Anne Lawrence asks us, "What force is powerful enough to make us give up our whole place in the world; to make us risk estrangement from our families, loss of our jobs, and rejection by our friends?" Perhaps the answer is a force powerful enough to also keep us living in abusive relationships and powerful enough to prevent us from preferring sight to blindness? Identity.

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Clinical Intuition supporting Blanchard's Model

To this point, I have addressed Blanchard's model solely as a scientific account. But my guess is that most of those who support Blanchard's model were never really so focused on its scientific merits anyway. Really Blanchard's model is intuitive at a place where our intuitions about transsexuality completely fall apart: 'macho guys' who adamantly insist they are 'really' women. I believe the best expression of how Blanchard's model handles this extreme comes from Anne Lawrence's essay, "Men Trapped in Men's Bodies":

It is ... difficult to understand why males who are attracted to women, who have been fairly successful as men, and who do not appear remarkably feminine would [transition]. What force is powerful enough to make us give up our whole place in the world; to make us risk estrangement from our families, loss of our jobs, and rejection by our friends? [new paragraph] I know of only one force that powerful. ... The force in question is one designed by nature to be terrifically powerful, because it is necessary to ensure the survival of our species. That force is, of course, sexual desire.

She is certainly correct about how powerful a force sexuality can be. She reviews some of the relevant scientific literature and to avoid a digression I will not repeat it here. A theory which uses sexuality as its basic mechanism does provide a way to grasp intuitively MtF transsexuals with exceptionally 'macho guy' histories. Sexuality is something we can intuitively comprehend as the cause because, as we have probably all seen if not experienced, people do incredibly insane things for sex! Identity doesn't seem so powerful in comparison. Could it really be "identity" motivating transsexuals?

Before addressing the power of identity, I feel it's important to put the transgendered community into perspective. In particular, who is the prototypical 'non-homosexual' MtF transsexual. Unfortunately, I do not know of any study with a representative sample of transsexuals from which to draw generalizations. Of all the 'non-homosexual' MtF transsexuals I have met in person and in non-clinical settings, only one had a 'macho guy' feel. Most I know are relatively androgynous, often with one or two clear masculine traits they cultivated (e.g., analytical, independent) but otherwise 'soft' in the way they interact with others. It's true many do not have feminine gender-typed careers, but there probably is a reason for this. I am in a feminine gender-typed field (Developmental Psychology) and was viewed as almost the 'token' male. Being one of the few men in a field dominated by women makes your sex very apparent. An alternative to choosing a feminine gender-typed career is to choose a male gender-typed career where you do not need to be especially masculine. This seems to be what many transsexuals do. It's almost cliche to note how many pre-transition transsexuals are in science or technology (e.g., computer science). Personally, I doubt many of us chose these career paths so consciously, but it is striking how we (as a group) fall into careers where we can have one or two positive male-gendered traits affirmed (e.g., analytical) while otherwise being accepted as relatively androgynous. To me, these typical patterns of 'non-homosexual' MtF transsexuals are very consistent with the idea that our identities guide our choices, whether explicitly or implicitly. The 'miltary macho guy' MtF transsexual is more extreme than a prototypical case. Blanchard's theory provides clear intuitions for understanding the extremes of the transgendered world. But I hope clinicians will not force the vast majority of us to fit a model merely because a portion of the community seems to intuitively fit. As an alternative, could we intuitively understand all transsexuals with identity as an underlying mechanism?

Anne Lawrence and others make explicit how powerful sexuality could be as an explanation of transsexuality. They implicitly suggest that identity, on its own, could be nowhere near as powerful an explanation. Is this so? Identity is actually one of the most studied psychological phenomena. In its various forms, identity is correlated with a wide range of things. Awareness of stereotypes about our identities can influence our behavior, including our scores on standardized tests and the way we view who we might be in the future is related to things as diverse as: delinquency in childhood and how we handle life-threatening illnesses. (respectively: e.g., Steel, C. M. (1997) "A Threat in the Air: how stereotypes shape intellectual identity and performance", American Psychologist, v.52(6), pp. 613-629; Markus, H. & Nurius, P. (1986). "Possible Selves." American Psychologist, v41(9), pp. 954-969; Oyserman, D. & Markus, H. (1990), "Possible Selves and Deliquency", Journal of Personality and Social Psychology, v59(1), pp. 112-125). This sample of evidence suggests identity has far-reaching implications. What remains unclear is: (1) can identity be a causal mechanism rather than merely a correlate and (2) if identity is a mechanism, just how powerful is it? To answer these questions, let's look at the phenomena of "self-verification."

"Self Verification" is the idea that, whatever our self concepts, we will actively seek to maintain our sense of self and actively thwart efforts to change our sense of self. Experimental manipulations suggest this is a true mechanism (e.g., Swann, W. B. & Read, S. J. (1981), "Self-verification processes: how we sustain our self-conceptions" Journal of Experimental Social Psychology, v.17, pp.351-372). The idea of self-verification might not be so surprising when you think about people with high self-esteem. They seek to find evidence that they are good and they minimize evidence to the contrary. But consider people with low self esteem. Do they really seek to keep thinking of themselves poorly? They do. A thought-provoking book on the subject is, "Self-traps: the elusive quest for higher self-esteem" by William B. Swann (1996). Consider the following excerpt about a previously summarized case study (pp. 18-19):

She reinforces her negative self-image by entering relationships with one abusive partner after another. Why would an intelligent women repeatedly choose partners who mistreat her? One thing is certain: such people are not masochists who derive pleasure from being walked on [evidence in footnote]. On the contrary, [she] and others with negative self-views suffer enormously at the hands of their abusive and demeaning partners. When asked to explain their choice of partners, they become uneasy and circumspect. If pressed, they sometimes point to a vague feeling of discomfort that they experience around people who like and respect them. "It's as if they don't quite know me," they sometimes complain half-jokingly. Wary of people who view them favorably, they gravitate toward those who do not.

I imagine most clinicians reading the above account will find it remarkably consistent with what they experience with their clients, whether transgendered or not. It's part of why getting therapy to work is so difficult; your client can often be the one thwarting therapy's success most. Examples of the profound extent to which we seek to verify our identities goes well beyond the case of low self-esteem. Examples include medical breakthroughs which we might have imagined would make people happy: a woman regains sight after years of blindness, a man with a falsetto voice all his life suddenly becomes capable of speaking as a rich baritone. Yet Swann (1981) discusses how each regrets the medical successes because they had so thoroughly assimilated their illnesses into their identities.

Anne Lawrence asks us, "What force is powerful enough to make us give up our whole place in the world; to make us risk estrangement from our families, loss of our jobs, and rejection by our friends?" Perhaps the answer is a force powerful enough to also keep us living in abusive relationships and powerful enough to prevent us from preferring sight to blindness?

Identity.

Though sexuality as a causal mechanism provides us with an intuitive way to understand the extremes of the transgendered community, identity provides us with an intuitive way to understand the transgendered community in its entirety.

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