Homosexuals are considerably overrepresented among mentally ill people known as transsexuals, and hence some correlates of transsexualism and related phenomena should be considered. Also note that this association cannot be explained in terms of the usual suspects, i.e., stigma, prejudice, discrimination and victimization.

Some definitions will help:

  • Transvestism: Cross-dressing.
  • Fetishism: Deriving sexual pleasure from nonliving objects.
  • Transvestic Fetishism: Deriving sexual pleasure from cross-dressing.
  • Transgenderism: Varying levels of identification with the opposite sex.
  • Transsexualism: A subset of transgenderism where the affected person desires to be the opposite sex and seeks sex-reassignment surgery and cross-hormone treatment. Transsexuals tend to cluster into two groups: those with straightforward opposite-sex identification and a more variable group consisting of those with opposite-sex identification in conjunction with autogynephilia.1, 2, 3
  • Autogynephilia: The phenomenon of a man deriving sexual pleasure by imagining himself to be a woman or having a woman’s body parts.

Note: Transvestic fetishism and autogynephilia are paraphilias.

Homosexuality, bisexuality and transgenderism

One comes across several GLBT (Gay, Lesbian, Bisexual and Transgender) organizations. Since gays, lesbians, and bisexuals experience same-sex attraction and [usually] engage in homosexual behavior, it makes sense that these groups are lumped together by homosexual activists, but why also include the transgendered in light of the fact that seeking mainstream acceptance is not facilitated by associating with people that many if not most in the general population regard as freaks? The answer is simple; a substantial number of transgendered individuals are homosexual or bisexual:

A number of transsexuals do not like being labeled homosexual. To address this issue, one should distinguish sex from gender identity. A person with male sex who has a female gender identity and is attracted to men would self-classify as a heterosexual because he believes that he is a woman. However, the standard conceptualization of a homosexual is based on biological sex, not gender identity. If this person seeks to look like a woman, then at best he can be made to look more feminine via sex reassignment surgery (SRS) and cross-hormone treatment, not become a woman as in someone with a female sex. This person's legal sex may change, but the biological sex doesn't. Hence, the person described is a homosexual.

Various considerations are consistent with the notion that male-to-female transsexuals attracted to men are a type of homosexual men:

  • Male homosexuals are more likely to have older brothers, on average, compared to heterosexual men, and male-to-female transsexuals who are attracted to men are also more likely to have older brothers, on average, compared to male-to-female transsexuals that are either asexual or attracted to women or attracted to the idea of imagining themselves as women or having women’s body parts.4, 5, 6, 7, 8
  • Not only has the subpopulation of vasopressin-containing neurons of the suprachiasmatic nucleus (SCN) been reported to be twice as large among male homosexuals compared to heterosexual men,9 2 out of 3 male-to-female transsexuals have also been reported to manifest an increased number of vasopressin-containing neurons in the SCN.10

There is a strong association between sex-atypical childhood behaviors and adult homosexuality:

Average effect size (Cohen's d, mean ± standard deviation) obtained in a meta-analysis: men = 1.31 ± 0.43, women = 0.96 ± 0.35; these effect sizes have been corrected for biases by the use of Hedges’s correction.11

Homosexuals and bisexuals are more likely to experience sex-atypical feelings of masculinity and femininity in adulthood compared to heterosexuals.12 An association between homosexuality and transvestism is readily observed in any gay pride parade. Men who have sex with men have also been shown to be relatively overrepresented among transvestic fetishists in a random, population-based sample of Swedes.13 Therefore, there is little doubt as to an association between homosexuality/bisexuality and transgenderism.

Transgenderism and its association with psychiatric morbidity and other anomalies

Psychiatric morbidity, specifically of personality, mood, dissociative, and psychotic disorders is especially elevated among individuals with sex-identity disorders, and sex-identity disorders often occur as secondary to some other mental disorder.14 For instance, delusions about one’s physical appearance and a desire to drastically alter one’s looks are not unusual among schizophrenics;15, 16 about 25% of schizophrenics experience cross-sex identification at some point in their life.17, 18, 19, 20 The association between schizophrenia and increased odds of homosexuals interests is well-documented.

About half of boys with feminine behavior and three-fourths of boys with highly feminine behavior develop into homosexuals.21 Behaviorally feminine boys manifest an elevated incidence of anomalous outcomes such as enuresis (involuntary urination), inguinal hernia, imperfect descent of testes, speech impairment, and possibly other minor physical anomalies.22, 23, 24, 25 Genes influence such defects.26, 27 In an examination of 43 behaviorally feminine boys, 2 (4.7%) had undescended testes and 5 others had some delay in fixation in the scrotal sac of one or both testicles vs. 0.78% in the general population; 32.6% had speech impairment, which is remarkable; 34.9% displayed enuresis at age 5 years or later vs. 9% at age 5 years or later in the general population; 18.6% had inguinal hernia vs. 1.9% in the general population, and the behaviorally feminine boys were also worse off than ambulant psychiatric controls on these measures.28

In reference to the association between behavioral femininity among boys and enuresis, as mentioned above, elevated left-handedness has been reported among individuals with primary nocturnal enuresis.29 Left-handedness is associated with prenatal developmental disturbances, as evidenced by a higher incidence of first trimester-originating minor physical defects among left-handers.30 Behaviorally feminine boys who wish to be girls manifest elevated left-handedness/non-right-handedness.31 Both homosexuals32 and transsexuals33, 34 manifest elevated left-handedness/non-right-handedness.

In reference to the association between schizophrenia (which results from prenatal developmental disturbances), homosexual interests and cross-sex identification, as mentioned above, compared to normal individuals, it has been documented that schizophrenics manifest elevated non-right-handedness,35, 36, 37, 38 schizophrenics manifest reduced functional brain asymmetry,39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 left-handed individuals manifest reduced functional brain asymmetry,50, 51, 52, 53 and both right-handed homosexuals and right-handed transsexuals manifest reduced functional brain asymmetry:

Studies examining visual55, 56 or auditory54, 57 task processing by right-handed homosexual and heterosexual men have revealed reduced functional brain asymmetry in homosexual men. Consistently right-handed male and female homosexuals tend to have reduced functional brain asymmetry compared to consistently right-handed heterosexuals; however, non-consistently right-handed male and female homosexuals tend to have greater functional brain asymmetry than non-consistently right-handed heterosexuals.54 Among heterosexuals, consistent-right-handers show greater functional brain asymmetry than non-consistent-right-handers.54 In contrast, both homosexual men and women do not show an association between hand preference and magnitude of functional brain asymmetry.54 The reduced association between motoric (related to movement) and linguistic components of cerebral asymmetry in homosexuals is consistent with elevated non-right-handedness among homosexuals.54 Both right-handed male-to-female transsexuals and right-handed female-to-male transsexuals manifest reduced functional brain asymmetry compared to sex-matched controls.58 The reduced functional brain asymmetry among MF-TS in spite of right-handedness is similar to the lack of association between hand preference and magnitude of functional brain asymmetry reported in homosexuals.54

Atypical brain asymmetries are associated with disturbed prenatal development;59, 60 also see the following:

A study examined 18 atypical functional brain conditions or phenomena (ABCP) (non-right-handedness, enuresis after age 5, learning and speech disorders, etc.) in a sample of 434 women with lifetime major depressive disorder.61 The correlation between ABCPs and migraine was 0.36, 95% CI = 0.26-0.43, p < 0.0001. Only 9% of women (n = 11) with no ABCPs had migraine, but 85% of women with 8 or more ABCPs (n = 40) had migraine.

Several developmental disruptors are associated with an increased likelihood of behavioral sex-atypicality, thereby associating sex-atypical behavioral traits with developmental disturbances:

Consider two examples below:

  • Prenatal exposure to anticonvulsants such as phenobarbital (PB) and phenytoin (PT) result in a smaller head, fewer teeth, maxillary hypoplasia, a higher prevalence of learning problems, mental retardation, lower verbal IQ, worsened spatial ability, and altered dermatoglyphics.62, 63, 64, 65, 66, 67 Prenatal PB and PT exposure disturbs sexual differentiation in animals via an androgenic effect. Dessens et al. compared 147 anticonvulsant-exposed Dutch subjects (72 men, 75 women) with an equal numbers of matched control subjects.68 Compared to controls, a greater number of anticonvulsant-exposed subjects reported current or past sex-atypical behavior and/or a desire to be the opposite sex. In addition, two anticonvulsant-exposed men reported exclusively homosexual experiences, whereas none of the control males reported exclusively homosexual behavior. Three of the subjects were transsexuals and had undergone sex reassignment surgery, a remarkably high rate given that only about 1 in 12,000 men and 1 in 30,000 women in the Netherlands are transsexual.69, 70
  • Polychlorinated biphenyls (PCBs) are developmental disruptors that decrease IQ and produce behavioral abnormalities with symptomatology similar to ADHD in children, and elevate hyperactivity, impulsiveness, and frustration in rats.71 Prenatal exposure to PCBs diminishes masculinized play behavior in boys and elevates masculinized play behavior in girls, and prenatal exposure to the developmental disruptors know as dioxins elevates feminine play behavior in both boys and girls.72

Male homosexual mental patients exhibit higher feminine identification than male homosexual non-patients.73 Among male homosexuals, greater boyhood femininity correlates with lower self-esteem,74 elevated suicidality,(75; see here) greater anxiety and a higher prevalence of depression in adulthood;76 such associations have not been reported with respect to more masculine behavior among girls,77, 78, 79 which is consistent with normally elevated sex-atypical behavior among girls,80, 81, 82 i.e., the threshold of sex-atypicality associated with disturbances in girls is higher than that among boys, and these disturbances won’t be revealed unless one has a sample size large enough to include several girls with highly masculine behaviors. On the other hand, the disproportionately bizarre behaviors/thinking of feminists (a considerable number of whom are homosexual, bisexual, or masculinized heterosexual women), extensively documented in the book here, provide plenty of proof that sex-atypical behaviors--beyond a threshold--among women are associated with disturbed functioning.


In summary, an association of homosexuality with varying levels of cross-sex identification provides additional evidence that homosexuality is accompanied by an increased likelihood of mental disorders not accounted for in terms of the usual suspects.


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