WEBVTT 1 00:00:00.000 --> 00:00:12.467 Episode 3 of the Charlie Rose Brain Series 3, underwritten by the Sloan Foundation, coming up. 2 00:00:12.467 --> 00:00:17.868 Tonight, we continue are magnificent human brain, with a look at gender identity and the 3 00:00:17.868 --> 00:00:19.601 biology of the brain. 4 00:00:19.601 --> 00:00:23.434 Gender Identity, is a persons subjective experience of their own 5 00:00:23.434 --> 00:00:24.334 gender. 6 00:00:24.334 --> 00:00:27.434 It may or may not correspond to the sex assigned to them 7 00:00:27.434 --> 00:00:28.334 at birth. 8 00:00:28.334 --> 00:00:34.367 The term transgender describes someone who feels his or her body and gender do not match. 9 00:00:34.367 --> 00:00:39.834 It is estimated that about 700,000 transgender people live in The United States. 10 00:00:39.834 --> 00:00:42.801 One of them joins me today to share his experience. 11 00:00:42.801 --> 00:00:47.067 Ben Barres is professor and chair of neurobiology at Stamford University. 12 00:00:47.067 --> 00:00:50.534 He lived and worked as Barbara Barres, until he changed his sex to male in 1997. 13 00:00:50.534 --> 00:00:59.534 Also here, a remarkable group of scientists, Norman Spack of Boston Children's Hospital, Catherine Dulac of Harvard University, 14 00:00:59.534 --> 00:01:02.534 Melissa Hines of The University of Cambridge and Janet Hyde of The University of Wisconsin at Madison. 15 00:01:02.534 --> 00:01:11.534 I am pleased to have all of them here and to begin this conversation with my colleague , Eric Kandel. 16 00:01:11.534 --> 00:01:13.534 What are we going to talk about? 17 00:01:13.534 --> 00:01:18.534 We're going to speak about, gender identity in the biology of the brain. 18 00:01:18.534 --> 00:01:20.534 This is a marvelous topic and I like it in particular, because it shows how brain science 19 00:01:20.534 --> 00:01:27.534 can be a liberating influence in our life. 20 00:01:27.534 --> 00:01:31.534 AS we understand the biology of our own gender identity better and become more comfortable with 21 00:01:31.534 --> 00:01:37.534 ourselves, we've become more empathic to somebody else's gender identity and we can 22 00:01:37.534 --> 00:01:46.534 understand if all of the sudden at age eight, nine or ten a person says, I'm in the wrong body. 23 00:01:46.534 --> 00:01:48.534 We really can sympathize with them and understand what's going on. 24 00:01:48.534 --> 00:01:56.534 But this is not only an interesting topic, it's an unbelievably timey topic. 25 00:01:56.534 --> 00:02:02.534 When you and I first began talking about this six months ago, it was not on the radar screen, we were ahead of our time. 26 00:02:02.534 --> 00:02:10.534 But now, you can't pick up an issue The New York Times or Vanity Fair without having a discussion of gender identity. 27 00:02:10.534 --> 00:02:17.534 And 17 million people watched the Dianne Sawyer interview. 28 00:02:17.534 --> 00:02:21.534 And what we can bring to bear in this subject, is not only a deep discussion of what sort of 29 00:02:21.534 --> 00:02:28.534 psychological and sociological issues are, but what the biological underpinnings of that is. 30 00:02:28.534 --> 00:02:33.534 When we begin to speak about the biological underpinnings, we want to distinguish, as you already implied, two different concepts, 31 00:02:33.534 --> 00:02:35.534 anatomical sex and gender identity. 32 00:02:35.534 --> 00:02:42.534 Anatomical sex is the body parts associated with sexuality and reproduction. 33 00:02:42.534 --> 00:02:50.534 Gender identity is a more subtle, complex image that is a sense of ones self as a male, female or something else. 34 00:02:50.534 --> 00:02:52.534 Let's begin with the anatomical sex. 35 00:02:52.534 --> 00:03:00.534 The anatomical sex is determined, not surprisingly by are genes. 36 00:03:00.534 --> 00:03:04.534 Genes are arranged in chromosomes and we have 23 pairs of chromosomes, we get half from our father-- 37 00:03:04.534 --> 00:03:09.534 we get one pair from our farther and one pair from our mother. 38 00:03:09.534 --> 00:03:16.534 22 of these are called autosomes and the difference between the fathers and mothers contributions are real, but 39 00:03:16.534 --> 00:03:17.534 there modest. 40 00:03:17.534 --> 00:03:23.534 But the sex chromosomes, the difference is really quite profound. 41 00:03:23.534 --> 00:03:30.534 Women are XX and men XY. 42 00:03:30.534 --> 00:03:34.534 The chromosomes are really quite different than the autosomes and they have a very important function in 43 00:03:34.534 --> 00:03:40.534 determining sex. 44 00:03:40.534 --> 00:03:46.534 Let's begin with the Y chromosome and see how that determines the sex of the male. 45 00:03:46.534 --> 00:03:47.534 We are born with an undifferentiated gonad that can move in either direction, it either can develop in 46 00:03:47.534 --> 00:03:51.534 to testes or ovaries. 47 00:03:51.534 --> 00:04:02.534 If there is a Y chromosome there, it has a region in it which is called the sex determining region of Y, that contains 48 00:04:02.534 --> 00:04:07.534 a gene that activates the differentiation of the undifferentiated gonad into the testes. 49 00:04:07.534 --> 00:04:19.534 If that Y gene is not there, you have an XX, you have a female gonad developed and each of those has profound consequences. 50 00:04:19.534 --> 00:04:20.534 Lets look at the male differentiates , first, the male testes. 51 00:04:20.534 --> 00:04:29.534 The testes develops within the first seven weeks in utero and if the testes matures as a result of the sex determining region of Y, the testes 52 00:04:29.534 --> 00:04:41.534 releases a massive amount of testosterone , comparable to the level you have at puberty and the adult. 53 00:04:41.534 --> 00:04:45.534 And that is responsible for giving you the male body form, the brain characteristic of male functioning, as well as having actions 54 00:04:45.534 --> 00:04:54.534 of sort of every aspect of your being. 55 00:04:54.534 --> 00:04:59.968 If this sixth determining region of Y is not, if you have XX, you have development of the ovaries, the ovary in 56 00:04:59.968 --> 00:05:06.968 turn secretes estrogen and progesterone and it gives you the female body form and it gives you changes in the brain. 57 00:05:06.968 --> 00:05:17.067 So clearly these are extremely important changes and that's the easy part, this is the anatomical part, the more subtle, the more 58 00:05:17.067 --> 00:05:25.334 elaborate part is the gender identity and that's why we brought together this spectacular group of people to talk about that. 59 00:05:25.334 --> 00:05:27.367 As you pointed out, we have Ben with us. 60 00:05:27.367 --> 00:05:37.701 Ben is a long term colleague, he is a major scientist in my field, in brain science, also in Catherine's field and he's chairman 61 00:05:37.701 --> 00:05:42.067 as you pointed out, the department of Stamford, member of The National Academy of Science and 62 00:05:42.067 --> 00:05:50.234 he's a transgender person, he made a decision in the 40s to actually undergo a bodily change and he can 63 00:05:50.234 --> 00:05:55.133 tell us what it was like before, when he felt he was in the wrong body and how he feels now. 64 00:05:55.133 --> 00:05:59.267 He not only can tell us how he feels, but interestingly enough since people knew him as 65 00:05:59.267 --> 00:06:04.834 a scientist before he underwent this change, they can describe what it was like interacting with him as a woman 66 00:06:04.834 --> 00:06:07.767 and now interacting with him as a man. 67 00:06:07.767 --> 00:06:09.267 We have Norman Spack with us. 68 00:06:09.267 --> 00:06:16.234 He is one of the pioneers in The United States of pediatric under criminology, you can help people make a decision 69 00:06:16.234 --> 00:06:22.501 as to weather or not they should go on with their idea that their in the wrong body and actually 70 00:06:22.501 --> 00:06:28.868 lead to a transformation and he has adopted a European strategy and really applied it in The United States of postponing 71 00:06:28.868 --> 00:06:33.968 puberty, so people can think through what they actually want to do and make the 72 00:06:33.968 --> 00:06:35.968 decision in intelligent and thoughtful fashion. 73 00:06:35.968 --> 00:06:40.968 And the reason he wants to delay puberty, is once puberty formed, its a much more radical procedure, then if 74 00:06:40.968 --> 00:06:41.968 you proceed before puberty. 75 00:06:41.968 --> 00:06:49.968 We have Catherine Dulac with us, again, an old friend who was here last time. 76 00:06:49.968 --> 00:06:57.968 She's interested in how sex is represented in the brain and she's found in mice, amazingly, that in the male mouse 77 00:06:57.968 --> 00:06:59.968 there's representation of the female. 78 00:06:59.968 --> 00:07:05.968 And in the female, there's representation of the male.This is not a completely novel idea, Freud, not working with mice, but with people, suggested 79 00:07:05.968 --> 00:07:11.968 we're all bisexual and we develop that way and one aspect of the sexuality matures, but the 80 00:07:11.968 --> 00:07:15.968 other remains and we certainly feel and we've heard about it in parenting, you pointed this out 81 00:07:15.968 --> 00:07:20.968 there are in men, female components and there are in women, male components, even in adult life. 82 00:07:20.968 --> 00:07:32.968 We have with us, Melissa Hines, who is interested in how kids differ, boys and girls in the games 83 00:07:32.968 --> 00:07:36.968 they play and how they interact to each other and she's interested in how hormonal levels 84 00:07:36.968 --> 00:07:45.968 effect child play in the games they get involved with. 85 00:07:45.968 --> 00:07:47.968 And we have Janet Hyde. 86 00:07:47.968 --> 00:08:00.968 Janet Hyde is interested in seeing what are the differences in cognitive capabilities between men and women 87 00:07:56.968 --> 00:08:04.968 And her data pretty much suggests that there's very little difference between them. 88 00:08:00.968 --> in computer science and mathematics and engineering. 89 00:08:04.968 --> 00:08:12.968 But as I've gotten to know, Janet a little bit better, I think that , that is incorrect. 90 00:08:12.968 --> 00:08:14.968 The more I speak to her, she majored in mathematics as an undergraduate, I've come to the conclusion that 91 00:08:14.968 --> 00:08:19.968 women are superior in mathematics and engineering and in computer science. 92 00:08:16.968 --> 00:08:26.968 Well, let me begin with Ben, tell me the experience that you 93 00:08:19.968 --> So anyway I think we're in for a fantastic program. 94 00:08:26.968 --> 00:08:31.968 went through, share with us a so much as you can about what led up to your decision, how you carried forward 95 00:08:31.968 --> 00:08:35.968 and in the impact its had on your life? 96 00:08:35.968 --> 00:08:40.968 Sure, I think in many ways my experience is probably typical for other transgender people. 97 00:08:39.968 --> 00:08:47.968 like a boy. 98 00:08:40.968 --> I was, I think only about four or five years old when I first started to have strong feelings that I felt more 99 00:08:47.968 --> 00:08:56.968 I was born as a girl, Barbara, but I felt like a boy, I played with little boys, I preferred boys toys, I remember 100 00:08:56.968 --> 00:08:59.968 dreadfully wishing I could be in the cub scouts and boy scouts. 101 00:08:59.968 --> 00:09:00.968 Every Halloween I would dress up as an army man or as 102 00:09:00.968 --> 00:09:04.968 a football player, this all just seemed very normal to me, I felt like a boy. 103 00:09:04.968 --> 00:09:07.968 But as I got into middle school, early teen years, I did start to feel more and more uncomfortable 104 00:09:07.968 --> 00:09:22.968 with this, I didn't feel I should have breasts, I didn't feel comfortable at all wearing dresses, make up 105 00:09:22.968 --> 00:09:30.968 jewellery and it became increasingly uncomfortable when I got into high school, you know I 106 00:09:30.968 --> 00:09:36.968 started to be teased more by kids, you know I just had a lot of confusion about my gender and I felt 107 00:09:36.968 --> 00:09:39.968 very ashamed of it, I never spoke with friends or family about it at all, ever once. 108 00:09:39.968 --> 00:09:41.968 No one? 109 00:09:41.968 --> 00:09:54.968 No, I just felt very ashame and very confused and don't forget this was the daysbefore the internet, so there wasn't a lot of information about this sort of thing. 110 00:09:54.968 --> 00:10:01.968 So as I got into my 20s, you know I was doing well, although I didn't feel good about my gender, I was doingwell in my career, I was doing medical training and research training, but I was increasingly 111 00:10:01.968 --> 00:10:05.968 uncomfortable and like many trans people I started to think about suicide, I never actually 112 00:10:05.968 --> 00:10:13.968 attempted suicide but I thought about it a lot. 113 00:10:13.968 --> 00:10:15.968 And this is actually a picture of me back when I was Barbara, I think I was 30 at that 114 00:10:15.968 --> 00:10:16.968 point and I was a brides maid at my little sisters wedding and I can still 115 00:10:16.968 --> 00:10:22.968 remember vividly, even though that was 30 years ago, just the agony 116 00:10:22.968 --> 00:10:28.968 that I felt, the discomfort, putting on that dress, wearing jewellery , wearing make up 117 00:10:28.968 --> 00:10:35.968 and still 30 years since, I still remember that. 118 00:10:35.968 --> 00:10:38.968 But anyway, I did complete my training and began a job at Stamford about 20 years ago when I was age 40. 119 00:10:38.968 --> 00:10:49.968 And about two years into that I actually developed breast cancer and I was still very 120 00:10:49.968 --> 00:10:51.968 confused about my gender identity, but I knew that I didn't like to have breasts and so when 121 00:10:51.968 --> 00:10:55.968 doctor said he needed to do a mastectomy to remove the cancer which very fortunately 122 00:10:55.968 --> 00:11:01.968 was picked up early and I was cured of, I said, while your there, please take off the other breast. 123 00:11:01.968 --> 00:11:10.968 And he was quite horrified, perhaps he was the first one I shared my feelings about gender 124 00:11:10.968 --> 00:11:14.968 identity, but since this cancer runs in my family, he did agree to remove the other breast and I 125 00:11:14.968 --> 00:11:19.968 just can't tell you how therapeutic that was, i felt so revealed to have those breasts removed 126 00:11:19.968 --> 00:11:24.968 and I recognized that was a very different response than my mom had when she had 127 00:11:24.968 --> 00:11:27.968 her mastectomy, she saw this as a huge blow to her femininity, but after the 128 00:11:27.968 --> 00:11:36.968 surgery, the doctor started talking to me about reconstructing the breasts and I was 129 00:11:36.968 --> 00:11:39.968 absolutely horrified, I said there's no way your putting those things back on me. 130 00:11:39.968 --> 00:11:46.968 So this was sort of a--maybe a increasingly a clue to me that really there was somethinga little bit different about my gender and it was only about a year later, I was reading the 131 00:11:46.968 --> 00:11:52.968 San Francisco Chronicle one day when I read a several page article about the life of James Green, 132 00:11:52.968 --> 00:12:01.968 an openly female to male transgender person in the Bay Area and I realized for the first time in my 133 00:12:01.968 --> 00:12:05.968 life that there were other people that had experienced the same sorts of genderconfusion, that there were other people like me and that I might be transgender and so I went to see 134 00:12:05.968 --> 00:12:15.968 Don Loub, who is sex change pioneer at Stamford and runs a gender clinic and indeed 135 00:12:15.968 --> 00:12:18.968 after they evaluated me, they told me that I thought I was transgender and they offered me the 136 00:12:18.968 --> 00:12:24.968 possibility of changing my sex which was immediately irresistible to me and very quickly 137 00:12:24.968 --> 00:12:28.968 within weeks, I decided to change sex, I've already had the upper surgery 138 00:12:28.968 --> 00:12:34.968 the mastectomy, I did not want lower surgery, but all that was needed was to take some testosterone and 139 00:12:32.968 --> 00:12:37.968 (laughter) 140 00:12:34.968 --> you can see the effects that's its had on me. 141 00:12:37.968 --> 00:12:41.968 It's powerful stuff and one of the most surprising things about the testosterone 142 00:12:41.968 --> 00:12:48.968 was that I actually to my great surprise, it became much harder for me to cry and 143 00:12:48.968 --> 00:12:54.968 male to females report that it now becomes much easier to cry, so that was perhaps 144 00:12:54.968 --> 00:13:03.968 a surprising experience, but i think the main experience that I had is just felt, 145 00:13:03.968 --> 00:13:10.968 after I changed sex, I cant--it's hard to describe the intense relief that I felt, just, like 146 00:13:10.968 --> 00:13:15.968 this weight lifted off of my back and I've been so much happier since, I've never hadanother suicidal thought and I have to say, at the time I decided to do this I was--as I was 147 00:13:15.968 --> 00:13:20.968 I had been I scientist at Stamford for several years, I was very worried that changing sex 148 00:13:20.968 --> 00:13:28.968 would alter--harm my career, this was 20 years ago, but I have to say that everybody 149 00:13:28.968 --> 00:13:32.968 all my colleagues and friends and family were immediately supportive and I've been 150 00:13:32.968 --> 00:13:38.968 very fortunate to have my career continue and to have lots of wonderful 151 00:13:38.968 --> 00:13:43.968 students and so forth.I guess the other thing that I'd like to say is that I think the other surprise, after 152 00:13:43.968 --> 00:13:51.968 changing my sex is that I found that living as a man has dramatically changed the 153 00:13:51.968 --> 00:13:54.734 way that people react to me. 154 00:13:54.734 --> 00:13:58.267 I can tell you a story about an experience that happened to me shortly after 155 00:13:58.267 --> 00:14:02.267 I changed sex, a couple years later I was invited to give a seminar about my research 156 00:14:02.267 --> 00:14:10.601 at MIT and one of my friends told me that after I gave the seminar, one of his colleagues was 157 00:14:10.601 --> 00:14:15.000 talking to him about the seminar and he said, gee, that Ben Barres, his work is so 158 00:14:15.000 --> 00:14:19.000 much better than his sisters, Barbara. 159 00:14:19.000 --> 00:14:20.300 (laughter) 160 00:14:20.300 --> 00:14:24.367 I think that, that experience sort of points out something that all of us 161 00:14:24.367 --> 00:14:28.434 transpeople weather we're female to male or male to female, we've lived life as both 162 00:14:28.434 --> 00:14:34.334 genders and we all share an intense anger at the different way that 163 00:14:34.334 --> 00:14:40.534 society treats men and women, simply based on their gender and I think in 164 00:14:40.534 --> 00:14:46.534 general, I think would we all say that, in general, society, with a man sort of assumes that 165 00:14:46.534 --> 00:14:52.200 their competent until proven otherwise, with women, their considered incompetent until proven 166 00:14:52.200 --> 00:14:53.534 otherwise. 167 00:14:53.534 --> 00:14:59.000 So this creates terribly unfair barriers for talented women for science, so I now devote 168 00:14:58.000 --> 00:15:03.000 Ok, let me turn to, Norman. 169 00:14:59.000 --> some part of my time trying to help women in their careers. 170 00:15:03.000 --> 00:15:07.000 So listening to that story, I assume , I mean this is a story that may be typical in terms 171 00:15:07.000 --> 00:15:13.000 of the--both someone who's questioning and to go from questioning to, to 172 00:15:13.000 --> 00:15:17.000 looking for solutions in the experience of the reaction after you have changed. 173 00:15:16.000 --> 00:15:23.000 Well, I wish we knew more, Charlie. 174 00:15:17.000 --> What does this say about gender identity? 175 00:15:23.000 --> 00:15:27.000 We certainly know it when we see it. 176 00:15:27.000 --> 00:15:39.000 I want to show you a very powerful example of identical twins who, in this case, one of the male 177 00:15:39.000 --> 00:15:51.000 twins and we have proven that these twins are indeed absolutely identical and born male.But one of them at age 3 started to say everything about being a girl. 178 00:15:51.000 --> 00:15:57.000 And in fact, if there was any issue that came up, she turned it into an issue of gender. 179 00:15:57.000 --> 00:16:04.000 And she did some of those things that we consider hallmarks ,like wearing-prefering to 180 00:16:04.000 --> 00:16:10.000 wear female underwear and female pajamas and etcetera. 181 00:16:10.000 --> 00:16:19.000 And by the age of seven, the family decided with the help of the counselor 182 00:16:19.000 --> 00:16:23.000 to change her name to a female name and to have the child assume a 183 00:16:23.000 --> 00:16:28.000 female role. 184 00:16:28.000 --> 00:16:38.000 So here is twin sister with twin brother at the age of, just about nine to ten years of age. 185 00:16:38.000 --> 00:16:39.000 What grade? 186 00:16:39.000 --> 00:16:47.000 And so--they were fourth grade.And what I want to point out is that is if I switched all the attachments to them, the 187 00:16:47.000 --> 00:16:48.000 earrings, the clothing, the hairstyle, the shoes, you could basically 188 00:16:48.000 --> 00:17:00.000 switch one for the other, the fact of the matter is that kids, with their clothes on are 189 00:16:59.000 --> 00:17:07.000 And actually their hormonal levels are virtually, at that particular point, interchangeable. 190 00:17:00.000 --> virtually interchangeable, pre-puberty. 191 00:17:07.000 --> 00:17:19.000 So everything happens, really at puberty. 192 00:17:19.000 --> 00:17:23.000 So here they are at age 14, now because it is so difficult to live in a gender different 193 00:17:23.000 --> 00:17:29.000 from your biologic sex, when you have the toxic effects of your genetically hormone 194 00:17:29.000 --> 00:17:41.000 driven puberty, which would basically make twin sister look exactly like twin brother. 195 00:17:41.000 --> 00:17:49.000 And you can see that she looks, still almost , like a nine or ten year old and there's 196 00:17:49.000 --> 00:17:50.000 a good reason for it, she's had her puberty suppressed. 197 00:17:50.000 --> 00:17:57.000 The next slide shows, the level of sex hormone across the human lifespan. 198 00:17:57.000 --> 00:18:00.000 Look at the blue line which is the male level of testosterone, the hormone that Ben was 199 00:18:00.000 --> 00:18:06.000 recieving and that some of us make, but that, during fetal life, especially in 200 00:18:06.000 --> 00:18:15.000 the mid trimester, the level of testosterone in a fetus rises to a level 201 00:18:15.000 --> 00:18:19.000 close to the full adult range. 202 00:18:19.000 --> 00:18:21.000 And then it falls and then there's another blip up, right after birth, a kind of 203 00:18:21.000 --> 00:18:28.000 second puberty and then things go completely dormant, in fact if they 204 00:18:28.000 --> 00:18:39.000 didn't go dormant, we'd have a whole bunch of pubertal looking fifth graders running 205 00:18:39.000 --> 00:18:46.000 around because everything is suppressed.ERIC KANDEL: When we're thinking about possible causes for transgender, and Ben 206 00:18:46.000 --> 00:18:51.000 and I spoke about this before, wouldn't it be possible to some aberration in 207 00:18:51.000 --> 00:18:53.000 testosterone secretion for example or estrogen secretion, doing intrauterine development 208 00:18:53.000 --> 00:18:57.000 or shortly there after, might be one of the contributing factors. 209 00:18:57.000 --> 00:19:04.000 It's certainly possible, it's certainly possible, there'sa very dynamic stage, we still don't know what that second bump is right after birth 210 00:19:04.000 --> 00:19:15.000 or what role it plays or weather boys who are born without testes, but are otherwise 211 00:19:15.000 --> 00:19:18.000 normal, show any differences as a result of that. 212 00:19:18.000 --> 00:19:21.000 The problem- -the problem, Eric is that , when we want to look at a hormone, we have to be 213 00:19:21.000 --> 00:19:28.000 able measure it--we have to get it out and measure it. 214 00:19:28.000 --> 00:19:32.000 Well, you cant get it out of the brain, the other problem is, sometimes it isn't 215 00:19:32.000 --> 00:19:40.000 the hormone level that's important, but the affinity of the receptor for the hormone and it's 216 00:19:40.000 --> 00:19:43.000 very, very difficult to measure--measure such things. 217 00:19:43.000 --> 00:19:46.000 This is really defing a really fascinating biological problem. 218 00:19:46.000 --> 00:19:52.000 To see what is the biological underpinning of trans gender identity. 219 00:19:51.000 --> 00:19:54.000 Because as you point out, its so important because kids who are in the wrong 220 00:19:52.000 --> Exactly. 221 00:19:54.000 --> 00:20:04.000 sex, you know, their incidents of suicide attempt is very serious. 222 00:20:02.000 --> 00:20:08.000 Yeah, so, this is something we really need to understand. 223 00:20:04.000 --> Oh, its one of the highest risks of any-- 224 00:20:08.000 --> 00:20:17.000 In the pubertal process, this whole system reawakens again, that system 225 00:20:17.000 --> 00:20:28.000 that had been awakened in utero , suddenly comes back in which, hypothalamic hittingthe pituitary caused the release of other hormones that strike the ovary or the testes and 226 00:20:28.000 --> 00:20:36.000 cause the release of what we call the sex steroid hormones which are testosterone and 227 00:20:36.000 --> 00:20:43.000 estrogen, mainly and those things produce the differences between the body of the male 228 00:20:43.000 --> 00:20:46.000 and the female associated with puberty. 229 00:20:46.000 --> 00:20:50.000 So we have been able to, probably since the 1980s, we've been able to block 230 00:20:50.000 --> 00:20:56.000 the release of the hormone from the hypothalamus to the pituitary and once you 231 00:20:56.000 --> 00:21:01.000 do that so far up stream everything downstream goes down to zero.And we have a record of this medication being completely successful in 232 00:21:01.000 --> 00:21:08.000 shutting them down until the appropriate time and also the fact 233 00:21:08.000 --> 00:21:10.000 that its completely reversible. 234 00:21:10.000 --> 00:21:15.000 Look how revealing this is, because the twin sister affirms a female identity and 235 00:21:15.000 --> 00:21:17.000 the puberty's blocked for two years, two years to get more time for counseling 236 00:21:17.000 --> 00:21:20.000 without the pressure of body change. 237 00:21:20.000 --> 00:21:28.000 That's very important because if we're going to give her estrogen, that's going to have 238 00:21:28.000 --> 00:21:30.000 perm effects. 239 00:21:30.000 --> 00:21:36.000 So take a look at what would happen to her if she hadn't been given this blockade, she 240 00:21:36.000 --> 00:21:39.000 would look exactly like twin brother. 241 00:21:39.000 --> 00:21:46.000 And he's in early puberty for a 14 year old, but so would she have been because 242 00:21:45.000 --> 00:21:51.000 Now here are the twins at age 17, at age 14, just after that picture was taken, she began 243 00:21:46.000 --> their identical. 244 00:21:51.000 --> 00:22:01.000 estrogen, while at the same time having her male hormones blocked. 245 00:22:01.000 --> 00:22:05.000 With that are patients don't need breast surgery when they feminize because it is so 246 00:22:05.000 --> 00:22:16.000 effective and she is now in that picture entering junior high school as is her brother and 247 00:22:16.000 --> 00:22:19.000 she's absolutely fabulous. 248 00:22:19.000 --> 00:22:25.000 This past October, the Dutch who taught us this, reported the first follow up of the 249 00:22:25.000 --> 00:22:26.000 patients, the 55 of whom, whose puberty was blocked and for whom 250 00:22:26.000 --> 00:22:31.000 sex steroids were later switched in the manner of our twin sister. 251 00:22:31.000 --> 00:22:42.000 The Dutch group all had surgery at 18 at which point their gender dysphoria, their total uncomfortableness 252 00:22:42.000 --> 00:22:44.000 with their gender disappeared 253 00:22:44.000 --> 00:22:53.000 And the Dutch found that the kids treated this way are psychosocially function as well or 254 00:22:52.000 --> 00:22:56.000 Is that a powerful argument for surgery? 255 00:22:53.000 --> better than the control group of non trans gender their being compared to. 256 00:22:56.000 --> 00:23:02.000 It's a powerful argument for available surgery at the right time for 257 00:23:01.000 --> 00:23:09.000 Also, I think one of the nice thing about the Dutch approach is that it 258 00:23:02.000 --> the right people. 259 00:23:07.000 --> 00:23:16.000 Once puberty sets in you have as--he just pointed out, physical changes that make it 260 00:23:09.000 --> delays puberty. 261 00:23:14.000 --> 00:23:21.000 occurring. 262 00:23:16.000 --> much more difficult to reverse, so you prevent those physical changes of the other six 263 00:23:21.000 --> 00:23:22.000 In addition to the biological changes that it delays, it allows the child to think through 264 00:23:22.000 --> 00:23:30.000 weather this is the course they want to be on, because some people say I'm in the 265 00:23:30.000 --> 00:23:31.000 wrong body, I want to be man, when their a woman, but change their mind after a few months. 266 00:23:31.000 --> 00:23:42.000 Think this is the wrong course, that occasionally happens. 267 00:23:42.000 --> 00:23:44.000 This delay allows not only the physiological process to be handled in a more satisfactory way, 268 00:23:44.000 --> 00:23:51.000 but the psychological evaluation to see weather this is the way the kid actually feels what 269 00:23:51.000 --> 00:24:02.000 is only a temporary decision in their minds.NORMA SPACK: So the Dutch gave me their protocol in 2006 and we started 270 00:24:02.000 --> 00:24:09.000 using it in Boston Children's Hospital at which time we were the only major medical 271 00:24:09.000 --> 00:24:18.000 center to do so, but we're not that many years since 2006 and over 40 programs now are 272 00:24:14.000 --> 00:24:19.000 So its now becoming the standard of care. 273 00:24:16.000 --> Mention it right here in the Times article. 274 00:24:18.000 --> doing it. 275 00:24:19.000 --> 00:24:29.000 Ok, now let me turn to, Catherine and talk about 276 00:24:27.000 --> 00:24:31.000 So as we have just heard from Ben and from Norman, 277 00:24:29.000 --> weather this is wired. 278 00:24:31.000 --> 00:24:39.000 humans have a very early and very strong sense of their gender identity and this is really 279 00:24:39.000 --> 00:24:44.000 a critical component of our individual identity as humans. 280 00:24:44.000 --> 00:24:45.000 Now, in early months as in humans, males and females display clear differences in 281 00:24:45.000 --> 00:24:56.000 behaviors, mostly, but not exclusively relate to sexual and social behavior. 282 00:24:56.000 --> 00:25:00.000 So for example, males and females have very distinct sexual and aggressive displays 283 00:25:00.000 --> 00:25:07.000 and we've seen in the previous episode that models of females are usually maternal 284 00:25:07.000 --> 00:25:10.000 and males in mammals are usually attacking the pups.So how are these differences established and how are they maintained? 285 00:25:10.000 --> 00:25:20.000 Well, the basic mechanics by which the brain controls gender specific behavior 286 00:25:20.000 --> 00:25:24.000 can not be studied experimentally in humans, so instead my laboratory is using the 287 00:25:24.000 --> 00:25:34.000 mouse as a model system, mice display clear differences, gender specific behaviors ans the 288 00:25:34.000 --> 00:25:39.067 mechanics by which the controls gender specific behavior in the mouse can be studied using 289 00:25:39.067 --> 00:25:44.701 all the modern tools and the power tools of modern neuroscience, molecular neuroscience and 290 00:25:44.701 --> 00:25:46.100 genetics. 291 00:25:46.100 --> 00:25:52.701 So, such typical behaviors, particularly sexual, aggressive and also parental behavior are 292 00:25:52.701 --> 00:26:00.067 extremely maintained across different animal species and so suggests that the (unintelligible) 293 00:26:00.067 --> 00:26:06.033 the brain control of those behavior is also very maintained across animals. 294 00:26:06.033 --> 00:26:11.267 Now in contrast, the signals that trigger these behaviors are usually extremely 295 00:26:11.267 --> 00:26:16.767 specific of a given species, so for example in the species of birds called the 296 00:26:16.767 --> 00:26:27.767 American flicker, there is only one sign that matters to trigger gender specific behavior and 297 00:26:27.767 --> 00:26:39.767 that is the black moustache on the face of the male.And so if you remove the black moustache from the face of a male, you just mask it 298 00:26:39.767 --> 00:26:41.767 then the other males will attempt to copulate with that male without a mustache because 299 00:26:41.767 --> 00:26:50.767 they will assume this is a female and similarly if you paint a moustache on the face of 300 00:26:50.767 --> 00:26:58.767 a female then the other males will attack that female with a moustache because they will 301 00:26:57.767 --> 00:27:04.767 So I have a male, I don't have a moustache I'm a female. 302 00:26:58.767 --> assume its a male. 303 00:27:04.767 --> 00:27:08.767 Now, mice in contrast, use mainly olfactory cues, a very specific set of olfactory cues called 304 00:27:08.767 --> 00:27:09.767 pheromone's. 305 00:27:09.767 --> 00:27:13.767 And humans are particularly sensitive to visual and auditory cues, a fact that has been 306 00:27:13.767 --> 00:27:24.767 exploited very successfully by the pornography industry. 307 00:27:23.767 --> 00:27:33.767 look into the brain, how is the brain processing the signals and establishing this 308 00:27:24.767 --> So once we know what are the signals that trigger gender specific behavior, now we can 309 00:27:33.767 --> 00:27:34.767 gender specific behaviors. 310 00:27:34.767 --> 00:27:48.767 As we have heard from, Norm Spack, In young males, there is a very important release of 311 00:27:48.767 --> 00:27:49.767 starried hormone testosterone and this release of testosterone has been shown to be 312 00:27:49.767 --> 00:27:56.767 absolutely essential to masculinized the brain. 313 00:27:56.767 --> 00:28:02.767 And in contrast females do not have release of testosterone, so in males the 314 00:28:02.767 --> 00:28:11.767 simplest interpretation is that testosterone is a essential to establish and maintain a very specific set 315 00:28:11.767 --> 00:28:17.767 of separate underlying male specific behavior and females organize their brain in a 316 00:28:17.767 --> 00:28:22.767 different way in order to control female specific behavior. 317 00:28:22.767 --> 00:28:24.767 Now, in our lab, we have performed a number of genetic experiments that show that 318 00:28:24.767 --> 00:28:32.767 the situation is a little bit more complex. 319 00:28:32.767 --> 00:28:33.767 The experiment we did is actually very simple, we looked at mutants for pheromone 320 00:28:33.767 --> 00:28:38.767 detection, which is indicated by this little cross here on the structure of the brain called 321 00:28:38.767 --> 00:28:45.767 the olfactory bulb. 322 00:28:45.767 --> 00:28:49.767 So this animal is simply insensitive to sex specific pheromonal cues and when we look at their 323 00:28:49.767 --> 00:29:01.767 behavior, we found something extremely surprising, so here in gray is a female mutant and 324 00:29:01.767 --> 00:29:03.767 in black is male and as you can see, this female is mounting the male which is a very 325 00:29:03.767 --> 00:29:09.767 male specific behavioral display, its a male specific sexual display, so these 326 00:29:09.767 --> 00:29:16.767 females in other words id displaying a male typical behavior. 327 00:29:16.767 --> 00:29:19.767 If we now look at the mutant males or a male that is unable to detect pheromone's, 328 00:29:19.767 --> 00:29:29.767 this male strangely, instead of attacking pups is now retrieving an infant and 329 00:29:29.767 --> 00:29:35.767 bringing it to a nest that this male has built right beforehand. 330 00:29:35.767 --> 00:29:38.767 So here, again this male is displaying a female specific parental behavior. 331 00:29:38.767 --> 00:29:41.767 So what do we learn out of this? 332 00:29:41.767 --> 00:29:47.767 Well, what we learn is that the brain of both males and females contain the 333 00:29:47.767 --> 00:29:56.767 representation of male and female behavior segment. 334 00:29:56.767 --> 00:30:07.767 So in females, a normal animals, the male behavior segment is repressed by the pheromonal 335 00:30:06.767 --> 00:30:07.767 And in males similarly the female specific segment is normally repressed. 336 00:30:07.767 --> system. 337 00:30:07.767 --> 00:30:13.767 But in the mutant that we observed, what is happening is the repression of the 338 00:30:13.767 --> 00:30:27.767 opposite brain, opposite sex behavior segment, does no longer exist and therefore the 339 00:30:27.767 --> 00:30:33.767 female now is able display both male specific behavior and female specific behavior. 340 00:30:31.767 --> 00:30:36.767 specific behavior. 341 00:30:33.767 --> Similarly, the male is able to display both a female specific behavior and male 342 00:30:36.767 --> 00:30:42.767 I think this is so beautiful, not only because this is something 343 00:30:42.767 --> 00:30:49.767 Freud was struggling with, but really I think provide a way we can begin thinking and 344 00:30:47.767 --> 00:30:57.767 behaviors, you can see how slight tilt for one reason or another could 345 00:30:49.767 --> exploring a transgender identity, if in fact we have the circuits for both kinds of 346 00:30:57.767 --> 00:30:59.767 contribute to wanting to be another gender. 347 00:30:59.767 --> 00:31:02.767 I think this is very profound.CATHERINE DULAC: Yeah, so I think that exactly as Eric mentioned, what this 348 00:31:02.767 --> 00:31:11.767 shows is that the brain of males and females are largely similar and that specific hormonal 349 00:31:11.767 --> 00:31:15.767 and genetic regulation leads to the predominate, but exclusive display of the behavior of 350 00:31:15.767 --> 00:31:20.767 a given sex. 351 00:31:20.767 --> 00:31:23.767 And this is physiological extremely important because animals, occasionally 352 00:31:23.767 --> 00:31:24.767 need to display the behavior of the other sex. 353 00:31:24.767 --> 00:31:32.767 We've seen in the previous episode that males are occasionally able to display 354 00:31:32.767 --> 00:31:36.767 parenting behavior (unintelligible). 355 00:31:36.767 --> 00:31:39.767 And similarly in many species, females are displaying mounting behavior as a sign of dominance 356 00:31:39.767 --> 00:31:52.767 and so the brain has actually been shown to be bisexual in fish, many years ago, in reptiles, 357 00:31:52.767 --> 00:31:57.767 more recently now in mice and we think that this ability to have both representation of the 358 00:31:57.767 --> 00:31:59.767 male and female brain could also be totally irrelevant to the prime of gender 359 00:31:59.767 --> 00:32:03.767 identity in humans.CHARLIE ROSE: Ok. 360 00:32:03.767 --> 00:32:07.767 Let me turn to Melissa and just talk more about divine in gender identity and 361 00:32:07.767 --> 00:32:12.767 sexual orientation and gender role behavior. 362 00:32:12.767 --> 00:32:17.767 I studied the role of testosterone in human gender development. 363 00:32:17.767 --> 00:32:20.767 And we've studied genetic conditions that cause people to have either higher or lower levels 364 00:32:20.767 --> 00:32:30.767 of testosterone during pre natal development than would otherwise be the case and 365 00:32:30.767 --> 00:32:34.767 evidence from those people suggest that testosterone in humans also influences gender 366 00:32:33.767 --> 00:32:44.767 and to start it is useful to put this in context, to expand our understanding of the 367 00:32:34.767 --> development, including gender identity. 368 00:32:41.767 --> 00:32:50.767 We've talked about anatomical sex and gender identity which is our sense of self 369 00:32:44.767 --> dimensions of gender related behavior. 370 00:32:50.767 --> 00:32:59.767 as male, female or something else, but also people have sexual orientation and this 371 00:32:59.767 --> 00:33:04.767 is separate to gender identity, it refers to our erotic interests in males, females, both or some 372 00:33:04.767 --> 00:33:13.767 people neither.And finally theres a third class of behavior called gender role behaviors and these are all the characteristics 373 00:33:13.767 --> 00:33:15.767 that differ on the average for males and females and among these some are bigger than others, some of the 374 00:33:15.767 --> 00:33:19.767 biggest ones are seen in childhood toy and activity preferences. 375 00:33:19.767 --> 00:33:30.767 The next image shows the sex difference in height and we're all familiar with this, males tend to be taller 376 00:33:30.767 --> 00:33:33.767 than females, but there's some overlap, so the males are the blue distribution and 377 00:33:33.767 --> 00:33:40.767 the females are the orange distribution and the people where the overlap is, would be people 378 00:33:40.767 --> 00:33:45.767 you wouldn't know their gender from knowing there height. 379 00:33:45.767 --> 00:33:48.767 And the next images show that these gender differences in play, play with toys ,like 380 00:33:48.767 --> 00:33:56.767 vehicles or boys toys, play with toys like dolls or girls toys are similar in size to the sex 381 00:33:56.767 --> 00:33:57.767 different in height. 382 00:33:57.767 --> 00:34:03.767 And finally we see the gender difference in identifying with the male gender and we can see that this gender difference is 383 00:34:03.767 --> 00:34:11.767 even bigger and there's almost no overlap between males and females, but there are some people who are in the 384 00:34:11.767 --> 00:34:14.767 other distribution and these include the people who want to change their gender. 385 00:34:14.767 --> 00:34:20.767 How does this come to be? 386 00:34:20.767 --> 00:34:25.767 We've talked about these sex differences in testosterone, some of which occur 387 00:34:25.767 --> 00:34:26.767 very in early in life and this correspond to a period of very rapid brain 388 00:34:26.767 --> 00:34:38.767 development and so it provide an opportunity for hormones to program the brain in ways that 389 00:34:37.767 --> 00:34:52.767 So the next image shows data about women who had very high levels of testosterone before birth 390 00:34:38.767 --> 00:34:42.767 might have enduring influences across the lifespan, including for instance gender 391 00:34:42.767 --> identification. 392 00:34:52.767 --> 00:34:57.767 and about two percent of women, who have very high levels of testosterone before birth, in adulthood 393 00:34:57.767 --> 00:34:58.767 decide to live as men and you might say that's not very many, only two percent, but its 394 00:34:58.767 --> 00:35:09.767 hundreds of times more than would otherwise do so, so this is increased many times 395 00:35:09.767 --> 00:35:12.767 over, by being exposed to high testosterone prenatally. 396 00:35:12.767 --> 00:35:15.767 And the next image shows men. 397 00:35:15.767 --> 00:35:20.767 In this case XY individuals who are actually XY females because there cells 398 00:35:20.767 --> 00:35:25.767 cant respond to testosterone, so they have testes, there producing male typical levels of 399 00:35:25.767 --> 00:35:33.767 testosterone including prenatally, but because their cells cant respond they look like girls at birth 400 00:35:33.767 --> 00:35:37.767 and their raised as girls and in adulthood almost 100 percent of them, 99.9 percent want to live 401 00:35:37.767 --> 00:35:40.767 as women. 402 00:35:40.767 --> 00:35:49.767 these are such profound findings because, although we don't really know in themass majority of cases what causes a desire to change sex. 403 00:35:49.767 --> 00:35:51.767 Here we find one concrete biological explanation, for a causative mechanism and it 404 00:35:51.767 --> 00:36:02.767 makes one relize this is not a social factor, it is clearly a biological factor and probably 405 00:36:01.767 --> 00:36:06.767 having one paradigmatic example is very powerful. 406 00:36:02.767 --> with time, we'll be able to identify a significant number of other ones, I think 407 00:36:06.767 --> 00:36:11.767 Yes, yes and also, going back to the toys children 408 00:36:11.767 --> 00:36:19.767 like to play with, when I began this work, people thought that these different interests in girls 409 00:36:19.767 --> 00:36:22.767 and boys were completely socially determined, but it turns out these are altered, too by 410 00:36:22.767 --> 00:36:24.200 prenatal testosterone exposure. 411 00:36:24.200 --> 00:36:30.667 So the next slide shows the toy choices of girls and boys in general, versus those in 412 00:36:30.667 --> 00:36:34.300 girls exposed to testosterone before birth. 413 00:36:34.300 --> 00:36:38.734 And boys spend most of their time playing with toys like vehicles, shown by the 414 00:36:38.734 --> 00:36:43.667 blue, and girls spend most of their time playing with toys like dolls, shown by 415 00:36:43.667 --> 00:36:48.801 the orange, and the girls exposed to testosterone prenatally are in between. 416 00:36:48.801 --> 00:36:52.467 So they spend about half their time playing with toys that boys normally 417 00:36:52.467 --> 00:36:56.801 choose and about 30 percent of their time, a reduced amount of time playing 418 00:36:56.801 --> 00:37:03.801 with the toys that girls normally choose. 419 00:37:03.801 --> 00:37:08.801 These are different dimensions of behavior and the influence on gender identity is 420 00:37:08.801 --> 00:37:16.801 less powerful, it appears than the influence of testosterone on childhood play. 421 00:37:16.801 --> 00:37:24.801 So that leaves a lot of unidentified factors, perhaps genetic factors or social factorsthat contribute gender identity outcomes. 422 00:37:24.801 --> 00:37:28.801 But finally, this is not just testosterone acting on the brain before birth, but also, children who 423 00:37:28.801 --> 00:37:36.801 had high levels of testosterone, engage in different behaviors and this has a feedback effect on their 424 00:37:36.801 --> 00:37:41.801 brain development, so this becomes an increasing mechanism, where there behavior is increasingly 425 00:37:41.801 --> 00:37:49.801 masculinized as they go through life.CHARLIE ROSE: Janet, talk about measuring cognitive performance and ability. 426 00:37:48.801 --> 00:37:54.801 Well, certainly in our culture we have lots of stereotypes that there are gender differences and abilities. 427 00:37:49.801 --> Right. 428 00:37:54.801 --> 00:37:58.801 People believe that boys and men are better at math and that girls and women are better at verbal 429 00:37:58.801 --> 00:38:06.801 skills, and that boys are better at spatial performance. 430 00:38:06.801 --> 00:38:08.801 So those are the stereotypes. 431 00:38:08.801 --> 00:38:12.801 Now, what did the real data show, once again we're looking at distributions for male 432 00:38:12.801 --> 00:38:20.801 and female performance, blue for males and orange for females. 433 00:38:19.801 --> 00:38:26.968 in mathematical performance. 434 00:38:20.801 --> What you see is that the most recent data show, actually that girls are tied with boys, now 435 00:38:26.968 --> 00:38:31.834 Many people find this surprising, but I have data for millions of people showing this, 436 00:38:31.834 --> 00:38:37.801 in regard to verbal performance, you can see that there is a female advantage, but it's 437 00:38:37.801 --> 00:38:44.100 teeny, tiny you can hardly see it on the graph, so these are very subtle, slight differences. 438 00:38:44.100 --> 00:38:51.167 For spatial performance, the difference is a little larger, favoring males and I'm showing you one 439 00:38:51.167 --> 00:38:57.200 particular kind of spatial performance which involves the ability to rotate three dimensional objects 440 00:38:57.200 --> 00:38:58.801 in your mind and think how they might look, other kinds of spatial performance don't show this 441 00:38:58.801 --> 00:39:08.801 quite as large a gender difference, you need this kind of spatial ability if you 442 00:39:08.801 --> 00:39:10.801 want to be an engineer or an architect or if you want to use a map navigate around New York City, 443 00:39:10.801 --> 00:39:14.801 so its important for somethings, but not everything, but I have to say that we get this gender 444 00:39:14.801 --> 00:39:20.801 difference in spatial performance in the absence of a spatial curriculum in the schools. 445 00:39:20.801 --> 00:39:27.801 That is we teach kids lots of verbal skills and lots of mathematical skills, we don't teach them 446 00:39:27.801 --> 00:39:35.801 spatial skills, these are completely trainable , and some school districts are now getting 447 00:39:35.801 --> 00:39:38.801 the message and starting to institute these programs, so if we want to do something 448 00:39:38.801 --> 00:39:48.801 to foster women getting into areas of engineering, where their very under represented, 449 00:39:48.801 --> 00:39:50.801 instituting a spatial curriculum, might really do a lot to help. 450 00:39:50.801 --> 00:39:58.801 I also want to emphasize the importance of cultural context in shaping these gender differences. 451 00:39:58.801 --> 00:40:05.801 This is the percentage of PHD's awarded to women in the U.S., by decade, beginning in the 1890s. 452 00:40:05.801 --> 00:40:11.801 Now, it turns out, I didn't know this, I don't know if you knew this, it turns out that even in 1890s, 453 00:40:11.801 --> 00:40:14.801 11 percent of the PHD's in math were going to women, in the 1890s. 454 00:40:14.801 --> 00:40:24.801 You can see it inches up a little bit there into the 1930s and then the percentage plummets in the 455 00:40:24.801 --> 00:40:26.801 1950s, so that only five percent of the PHD's are going to women. 456 00:40:26.801 --> 00:40:36.801 Than its been inching up ever since, so that actually today, 31 percent of the PHD's 457 00:40:36.801 --> 00:40:39.801 in mathematics are going to women. 458 00:40:39.801 --> 00:40:41.801 Why did it plummet in the 50s? 459 00:40:41.801 --> 00:40:42.801 It was the 1950s, right? 460 00:40:42.801 --> 00:40:44.801 The men came home from the war, the women were delighted t to see them, they moved to 461 00:40:44.801 --> 00:40:54.801 the suburbs and had lot's of babies, so there's not some single, biological force that causes women to be enough 462 00:40:54.801 --> 00:40:59.801 to get a PHD in math, it has much more to do with cultural context. 463 00:40:59.801 --> 00:41:04.801 Well, its findings like these that I've shown you for verbal and math performance and so on, 464 00:41:04.801 --> 00:41:11.801 that led me to propose what I call the principal of gender similarities, which is that males and 465 00:41:11.801 --> 00:41:18.801 females are actually quite similar, on most, not all, but most psychological variable , you saw it 466 00:41:18.801 --> 00:41:23.801 for math and verbal performance, which are widely stereotyped to show gender differences. 467 00:41:23.801 --> 00:41:30.801 And of course this has implications for women in science, technology, engineering and math careers, so this 468 00:41:30.801 --> 00:41:38.801 graph shows exactly what the gender similarities hypothesis is. 469 00:41:38.801 --> 00:41:44.801 again, we have the overlapping distributions, normal distributions for males and females, females shown 470 00:41:44.801 --> 00:41:49.801 in orange and males in blue and you can see there's just huge overlap, areas where males and females 471 00:41:49.801 --> 00:41:50.801 are quite similar. 472 00:41:50.801 --> 00:41:53.801 Let me turn now to looking at psychological disorders, because for some psychological disorders, we do 473 00:41:53.801 --> 00:42:03.801 get very lopsided gender ratios, so in the left part of this graph, you can see two disorders where many more 474 00:42:03.801 --> 00:42:06.801 men than women are effected, those are alcoholism and autism, you see the blue bar is the preponderance 475 00:42:06.801 --> 00:42:16.801 of males, that's not to say that we don't have women alcoholics or girls with autism, but its a 476 00:42:16.801 --> 00:42:18.801 preponderance of males. 477 00:42:18.801 --> 00:42:24.801 If we look at the right, we can see for depression and the eating disorder of anorexia , here we have 478 00:42:24.801 --> 00:42:27.801 preponderance of women, shown in the orange bars. 479 00:42:27.801 --> 00:42:35.801 So we do have these lopsided gender raito's, we wonder why these are? 480 00:42:35.801 --> 00:42:44.801 I'm most familiar, my research has been on gender differences and depression, we can see that the gender difference 481 00:42:44.801 --> 00:42:45.801 and depression is not present in childhood, but it begins to emerge between 13 and 15 years of age, as you can 482 00:42:45.801 --> 00:42:54.801 see the orange bar is going up there. 483 00:42:54.801 --> 00:42:55.801 And it widens between 15 and 18 years of age, so gender difference and depression emerge in adolescence. 484 00:42:55.801 --> 00:43:04.100 And if we're going to crack--it's a two to one ratio, twice as many women as men depressed, 485 00:43:04.100 --> 00:43:09.167 we're going to crack this question, we need to understand why the gender difference emerges in 486 00:43:09.167 --> 00:43:10.534 adolescence . 487 00:43:10.534 --> 00:43:16.934 Many factors are doubtless, involved, it may have something to do with genes, we have a few genes that have been 488 00:43:16.934 --> 00:43:22.133 identified that have to do with depression, it may have to do with pubertal hormones, because the 489 00:43:22.133 --> 00:43:26.567 difference emerges just as puberty is coming on. 490 00:43:26.567 --> 00:43:33.234 It may have to do with other factors such as the media emphasis on hyper skinny models and 491 00:43:33.234 --> 00:43:38.367 girls as they go through puberty , the bodies get farther way from skinny models, boys have the 492 00:43:38.367 --> 00:43:42.367 advantage, because their adding muscle and that's the way the models look. 493 00:43:42.367 --> 00:43:55.367 So that may be a factor, we also know that there's plenty of peer sexual harassment in the 494 00:43:55.367 --> 00:43:56.367 schools and also may contribute to this gender difference. 495 00:43:56.367 --> 00:43:59.367 Ok, thank you, Janet.Ben, let me just go back to this idea of how society is responding, because 496 00:43:59.367 --> 00:44:09.367 we know from the cover of Vanity Fair, The New York Times story, we know 497 00:44:09.367 --> 00:44:14.367 from Time Magazine did a cover story , which I'm told was the second biggest 498 00:44:14.367 --> 00:44:18.367 selling biggest selling Time Magazine cover that year, with one exception of the pope. 499 00:44:18.367 --> 00:44:22.367 Transgender's right behind the pope.(laughter) 500 00:44:22.367 --> 00:44:27.367 well, I think that its unfortunate that society often considers 501 00:44:27.367 --> 00:44:33.367 trans sexuality to be a mental illness or an amoral choice. 502 00:44:33.367 --> 00:44:36.367 And because of this, trans gender people are still often denied basic human rights, 503 00:44:36.367 --> 00:44:44.367 their often subject to violence and in many states transgender people can still be fired 504 00:44:44.367 --> 00:44:50.367 just for being transgender. 505 00:44:50.367 --> 00:44:55.367 But as we've heard today on this program, the brain has innate circuits, that determine 506 00:44:55.367 --> 00:45:02.367 are gender identity ans so being transgender is not a choice that I made, but its how I 507 00:45:02.367 --> 00:45:06.367 was born.And I should mention something we haven't really brought out yet, that there's a broad spectrum 508 00:45:06.367 --> 00:45:08.367 of transgender people. 509 00:45:08.367 --> 00:45:13.367 Some of them prefer not to change sex or even to be identified as male 510 00:45:13.367 --> 00:45:15.367 or female, but for some of us there is a compelling 511 00:45:15.367 --> 00:45:25.367 innate need to change sex and denied that possibility, 40 percent of us attempt suicide. 512 00:45:25.367 --> 00:45:32.367 And that's why I think that by helping transgender teens to avoid this agony, Dr. Spack and 513 00:45:31.367 --> 00:45:39.367 When you are advising students at Stamford, right? 514 00:45:32.367 --> the Dutch Pioneers are such great heroes. 515 00:45:37.367 --> 00:45:49.367 You know, its interesting Catherine , just in recent years I've really been amazed at 516 00:45:39.367 --> I mean what role do you play, what is it that you can provide? 517 00:45:49.367 --> 00:45:53.367 how many young, LGBT, you know, Lesbian, Gay, Bisexual, Trans gendered, students, trainees 518 00:45:53.367 --> 00:46:03.367 young scientists are reaching out to me, these days almost every time I visit another university to give a talk 519 00:46:03.367 --> 00:46:12.367 I often get e-mails in advance from young kids, often still in the closet and very concerned about 520 00:46:12.367 --> 00:46:13.367 weather coming out will harm there careers and they often want to meet with me and talk about this and I 521 00:46:13.367 --> 00:46:26.367 always advise them to be open and to live openly as who they are, people are very, very excepting, today. 522 00:46:25.367 --> 00:46:34.367 other people define who you are. 523 00:46:26.367 --> Sure, there's always going to be a few bullies, a few people that are ignorant, but never let 524 00:46:34.367 --> 00:46:35.367 So, what should parents do? 525 00:46:35.367 --> 00:46:42.367 I think the first thing that parents ought to do as with most things, is 526 00:46:42.367 --> 00:46:54.367 sit down and take a deep breath, ok, and realize that, the pre pubertal child is in a state 527 00:46:53.367 --> 00:47:03.367 Its no accident that both boys and girls go to the boy toys and girl toys in kindergarten. 528 00:46:54.367 --> of exploration. 529 00:47:03.367 --> 00:47:04.367 Right. 530 00:47:03.367 --> 00:47:14.968 This is almost always a gender role play, which is normal for children. 531 00:47:04.367 --> This is not gender identity expression, by and large. 532 00:47:14.968 --> 00:47:25.100 Now, of children who are fairly persistent in their crossgender play, but are pre pubertal, 533 00:47:25.100 --> 00:47:29.634 only about 20 percent will go on to be transgender. 534 00:47:29.634 --> 00:47:35.334 80 percent are not going to be transgender and what I would say to parents 535 00:47:35.334 --> 00:47:43.133 is that, if your child is getting close to puberty, or worse, is already in and is 536 00:47:43.133 --> 00:47:49.334 showing this kind of behavior, particularly underwear wearing and saying I'm the wrong 537 00:47:49.334 --> 00:47:56.701 gender and binding breasts etcetera, then you need to get help for that child 538 00:47:56.701 --> 00:48:11.701 fast, and that may be calling your pediatrician and ask for a gender specialist to meet 539 00:48:11.701 --> 00:48:12.701 with your child, because a child who is--according to the Dutch and us and others, a child 540 00:48:12.701 --> 00:48:18.701 who holds on to the belief that their in the wrong the body at the onset of puberty, feels 541 00:48:18.701 --> 00:48:26.701 like pinocchio becoming a donkey and may well take their life. 542 00:48:25.701 --> 00:48:37.701 Over this series of three years, Eric, you and I found a range of things 543 00:48:26.701 --> So, this is--these are the kids who are the real deal. 544 00:48:37.701 --> 00:48:43.701 that we traced to the brain and understood and some levels--in some cases the-- 545 00:48:43.701 --> 00:48:50.701 what we understood about what was taking place within the brain was large and 546 00:48:50.701 --> 00:48:54.701 in some cases small, where do you put this, in terms of 547 00:48:54.701 --> 00:48:56.701 understanding what's going on?ERIC KANDEL: I think we're at the very early stages in understanding whats 548 00:48:56.701 --> 00:49:00.701 going on and I think the wonderful thing about this discussion, it points out, number one, 549 00:49:00.701 --> 00:49:02.701 there really is a biology, its a challenging problem, its extremely fundemental, but our 550 00:49:02.701 --> 00:49:08.701 understanding is just verey, very modest. 551 00:49:08.701 --> 00:49:15.701 We talked about this before, many times people have asked Charlie and me, how long 552 00:49:15.701 --> 00:49:19.701 do you think it will take before we'll have a really satisfactory understanding of the brain. 553 00:49:18.701 --> 00:49:25.701 We've made a lot of progress in the last three years in The Brain Series alone. 554 00:49:19.701 --> And our position has been a century. 555 00:49:25.701 --> 00:49:31.701 (laughter)But we're a long way , to really understanding the brain systematically. 556 00:49:31.701 --> 00:49:42.701 Gender identity is so essential to who we are and ourability to be happy.I think, you know, we have a duty to be able to provide some type of explanation, but 557 00:49:42.701 --> 00:49:45.701 theres something really important, too, which is to understand that its not all blackand white. 558 00:49:45.701 --> 00:49:50.701 I think its important to remember that differences are not disorders. 559 00:49:46.701 --> 00:49:53.701 And I'm proud to be transgender, I think that different brains 560 00:49:50.701 --> Absolutely. 561 00:49:53.701 --> 00:49:59.701 drive innovation and different perspectives and so--I think it's--you know, 562 00:49:59.701 --> 00:50:09.701 the real question is, why society persists in insisting that male brains are better brains, which as we've heard tonight 563 00:50:09.701 --> 00:50:13.701 is definitely not the case.ERIC KANDEL: I think one thing that would be interesting to see is, as you function in a way that 564 00:50:13.701 --> 00:50:21.701 your comfortable with, it has freed you up, it's impossible in a single case to answer this, 565 00:50:21.701 --> 00:50:24.701 has it increased your creativity? 566 00:50:24.701 --> 00:50:31.701 Well, I think that it released a lot of mental energy that was devoted 567 00:50:31.701 --> 00:50:32.701 to confusion and to feeling suicidal and so I would say yes, I felt so 568 00:50:32.701 --> 00:50:38.701 much happier and productive as a person. 569 00:50:38.701 --> 00:50:39.701 That's wonderful. 570 00:50:39.701 --> 00:50:45.701 What percent in people also undergo anatomical change? 571 00:50:45.701 --> 00:50:59.701 The issue is that we're now in a state of flux about the--and operationsthat make us $25,000 which is a female-- a male to female genitoplasty and the reason I say that 572 00:50:59.701 --> 00:51:11.701 is because insurance companies are waking up to the idea that this is a medical condition, thatits entitled to be billable for a surgical and medical aspects of their care can be covered by 573 00:51:11.701 --> 00:51:20.701 insurance and so its going to change everything, because up until now people had to save 574 00:51:20.701 --> 00:51:22.701 all that up to have the surgery. 575 00:51:22.701 --> 00:51:23.701 And it starts from the top down, first you have to not make it a mental illness, you have to 576 00:51:23.701 --> 00:51:30.701 define it as a physical problem, which it is. 577 00:51:30.701 --> 00:51:38.701 But hiding it as being gay was, prior to 1973, what freed up people starting to see gay people 578 00:51:38.701 --> 00:51:40.701 as not having a psychiatric illness, it was having it removed from the diagnosis and 579 00:51:40.701 --> 00:51:43.701 statistical manual of mental illness. 580 00:51:43.701 --> 00:51:51.701 So, that's happening now and we will just see, the colleges are doing it, there self insured 581 00:51:51.701 --> 00:52:00.701 maybe even the college you went to, Charlie, is paying for peoples everything, because I'm 582 00:52:00.701 --> 00:52:01.701 going over to some of them and seeing it done.CHARLIE ROSE: Thank each of you very much for coming. 583 00:52:01.701 --> 00:52:09.701 It as--I think its a, you know, there is enormous interest as you can see in publications 584 00:52:09.701 --> 00:52:17.701 that are devoting attention to it and also the conversation that's taking place, I mean 585 00:52:17.701 --> 00:52:23.701 even, I remember, when this subject was introduced in terms of a television program, 586 00:52:23.701 --> 00:52:29.701 I remember someone came up to me and identified themselves as transgender, you know and 587 00:52:29.701 --> 00:52:37.734 said--but they said that--to me that the fact that its getting so much attention made all 588 00:52:37.734 --> 00:52:45.467 the difference in their life, you know, and so they felt not so isolated and not so different. 589 00:52:45.467 --> 00:52:51.534 I mean they felt like that there had been identified something, so they can have an appreciation 590 00:52:51.534 --> 00:52:54.767 of where they stood and what their options were. 591 00:52:54.767 --> 00:52:56.234 So, what are we doing next time? 592 00:52:56.234 --> 00:52:59.133 We're going to continue to discuss child development, which we 593 00:52:59.133 --> 00:53:01.133 discussed earlier. 594 00:53:01.133 --> 00:53:04.133 What are the consequences of growing up under very difficult circumstances, how does it effect the 595 00:53:04.133 --> 00:53:09.133 cognitive development of children and is this passed on from generation to generation, so 596 00:53:09.133 --> 00:53:12.133 we're going to learn a lot more about child development, next time. 597 00:53:12.133 --> 00:53:14.133 Thank you. 598 00:53:14.133 --> 00:53:15.367 Thank all of you. 599 00:53:15.367 --> 00:53:16.901 And thank you. 600 00:53:16.901 --> We'll see you next time.