In the early 1950’s, a well known Canadian psychiatrist named Dr. Donald Ewen Cameron developed the concept of “psychic driving.” The idea was that mental illnesses could be cured by reprogramming new narratives into subjects. He recruited from the local community to participate in his studies. Most of his volunteer subjects suffered from relatively minor psychiatric complaints, such as neurosis or depression.
The back bone of psychic driving was subjecting patients to a continuously repeated audio message on a looped tape, often repeated hundreds of thousands of times over periods of months in order to alter their thought patterns. In order to subdue his patients he subjected them to potent cocktails of drugs such as curare, LSD, 3-Quinuclidinyl benzilate (BZ in NATO code), and sodium thiopental. Physically, the subjects were given electroconvulsive (shock) therapy, subjected to sensory deprivation for extended periods, and put in complete isolation for months on end. All the while the subjects were exposed to messages that were intended to overwrite their depressive or neurotic narratives.
After years and years of pushing the limits of how much the human body and mind could take, and exhausting the time, money, and patience of the CIA which was funding his experiments as part of MKULTRA, his experimentation was a complete failure. Any positive results were transitory in nature. None of the patients were cured, or even improved. Most suffered serious side effects; from incontinence, to amnesia, to persistent cognitive difficulties. Despite all this, they retained their original psychiatric conditions, and the narratives implanted in them were meaningless background noise.
Fast forward to a more recent case study. A 57 year old woman in the UK was born without a thumb and a finger on one hand. However, at the age of 21 she lost that hand in a car accident. After the accident, she developed phantom pains and other sensations in the missing hand… including the two fingers she had never had. This suggests that mental self image is deeply hardwired. It also begs the question; is it possible that someone has a mental self image of their body, including primary and secondary sexual characteristics, hard wired from birth? This article would seem to suggest yes.
Even more importantly, though, is the question, “Could a person could be wired to perceive their body as one gender, while physically being another?” Preliminary studies of FTMs suggests that they are subject to having sensations of a “phantom penis” even prior to SRS. This same preliminary study also showed that MTFs were much less likely to have phantom sensations after SRS than the general population. Given the variance in human neuropathology, and the observations from the examples above, the answer again seems to be a Mythbuster-like verdict of “Very Plausible”.
Further piling onto the evidence provided by both Dr. Cameron’s work, and the observations yielded by the woman in the UK, is the oft stated fact that no effective psychotheraputic or pharmacological treatment has ever been found to cure gender dysphoria. Anecdotally, when speaking with people who have gender dysphoria, one finds that no matter what drugs are given to a dysphoric person, the dysphoria is still there, but the secondary symptoms are relieved. Thus, a depressed gender dysphoric person given Prozac or Wellbutrin simply becomes a less-depressed gender dysphoric person. A bipolar person with gender dysphoria given lithium becomes a more stable person with gender dysphoria. The list goes on and on with medications, including those meant to treat schizophrenia and delusional behavior. People are always still dysphoric after the other mental illness is addressed pharmacologically.
The only generally effective, and accepted, treatments for alleviating gender dysphoria are to allow the person to match their mental self image to their actual physical appearance via a combination of hormones and surgeries. This conclusion is what you would expect, though, given the first two cases. Thus each observation reinforces the conclusions of the others.
The implications of the three observations taken together are tremendous. It implies that gender dysphoria is not related to sexuality, in the sense that it defies Blanchard’s typology. It implies that indeed, people are born this way. Transsexuality is not a moral failing. They also reinforce the recommendations of the WPATH SOC that proper treatment is to “just run with it.” The confluence of all these clues should serve as a dire warning of the dangers and futility reparative therapies. It certainly supports the clichéd narrative of “being trapped in a man’s / woman’s body”.
Further research is clearly warranted, but perhaps these factors taken as a whole are finally a partial answer to the “why” of gender dysphoria.