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Stanford University final realm of Neurobiology rather than issues of gay versus straight what is the neurobiology of trans sexuality and that used to be considered to be purely a domain of psychopathology in being gay used to be a certifiable psychiatric disorder up until the early 1970s the American Psychiatric Association in their textbook the diagnostic Statistical Manual you could be psychiatrically certified as ill a psychiatric disorder was being homosexual or lesbian and then in what had to have been one of the more all-time Blowout committee meetings ever they decided that no actually it's not a psychiatric disorder and overnight about 40 million Americans were cured of a psychiatric disease the notion of transsexuality as a psychiatric disorder has had much much longer shelf life what's the neurobiology of that today there have been a handful of studies and they show essentially the same thing really really interesting another region of the brain that shows a sex difference in its average size don't even worry about the name of this it's called the bed nucleus of the stria terminalis it's where the amygdala begins to send its projection into the hypothalamus another one to those gender differences there's one type of neuron in there with a certain type of neurotransmitter we're very very reliably it is about twice the size and males than in females sufficiently so that even in human brains you could pretty confidently determine the sex of somebody by seeing the number of these neurons you'll see I'm not even saying the name of the neurotransmitter it's irrelevant it's just another one of those differences a dimorphism in a region of the brain a really really reliable one and this was a study done by some superb neuroanatomists looking at transsexuals and what they showed was very interesting which was very very reliably and a very powerful effect what you would see in their latch large sample size of transsexuals post mortem was people would have this part of the brain the size not of their sex that they were born with but rather of the sex they insisted they always actually were Wow immediate questions one must ask okay well maybe this is due to the fact that when people change gender transsexual procedures there's a whole lot of hormones involved and maybe that's doing something of this part of the brain critical control that they had was this was looking both the transsexuals who had made gender changes and those who went to their deathbed saying this is not the sex that I am I got the wrong body but never made the change it wasn't a function of having actually gone through the transition and the endocrine manipulations with it another control they had which was looking at men who would get a certain type of testicular cancer where they would have to be treated with certain feminizing hormones in other words very similar to some of the endocrine treatments of male to female transgendered individuals and postmortem you didn't see the changes there it has nothing to do the hormones it had to do with the person insisting from day one that they got the wrong body and this was a landmark study fabulously well done and controlled and replicated once since then showing that what transsexualism used to be thought of is that people who think that they're a different gender than they actually are but this study suggests is what transsexual and is about is people who got the wrong gendered body and these are people who are chromosomally of one sex in terms of their gonads they're of that sex in terms of their hormones they're of that sex in terms of their genitalia and their secondary sexual characteristics they're of that sex but they are insisting that's not who I really am this part of the brain agrees with them also very interestingly that study was done by the same Dutch scientists who did this one again this is very complex terrain in terms of what these things wind up implicating interestingly that study was published right around the time that the city of San Francisco did something very cool which was for city employees now medical insurance will cover transgender operations however there's no evidence that the obscure endocrine journal published that a lot fear or something did that like the afternoon before you know the San Francisco commissioners have their meeting on that one but nonetheless this is a subject with all sorts of realms of implications one additional study about transsexualism okay how many of you know about phantom limb syndrome okay you are a guy with a penis and you get a certain type of penile cancer and what's often done is your penises excise that is cut off and about sixty percent of men who have had to have their penises removed because of cancer there wind up getting phantom phantom penile sensations which I don't want to know that what you see though is when you take transgendered individuals who go from male to female in other words as part of it having their penises removed zero percent rate of penile phantom sensation suggestion being that there is something much more normal in that case than when a penis is being removed for cancer a whole new area of research very novel very challenging okay
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