The Big Lie about Gender and Sexuality

They are not the same thing, but they are deeply intertwined

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Pixabay/creative commons

“Sexuality is who you go to bed with; gender is who you go to bed as.”*

I first heard this explanation of the difference between sexuality and gender from sensitivity readers I hired to give notes on my book TOMBOY. (I can talk about why I did that when the paperback comes out on 12/14!). While I remarked that this was not my definition of gender—I consider gender to be expectations and norms based on sex—I understood that some people, especially many of those I was interviewing for the book, interpreted gender as an internal sense of self. I didn’t question it at the time.

But there was something even bigger I didn’t think to ask: Why were we defining gender in relation to “going to bed?”

I now believe this is key to one of the biggest misconceptions being promulgated in schools, the media, and the medical and mental health fields—namely that gender and sexuality are not deeply intertwined.

In fact, they are, and both have to do with “going to bed.”

As acknowledgements of and debates about trans kids have grown, so has the insistence that other cultures have them, too, and that gender identity—a kind of gendered soul, independent of the body—is a cross-cultural concept. You might have heard of the muxes of Mexico, the Samoan fa'afafine, Brazil’s travestí or the hijra of India, each group often referred to as a “third gender.”

What do they have in common? They are androphilic males. That is, they are males attracted to other males, and they are traditionally feminine in their mannerisms. The fa'afafine experience “transgendered male androphilia,” which, per Paul L. Vasey and Doug P. VanderLaan in a paper called “Birth order and male androphilia in Samoan fa'afafine,” “occurs between a male who is markedly gender-atypical and another who is more or less gender-typical for his own sex.” They don’t treat each other as equals and have different social roles, they write—but at least fa'afafine have a place. “In many non-Western cultures, transgendered androphilic males often occupy ‘alternative’ gender role categories that are distinguished linguistically from the gender-normative categories of ‘man’ and ‘woman’,” they write.

Note that they occupy alternative gender role categories, not gender identity categories. There is a linguistic distinction but not a biological one, and there is no insistence that these men are women, or that their gender nonconformity—that is, their membership in one sex category and tendency to behave more like the other—is unrelated to sexuality. Rather, their gender and sexuality are accepted as intertwined, and this third category creates space for them to be themselves.

If they’re feminine males attracted to other non-feminine males, you may be wondering, why aren’t they just called gay men?

Lots of reasons, foremost among them cultural differences. Vasey and VanderLaan note that sometimes “attempts to draw comparisons among androphilic males in these different groups are misguided because these phenomena cannot be understood outside the unique cultural contexts that give rise to them.” Homosexuality in those cultures mentioned above may be illegal or taboo, but this third gender category is not. In the west, homosexuality is known and named, whether it is accepted, embraced or denounced. We have such different experiences of gender (used here to mean how masculine or feminine someone is) and sexuality that we can’t draw straight lines between those cultures and ours. Our categories are different.

But the truth is, these are varied ways of understanding very similar people, namely feminine, androphilic males. When we insist that gender and sexuality are separate, we ignore the established relationship between childhood gender nonconformity, gender dysphoria and/or cross-sex identity and later non-heterosexuality. Vasey and VanderLaan note that almost universally, “androphilic males recall significantly more cross-gender behaviours in childhood when compared with their gynephilic counterparts.” And: “cross-gender behaviour in childhood reflects a culturally invariant pattern of psychosexual development shared by most androphilic males.” That is, most (though not all!) very feminine young boys will grow up to be attracted to men, in many different cultures.

There are correlations between childhood masculinity, or tomboyism, and lesbianism, too. In one study called “Tomboys Revisited: A Retrospective Comparison of Childhood Behavioral Patterns in Lesbians and Transmen,” 30% of the reference group (non-lesbians or trans men) had been called tomboys growing up, while 73% of the lesbians and 90% of the transmen had been called tomboys. What was the big difference between the transmen and the lesbians in this study? Mostly age. The mean age for transmen was 29.6 and 51.7 for lesbians. The transmen had much easier access to the technology that can change the appearance of one’s sex, and lived in a time when it was openly discussed as an option. (They were also more likely to wear boys’ underwear and shoes.) But plenty of girls with masculine behavior grew up to be straight, and that’s because tomboyism has historically been accepted as a normal variation of girlhood, and in multiple eras has been encouraged for girls.

Meanwhile, in a recent study of boys referred to a gender clinic for what was then called gender identity disorder (not all of them met the criteria for it), 88% of them desisted, and 63.6% were later same-sex attracted. There was significant overlap between cross-gendered childhood behavior and later sexuality. This finding is fairly common in studies of kids with early onset gender dysphoria, who were not socially transitioned (a very recent practice): The great bulk of them desisted, and most grew up to be gay.

To some of us, the connection between childhood gender nonconformity or gender dysphoria seems obvious. We’ve known young, feminine boys or masculine girls who grew up to be gay (and some who haven’t, of course). But even before we taught kids that there was something called “gender identity,” a male child’s feminine behavior was often vexing to those around him, and often to the boy himself. That’s why, until about 2005, more boys were referred to gender clinics than girls. They didn’t have the protective tomboy category. But older boys and younger boys often had very different experiences of gender dysphoria.

Since the 1980s, psychologist and sexologist Ray Blanchard had been researching and reporting on what he saw as two main types of patients seeking sex reassignment. He broke them down into homosexual transsexuals and non-homosexual transsexuals. The young kids presenting at clinics tended to grow up to be same-sex attracted, and often consisted of extremely feminine boys and masculine girls, whose distress might have come both from an internal sense of not fitting in and/or from parental and other external pressures to do so. They often ended up fitting in Blanchard’s homosexual transsexual typology—boys who were so naturally feminine that they felt like girls, and girls who were so naturally masculine that they felt like boys.

But another cohort often didn’t present until puberty or later, and rarely had a history of childhood gender nonconformity, cross-sex identity or dysphoria. And they were heterosexual, bisexual or asexual. Most got an erotic charge from imagining themselves as women, which manifested in everything from wanting to wear women’s clothes to masturbating to the idea of themselves lactating or menstruating. Blanchard called this “autogynephilia,” or “love of oneself as a woman.” The bottom line: their transgender identity was a manifestation of their sexuality.

It used to be that the older a young person came out as transgender, the more likely they’d persist, but that was likely because those were autogynephilic men. Sexuality is difficult to change, and because autogynephilia is related to sexuality, it will likely persist.

Starting in 2013, many more kids started going to clinics, and the patient group became increasingly female. This new cohort has very little in common with the young people clinicians had seen in decades past. The teen girls (and boys) often seen today, with a host of complicated mental health issues, peer pressures, and social media influences, have really not been studied, except in Lisa Littman’s study based on parental reports (a perfectly reasonable basis for a study, but the conclusion she comes to is that we need more research—which, clearly, we do). This new cohort confounds the research that came before, and disrupts the long-established connection between gender dysphoria or gender nonconformity and sexuality. That doesn’t mean the connection has disappeared. It means that quite suddenly a brand new patient group has gender dysphoria, and we may need new methods of treating it. The combination of a new zeitgeist that celebrates rather than pathologizes trans people, and an increasingly available and powerful technology, has radically altered the clientele of gender clinics. Many of those clients are woefully misinformed about the overlap of gender and sexuality.

There are certainly far more than two types of people seeking gender medical interventions today, but that doesn’t mean these theories aren’t important. Blanchard’s theories are objected to or rejected by many people, who feel that it makes trans women out to be perverts, though Blanchard himself never attached moral judgment to the category; it was strictly a way of describing the patients he saw. It’s possible that autogynephilic males as the ones most invested in insisting that gender and sexuality are unrelated, and clearly that idea of disconnection has been cemented in society. Few young males transitioning today have ever heard of autogynephilia. Yet many autogynephiles, including Debbie Hayton, James Shupe and Anne Lawrence, see themselves clearly represented in the research once they find it, which helps alleviate their suffering. As this autogynephilic young man explains, sometimes understanding the source of your urges can alleviate the need for surgery or medical interventions. And other times, knowing the source can still lead you down the medical path, but for different reasons.

I am not against creating new categories. I have spent a lot of time with kids who are tremendously different from other kids in their sex category and my message to them is: That’s fine, that’s great, you’re perfect just as you are. It is incredibly distressing to me that 1) this message could be misinterpreted as hateful and 2) gender nonconformity continues to be misunderstood, pathologized, and medicalized, when all it needs to be is accepted. It is not a predicator of any one outcome. We see correlations, not causation. GNC kids are more likely to be gay, but there’s no way to know until they grow up and find out themselves. If a new category makes psychological space for that, okay. But I find these categories don’t normalize nonconformity; they end up pathologizing it anew, which can lead to medicating it.

Some have questioned whether the desistance statistics will change now that social transition is a common practice; will kids persist in their transgender identity if they’ve been living that way since they were young, rather than, as they once did, tend to find their dysphoria resolves as they understand their sexuality more? That is, will social transition create a condition that would otherwise have gone away on its own?

More importantly, if it’s hard to tell the difference between whose dysphoria will subside and whose will get worse; who will identify as gay and who will identify as trans (or neither); who will end up being fine with their bodies and who will find that the much more complicated and high-risk choice of transitioning is the most successful way to treat dysphoria—then how can we know whether social transition is safe or ethical? How can we assuredly forecast future meaning from childhood gender nonconformity? I have met doctors and psychologists who feel that with careful evaluation over long periods of time, such a distinction is possible. But even some of them have had patients detransition due to regret.

I’ve talked to a number of detransitioners who thought that their feelings, their differences, their distress, their gender nonconformity was about gender, not sexuality, because that’s what they’d been taught. They thought that their body needed to be fixed, but some of them hadn’t even used their body for sexual pleasure yet. We don’t know the long-term effects of blockers, hormones and surgeries on sexual pleasure when children transition. (I have heard from several detransitioned lesbians that their sexual appetite vastly increased and changed when they went on testosterone, and several became attracted to men. Seems like a great thing to study).

There’s so much we don’t know. But we do know that gender and sexuality have much in common, and we should make sure young people know that, too.

*PS: Should it be “whom you go to bed as”…?