We have come a long way since the understanding of almost 70 years ago. I fundamentally have no problem with the difficulties researchers were grappling with then as discussed in the article. Knowledge and understanding were far more limited. At that time there was a lot of confusion as to what exactly was the source of gender identity—the sense of either feeling like a boy or a girl or neither or both. In recent decades we have begun to realize that the brain structure and function of transgender brains matches that of the gender they identify with, not the gender that has been assigned to them because of primary sexual characteristics. A better way of looking at the debate I think is to realize that the concept of sex involves not just observable external genitalia, but also brain structure which cannot be seen. By focusing on the external we ignore another important part of the equation. Brains can be “sexually“ male or female or somewhere in between. To the extent that someone has a brain that is female, their gender identity is female because that reflects their self-awareness and sense of personhood.

The discussion needs to be expanded from beyond what is visible to include those invisible aspects of human anatomy which are just as important in determining someone’s true gender. Even those who do not fully accept the ever expanding medical and scientific evidence, for the most part have rejected the idea that gender dysphoria is a psychological pathology which can be cured. They at least accept it is a natural part of the person afflicted with gender dysphoria. If it is not a mere whim or psychological preference, where does it come from? The answer is becoming more evident that it comes from the structure and operation of the brain. In current debates, we focus on the wrong thing, or more accurately leave an important aspect of the science out of the discussion. Transgender women are women because they identify as such because of brain structure and chemistry. Transgender men are men because they identify as such for the same reason. Nonbinary people fall somewhere in between. That is just the way they are. There really is no debate.

The dispute will continue to rage until the general public understands that sex is determined both by the brain and by primary and secondary sexual characteristics. Both are necessary to have a fully congruent person. Most cisgender people are unaware of the possible discrepancy because their brains and sense of identity match their physical characteristics. With trans people, there is a mismatch. The aren’t somehow defective, just different. But that that is the nature of the natural world. Sex and gender exist on a continuum. The concepts are not binary, not either or. Hopefully, with better general understanding, the vitriol will begin to subside and transgender people will be accepted as full members of society, no different than those who are left-handed or have blonde hair or blue eyes or any other distinguishing characteristic. They are no different from any of the rest of us with regard to their essential humanity. There is nothing to fear from them as a group. Indeed I would posit that they are some of the most sensitive, loving, and affirming people alive because they are acutely aware of the ways in which they are different from the majority of the population and of the diversity which actually is present in humankind. In the same way that people of color are aware of the unspoken irrational biases of white people, transgender people are equally aware of the often unconscious and irrational biases of cisgender people. It gives us a unique perspective on life and a more magnanimous nature. We tend to be inclusive and understanding as a group.