Some people seem very sure of their sexual preferences from an early age, some are confused for many years, and some change their minds as they grow up. And all of that is OK. As I became aware of sexual urges from about the age of ten, I used to fantasise about being rescued and seduced by a knight in shining armour. Well, actually by Starsky or Hutch - I never could quite decide who should have the honour. At the same time I was experimenting with my neighbour - we would kiss and cuddle in bed. I was always the man and she was the woman. But when I was a teenager and was faced with the possibility of actual sexual experiences, I was scared and didn't want to have anything to do with it all. I didn't masturbate, I didn't want to kiss anyone. Then I fell in love. We did kiss, and I wanted more, but it transpired that he was gay. I did fumble about a bit with a few boys, not really enjoying it, and then I was sexually abused at a party and that put me off completely, not surprisingly. The term we used for how I viewed sex was "frigid." Nowadays, a young person in my position might describe themselves, or be described as ace or asexual.
Once I had lost my virginity to a man, the sexual urge floodgates opened and I secretly fancied all sorts of people; straight men, straight women, gay men, lesbians, trans women. I really didn't tell anyone about all these urges. I had some fumbles with women but it never quite worked out. And I was asked out on a date by Ronnie, an androgynous-presenting French singer who had a hit called If you want me to stay. I had a massive crush on her but I didn't go. I stood her up. In fact thinking about it, a lot of my crushes were on androgynous looking people, male and female. This image of Ronny is from the Discogs website: www.discogs.com/release/220648-Ronny-If-You-Want-Me-To-Stay
I was born female and I have always been OK with being female. That makes me cisgender. Some people feel that they are in one body and have characteristics of the opposite gender, and this doesn’t trouble them. But not everyone is comfortable in the body they were born with. They may struggle to identify with their cisgender peers from a young age, knowing that somehow they are different. This can lead to very intense feelings and cause depression and anxiety, having a massive impact on a person's well-being. This can develop into gender dysphoria. People with gender dysphoria may suffer from low self-esteem, become withdrawn or socially isolated, experience depression or anxiety, take unnecessary risks, and neglect themselves.
Treatments for gender dysphoria vary depending on what is best for the person, and are provided by specialist clinics. They include intensive counselling and discussions about transition.
The three main types of transition are social, legal and medical, and transition can involve many different elements and stages, including some or all of the social, legal and medical stages. What is most important for the individual is their inner journey, which often begins with a person accepting to themselves that they need to change, and then deciding what they need and want in order to become their authentic self.
We now have over fifty terms to describe our sexuality and identity. This can be both a blessing and a curse. On the one hand, people have more ways to explain themselves to others, should they choose to do so, but on the other, it can be confusing, especially for young people trying to work out who they are, and it can attract attention from ignorant and hate-filled individuals who like to accuse anyone different of being "woke." I am woke by the way. And proud of it. Proud that I am concerned about equality. Many people don't like labels at all, and some of my LGBT+ friends say that labels are made by others to describe them, not by themselves.
When using the terms sex and gender, it is important to remember that “sex” (female/male/intersex) describes biological traits. "Gender” on the other hand, is a broader term that reflects how a person lives within society. Someone's gender identity could be woman, man, transgender, non-binary, or a number of other possibilities.
Most people are born either male or female. But some are born intersex, that is, they have sexual organs of both sexes, to varying degrees. The exact incidence of people born intersex is not quite known and estimates vary from under 1% to 2%. The Trevor Project offers support and guidance. Their report, The Mental Health and Well-being of LGBTQ Youth who are Intersex highlights that when children are born, they are usually immediately categorized as either a “boy” or a “girl,” typically based only on a visual inspection of external genitalia. They feel that this categorization is problematic as it inaccurately assumes that sex and gender are binary characteristics that are visually apparent at birth. For some people, their intersex traits might be internal, such as a person born who appears female on the outside, but who has internal testicles. With over forty different medical terms for the ways sex anatomy might develop, the argument that gender is binary does seem somewhat dated. There's a great quote from The Intersex Society of North America, cited by the Trevor Project: “Nature doesn’t decide where the category of ‘male’ ends and the category of ‘intersex’ begins, or where the category of ‘intersex’ ends and the category of ‘female’ begins. Humans decide." In other words, we have developed the labels to describe what happens in nature. And with intersex people, the terms are derived from the medical community, who have historically labelled being intersex as a condition.
While it is now understood that gender identity is influenced by biology, environmental factors, and a person’s self-identification, there remains controversy around the treatment of intersex by medical professionals, because treatment often hinges on acceptance of an anatomically binary theory: someone with a Y chromosome must have an “adequate” penis if they are to be assigned the male gender, and someone without a Y chromosome is declared a girl no matter their genitalia. Despite evidence to the contrary, there are numerous articles by medical professionals who still say that sex is binary. I was very disheartened to read an article from 2021 in the British Journal of Psychiatry which categorically states that "Humans are sexually dimorphic: there are only two viable gametes and two sexes, whose primary and secondary sexual characteristics determine what role they play in human reproduction. Sex is determined at fertilisation and revealed at birth or, increasingly, in utero."
As I have mentioned elsewhere, the medical fraternity, the state and the church have historically pathologised, discriminated against and demonised being trans, being gay and being intersex. People who were not heterosexual or cisgender were seen as a problem that needed fixing. Or they were erased from the narrative altogether, as if they didn't exist. Gradually, through scientific evidence, and through actually listening to people's lived experience, these attitudes have shifted in recent years, and society has sought more to protect than to persecute LGBT+ people. But there is still a long way to go, and at the moment there is a worrying trend of homophobia and especially of transphobia.
The bank of scientific data that is growing, points towards confirming that sexuality, sex and gender are very complex. For example, although much more research is needed, as far as scientists know, about a third of the precursors that determine our sexuality are accounted for by genetic factors - factors we inherit. One of the main issues facing researchers studying this, is that complex human traits such as sexuality are unlikely to be due to a single gene. Also, we aren’t yet at the stage where we can reliably study the effects of multiple genes at once, and it may be that one gene is important for determining sexuality in one family, but not in another. What we do know for certain is that there is no specific “gay gene” which determines sexual orientation. That said, there is growing evidence that there may be something significant in males on chromosomes eight, thirteen and fourteen. For example, one study of 409 sets of gay brothers showed that there were some commonalities on the X chromosome and chromosome eight. It is thought that genes on the X chromosome may carry some code or signal that predisposes male children to be gay, making the X chromosome somehow dominant. A literal gay-coding. Research indicates that there may be many other genes, as yet unidentified, that contribute to a feminine or a masculine sexual identity, and that they are not necessarily all concerned with sex hormone signals – some may be connected with brain function and behaviour.
Homosexuality appears to be a paradox because gay men haven’t traditionally had children of their own, and therefore don’t conform to evolutionary logic because they don’t keep the species going through reproduction. However, if homosexuality was an unwanted human trait, surely it would have disappeared long ago due to natural selection, the process governing how species evolve. Rather, being gay seems to have evolved as a natural part of society which can benefit the family, particularly in certain settings. There’s a theory that gay men in the family will help their siblings raise the next generation, promoting family bonds and helping to reduce stress. This theory is called kin selection, meaning that families are genetically predisposed to have gay men in order to promote a nurturing household. A study in Samoa provided evidence for this: the gay uncle, “fa’afafine,” plays an integral role in family life. This of course only works if this role is accepted in the family, as it is in Samoan culture. Studies in the UK and America did not find this to be the case, and sadly this could be due to the high rates of homophobia, ostracising gay men from the family rather than embracing them.
The Fraternal Birth Order Effect (FBOE) is a phenomenon that has been the subject of some big research studies, and it’s thought that FBOE has something to do with changes that occur in the womb. Homosexuality in men is positively correlated with the number of older brothers that the gay man has, as shown by a study of over six hundred men, half gay and half straight. Thus, if you have an older brother, and you are male, you are more likely to be gay. Furthermore, the more older brothers that you have, the more likely it is that you will be gay, as each older brother increases the odds of homosexuality in the youngest by thirty-three per cent. This happens even when these brothers have been reared in different households. FBOE is very significant, and for men with three or four older brothers, the likelihood of homosexual orientation may be more than doubled. FBOE does not occur if the youngest male has older sisters rather than brothers, and it does not explain homosexuality in first-born males. The sexual orientation of females is not influenced at all by this birth order effect, and having older sisters does not influence the sexuality of their younger siblings.
There is emerging evidence that being trans could also have a genetic element. In a study of 380 trans women who had undergone or were planning sex change operations, researchers looked in fine detail at genes involved in hormone pathways. They found that trans women have a high frequency of DNA variants on four genes that alter sex hormone messaging before birth.
Some adults still believe that if youngsters encounter LGBT+ people or culture, this might lead them into a similar lifestyle when they would otherwise have been heterosexual; if a young person is seduced by a homosexual, this will turn him gay. Other theories continue to propose that homosexuality is the result of difficult relationships at home, especially with the parent of the same sex. These theories are based on results from therapeutic interventions that are now deemed unscientific. In addition, the sexual orientation of the child does not appear to be affected by the sexual orientation of the parents. Even if the way we’re brought up and nurtured is found in the future to be more important in the determination of sexual orientation than it currently seems to be, it would still only be one part of the many variables that contribute to making people who and what they are. The present weight of evidence is strongly in favour of non-social causes of sexual orientation rather than social ones.
Science has also shown that to some extent, gay men’s brains differ from straight men’s, and lesbian women’s from straight women’s. These differences include variations in total brain volume, in grey and white matter proportions and volumes, and in tissue densities of several of the brain’s core areas (the oldest parts of the brain in evolutionary terms). A study of seventy-four participants found that there is a link between sexual orientation and Grey Matter Volume (GMV) in the cerebellum, thalamus and putamen, areas of the brain that control aspects of movement, information processing and messaging. Another study involved the analysis of brain data from a massive sample of 18,465 individuals from the Biobank in the UK. A biobank is a store of anonymised data that researchers constantly add to, enabling large-scale research to be conducted. Participants were asked: “Have you ever had sexual intercourse with someone of the same sex?” where sexual intercourse was defined as vaginal, oral, or anal sex. Differences in brain anatomy were easy to distinguish between straight men and straight women. However, it was less easy to distinguish between the brains of gay men and lesbian women. This was because those patterns that were more obvious in distinguishing between straight male and female adults were less pronounced in both gay men and lesbian women. The brain region that showed the most consistent differences in both gay men and lesbians versus straight people was the calcarine sulcus, primarily responsible for processing visual information. The brain regions of interest in this study became larger in lesbian women and smaller in gay men, as compared to their straight counterparts.
Based on studies with animals and with humans, it is thought to be entirely possible that differences in adult sexual orientation are the result of exposure of particular brain regions to atypical hormone levels during a crucial period of foetal development. It seems that exposure to male hormones, androgens, during this “window” is associated with the development of male anatomy and sexual attraction to females (gynephilia). It’s thought that differences in the levels of hormone exposure could influence sexual orientation, sometimes resulting in adult males who experience attraction to males (androphilia), or adult females who experience gynephilia.
A study of the brains of trans people, specifically male-to-female trans women, found that their brains’ reactions to seeing erotic images were similar to biological women’s reactions rather than biological men, suggesting that trans women’s brains tend to process information in a similar way to biological women. This study was done with trans women before they had undergone any treatment, but who were living as women.
These results, and others like them, show that there are some measurable differences in people’s brains depending on their sexuality and their gender identity. However, all the researchers agree that this research is in its infancy and that much more is needed.
I've always had a theory that sexuality and gender are on a spectrum. I can remember discussing this with friends in the pub years ago, when I suggested that we are all somewhere on that spectrum, and that we might move about on it through our lives. So, when I began to research for my book, I was delighted to find evidence that supported this idea. I'm biased, as I looked for evidence to support my theory. That's what humans do: we are all biased, whether we like it or not. But I did seek evidence that was backed up by findings rather than just opinion. One of the first people to propose a spectrum of sexuality was Kinsey, who produced The Kinsey scale, also known as the Heterosexual-Homosexual Rating Scale, which is a visual model used to describe one’s sexual orientation at any given time. It's now felt, however, that this might be a bit over-simplistic. The Sexuality Spectrum page on The Sexology Institute website mentions a study by Washington State University where data from over 33,000 adults was analysed. They concluded that a categorical model best described sexual orientation rather than a continuum model like the Kinsey scale. Their conclusion was that sexuality isn’t a sliding scale so much as it is a complex variety of options. The research suggests that sexual orientation is not a matter of degree but rather of distinct and meaningful categories. And the findings tended to support the idea that sexual orientation has a biological foundation. The Trevor Project have produced a diagram which illustrates this.
The lived experience of LGBT+ people is proof that they exist. It sounds too obvious, but it needs to be said I think. You really shouldn't deny someone's existence if they are there in front of you. As more laws have emerged to protect LGBT+ rights, and as we have more ways to communicate than ever before, LGBT+ people are more visible than ever. It's not the case, despite what the haters say, that they weren't there before.
There are loads more references that I could have used, but I'll leave it there for now. I hope this has shone a little light on a complex subject. The bottom line is that sex, sexuality and gender cannot be explained in binary terms. Anyone who chooses to pretend otherwise is, as far as I can see, rather blinkered.
Em x
This article is based partly on chapters in my award-winning book.
Bent Is Not Broken. Buy the eBook (various platforms) or get the paperback on Amazon via:
To read more blogs about about LGBT+ culture and history, and to find out more about the author, head to www.bentisnotbroken.com
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