The Man Who Would Be Queen: a response

by Caillean McMahon, D.O.

Dr. McMahon is a Forensic Psychiatrist and a doctor of osteopathy. This essay is in response to The Man Who Would Be Queen by J. Michael Bailey.

Mr. Bailey's claims of a vocal transsexual minority opposing him conjures the image of shrill voices screaming venom unintelligibly and hysterically. My own experience with the opposition to his work has been far less dramatic. Trans-activists of my acquaintance who have read it raise questions about the study model used, the lack of a population wide enough to be statistically significant, the lack of objective testing and quantification of the psychological status of the study subjects.

At the risk of committing the same error of lacking a statistically significant survey population, I will remark that of the transsexuals that I have contact with who are familiar with the premises of Mr. Bailey's work, none have agreed with him.

Were I to undertake such a study (I am published and do ongoing research in psychiatry) I would have designed a drastically different model to protect from challenges from the medical community and to make the conclusions that I presented defensible. "Queen" lacks that type of organization.

I believe that there in inherent problem with trying to develop any psychological model dealing with transsexuality. Our working definition of the condition describes symptoms, not any aetiology. As with the term fever as used in the 17th century(a diagnosis and not a description at that time) I believe that transsexuality can be and is the result of multiple causalities; using the concept of multiple determination of psychic function put forward by Waelder in 1947 we end up with a panoply of factors that influence gender identity either individually or in concert. We have learned that neuronal function is often both excitatory and inhbibitory, we have learned that pathways exert multiple effects on other pathways. The imposition of a simplistic model of aetiology on a constellation of behaviours and symptoms as complex as those found in transsexuality perforce creates a "cookie cutter" image of what a transsexual is. A colleague once remarked to me that there were as many ways to transition as there were transsexuals; the corollary to that would seem to be that there are likely as many causes of transsexuality as there are transsexuals because of multiple factors acting together or failing to act together that produce the same outcome.

Mind you, I have conducted no study. I do not have a statistically significant population. I have obtained no patient, friend, or colleague's permission to use their shared experiences to announce conclusions; but then, neither did Mr. Bailey.