<p>You asked a good question and I want to help clarify technical information in the hopes of everyone who discusses this topic doing so more clearly.</p>

<blockquote>
  <p>To put it more simply: how does someone know that they were born as
  the wrong gender?</p>
</blockquote>

<p>The question itself displays a misunderstanding of terms.  When we all learn the terms and understand how they relate to each other we can really start to come together on this very polarizing topic.</p>

<p>Based on the American Psychiatric Association which is documented on my answer <a href="https://psychology.stackexchange.com/questions/8803/what-are-the-meanings-of-the-word-gender/19793#19793">here</a>, the following defines Gender and Sex:</p>

<p>Gender is a man made social construct that changes with time and place.
Sex is the biological reality of a person.</p>

<p>Based on these definitions it is technically impossible for a person to know they were born as the wrong gender for 2 reasons:
You are born with a sex.  Second, gender identity is changing by social norms at any given time.</p>

<p>So, I propose to you that an answer of sorts to your question is this:</p>

<p>We are all born a biological sex and that there is inherently nothing wrong or missing in what we were born with.  As unique individuals we grow in a society/culture which is also unique in how they expect a biological sex to act.  The Gender Dysphoric person has negative experiences which cause emotional and psychological stress which can have the outward expression of one wishing to no longer be identified with the Social Gender identity of the Biological Sex they were born as.</p>

<p>This problem is purely a man made problem as the internal feelings of a biological male/female do not match the expectations of what the population around that person have.  This mismatch, when strongly negative or complicated by mental disorders, causes a reaction.</p>

<p>It is important to note that based on these definitions that the reaction of Gender Dysphoria is mismatched with the actual problem.  The true problem is Gender which is social.  Gender Dysphoria is medically treated on a Sex/Biological level.  There is a great divide in the understanding and acceptance of this issue as it applies to the real definition of terms and impact on people's lives.</p>

<p>Added Reference link.
<a href="https://www.aap.org/en-us/Documents/solgbt_webinar_transition_garofalo.pdf" rel="nofollow noreferrer">https://www.aap.org/en-us/Documents/solgbt_webinar_transition_garofalo.pdf</a></p>

CC BY-SA 4.0
2020-01-08T09:49:24.700Z
I see no APA documentation on that linked answer. Additionally, answers should stand on their own, so a direct reference/link is needed here as well.
Steven Jeuris
CC BY-SA 4.0
2020-01-09T00:04:45.130Z
I still see the link there as well as others...
Adam Heeg
CC BY-SA 4.0
2020-01-09T01:51:31.123Z
I don't see any support for this answer in the added link.
Bryan Krause
CC BY-SA 4.0
2020-01-09T08:34:36.773Z
@AdamHeeg I see you edited APA to 'American Academy of Pediatrics' in the other answer. At least, the same should be done here. The slideshow gives some (unpublished) proof those definitions are used by AAP, but I see no direct citations/references to APA definitions.
Steven Jeuris
CC BY-SA 4.0
2018-05-23T13:46:12.197Z
2020-01-08T23:24:24.877Z
2020-01-08T23:24:24.877Z
Adam Heeg
<h1>A conscious basis for gender identification?</h1>

<p><strong>There is currently no evidence to suggest that conscious experiences are a factor in leading a transgender person to identify with the opposite sex.</strong> Additionally, there is mounting evidence that transgender children are statistically indistinguishable from children of the gender with which they identify, meaning the process is set as early as five years old in humans (Olson, Key and Eaton, 2015). This suggests a predominantly biological basis. Because we cannot, for good reasons, conduct the appropriate experiments on humans, it is difficult to collect direct experimental evidence for any biological hypothesis, however.</p>

<h1>Mammalian gender and sexual behavior</h1>

<p>Rather than resulting from experience, <strong>the direction in which any mammal's sexual behavior will develop generally appears to be set sometime during the prenatal period</strong>, long before humans start having or remembering conscious experiences. In some sense, it appears that gender may be more biological and less psychological than traditionally believed.</p>

<p>The subject was covered in a recent <a href="http://www.nature.com/neuro/journal/vaop/ncurrent/full/nn.3988.html">Nature</a> article, where researchers concluded that <a href="http://epigenie.com/sex-on-the-brain-dna-methylation-defines-gender/">DNA methylation plays a primary role in the determination of gender and sexual behavior</a> (Nugent et al., 2015). In their experiment, the researchers manipulated developing rats' exposure to gonadal steroids by gene manipulation and pharmacological means, and thereby <strong>induced or inhibited masculinized sexual behavior</strong>.</p>

<blockquote>
  <p>Pharmacological inhibition of Dnmts mimicked gonadal steroids, <strong>resulting in masculinized neuronal markers and male sexual behavior in female rats. Conditional knockout of the de novo Dnmt isoform, Dnmt3a, also masculinized sexual behavior in female mice.</strong> RNA sequencing revealed gene and isoform variants modulated by methylation that may underlie the divergent reproductive behaviors of males versus females. <strong>Our data show that brain feminization is maintained by the active suppression of masculinization via DNA methylation.</strong></p>
</blockquote>

<p>One should be careful to generalize from rats to humans, but the proposed developmental dynamic of gender is highly consistent with the way mammalian <em>sex</em> is believed to be determined, and <strong>the ability to induce and inhibit masculinized sexual behavior at will provides substantial evidence for the DNA methylation dynamics</strong> hypothesis. </p>

<h1>Concluding remarks</h1>

<p>We ultimately do not yet fully understand the basis for human sexual behavior. What we can say is that <strong>we have no evidence for the idea that conscious experiences are in any way a factor in the development of gender or sexual behavior</strong>, and that already by five years old, <strong>the direction of sexual behavior development has been set for long enough to render the transgender child statistically indistinguishable from a cisgender child of the gender they identify with</strong>. A possible candidate theory for an underlying biological mechanism is prenatal DNA methylation dynamics.</p>

<h1>References</h1>

<ul>
<li>Nugent, B. M., Wright, C. L., Shetty, A. C., Hodes, G. E., Lenz, K. M., Mahurkar, A., ... &amp; McCarthy, M. M. (2015). Brain feminization requires active repression of masculinization via DNA methylation. Nature neuroscience.</li>
<li>Olson, K. R., Key, A. C., &amp; Eaton, N. R. (2015). Gender Cognition in Transgender Children. Psychological science, 0956797614568156.</li>
</ul>

CC BY-SA 3.0
2015-04-22T21:17:09.563Z
This is a fantastic answer...but, I feel, to a slightly different question. While I am willing to reform my question to accommodate your answer, what I am more interested in is what thoughts or feelings reveal to a transgender that they were born as the wrong gender. For instance, I know that I'm male because I have a penis, and I know that I'm heterosexual because I find myself attracted to females and not males. So how does Nick know that he should really be a Nadia? What is his/her rationalisation?
lemon
CC BY-SA 3.0
2015-04-22T21:20:01.417Z
@lemon I focused on the question, "What conscious experiences lead a transgender person to identify with the opposite sex?" The answer to the question in your comment is that there is no evidence to suggest any rationalization happens at all. That is just the way Nadia's brain developed in the womb, and Nadia's parents/doctors made a wrong gender assessment at birth (most likely based on visual inspection), then named her Nick.
Christian Hummeluhr
CC BY-SA 3.0
2015-04-22T21:22:54.413Z
If you close your eyes and forget what you look like, and forget the fact that you've always been told that you're a boy, can you identify your gender? If so, how?
lemon
CC BY-SA 3.0
2015-04-22T21:37:07.087Z
@lemon The evidence suggests I would, yes. We do not know how in a biological sense, but the time scales involved more or less rule out any conscious involvement. If five year olds are already statistically indistinguishable, then the process has almost certainly started in the prenatal period.
Christian Hummeluhr
CC BY-SA 3.0
2015-04-22T20:06:32.703Z
2015-04-22T20:06:32.703Z
Christian Hummeluhr
<p>What conscious experiences lead a transgender person to identify with the opposite sex?</p>

<ul>
<li><em>Physiology</em> is clearly not determining.</li>
<li><em>Sexual orientation</em> is not determining (homosexuality).</li>
<li><em>Clothing</em> preference is not determining (cross-dressing).</li>
</ul>

<p>To put it more simply: how does someone know that they were born as the wrong gender?</p>

<developmental-psychology><gender>
Conscious basis for gender identification
lemon
# Conscious basis for gender identification

(Asked by: username_0 on 2015-04-13)

What conscious experiences lead a transgender person to identify with the opposite sex?

* *Physiology* is clearly not determining.
* *Sexual orientation* is not determining (homosexuality).
* *Clothing* preference is not determining (cross-dressing).

To put it more simply: how does someone know that they were born as the wrong gender?

**Tags:** developmental-psychology, gender


---

## 2 answers

### Answer by username_4 on 2015-04-22. Score: 18 | Accepted answer

# A conscious basis for gender identification?

**There is currently no evidence to suggest that conscious experiences are a factor in leading a transgender person to identify with the opposite sex.** Additionally, there is mounting evidence that transgender children are statistically indistinguishable from children of the gender with which they identify, meaning the process is set as early as five years old in humans (Olson, Key and Eaton, 2015). This suggests a predominantly biological basis. Because we cannot, for good reasons, conduct the appropriate experiments on humans, it is difficult to collect direct experimental evidence for any biological hypothesis, however.

# Mammalian gender and sexual behavior

Rather than resulting from experience, **the direction in which any mammal's sexual behavior will develop generally appears to be set sometime during the prenatal period**, long before humans start having or remembering conscious experiences. In some sense, it appears that gender may be more biological and less psychological than traditionally believed.

The subject was covered in a recent [Nature](http://www.nature.com/neuro/journal/vaop/ncurrent/full/nn.3988.html) article, where researchers concluded that [DNA methylation plays a primary role in the determination of gender and sexual behavior](http://epigenie.com/sex-on-the-brain-dna-methylation-defines-gender/) (Nugent et al., 2015). In their experiment, the researchers manipulated developing rats' exposure to gonadal steroids by gene manipulation and pharmacological means, and thereby **induced or inhibited masculinized sexual behavior**.

> Pharmacological inhibition of Dnmts mimicked gonadal steroids, **resulting in masculinized neuronal markers and male sexual behavior in female rats. Conditional knockout of the de novo Dnmt isoform, Dnmt3a, also masculinized sexual behavior in female mice.** RNA sequencing revealed gene and isoform variants modulated by methylation that may underlie the divergent reproductive behaviors of males versus females. **Our data show that brain feminization is maintained by the active suppression of masculinization via DNA methylation.**

One should be careful to generalize from rats to humans, but the proposed developmental dynamic of gender is highly consistent with the way mammalian *sex* is believed to be determined, and **the ability to induce and inhibit masculinized sexual behavior at will provides substantial evidence for the DNA methylation dynamics** hypothesis.

# Concluding remarks

We ultimately do not yet fully understand the basis for human sexual behavior. What we can say is that **we have no evidence for the idea that conscious experiences are in any way a factor in the development of gender or sexual behavior**, and that already by five years old, **the direction of sexual behavior development has been set for long enough to render the transgender child statistically indistinguishable from a cisgender child of the gender they identify with**. A possible candidate theory for an underlying biological mechanism is prenatal DNA methylation dynamics.

# References

* Nugent, B. M., Wright, C. L., Shetty, A. C., Hodes, G. E., Lenz, K. M., Mahurkar, A., ... & McCarthy, M. M. (2015). Brain feminization requires active repression of masculinization via DNA methylation. Nature neuroscience.
* Olson, K. R., Key, A. C., & Eaton, N. R. (2015). Gender Cognition in Transgender Children. Psychological science, 0956797614568156.

> **Comments:**
> **username_0**: This is a fantastic answer...but, I feel, to a slightly different question. While I am willing to reform my question to accommodate your answer, what I am more interested in is what thoughts or feelings reveal to a transgender that they were born as the wrong gender. For instance, I know that I'm male because I have a penis, and I know that I'm heterosexual because I find myself attracted to females and not males. So how does Nick know that he should really be a Nadia? What is his/her rationalisation?  
> **username_4**: @username_0 I focused on the question, "What conscious experiences lead a transgender person to identify with the opposite sex?" The answer to the question in your comment is that there is no evidence to suggest any rationalization happens at all. That is just the way Nadia's brain developed in the womb, and Nadia's parents/doctors made a wrong gender assessment at birth (most likely based on visual inspection), then named her Nick.  
> **username_0**: If you close your eyes and forget what you look like, and forget the fact that you've always been told that you're a boy, can you identify your gender? If so, how?  
> **username_4**: @username_0 The evidence suggests I would, yes. We do not know how in a biological sense, but the time scales involved more or less rule out any conscious involvement. If five year olds are already statistically indistinguishable, then the process has almost certainly started in the prenatal period.  

---

### Answer by username_1 on 2018-05-23. Score: -5

You asked a good question and I want to help clarify technical information in the hopes of everyone who discusses this topic doing so more clearly.

> To put it more simply: how does someone know that they were born as
> the wrong gender?

The question itself displays a misunderstanding of terms. When we all learn the terms and understand how they relate to each other we can really start to come together on this very polarizing topic.

Based on the American Psychiatric Association which is documented on my answer [here](https://psychology.stackexchange.com/questions/8803/what-are-the-meanings-of-the-word-gender/19793#19793), the following defines Gender and Sex:

Gender is a man made social construct that changes with time and place.
Sex is the biological reality of a person.

Based on these definitions it is technically impossible for a person to know they were born as the wrong gender for 2 reasons:
You are born with a sex. Second, gender identity is changing by social norms at any given time.

So, I propose to you that an answer of sorts to your question is this:

We are all born a biological sex and that there is inherently nothing wrong or missing in what we were born with. As unique individuals we grow in a society/culture which is also unique in how they expect a biological sex to act. The Gender Dysphoric person has negative experiences which cause emotional and psychological stress which can have the outward expression of one wishing to no longer be identified with the Social Gender identity of the Biological Sex they were born as.

This problem is purely a man made problem as the internal feelings of a biological male/female do not match the expectations of what the population around that person have. This mismatch, when strongly negative or complicated by mental disorders, causes a reaction.

It is important to note that based on these definitions that the reaction of Gender Dysphoria is mismatched with the actual problem. The true problem is Gender which is social. Gender Dysphoria is medically treated on a Sex/Biological level. There is a great divide in the understanding and acceptance of this issue as it applies to the real definition of terms and impact on people's lives.

Added Reference link.
<https://www.aap.org/en-us/Documents/solgbt_webinar_transition_garofalo.pdf>

> **Comments:**
> **username_2**: I see no APA documentation on that linked answer. Additionally, answers should stand on their own, so a direct reference/link is needed here as well.  
> **username_1**: I still see the link there as well as others...  
> **username_3**: I don't see any support for this answer in the added link.  
> **username_2**: @AdamHeeg I see you edited APA to 'American Academy of Pediatrics' in the other answer. At least, the same should be done here. The slideshow gives some (unpublished) proof those definitions are used by AAP, but I see no direct citations/references to APA definitions.  

---

