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MEDICAL RESEARCH: U.S.

Controversy Erupts Over Gay and Transsexual Book

NTAC Urges NAS Review, Independent Research


6/21/2003

The gloves have come off, and a scientific brouhaha has developed over J. Michael Bailey?s book, The Man Who Would be Queen, published by Joseph Henry Press, imprint for the National Academies, including the National Academy of Science. Respected members of the medical and scientific world as well as transgender activists have decried as worse than junk science a publication that is long on intuition and devoid of original research data.

Such well known and respected transsexual women as Professor Lynn Conway, University of Michigan; Professor Joan Roughgarden; Stanford University Biology Department, Dr. Becky Allison, MD; and Christine Burns, Vice President of Britain?s Press for Change organization, decry the simplistic Blanchard theory posited as truth by Bailey based largely on his observations of transsexual prostitutes and others who frequent gay bars in Chicago. They have expressed concern over the treatment transsexuals could expect if the Blanchard-Bailey position were taught as fact. Conway, Roughgarden and Burns have called on the National Academy of Science to investigate Bailey?s work and to remove the book from under the imprimatur of the national Academies.

The National Transgender Advocacy Coalition (NTAC) supports this action and calls for independent research into other potential transsexual taxonomies. Many educated, intelligent, and successful transsexuals disagree that ?two sizes fit all.? The categories of homosexual and autogynephile do not capture these individuals? experience and ignore their self-description and understanding. Bailey's limited definitions turn all other opinions into ?self-deception,? which strains credulity.

Even Anjelica Kieltyka, portrayed as ?Cher,? a major character in Bailey?s chapters on autogynephilia has disavowed Bailey and Blanchard?s all-inclusive categorizations. She has been quoted as writing, ?It is most unfortunate that he [Bailey] used me and my case history as the ?poster child for autogynephilia?... using all of my case study (under the pseudonym of "Cher") to support his chapters on ?autogynephiliacs.? Unfortunate because here was an opportunity to break away from, rather then [sic] give further support to a dead ?Freudian? mixture of onanism, narcissism and paraphilic transvestite fetishism. I refused to join this bandwagon of Bailey, Blanchard and Lawrence, to which I would also add Zucker and Bradley of the Clarke Institute.?

In a May 3, 2003 letter to the presidents of the National Academy of Science and the National Institute of Medicine, Dr. Joan Roughgarden, Stanford University Professor of Population Biology, states the following: ?Many are claiming that the Academy has become complicit in publishing junk science... The situation is actually worse however. Junk science at least goes through the motions of science. Junk-science books include references, footnotes, data tables, and statistics to create the semblance of science. Only by tracking down the references can junk science be refuted. Bailey, on the other hand, has written a thin book without references, a book that nonetheless makes exceptionally broad and dubious claims in the name of science, and draws legitimacy from appearing under the Academy's imprint and on the Academy's website. The situation is remarkable. There's nothing in Bailey's book to refute other than hot air - no data tables, no statistics, no knowledge of the principles of classification, no experiments, no controls, no out-groups, nothing.?

Three primary reasons for the opposition of successful transsexual scientists and educators to Bailey?s book include a near complete lack of research details or reference; the apparent omission of transsexuals from other than the gay bar, sex worker, and erotic sex scenes; and the insistence that those transsexuals who strongly disavow being homosexual or autogynephilic are simply in a state of self-deception or are lying. In placing all MTF transsexuals in one of two narrowly defined categories that don?t match the reported feelings of many transsexuals, Bailey is deemed guilty of faulty research, faulty conclusions, sensationalism, and perhaps, of promoting a homophobic and transphobic approach to treatment. Bailey, Blanchard and Lawrence contend that transsexuals coming from a heterosexual life who deny eroticism as the primary reason for their transition are not being truthful. Since they consider the feelings of such transsexuals to be false by presumption, then all such transsexuals must be autogynephilic. QED. No need for further research.

Bailey, an Associate Professor of Psychology at Northwestern University, contends that early onset MTFs ? those who have known since childhood that they are ?women trapped in a man?s body ? are extremely feminine homosexual men. He identifies only one other classification of MTF transsexuals: autogynephilics. These, he contends, are men who are so erotically obsessed with the image of themselves as women that they live as women, undergoing sex reassignment surgery, if possible. Thus, Bailey reiterates the 20 year-old conclusions of Ray Blanchard at the Clarke Institute in Toronto, who first developed the model of autogynephilia to explain transsexuals who transition later in life, often following a long-term and successful male role. Blanchard?s theory on autogynephilia and his categorization of only two types of transsexual received little lasting notice until resurrected by several articles written by Dr. Anne Lawrence, MD and PhD, of Seattle a few years ago.

On page 146 of his book, Bailey writes, ?The two types of transsexuals who begin life as males are called homosexual and autogynephilic. Once understood, these names are appropriate. Succinctly put, homosexual male-to-female transsexuals are extremely feminine gay men, and autogynephilic transsexuals are men erotically obsessed with the image of themselves as women.?

In a recent note to an autogynephilia discussion list, however, Bailey said, ?I have never written that transsexuals who transition from men to women are still men. Nor has Ray Blanchard. Nor has Anne Lawrence. The phrase ?men trapped in men's bodies,? which applies to autogynephilic transsexuals, means simply that they are not naturally feminine in the way that homosexual m-f transsexuals are. It doesn't mean that they do not achieve femininity, and regardless of how feminine they are, once they decide to become women and enter that role (regardless of genital status), they are women, in my opinion.?

Bailey posits that transsexuals who lived in the role of straight men suffer from sexual aberrations (paraphilias) rather than from the more commonly accepted mismatch between body and the brain?s gender identity. Bailey, Blanchard, and Lawrence seem to discount the role of gender in Gender Identity Disorder (GID), assigning the role instead to either homosexuality or sexual obsession. Bailey states (page 176), ?With luck, the next revision of the DSM [Diagnostic and Statistical Manual for Mental Disorders] will distinguish ?homosexual? from ?autogynephilic? transsexualism.? Outspoken critics hope not. A Pacific Northwest gender counselor and a post-operative medical doctor recently stated ? in private - words to the effect that ?this bad idea will die off as it deserves to do if we just don?t make a big deal of it.?

Dr. Ben Barres, MD, PhD, professor of Neurobiology and Developmental Biology at Stanford University and a female to male transsexual puts it this way. ?Bailey truly doesn't get the gender identity dissonance that transsexuals experience -- it really is hard for people to understand what they haven't experienced themselves. I have talked with many MtFs who have contacted me and have listened to the feelings they have gone through their whole lives and it is always an exact mirror of what I have experienced as an FtM. These MtFs have no reason to lie to me, as I have no power over what treatment they receive. For Bailey to say that most MtFs are primarily doing the gender change because of a fetish rather than a true gender identity issue just doesn't ring true to me or to many other people that have worked in clinics taking care of many MtFs.?

The danger of teaching incomplete results as fact can be seen in Bailey?s own comments (page 206). ?They [my undergraduate students] are especially hesitant to support [sex reassignment] surgery for nonhomosexual transsexuals, once they learn about autogynephilia. ? When I press them, they say something like the following: ?But they don?t have the wrong body; they are mentally ill.?? Bailey notes that Paul McHugh, then Chairman of the Department of Psychiatry at Johns Hopkins used a version of that argument to close the John Hopkins gender identity clinic many years ago.

Thus, Bailey seems to realize that -- despite his avowed support of transsexuals and of gay men -- he is developing a generation of potential gender counselors, legislators, and doctors who will see sex reassignment as a bad solution to a sexual aberration rather than as an effective ?cure? for matching body and the brain?s gender identity.

Dr. Sarah Fox, who attended graduate school with Bailey at the University of Texas and was briefly a teaching assistant under one of Bailey's most influential professors says that Bailey?s apparent lack of concern comes as little surprise to her. Says Fox, "[The professor under whom she and Bailey studied] was a noted authority on supposed intelligence differences between the races and sexes. Irrespective of whether such differences may exist, I was very uncomfortable with how his teachings might be used and/or abused by those with social and political agendas. I discussed my apprehensions with him on at least two occasions. He stood firm that a scientist's job is to do the research and that it is up to others to sort out the ramifications. Bailey seems like a chip off the old block."

In her opinion concerning Bailey?s book, Dr. Julie Maverick, NTAC Vice-Chair, said, "This book is supported chiefly through ?proof by blatant assertion.? The lack of scholarship and unwillingness to discuss opposing views strongly diminishes the scientific credibility of this book immediately. I rather doubt it would have passed rigorous peer review." Dr. Maverick noted, for example, the lack of credence afforded by Prof. Bailey to valid, peer-reviewed papers published in the 1990s that showed gay men and male-to-female transsexuals to have different brain chemistries and structures from each other (e.g., Zhou, et al., 1995, Nature). Those studies showed that the brain chemistry and structure of the transsexuals studied were much more like those of women than those of gay men.

Dr. Maverick also noted that studies of intersex biology and behavior clearly demonstrate a wide range of physiological and psychological conditions within a transgender framework that do not fit the Prof. Bailey?s scheme.

Dr. Robyn Walters, NTAC Media Director notes that, following a half dozen or more email exchanges in recent weeks on an international autogynephilia news list that counts Anne Lawrence and Michael Bailey as members, she has yet to receive an answer to the question of why many supporters of Blanchard?s theory and Bailey?s book are adamantly opposed to even the possibility that there could be another theory. A more comprehensive theory might include gender identity as well as autogynephilia and homosexuality as special cases. This would be akin to the General Theory of Relativity including the Special Theory of Relativity. ?Responses to this line of questioning have merely repeated the mantra that there are only two types of MTF transsexual and that those who consider other explanations are self-deceptive liars,? Walters reported. ?Relying solely on an unproven presumption of massive self-deception does not appear to be good science.?

NTAC considers the National Academies? imprimatur assigned this book to be misplaced and ultimately harmful. Reliance on Bailey?s work will likely hurt our community in terms of health care and in terms of legal, medical, and societal acceptance. NTAC considers that questionable science -- potentially incomplete science -- cannot remain unchallenged and must not alone form the basis on which future generations of transsexuals will be judged and treated. Therefore, NTAC urges the National Academies to review the research credibility behind The Man Who Would Be Queen. In addition, NTAC urges the National Academies and such organizations as the Gill Foundation, National Gay and Lesbian Task Force, Rikki Swinn Institute, Human Rights Campaign, and others to join forces in organizing and funding an independent study to analyze and categorize transsexuals who disavow a history of homosexuality and who disavow eroticism as the reason for making their bodies anatomically congruent with their sense of gender identity. The results of such a study, coupled with the theory of Ray Blanchard and the anecdotes of Michael Bailey, could well lead to a ?Unified Theory of Transsexualism? and better represent and serve the diversity of our community.

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Founded in 1999, NTAC - the National Transgender Advocacy Coalition - is a 501(c)(4) civil rights organization working to establish and maintain the right of all transgendered, intersexed, and gender-variant people to live and work without fear of violence or discrimination.


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