I guess my doubts are really rooted in the terminology and how it's applied.
Zom, thank you for the discussion. I will look for the cite but the American Academy of Pediatrics believes the innate sense of being male or female is set by the age of four. I know at that age I already had a sense of wrongness.
I have only three specific memories when I was five years old. One of these memories is of my mother telling me that whether a baby was born a boy or girl was a matter of chance. I must have looked confused so she said, “it’s like a coin toss.” This statement had such emotional power that I remember where I was sitting and the sounds of the floor furnace to my right making those little popping and pinging metallic sounds as this information thundered inside of me.
It already felt wrong but now I knew what went wrong. I lost the stupid coin toss. It had gone horribly wrong. I lost when I was meant to have won.
I wanted a do over. 2 out of 3? 3 out of 5? Whatever it took.
Trust me: there was nothing in that time (nope, won’t date myself entirely!) and place (small town, rural Oklahoma) to make a five year old kid think that being born a boy was a crushing loss but I felt loss to my marrow. It was a sense of wrongness, an epiphany followed by a miasma which never went away. Of course, I did not know the words epiphany or miasma in that time and place any more than I knew words like “transgender” or “gender dysphoria.” There was no name for what I was and, as far as I knew, I was utterly alone.
I now feel a sense of immense relief which is impossible to fully describe. It sometimes takes my breath away. Like 41% of our population, when I was 19 I attempted suicide. How I felt then is a distant memory to which I have a hard time even connecting. I wish I had my doctor friend’s research citations as to how suicidal ideation and attempts plummet when the WPATH Standards of Care for GD are followed. Society can make life hard for trans* people but the internal struggle stops.
Here’s one more point before connecting back to your thoughtful points. With men who have their penises amputated for some reason like cancer, the phantom limb syndrome occurs in 65% to 85% of cases.
Of all the people I know who have had reassignment surgery, none of them have a phantom limb. Before my surgery this was a huge fear of mine. I would go through all of this pain and expense ($22K about) and end up feeling it was still there. I think something neurological is going on and this is not the only evidence I could cite.
I have no doubt about gender identity being separate from how that identity is expressed. I think gender identity probably breaks down into a U shaped curve with most at either ends of male or female (including trans) but with some identifying in the middle. I say this because I have friends who express that duality. I wonder in those cases whether they are confusing gender identity with gender expression, i.e. how we express masculinity or femininity.
Gender expression is infinitely variable within cultural constraints.
You are the only person to ask the relevant question. What does it mean to be, for example, a woman? DNA? A person with androgen insensitivity syndrome has XY chromosomes but has female anatomy at birth.
The leading theory is that trans women have a similar insensitivity to the androgen spurt which occurs in brain differentiation. My doctor friend assures me there are different male and female structures in the brain and that several studies show a similarity between the brains of transwomen and female women.
DNA is an incredibly complex code which sometimes goes awry. If that coding does not create male genitals, is a person still a man because of XY chromosomes? If that coding does not switch the default female setting in the brain to male, is that person a man?
Coding which does not work is irrelevant. What is between the legs is not nearly as important as what is between the ears.
I agree that no one knows the full truth. We may be far more complex than we ever imagined. Until we have some kind of Kurzweilian explosion of understanding about the body and brain, some of this will be people doing their best under a situation which, if not treated, causes them to want to die. 41% is the suicide attempt rate. Suicidal ideation is almost universal in cases of untreated GD.
I have little doubts about the broad outlines of GD and gender identity.
Finally, (yes, this post will end) I agree terminology is in need of a rework. “Trans,” as I’m sure you know is a latin prefix for “across,” e.g. transcontinental. I do not think I am moving across genders. I am only being myself. (“Cis,” as I'm also sure you know, is “on the same side,” e.g. Cisatlantic.) Fifty years from now we will almost certainly use different terms.
Allie