Bigender – Boy Today, Girl Tomorrow?

By Neuroskeptic | April 8, 2012 8:49 am

An interesting report in (believe it or not) Medical HypothesesAlternating gender incongruity: A new neuropsychiatric syndrome providing insight into the dynamic plasticity of brain-sex.

Bigender individuals report alternating between male, female, and (sometimes) mixed gender states. Case and Ramachandran – that’s V.S. Ramachandran of phantom limb fame – write:

Under the transgender umbrella, a distinct subset of “Bigender” individuals report blending or alternating gender states. It came to our attention that many (perhaps most) bigender individuals experience involuntary alternation between male and female states, or between male, female, and additional androgynous or othergendered identities (“Multigender”)…

But almost no-one’s studied the bigender phenomenon –

A survey of the transgender community by the San Francisco Department of Public Health found that about 3% of genetic males and 8% of genetically female transgendered individuals identified as bigender. To our knowledge, however, no scientific literature has attempted to explain or even describe bigenderism; a search of PsychInfo and PubMed databases returned zero results… the study of this condition could prove illuminating to scientific understanding of gender, body representation, and the nature of self.

No scholarly paper would be complete without some elaborate new jargon, of course –

For the purposes of our research we are calling this condition “alternating gender incongruity” (AGI). We seek to establish AGI as a nosological entity based in an understanding of dynamic brain representations of gender and sex.

So they designed a survey (details in the paper) and sent it to members of a bigender internet forum. The forum had 600 members, although many were lurkers; they got a total of 39 replies. So it’s a highly self-selected sample, then, but that’s inevitable I think. Here’s what they had to say –

Of the 32 alternating bigender respondents included [some were excluded for diagnoses of DID etc], 11 were anatomically female (identified as female at birth)… One respondent identified as intersex, but only for reasons of androgynous facial appearance…

10/32 respondents agreed that their gender switches were “predictable.” The period of gender switches was highly variable, ranging from multiple times per day to several times per year. A majority (23/32) of respondents, however, reported that their gender switched at least weekly [with 14 saying it switched at least once per day].

What are the switches like? Some respondents are quoted –

“I still have the same values and beliefs, but a change in gender is really a change in the filter through which I interact with the world and through which it interacts with me.”

“My voice usually ends up being higher than other times, I’ll be more emotional, my views on things like politics tend not to change, but how I react to certain things does. Like if I’m in male mode and I see someone crying I’ll think more along the lines of, ‘Man up…’ while if I’m in girl mode I’ll think more along the lines of ‘Oh sweety!’”

This being Ramachandran, the paper also touches on left handedness, brain hemispheres, phantom genitals and more, but it’s fair to say that all this is pretty speculative –

In myth, art, and tradition throughout the world the left side of the body (and hand) – and therefore the right hemisphere – is regarded as more “feminine” – intuitive and artistic. One wonders therefore whether gender alternation may reflect alternation of control of the two hemispheres. Such alternation is seen to a limited extent even in normal individuals but may be exaggerated (and more directly involve the gender aspect) in AGI…

Personally, what I find most interesting about this is the question of what would have happened to ‘bigender’ people before the term ‘bigender’ came along; it seems to be newer, and certainly less widely used, than ‘transgender’/’transsexual’.

Would they have been identified as transgender? Maybe… but maybe not. Would they have had any label at all?

ResearchBlogging.orgCase, L., and Ramachandran, V. (2012). Alternating gender incongruity: A new neuropsychiatric syndrome providing insight into the dynamic plasticity of brain-sex Medical Hypotheses, 78 (5), 626-631 DOI: 10.1016/j.mehy.2012.01.041

CATEGORIZED UNDER: mental health, papers, surveys
  • Neuroskeptic

    I've just noticed that “bigenderism” could also mean “being in favor of big ends

  • petrossa

    To me it is much like the present day craze of detecting ever tinier traces of 'poisonous' pollutants in the environment.

    For centuries people in europe drank tapwater from leadpipes, i still do. It was only after they could detect small enough levels they got all het up about it.

    Sure lead is bad, but at the tracelevels in tapwater you'd have to drink very much, in any case more then any child could drink in a given time to have detrimental effect.

    The proof is abundantly clear, there are as many non compos mentis today as centuries ago. If not more.

    So now we have the gender issue. Gender used to be easy boy/girl, as we start to go down to the most infinitesimally small details of the grander picture we create these subcategories.

    A whole new group of 'abnormals' created. Money in the pocket for the whole industry. Everybody happy except ofcourse the victims but who cares. Science must be triumphant.

  • Andrew Oh-Willeke

    Interesting study. My intuition is that this condition is quite different in cause (which is of course unknown) than more common forms of transgender identity or sexual orientations other than heterosexuality, or intersex conditions.

    One notion that this condition would validate, which has some suggestive support in other contexts, is that almost everyone has both a male and female psychological “operating system” buried in their brains even though the vast majority of us can only access half of it (usually all male or all female, but sometimes chunks of one and chunks of the other).

    I'd be curious to see if it would be possible to identify in a meaninigful way some group of people who are remarkable for being able to see the point of view of both men and women as a sort of “subclinical” version of a similar concept – the multiple perception capacity without confusion of identity – and one might find people people undiagnosed bigender or transgender identities within them.

    This study identifies bipolar disorder and ambidextrous traits as comorbid. Other their other psychological conditions common comorbid with bipolar or ambidextrity?

    The risk factors for schitzophrenia and bipolar (and the apparently biological basis for the two psychoses) have similarities, and one wonders if these could be in some instances bipolar with some schitzophrenia mixed in.

    Ambidexterity (of a variety other than simply being trained to use ones naturally non-dominant hand) seems like a better fit for the hemispheric ambivalence model advanced in the article.

  • Ivana Fulli MD

    First it remains to be seen what is feeling as a woman and what is feeling like a man when you take off the culture impressed in people minds and hearts.

    To take an example on the side- but very clear- the ancient Romans had nothing against pedophilia and were very favorable to prostitution and bisexuality.

    The classical Chinese work of art seem to show that pedophilia was not an offense –providing that you own the child between your own servants. Times change not always for the worst.

    People should also be allowed to have the psychologists and the psychiatrists out of their sexual lives when they do not harm children or vulnerable people: some people do not like sex or change their sexual preferences ( I know of several formerly hetero-sexual men for decades of adult life who became progressively homosexuals later in life and of a man who described himself as an homosexual who wake up a morning and felt suddenly heterosexual only and had felt so for many years ). So what?

    I remember vividly one homosexual activist who was depressed after a woman -he made love to in order to procreate a genetic offspring easily- gave him “too much” sexual pleasure. Working on it he was afraid about what his homosexual circle of friends will think about that new him thinking that marrying an open-minded woman to raise children with her would not be such a bad idea! I am not making that up.


    The damage caused by publicity seeking academics taking advantages of vulnerable and gullible people is unevaluated on the sexuality- front.

    And the DSMs' money and fame seeking gangs have shown the worldtheir full moral measure when homosexuality was considered a DSM meantl disorder and the behaviorists together with the psychonalysts tried to cure it.

    PS: What I learned from aspies is their honestly and frankness about sex- although some aspies are at the same time gullible and could be abused sexually -or sadly easily accused of being abusers (“sex dates”)and also real abuser by genuine lack of concern for age or inability to understand flirting for commercial or diplomatic purposes.

    I wish “neurotypicals” were as frank as the aspies.

  • Anonymous

    I wish they had done a bit more research. “Bigender” is typically used by people who feel both male and female – either at once or with extremely frequent switching. The umbrella term for people whose gender varies with time is “genderfluid”, which includes people who are permanently or some of the time not in a binary state. I'd like to see more research into non-binary people in general.

  • Zoe Brain

    The phenomenon is real, and really inconvenient for a binary gender model, or even a trinary one.

    I've observed it in two people, one highly Intersex, one not.

    It really doesn't fit into any of our models. That makes it really interesting, as by studying the issue, we may be able to improve existing ones.

    The handedness issue is about the only non-surprise. Non-right-handedness is a neural atypicality that's correlated strongly with Homosexuality, Transsexuality, and Intersex.

    See for example :
    Dichotic Listening, Handedness, Brain Organization and Transsexuality Govier et al International Journal of Transgenderism, 12:144–154, 2010

    Schizophrenia is also correlated with a progressive sexual undifferentiation of neuro-anatomy.

    Reversal of normal cerebral sexual dimorphism in schizophrenia: evidence and speculations. Mendrek A. Med Hypotheses. 2007;69(4):896-902

    It's unfortunate that so much of this is so poorly evidenced – but with lack of study, it's the best guess we have.

  • Zoe Brain

    I should add – I'm anything but typical. Effectively Transsexual but technically Intersex. With the common sequelae, Ambidexterity, mildly Aspergic etc.

    Just as 5ARD and 17BHSD can cause a degree of “Natural Sex Change” (more apparent than real) from F to M, so 3BHSD and X0/XY can cause endocrinal instability leading to a change in the other direction.

    I have the 3BHSD form of CAH. I looked male at birth, though puberty was partial, and I was (mis)diagnosed with “underdeveloped male syndrome” – now known to be mild PAIS – at age 27. At age 47, after a rather more complete female puberty (with LDL readings from dangerously high to dangerously low etc) I was re-diagnosed as a “severely androgenised non-pregnant woman. By that time, I'd lost 1/3 my body mass in 3 months, and with other changes, could no longer “pass as male”. The hormonal chaos darn near killed me.

    My gender identity had always been female, but what's a girl to do when she looks like a short linebacker rather than a cheerleader? Typically of cases of CAH, I was something of a Tomboy anyway, so it was… tolerable. Hellish, but I could live with it. A strong Death-Wish so it would be over, but no suicidal ideation.

    The change was something of an impossible dream come true, and I originally presented myself for treatment as someone obviously delusional. I took a lot of convincing that the evidence of my senses accurately reflected objective reality. It seemed far too objectively probable that I'd cracked under the stress.

    Anyway, I'm my own experimental animal, no need for ethics committee clearance. Alas, my objectivity is hopelessly compromised, there's too much danger of me over-generalising my own experience to others.

    No, I've never understood men, sorry. I could predict responses to stimuli – I had to be able to to mimic them – but could never figure out how anyone could think like that, even though my brain is somewhat masculinised in some areas. I fit a binary model as well as any other female engineer.

  • Zoe Brain

    @Ivana Fulli MD –
    What I learned from aspies is their honestly and frankness about sex- although some aspies are at the same time gullible

    Thanks for that. I'd wondered why I don't appear to be embarrassed at “revealing all” about my interesting history – despite my natural shyness and social aversion.

    I'd assumed it was because I'm a scientist, and science doesn't work without full disclosure, and egoless study. That may still be the explanation, but your observation is worth exploring as a plausible alternative. Thanks!

    Regarding “gender identity” – more properly “sex identity” as ~80% of “gendered behaviour” has no biological basis – there are two papers which, taken collectively, explain things in terms of a binary model pretty well.

    Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation Garcia-Falgueras A, Swaab DF Endocr Dev. 2010;17:22-35

    The fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in extreme cases in trans-sexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no indication that social environment after birth has an effect on gender identity or sexual orientation.

    Biased-Interaction Theory of Psychosexual Development: “How Does One Know if One is Male or Female?” M.Diamond Sex Roles (2006) 55:589–600

    A theory of gender development is presented that incorporates early biological factors that organize predispositions in temperament and attitudes. With activation of these factors a person interacts in society and comes to identify as male or female. The predispositions establish preferences and aversions the growing child compares with those of others. All individuals compare themselves with others deciding who they are like (same) and with whom are they different. These experiences and interpretations can then be said to determine how one comes to identify as male or female, man or woman. In retrospect, one can say the person has a gendered brain since it is the brain that structures the individual’s basic personality; first with inherent tendencies then with interactions coming from experience.

  • Zoe Brain

    As a first approximation, the binary model works pretty well. It soon runs in to difficulties though. Trans people's brains are not all-male or all-female, but mixed, and with features found in neither classic M or F brains.

    Regional gray matter variation in male-to-female transsexualism. by Luders et al Neuroimage. 2009 Jul 15;46(4):904-7.
    We analyzed MRI data of 24 male-to-female (MTF) transsexuals not yet treated with cross-sex hormones in order to determine whether gray matter volumes in MTF transsexuals more closely resemble people who share their biological sex (30 control men), or people who share their gender identity (30 control women). Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men. These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity.

    Moreover, in cases of 5ARD etc, about a third of those undergoing the change don't want it; a third want it, sometimes desperately; and the final third just accept it as one of life's challenges.

    See Gender change in 46,XY persons with 5alpha-reductase-2 deficiency and 17beta-hydroxysteroid dehydrogenase-3 deficiency. Cohen-Kettenis PT. Arch Sex Behav. 2005 Aug;34(4):399-410.

    an estimation of the prevalence of gender role changes, based on the current literature, shows that gender role changes occur frequently, but not invariably. Gender role changes were reported in 56-63% of cases with 5alpha-RD-2 and 39-64% of cases with 17beta-HSD-3 who were raised as girls. The changes were usually made in adolescence and early adulthood. In these two syndromes, the degree of external genital masculinization at birth does not seem to be related to gender role changes in a systematic way.

    So a Trinary model, M, F, Bi-Gender, works better. This also explains why only 1/3 of arbitrary sex reassignments of Intersex children are disastrous, rather than 1/2. A continuous multi-dimensional model is probably required for complete accuracy.

    Gender Fluidity may be explicable by Gender Identity not crystallising (according to Diamond's theory) solidly, or even at all.

    • Tao

      the cornerstone of gender identity is essentialist deterinism fueled by sex stereotypes. this research is merely medical materialism.

  • Anonymous

    First, it should be pointed out that the theory that slow hemispheric switching might provide the explanation for bipolar disorder was first proposed by John Pettigrew and Steve Miller in 1998. There are some interesting similarities between their 1998 paper and the theory put forward by Case and Ramachandran. According to the discussion section of the article in Medical Hypotheses Case and Ramachandran “plan to test hemispheric switching in AGI using airflow in the nostrils (a technique first described in
    ancient Indian texts on meditation), as well as using measures of lateralized attention.If so, would cold-caloric vestibular stimulation
    or transcranial magnetic stimulation (TMS) trigger a gender

    It's hard to imagine anyone in the world of neuroscience taking this sort of proposal seriously.

  • absoluterelativist

    Really? Bigenderism as a new nosological category? What is supposed to be wrong with these people? It seems like slightly depressing intellectual masturbation on the part of the authors. I just feel that these mental states are more a normal fluctuation than some kind of “type” that needs new categorisation.
    From the descriptions you posted, Neuroskeptic, it seems like these are just sensitive and introspective people who choose to describe their shifts in mood or attitude in terms of masculine and feminine personalities (reminiscent of Jungian anima / animus).
    At most, I would suggest the authors pursue this hypothesis as a confirmation of the Jungian theoretical framework, but I fail to see how this could at all help people who are ill.

    • IHaveALifeDoYou

      ah shut up, you don’t know what your talking about, there is a gender identity called Bigender. look it up dopey.

    • KitSylph

      I’m bi-gender, although you can take that with skepticism if you like, considering I hadn’t heard the word until this past week (which is why I’m out hunting down articles about it on the Internet). The experience, though, has been with me since at least second grade. That was long before the term was coined, unfortunately, so I was clueless for decades.

      First, let me apologize on behalf of some of my less-than-civil fellow bi-genders. We’re a minority (bi-gender) within a minority (transgender) within a minority (LGBTQ), and we often feel a lot of confusion and self-doubt because there’s very little validation for who we are. It can make a person feel a little defensive.

      I completely agree with you that classifying bi-genderism as a disease is completely off-track. How is being who we are but not fitting into a predefined category a disease? The only dysfunction and trouble come from having to reconcile being bi-gender with being a person in a world that has no concept of bi-genderism and is often bigoted toward trans people of all kinds.

      But describing it as just shifts in mood…no, no, no, that’s really not it. It’s identity, sense of self. Our perceptions and moods and ways of being change because our gender identity shifts; those changes are the effects, not the core experience. The core experience is that sometimes we feel “I am definitely female” and other times we feel “I am definitely male.” It’s not a decision, or a judgment, or an option, or a choice. It’s a gut-level feeling that doesn’t go away no matter how much you try to banish it and be normal. Or even banish it and just be consistent! Believe me, I’ve tried to banish it, for years and years. I suspect most of us have.

      I wouldn’t be surprised if there turned out to be a neurological basis for bi-genderism (or more than one, because there are several different types of bi-gender people, as if bi-gender wasn’t confusing enough in the first place), but I also wouldn’t be surprised if it were a mainly psychological aspect of the identities we build. I’m concerned about phrasing it as possibly “just” psychological, though, because then people start imagining that it’s a choice. It’s “just” psychological in the way that things like loving horseback riding or wanting to be a mother or fear of heights or being a math genius or being extremely shy or being straight is “just” psychological. We live our lives solely in our brains, and many of the conditions of our identities are not subject to change once constructed.

      Did you know that it’s close to neurologically impossible to unlearn a habit? It seems like we get rid of old habits, but really we just develop replacement ones that we strengthen while weakening the triggers for the old habit. Psychology is neural structure, and neural structure is physical. Neural plasticity is amazing, but it doesn’t mean we can change anything about our brains at will. (Absoluterelativist, I’m not suggesting you’re saying such a thing, by the way!)

      But once you get past the shame and confusion of not fitting the gender you’ve been assigned, and in fact not consistently fitting any one gender at all, there’s space to begin to wonder whether bi-genderism isn’t a natural and perhaps even common state. Not many people identify as bi-gender, but also not many people have heard of it, and there’s a huge cultural disincentive to identify that way as well. It may well be that in coming decades, if we have the space as a society to explore it, that bi-gender identity will spread as if magically as people realize that there is such a thing and that it could help explain how they’ve been feeling all their lives.

  • Neuroskeptic

    “I fail to see how this could at all help people who are ill.”

    Well, I don't know if people who identify as bigender would consider it an illness. Probably not. But, again I don't know, but I'd imagine that they'd consider the concept helpful because it helps explain & conceptualize their experiences.

    You say that “it seems like these are just sensitive and introspective people who choose to describe their shifts in mood or attitude in terms of masculine and feminine personalities” and indeed that's possible, but it raises the question of why they do that; most people don't feel that their gender is in question, in this way, but some people do – surely there is a reason for that.

  • Brin Convenient

    First of all, I so adore when trans people are compared to pedophiles. :/

    To answer the question of where we have been before bigender entered common usage, most often and most likely, bigender people who sought therapeutic help for their gender dysphoria were pushed down the path of the HBIGDA, now WPATH, Standards of Care, which recommended a traditional transsexual path of care, at least until version 7 was released this September. It has been difficult getting therapists to rethink their notions on transgender care and stop shoving full medical and surgical transition down the throats of those who were seeking help for their gender dysphoria.

    In Version 7, bigender is recognized as a valid identity, along with genderqueer and genderfluid (page 9). On, we found that extraordinarily validating and pleasantly surprising, as it hadn't been something we agitated for.

    Most bigender people I know are not disordered, just confused and seeking their own way. The difficulty of bigender not being the same as transsexuality is that the body dysphoria we experience is not constant, but appears and disappears with the strength of our switch to our non-assigned-at-birth gender.

    I recognize that my anecdotes do not add up to scientific data, and I find some of Case and Ramachandran's approach to be questionable. However, as has been pointed out, there is next to no prior research on this topic and something has to be the first. I'll be interested to see what happens as a result of this opening salvo.

    Also, @Neuroskeptic, when I was seeking to create the website, I had to settle for because was, and is, owned by a company called “Big Ender Clothing.” They still own the domain, but have since changed their name to BE4.

  • Brin Convenient

    We hae speculated amongst ourselves that there may be a larger cohort of people who *could* identify as bigender, but who don't experience dysphoria to the extent that they'd reconsider their own gender identity instead of pushing the boundaries of what is acceptable or how they define their assigned-at-birth gender (i.e. masculine women and feminine men who are also comfortable being feminine and masculine, respectively).

    And, no, we don't consider ourselves (insofar as I can speak for anyone else) to be ill, and I know it was extremely comforting and validating to find the term bigender and have it resonate with my own identity. I knew I as not completely comfortable with my assigned gender (and body) the way cisgendered men appear to be, yet I knew I did not want to transition to living as a woman full-time as the idea sparked similar dysphoria. Unfortunately, there didn't seem to be anything in-between. Until I discovered the idea of bigender falling under the transgender umbrella.

  • Neuroskeptic

    Brin: Thanks very much for the comments. I'll reply later, I just wanted to say, I don't think anyone meant to compare bigender to pedophilia; as far as I can see Ivani Fulli was just making a general point that the concept of “male” has changed over the years, because in previous times, pedophilia (in some contexts) was considered a valid part of being male while it now isn't.


  • Brin Convenient

    Fair enough. I may be a bit oversensitive to the trope of off-handedly tossing pedophilia into a conversation about LGBTQ identities. It's often used to subtly suggest some actual association between the concepts.

    There is no question that the expressions of “male” and “female” are culturally mediated (in the words of Natalie Reed) but that doesn't stop anyone in any culture from identifing as male or female, either congruent or incongruent with their assigned-at-birth sex. The fact that we express our gender using the cultural expressions of male or female does not obviate the fact that we are, in fact, expressing our gender. Cisgender people just have the luxury of not having to think about it and thus not experiencing the pain of being forced to fulfill a gender expression and role that is counter to his or her identity.

    Not that it isn't obvious, but I should point out that I'm neither a scientist, nor a medical professional. I'm just a bigender person with a big mouth.

    • Tao

      “Cisgender people just have the luxury of not having to think about it and thus not experiencing the pain of being forced to fulfill a gender expression and role that is counter to his or her identity. ”

      untrue. radical feminists reject gender.

  • ivana Fulli MD

    Thanks Neuroskeptic,

    for stating clearly my intention when citing the ancient Romans fondness for prostitution, bisexuality and pedophilia in your good English. You never cease to astonish me with your talent in being concise and comprehensive at the same time!

  • Ivana Fulli MD

    Brin Convenient,

    May I humbly suggest you think upon :

    “Truth is a fruit that can only be picked when it is very ripe.”–Voltaire

    Because in my view, the bigender activists will gain for sure a mentally ill status someday with the DSMs makers when they might just probably reflect an extreme form of “a trait” belonging to human condition.

    As very often, petrossa expressed here a view worth thinking upon!

  • ivana Fulli MD

    Zoe brain,

    Thanks for having been fair and nice to my comment in a typically aspie manner.

    What made me want to become an “aspie specialist” (in the” knowledge by learning “tribe) is their fundamental self-honesty and social honestly – not that they never lie but they lie badly when they fell like they have to often by education- and although it would be stupid to negate their “special interest narrow view” on some subject , fairness and careful look at your objection is something you can count on always dealing with aspies- when they have had the time to deal with your disruption of their thought of course.

    The problem is always, to my mind, to decide what should be considered “aspie trait” or “human kind trait”:

    I n that case , I just wonder if human condition is “bigender” (masked by culture and education in most “neurotypicals”) or if a certain amount of “bigenderism” is a frequent aspie trait.

  • Brin Convenient

    petrossa said: “A whole new group of 'abnormals' created. Money in the pocket for the whole industry. Everybody happy except ofcourse the victims but who cares. Science must be triumphant.”

    and Ivana said: “Because in my view, the bigender activists will gain for sure a mentally ill status someday with the DSMs makers when they might just probably reflect an extreme form of “a trait” belonging to human condition.”

    In response, I'll point out that bigender people are also transgender people, that bigender is under the transgender umbrella and bigender people also experience Gender Dysphoria as categorized in the DSM.

    Because of this, our treatment follows the same WPATH Standards of Care as a transsexual patient, with the exception that the appropriate transition path may be less than a transsexual. What I'm getting at is that there is not a new class of people being pathologized here, we are people who would have been diagnosed with Gender Identity Disorder under the DSM IV anyway. Insofar as there are bigender activists, as opposed to bigender-identified transgender people, we seek only to ensure that our treatment under the Standards of Care is differentiated enought to be appropriate to the patient and not to the similar, but distinct, condition of a transsexual.

    We were already going to be diagnosed with a mental illness, which GID is, if we sought treatment for our gender dysphoria.

    No one's being pathologized who wouldn't already under the current guidelines, not that we want to be pathologized at all.

  • ivana Fulli MD

    brin convenient,

    To make a long story short I refuse to think with the DSMs as a screen between my professional psychiatrists self and people’s complains- be it mood disorder complains or sleep disorders or eating disorders or sexual identity disorder or whatever.

    I am 1000 % “recovery minded” and a true believer in the knowledge by experience of client but it doesn’t mean that any complain by any client is rightly self-diagnosed. Far from it.

    As far as I understand the situation in the USA, you might need a DSM diagnostic to get money support for treatment but many psychiatrists and psychologists do not hesitate to over diagnose people (for example with autistic label) in order to get their clients -and often themselves by transitivity – money from insurances.

    In my personal –and very limited experience- you always need to work with a client on his complains without “buying it for their offered values”at the beginning of a cognitive therapy – before it becomes clear where the “mind over moods magic” of cognitive therapy might have an opening to make a person feel better about herself or himself (and often her, his situation in the society).

  • Anonymous

    @Neuroskeptic: LOL

    @petrossa: A gloomy view. As a bigendered person, I found this article refreshing because it's really the first time I read about a definition that fits me. I had struggled in the past with ill-fitting pigeonholes. Ultimately, Petrossa has a point – and we should avoid pigeonholes altogether. These terms should help guide our dialog, but not confine us.

    @absoluterelativist: For me, it's more than changes in mood. I undergo a complete latitude change, and have a different relational pov. For about 3 months I'm largely male, and feel so; then for about 1.5 months I'm palpably female. I spent most of my life downplaying the female traits, but now that I've grown more comfortable and am in a safe environment, they're much more evident. This is an involuntary cycle, meaning it's not decision-driven – for me, it feels like the tides.

  • Anonymous

    I knew the existence of the term “bigender” one month ago and soon I found myself in this description. I'm genetically female and my body is very feminine, but inside me I've always feel a male with also a female personality.
    My interior image is that of a man, but I like my female body and I don't desire to change it into a male body. I like it as it is.

    On the other side, according the situation my behaviour changes: sometimes I react to events as I were a male, sometimes like a female.
    I have to make clear that for all my life I didn't accept the bynarism male-female, I don't see any separation between them. I've always fought anyone who pretended I showed a pure female behaviour if I wasn't in the female mode. I think that anyone has feminine and masculine features inside.
    An exclusively male or exclusively female behaviour would make me feel uncomplete, missing something.

    I understand that it can be a mess for people who doesn't know me, but inside me I have a unique personality, I'm one unique human being that includes both feminine and masculine features. A bit more masculine than feminine, to be sincere.
    Which of my sides prevales it depends on circumstances.
    I can react as a female or a male and vice versa along the same conversation with the same person. But for me is natural and my opinions, my thoughts are always the same.
    I'm very happy that finally this thing has come to evidence.

    • Tao

      ‘like a man’ and ‘like a woman’ are both essentialist and determinist.

  • Kyle/Kylie

    I am 14 and switch between boy and girl mode regularly. I am afraid to let my parents know that I am bigender, therefore when I am in girl mode it is only in my room or when they are not home. It drives me crazy sometimes to want too go to girl mode but I can't because I am afraid.

    • Tao

      what makes you think you are switching from boy to girl? what do you define as boy or girl?

      • general809

        Not physically, but psychologically. Don’t cause an argument because you’re too ignorant to accept anything out of the ordinary. Please.

        • Tao

          that is not an answer. why do my questions infer ignorance or malevolance? what does it mean to be a boy or a girl psychologically? what is the difference?

          • Vanessa Rosado

            @@disqus_FF3FEchYWD:disqus It is state of mind from the part of your brain that involves gender identity. It is also like ” a sense off.” Also, as someone that identifies as bigender myself that is how i can describe in two waysidentifying as male and female. Tao was just asking a question. @general809:disqus

          • Vanessa Rosado


      • Staska Kolbaska

        your scum terf side is showing.

    • Lily

      I identify as bigender, so I know how that feels. I never knew how to express my desires until I was 17, when I found people I could open up to. I would encourage you to open up to someone, but be careful with it; I think it goes without saying that it can be dangerous if the wrong people know.

      As for your parents…I really don’t know what to say. I came out to my mom at 18, and two years later, she finally accepted it, and I started talking to her again. Still, at 21, haven’t told my dad. Insert statement on social conditioning of boys here. You know your situation better than I do, I’ll just suggest that you do what you think is right, what you feel you need to do, and stay strong and confident in who you are.

      With love, from one wo/man to another. <3

    • Nik/Indra

      I am 13 and i change between girl and boy mode rather unexpectedly. It can be really hard to admit to your parents that you are bigender, and i know how you feel.

  • Tao

    i’m disappointed by the lack of skepticism here. the cornerstone of gender identity is essentialist determinism fueled by sex stereotypes. this research is merely medical materialism.

  • Roxanne

    Alright guys. Help me out here. I am a fifteen year old girl, and I identify as a girl. But sometimes it just doesn’t feel right. I like guys and everything, but sometimes I feel kind of masculine, but in a feminine way? Like I either want to be a girl, or a “gay guy”. I’m so confused. What’s going on here? Any advice?

    • Tao

      Don’t worry, it’s not uncommon or a “psych disorder,” despite what some would like you to believe. Since gender is socialized, it affects some more than others. Rejection or discomfort toward the expectations others have about your sex does not mean you are the opposite sex. It just means that you are a radical feminist, and therefore do not believe that gender roles and attributes are directly attached to biology alone. You can read more here:

    • Tao

      As far as advice, I’d say to be true to yourself, allowing exploration into your gender expression and sexuality. I strongly recommend DBT, because it can help people combine opposing/confusing pairs feelings or ideas into something that makes sense and reflects your values.

  • Tao
  • Lily

    I always considered myself a cross-dresser, till I found the term almost a year ago. I wanted to be a woman, but only sometimes, so I didn’t see myself as transgender. And, until I was 17, I tried to suppress my desires, and be a “Real Man,” so that didn’t help.

  • Frederick/Frederica

    I’m fourteen, close to fifteen, and I’m Bigender. I switch every few days, maybe even weeks, but the changes aren’t drastic. I’m a female biologically, but today I’m male. I don’t want to let my friends know because I’ve changed my sexuality so many times before, trying to figure it out, if I change to Non-binary, I’m going to be called an attention whore.
    I wish I never really figured out why some days I wanted to wear dresses and have my hair up, and others I wanted to go out to play some foot ball in the mud with my male friends. It’s kind of harrowing.

  • Rei Varda

    I identify as Bi-gender but been using the more common used term now for it of Gender Fluid as I think that fits better. I see myself as Intersex as well cause my body tries to be both male and female to. As I was born what seemed as a male at first and then at puberty I started growing boobs and getting hips and acting much like a girl. I felt stuck in between genders all my life. I go form male mode to female mode all the time. I hid my female mode for the longest time out of fear. But it caused me a lot problems pain and suffering. So now I try to let my female side out I feel is much stronger then the male more. I was always angry and hateful toward myself and society for what seemed like no reason tell I quit trying to be just male. Now I do not feel that way. It caused me so many problems. All cause I was forced to just be one gender I felt. I felt punished for some thing that was not my fault. I like now a days people are much more accepting and I can freely be me more. I just gave up on trying to be one thing I will never be. And just be me of both. 😛

    • James Grant

      I am forty years old and just recently accepted the term bigender only because it was the closest description of what I feel. Over thirty plus years, I hid my feminine half and put all my energy into presenting, thinking, and being male. Exhausting. I gave her time at home, alone, yet the more I did this, I isolated what my perceived attributes as feminine by social standards with her. All I was left with was half of myself with an overemphasized masculine side. I believed that no one would understand and hid it until recently. They may not understand, but they are witness to a better, stronger person. Two halves are one…bigender.

      • Rei Varda

        Do you read the Misfile or Rain transgender web comic are both good places and the forum for Misfile on Napalm Luck is a very good place with nice people to go. I have a thread there called I think i am going gender crazy. here is the like to the last page as it as been going on a while for me.

        But yeah I let myself to just be me no matter what mode I am in. It does not change who I am. Just how I interact and do some things. It can be fun if you let it be and do not listen to those who say you can not. Some times the two over lap and it gets very hard for me to do things. i just try to not fight it and go with it. The more i fight the worse it gets. I love how unpredictable it makes me seem to others. I get away with a lot more then most cause of it. I like seeing things form all sides so I can better make a choice. I never understood this whole thing of limiting ones self to just one thing. I can not as easy as most so that gives me a great advantage that makes up for the rest of the bad that comes with it. In many way I am stronger, smarter and wiser then most cause of all this. For I see it as ever Disadvantage can be an Advantage if only you are will to look and see. To me every Cruse is also a blessing and every blessing a curse. You just got to find a way to turn it around into your favor. Make Lemonade out of Lemons. That is the one and only secret to be learned in life. I have learn the hard way to many times in my life to ignore. I so love Irony. God the Universe or what ever you believe in made us this way for a reason I think. Often in the Bible the ones he loves the most he gives the worst challenges to. To make them better for it in other ways. Not by riches and what others think is right but by spirit making us in the end more whole. I never thought of God as just male or female but both. Maybe God just made a few a little to much in his/her image. 😛

  • Freda

    As to the question of what we’re bigenders before the term “bigender” was coined… We have been around as long as typical typical genders, many Indian tribes used terms like ” two spirited” and in far eastern religions and beliefs that believe in reincarnation it’s normal that some times you are born male sometimes female and sometimes somewhere in between. Unfortunately many of the western religions made it taboo and caused people to hide who they are.



No brain. No gain.

About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.


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