Fairfax, VA, USA. Whoever we were and whatever we did before transition, the tasks we now face go beyond the bromides of I can get on with my life and I can just be who I am or These days, I can just be.

Children are out there asking questions that press against heart and conscience: And who are you, really? and What about us? These are issues that have already reached the family dinner table.

Many of us today raise children; in time, there will be even more families where one or both parents have a transsexual history.

There are even more children involved than we think. Even a cursory meditation on the science of our birth condition reveals that we share underlying developmental mechanisms in common with other, nominally unrelated, birth anomalies. Science has focused our attention on fundamental processes and mechanisms, revealing a deep structure that undergirds a profoundly different understanding of family. Solving the mysteries of our origins can help other, younger versions of ourselves and contribute to solutions for many more unknown to us.

Giving back

"We have much to share with the world and it is time to give back.

Our particular exploration of the uniqueness represented by a body plan gone awry during human development yields informative results. We should share the information.

The alleviation of suffering from other, seemingly unrelated, conditions will someday be directly attributable to what we have learned about ourselves."Transsexuals in transition commonly use comparisons to justify themselves that range from supposed birth defects (e.g., cleft palate and other anomalies) through minor genetic variations through an act of God. These similes are serviceable in their own way but beg an important question: "If transsexualism is like cleft palate, why isn't cleft palate like transsexualism". Perhaps it is but only in some important way down below the surface seldom reached in casual conversation.

Families of Deep Structure

Family life brings consideration of issues that mean the most to people, all attached to self and others. Many of us with transsexual histories lost family, friends, children, and other social relationships. Too many will never reconcile, but the wounds closed for some and made possible a degree of reconciliation. Others come through with some or all of their relationships intact, a trend strengthened by increasing medical and social acceptance.

A substantial portion of those people with a transsexual history are essentially childless because of their previous losses and/or — as in the case of MtFs — the inability to conceive. However, they can still form relationships with a partner who has children or play very important roles in an extended family. Someday these arrangements may well be looked upon as a foundational step toward full and unimpeded access to a satisfying family life.

There have only been small steps so far, but the future is clear: both nuclear and extended families will include people with a transsexual history whether they themselves have children or not. Whether formed via previous history, marriage, and/or adoption, the children will appear and their needs cannot be denied. Public perceptions of people with a transsexual history are enriched as such families buckle down to the same challenges faced by the rest of society. And many, if not most, will be out.

Truly, we have — and will have — more children to raise and their general welfare does not depend on immediate and deep knowledge of our past. But experienced parents know this will not be enough in the long run, given the hunger of children for specific knowledge of their origins. We must at all times respect individual desires for privacy, of course, but for many full disclosure will be essential and very likely an article of civilized family life.

Perhaps this is only a highly optimistic vision but for children growing up in such families, parental history will no longer be located in a distant and very secret family past. Moreover, this will liberate conversation at the family dinner table to include open talk of family trees and issues of the day peculiar to people of a transsexual history. Such conversations are a bracing opportunity for calm consideration of who we are and for the children — who they are.

Rare and Random ...

There is every indication that transsexuals are both rare and random. We, people born with a misalignment of our brains and anatomical sex, seem to turn out in every imaginable social context. To some, it appears we occur for no discernible reason and must be the result of conscious decision. Perhaps for social analysts the transsexual population group is too large and disguised to discern a pattern.

A rare prevalence can be defined in mathematical statistics as one with a probability that is greater than 0%, but less than 5%. [N1] The upper bound is open to argument but you get the idea. We also have to consider absolute numbers. Using the 0-5% range, the prevalence in one billion people can be as many as 50,000,000.

When a group of things are nearly identical (varying in one characteristic) they will have an order. For example, the first eight numbers can be in a sequence (e.g., 12345678) or in some other order (e.g., 14159265). The second group may look disordered but it happens to be the start of a sequence beyond the decimal point in the value of pi (3.14159265 ... n). The number group is said to be ordered (even though the true value can be calculated out to some unknown value).

If a group lacks any any sort of apparent order, any one number can be described as a random occurrence. Note we are talking about apparent order. Sometimes, we simply do not know whether a particular value is provably random or not, nor can we discern a pattern. The solution may require a very large sample.

Standard estimates placed the earth's population at 6,790,062,216 in 2009, of which there were 2,234,860,865 males between the ages of 15-64 years. To show how rare we are let us assume the ratios used for the transsexual population refer only to post-ops. Note that with an incidence between 1:50000 and 1:35000, commonly used when discussing post-op MtF transsexuals, this works out to between 44,697-63,853 women worldwide who have had surgical correction. Another recent estimate argues for 1:2500, or 893,944 postops. Another estimate of 1:500, based on methodologically suspect assumptions about preops, results in 4,469,721 women, just 0.20% of the subject "male" population. So, even with these generous assumptions, we are exceedingly rare. [N2]

Whatever the actual number, it can only increase at a pace with continuing population growth, but it is still a tiny and rare number in the broader scheme of things. Even so, we have to wonder: where are they all? Running counter to upward population trends, there are many cultures where transsexuals are outcast if discovered and susceptible to higher mortality rates. Political and social inequities subject the transsexual populations to unequal distribution of rights and resources, all too often resulting in depression, careless living, suicide, and murder. This further reduces our absolute numbers.

And this: the prenatal environment can be a particularly hazardous place for fetuses with genomic variations and other birth conditions. This is attested to by evidence from studies of fertility, miscarriage and prenatal complications. Of those conceived, how many transsexuals are born? We may never know, of course, but the hazards before birth are more than matched by those thereafter. [N3]

... But Not So Unique

Given our uncommon nature (and incidence), many postops among us who lay claim to a transsexual history are accused of claiming biologically unique status, one of the hooks for false accusations of sociopolitical separatism. The basic idea behind the accusation of our supposed unique status is that we promote ourselves as singular examples of humanity with absolutely no like or equal and represent an absolute condition. Such claims then face social punishment from those who, like activist transgenders, persist as sociopolitical ideologues who emphasize social uniformity over personal autonomy.

If we push all that aside and look down into the problem we can see there are more powerful forces at work, traceable to the nuanced findings of science. All humans, including transsexuals, share a common evolutionary descent, with refined (and evolving) mechanisms for inheritance, embryogenesis, and subsequent development throughout life. We are subject to the same chemical processes and developmental frameworks that are in place for everyone else. And like other people, things can go well or not, depending on the coherence and efficiency of our developmental processes. This explains the individual differences among transsexuals but more importantly it shines a bright light on the developmental mechanisms we share with other, nominally unrelated, birth anomalies.

The accumulation of evidence suggests that a psychosexually undifferentiated individual at birth does not exist. Some sort of differentiation takes place, no matter what value we may place on the resulting configuration. Genetic information is used to synthesize products used to create our basic structures and their configuration ( gene expression), a process that may be modulated, giving us our nuance and individuality. All cells in an embryo contain the same DNA, which includes both genes and non-coding sequences (the genome). Different genes are turned off and on during chromosome formation and later in different cells at different times to form specific tissues and organs as the embryo develops. Which instructions are read, and how, exerts a powerful influence on who we are and our commonality with others.

Our brain sex is established very early in our development, (comparatively) long before the emergence of our limbs and other structural components. Basic research findings show how an individual's neural crest (the progenitor of our neurobiology) can form in a generally correct manner but be left isolated in part or whole by malfunction in the execution of the brain's matching body plan. If our chromosomes and their contents are disorganized, or the information misapplied, variations in our body plan can occur at birth that range from the benign to the devastating.

Overall sex differentiation includes hormones, but also how the endocrine structures arose to manufacture and deliver those substances. How does this happen in the first place and how do they map to genomic/genetic drivers present in our DNA at conception? In other words: even if a brain is awash in hormones contrary to the morphologically external phenotype, how did the organizational capability to do so come about in the first place — and what triggers (activates) the event? It may well be that our brains (and signals sent to the mother) had a built-in expectation of a different genital anatomy. That is, our brains were already sexed before the hormonal events took place.

Moreover, the general framework described here can also occur in other contexts that involve non-sexual organs or bodily structures.

Our True Community

People form communities of interest around all kinds of issues that range from medical reversals (e.g., breast cancer) through civic initiatives (e.g., political campaigns). Somewhere in there, one can find birdwatching rivalries, transgender complaints, and other controversies. Activists on one side or other invoke a politically constructed notion of family to compensate for real or perceived social rejection and promote solidarity.

This can be useful up to a point, but too often impedes pragmatic action toward fixing the situation that stimulated controversy in the first place. Moreover, such structures become ossified and impervious to changing circumstances. For ideologues, there is nothing worse than having to drink the bitter brew of their own imploded worldview.

Case in point: science continues to find commonalities between birth conditions with causes that are traceable to the same underlying and canonical processes. [N4] The actual numbers are elusive, but their occurrence is constant and widespread. [N5] In any case, transsexuality and other birth conditions have much in common with each other. This poses the challenge for identifying common opportunities for research, funding, and nurturing social acceptance. No matter how the eventual numbers for transsexuals work out, we are still rare and can join with others in a similar position to increase our leverage.

Strictly social arguments based on outdated assumptions drawn from behavioral bias have no traction in a world increasingly oriented toward hard data collection, hypothesis formation, and experiment. Those of us with a transsexual history no longer need to prove our existence, since we are here. Scientifically speaking, we are "facts", our existence capable of scientific verification through direct observation.

But certain questions have enormous implications, like How did this happen? and Where did we come from? and What does it mean? and Where do we go from here? and others. These are considerations larger than ourselves that do not apply solely to ourselves, and have a special relevance for the children.

Many other people, born with anomalous conditions, ask the same kinds of questions. Moreover, the techniques used for our hormonal and surgical correction are the outcome of a long history in science, medicine, and law — with much more to come. Other patients, with other issues, have contributed much from their experiences to our treatment and survival.

We have much to share with the world and it is time to give back. Our particular exploration of the uniqueness represented by a body plan gone awry during human development yields informative results. We should share the information. The alleviation of suffering from other, seemingly unrelated, conditions will someday be directly attributable to what we have learned about ourselves.

Our true community awaits the participation of our families.

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