Dreger: When people ask me how transgender is different from intersex, I usually start by saying that that intersex and transgender people have historically suffered from the opposite problems for the same reason. Whereas intersex people have historically been subjected to sex "normalizing" hormones and surgeries they have not wanted, transgender people have had a hard time getting the sex-change hormones and surgeries they have wanted. Both problems arise from a single cause: a heterosexist medical establishment determined to retain control over who gets to be what sex.
![]() |
| Manly: legs |
Dreger: In the great majority of cases, medical scans won't detect any intersex feature in a transgendered person's body. Nevertheless, many people believe that transgender must be a special form of intersex involving the brain.This fits with my comment that some transgender individuals look to the existence of intersex individuals to provide justification for their behaviour.
Dreger: Although there is very little science to support it, this has become the most popular explanation of transgender, probably in part because it is the easiest one for uptight heterosexuals to accept. (...) In practice, this story of transgender can function as a kind of get-out-of-male free card for men who seek to become women anatomically. When that card is played, the comforting narrative of "true selves" is preserved.And there are scientific papers (such as this one) which seek to demonstrate anatomical differences in the brains of trans people. Though mostly their brains are very similar, some studies purport to demonstrate subtle differences in tiny regions of the brain (for example, some regions in MtF transsexuals are less like men and more like women). Most of these studies have small numbers of non-randomised participants, and even if these findings are robust (and I am nowhere near convinced that they are), correlation is not causation.
Science may indeed unlock some of these puzzles in time, but the only thing I am convinced of is that the science is pretty unconvincing so far.
![]() |
| Controversial: Bailey |
Dreger points out that the French translation of autogynephilia is amour de soi en femme (love of oneself as a woman) which is a much nicer expression.
But where I feel uncomfortable about the autogynephilia model, a lot of people felt a lot worse.
Dreger: Before Bailey, many trans advocates had spent a long time working to desexualize and depathologize their public representations in an effort to reduce stigma, improve access to care, and establish basic human rights for trans people. (...) This is similar to how gay rights advocates have desexualized homosexuality in the quest for marriage rights, portraying themselves in living rooms and kitchens instead of bedrooms, in order to calm fearful heterosexuals.
Indeed, a few retrograde clinicians, like Paul McHugh, a psychiatrist at the Johns Hopkins School of Medicine, still actively use the idea that male-to-female transgender is really about perverted sexuality and mental illness to argue against access to sex-transitional hormones and surgeries.
For Bailey or anyone else to call someone with amour de soi en femme an autogynephile or even a transgender woman-- rather than simply a woman-- is at some level to interfere with her core sexual desire. Such naming also risks questioning her core self-identity in a way that calling the average gay man homosexual simply can't. One really must understand this if one is going to understand why some trans women came after Bailey so hard for naming and describing autogynephilia. When they felt that Bailey was fundamentally threatening their selves and their social identities as women-- well, it's because he was. That's what talking openly about autogynephilia necessarily does.
![]() |
| Lynn Conway by Charles Rogers |
But back to the book. Dreger goes on to describe how a prominent transwoman called Lynn Conway, at the University of Michigan, started "what became a war" against Bailey, assisted by Andrea James and Deirdre McLoskey. Together they began to systematically ruin Bailey's reputation. They campaigned to have the book removed from consideration for the 2004 Lambda Literary Award. They cooked up stories about him practising psychology without a licence, doing research without appropriate ethical oversight, and even having sex with one of his research subjects. And Dreger digs deeply and thoroughly into all of this, interviewing as many of the original people involved as possible.
Dreger: As a result of all this, Bailey came across pretty clearly as an abuser, a trans-basher, and a sexual pervert.But why did Conway, James and McLoskey feel they had to do all those things?
After nearly a year of research, I could come to only one conclusion: the whole thing was a sham. Bailey's sworn enemies had used every clever trick in the book-- juxtaposing events in misleading ways, ignoring contrary evidence, working the rhetoric, and using anonymity whenever convenient, to make it look as though virtually every trans woman represented in Bailey's book had felt abused by him and had filed a charge.
Dreger: "Narcissistic injury," the physician-researcher Anne Lawrence said to me, by way of explanation. "Followed by narcissistic rage." That, she told me, was the only real way to explain what happened to Bailey. The whole thing had been an attempt to kill the messenger bringing a message that Lawrence guessed wounded the accusers' sense of self.
![]() |
| Captivating: the book |
Overall, the book is a phenomenal read; gripping as a thriller, scholarly, yet incredibly human. There are so many points in the book where I thought: I can't believe I am actually reading this! I can't recommend it highly enough.
We part company with the book at this point, partly because this blog post is already way too long, and partly because the book leaves the subjects of gender and sex as Dreger finds other (compelling) subjects to sink her hungry scholastic teeth into.
I think the world of gender is changing more rapidly than it ever has before. The emergence of transgender celebrities like Laverne Cox and Caitlyn Jenner has caused mainstream society to become much more aware (and thankfully, accepting) of trans people and trans issues. Nonetheless, I am very uncomfortable about what happened to Bailey: vilified for his views, not because they were wrong, but because they made people uncomfortable. Dreger points out (and I don't know why I didn't think of this before) that as a result of Conway's attack on Bailey, "no one in sex research will touch male-to-female transsexualism with a ten foot pole any more. Which must have been just what Conway meant to do". That explains why there isn't good science: because scientists fear personal retribution if they publish results which are unpopular.
The way to enlightenment is not to silence people, even the ones who disagree with us, but to engage in open, civil, respectful debate; to seek out the best evidence, and incorporate it into the picture, recognising that the picture isn't complete and may yet change as new discoveries come to light.
Dreger's book has inspired me to be a little more upright, a little more outspoken in defence of the truth, a little more questioning of the "facts", than I was previously. And perhaps, therefore, a little more willing to extend my middle finger, just like Galileo.





























