Originally published at Psychology Today by Joe Herbert Ph.D.
Sexuality is not a binary event: Kinsey taught us that more than 60 years ago. So now we recognize that sexual preference can range from exclusive heterosexuality to homosexuality through a series of intervening states. The same applies to gender identity: whether someone thinks they are male or female. Whilst most people would ‘agree’ with their chromosome constitution (XY is male, XX is female) a few do not. Even those who do, are not unanimous in what they mean by ‘male’ or female’, or how ‘male or ‘female’ they are. There are some well-known discrepancies: the best is the androgen-insensitive syndrome (AIS) which, if complete, usually results in a female phenotype and gender identity in an XY body. This suggests that early exposure to testosterone might play a major part in the development of sexual identity, as it does in other aspect of sexuality, though certainly not a solo role. Levels of testosterone and the sensitivity of the developing brain to it vary. It’s likely that gender identity is also variable, and is subject to many influences, and that these can change during the life span. But our society demands a binary definition. You are either male or female: in most countries, your passport says so, your workplace says so. But your brain may not be quite so definite.
Helping those who are gender dysphoric is thus a skillful business, and there are few who do it well. One of those was the Gender Identity Clinic at Toronto’s Center for Addiction and Mental Health (CAMH).