JAMA articles on transsexualism

Editor's note: KS sent me this interesting piece of research on the lack of attention in the published medical literature on transsexualism. She's written up a comparative survey of work in the Journal of the American Medical Association (JAMA) and other prestigious medical journals over the last 40 years.

Her observation illustrates that there is a void in scientifically rigorous study of our condition from a medical standpoint, and into this void has come a lot of sloppy work such as Ray Blanchard's and that of other theoreticians using questionable diagnostic tools like penile plethymography.

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I started working on this last Friday, but have had constant interruptions. Seeing as how my week is going, I'm sending this on "as is" so you all can use whatever you find useful. I was going to track down ALL the AMA publications and read them, then break down the articles by date range to show a shift in thinking aligned with times this country tended toward extreme, erm hmmm, shall I say "fascism." We are obviously in one of those periods now. -- k.

I've been poking around the Journal of the American Medical Association, seeing what's been published regarding TS, when, and who authored it. I tend to look for patterns, like most good primates, and there are some very clear patterns that need thinking about:

A baseline search for the following words anywhere in the article of all available articles and archives between 1962 and 2003:

Keyword # of results
Blood
12, 926
Sex
6,813
Gender
1,415
Homosexual
431
Gay
305
Lesbian
82
Transsexual (including -ism, -ity)
21
Transexual
0

Of the 21 articles published by the AMA in the last 40 years concerning transsexualism, the topics and disciplines are as follows:

1 article in the Archives of Opthomology:

Ajita Grewal, Robert Y. Kim, and Emmett T. Cunningham, Jr Miliary Tuberculosis
Arch Ophthalmol 1998 116: 953-954. [Full Text]

2 articles in the Archives of Internal Medicine:

C. J. Fortin, T. Klein, H. L. Messmore, and J. B. O'Connell Myocardial infarction and severe thromboembolic complications. As seen in an estrogen-dependent transsexual. Archives of Internal Medicine 1984 144: 1082-1083. [Abstract]

M. deMarinis and E. N. Arnett Cerebrovascular occlusion in a transsexual man taking mestranol. Archives of Internal Medicine 1978 138: 1732-1733. [Abstract]

9 arcticles in the JAMA:

M. M. Belli Transsexual surgery.. A new tort? JAMA 1978 239: 2143-2148. [Abstract]

T. J. Pritchard, D. A. Pankowsky, J. P. Crowe, and F. W. Abdul-Karim Breast cancer in a male-to-female transsexual. A case report
JAMA 1988 259: 2278-2280. [Abstract]

HIV-Related Tuberculosis in a Transgender Network-Baltimore, Maryland, and New York City Area, 1998-2000
JAMA 2000 283: 2515-2516. [Full Text]

Domeena C. Renshaw Lessons From the Intersexed. JAMA 1999 281: 1137-1138. [Full Text] JAMA 1992 267: 1342

K. L. Lehrman Pulmonary embolism in a transsexual man taking diethylstilbestrol. JAMA 1976 235: 532-533.

Joe Leigh Simpson, Arne Ljungqvist, Malcolm A. Ferguson-Smith, Albert de la Chapelle, Louis J. Elsas II, A. A. Ehrhardt, Myron Genel, Elizabeth A. Ferris, and Alison Carlson Gender Verification in the Olympics. JAMA 2000 284: 1568-1569. [Full Text]

Books, Journals, New Media Received. JAMA 2000 283: 676-677. [Full Text]

Domeena C. Renshaw Hermaphrodites and the Medical Invention of Sex. JAMA 1999 281: 1138-1139. [Full Text]

9 articles in the Archives of General Psychiatry:

R. E. Hellman, R. Green, J. L. Gray, and K. Williams Childhood sexual identity, childhood religiosity, and "homophobia" as influences in the development of transsexualism, homosexuality, and heterosexuality
Arch Gen Psychiatry 1981 38: 910-915. [Abstract] <>

Henry J. Friedman The Sexual Century
Arch Gen Psychiatry 2002 59: 667-669. [Full Text] <>

D. H. Barlow, G. G. Abel, and E. B.. Blanchard Gender identity change in transsexuals. Follow-up and replications
Arch Gen Psychiatry 1979 36: 1001-1007. [Abstract] <>

Cindy M. Meston and Penny F. Frohlich The Neurobiology of Sexual Function
Arch Gen Psychiatry 2000 57: 1012-1030. [Abstract] <> [Full Text] <>

L. M. Lothstein and S. B. Levine Expressive psychotherapy with gender dysphoric patients
Arch Gen Psychiatry 1981 38: 924-929. [Abstract] <>

H. J. Baker Male transsexualism.. Confirmation of a hypothesis?
Arch Gen Psychiatry 1975 32: 1587-1588. [Abstract] <>

D. H. Barlow, E. J. Reynolds, and W. S. Agras Gender identity change in a transsexual
Arch Gen Psychiatry 1973 28: 569-576.

S. I. Harrison, A. C. Cain, and E. Benedek The childhood of a transsexual
Arch Gen Psychiatry 1968 19: 28-37.

H. Greilsheimer and J. E. Groves Male genital self-mutilation
Arch Gen Psychiatry 1979 36: 441-446. [Abstract] <>

The three articles written by Domeena Renshaw for JAMA belong in the psychiatry/psychology group. Here is a little background on Ms.Renshaw:

Domeena Renshaw, MD: Loyola University/Stritch (Chicago-based Jesuit/Catholic school) - Department of Psychiatry and Behavioral Neurosciences
Major research:
Biochemical, endocrinological and immunological aspects of psychotic, mood and anxiety disorders
Psychological and biological elements of sexual function disorders, AIDS, substance use disorders and psychoses
Clinical trials
So of the 21 articles published by the AMA in the past 40 years, more than half (12) are written by psychiatrists, psychologists, or sex researchers with dubious claims to objectivity.

Some of these people would take issue with Bailey, however. Bailey's critics include:

Henry J. Friedman
"...the designation of one form of sexuality, namely, heterosexuality as normal has created an atmosphere in which homosexual individuals would be better served by avoiding psychoanalysis with a heterosexual psychoanalyst who adhered to such a viewpoint about normal sex as heterosexual." (Bailey insists he is heterosexual, and often refers to heterosexual sex as "normal.")

http://www.selfpsychology.org/1998conf/abstracts/A_01-Friedman.htm

Cindy Meston and Penny Frohlich use hard science, and are critical of unsupported test data from devices (http://homepage.psy.utexas.edu/homepage/group/MestonLAB/laboratory/plethysmograph.htm) or limited test subjects. See Dr. Meston's lab page for more info -- http://homepage.psy.utexas.edu/homepage/group/MestonLAB/about_us/meston.htm


The Green/Blanchard/Bailey party line supporters include:

Leslie M. Lothstein (MMPI Statistician, Kinsey-quoter and Green afficianado)
http://www.usdoj.gov/crt/foia/tal327c.txt