is perpetuated by the prohibitionist laws has made violence against us acceptable. Please join with sex workers around the world and stand against criminalization and violence committed against prostitutes.

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    Cross-posted at Harlot’s Parlour

    Trans activist Sass Rogando Sasot’s speech at the UN

    December 13, 2009

    You Tube link: http://www.youtube.com/watch?v=JrOc6CIQjtc

    A written transcript of the speech Reclaiming the lucidity of our hearts may be found on the blog of her organisation, link here

    United Nations, New York, 10 December 2009: Panel discussion organized by the Permanent Missions to the United Nations of Argentina, Brazil, Croatia, France, the Netherlands, Norway and Sweden on the occasion of the International Day of Human Rights.

    Theme: Opposing grave Human Rights Violations on the basis of Sexual Orientation and Gender Identity

    The entire UN session on SOGI (Real media, 1 hour and 25 minutes) may be viewed at the UN website, link here

    (Curtsey to Emma at Support Transgenre Strasbourg for the video links, and pinay23 for the link to the transcript)

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    Cross-posted at Questioning Transphobia and The F-Word

    Psychiatry’s civil war

    December 12, 2009

    New Scientist magazine has published a lengthy article – Psychiatry’s civil war – about the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders and the “open conflict [which] has broken out among the upper echelons of US psychiatry” regarding the attempt to “extend definitions of mental illnesses so broadly that tens of millions of people will be given unnecessary and risky drugs”.

    (Note: Since the article was posted, the American Psychiatric Association has announced that the publication of DSM-V will be delayed until May 2013 to “allow more time for public review, field trials and revisions”.)

    The whole article is worth reading, but in particular it has this to say about the redefinition of gender identity:

    We are who we say we are

    Is history repeating itself? That’s the question facing psychiatrists considering how gender identity should be defined in DSM-V. The APA has a legacy of uneasy relations with the lesbian, gay and transgender community, having included homosexuality in the DSM’s list of psychiatric disorders until 1973. Some transgender activists want issues of gender identity kicked off the list of mental illnesses too.

    These activists are up in arms over the membership of DSM-V’s sexual and gender identity disorders work group, in particular the selection of Kenneth Zucker of the University of Toronto, Canada, as its chair. Zucker is reviled by some transgender activists for his work on therapy to reorient children who feel that they were born into the wrong sex. An online petition objecting to the work group’s composition has more than 9500 signatures.

    The group is nevertheless likely to recommend changes that could actually ease tensions. One of these is a change in the name of a diagnosis that as currently phrased is inherently offensive to transgender people. “‘Gender identity disorder’ falsely implies that the gender identities of gender variant people are in themselves disordered,” says Kelley Winters, founder of GID Reform Advocates.

    The work group has not yet revealed its proposed name, but “disorder” will be dropped. “We’re sensitive to issues of language,” says Zucker. One possibility is “gender dysphoria”, which focuses on the inherent distress of people living in a body that doesn’t match their identity.

    That would not satisfy those transgender activists who want issues of gender identity removed from the DSM altogether. But others argue for the retention of a renamed condition to make it easier for those distressed by the mismatch between their identity and their bodies to seek assistance, and also to help those who need sex-change surgery to get it paid for. Even now, many transgender people face problems when insurers refuse to recognise the treatment as a legitimate medical expense.

    My opinion on the binary options mentioned in the last paragraph is somewhere between the two viewpoints: I would be more than happy for any mention of gender identity to be dropped provided that trans people are not, as a consequence, denied access to timely, appropriate and free medical treatment. Transitioning needs to be refocused away from a gatekeeping approach to one of facilitation and support.

    Additionally, New Scientist has also published an op-ed companion piece – Time’s up for psychiatry’s bible – which suggests that:

    With the advent of the internet, there is no longer any compelling need to rewrite the diagnostic criteria for the whole of psychiatry in one go. Yes, diagnoses should be revised as new scientific findings come in. But for this, specialists can be assembled when necessary to address specific areas that have become outmoded. Their suggestions can be posted on the web for comment. More research can be commissioned, if necessary. And when consensus is reached, new diagnostic criteria can be posted online.

    Similarly, standing panels could periodically review issues that cut across the whole of psychiatry – such as the inevitable shift away from checklists of symptoms towards a system based on measurements of the underlying biological and psychological determinants of mental health.

    Apparently there is resistance to this move towards such a “living document” because such a transition (no pun intended):

    [...] would have hurt the APA’s coffers, as a book that becomes a required reference is a big earner; DSM sales since 2000 exceed $40 million.

    Which rather leaves me wondering exactly where the APA’s real priorities lie: in providing a framework that would actually help the people who need it, or generating arguably obscene profits at the expense of our health and wellbeing.

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    (Curtsey to Martha T.G.O. on the TGEU listserv for the heads-up)

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    Cross-posted at Questioning Transphobia

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    Previous posts about the DSM on this blog:

    Dusk + Blackdown v Grievous Angel “Margins Music Redux”

    December 11, 2009

    look around…
    look around…
    look around…
    this was not the world i was born in…

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