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The mismatch between body and identity

The mismatch between body and identity

Photographer:Fotograaf: Joey Roberts

Wishful thinking

Imagine you, a researcher, are given a bag of money, unlimited time and personnel. What research would you do? PhD student Mathilde Kennis would like to research gender-fluid people using MRI. Except this is not possible, at least not yet.

It is a question that often comes up in the transgender community: how is sex after a transition? Hardly any research has been done on this, says Mathilde Kennis (25), a PhD candidate at the Faculty of Psychology and Neurosciences since last September. She is starting a diary study, in which transgender persons regularly make notes of their sexual well-being: how it feels, whether their bodies are an obstruction, or a depression is spoiling their fun. “They suffer a great deal from psychiatric disorders, 40 per cent has at some stage carried out a suicide attempt.”

At the same time, Kennis is preparing a neurobiological study in which she studies the brains of transgender persons before, during and after their transition. She will zoom in on specific areas of the brain where the link or mismatch between body and identity is processed. The question is whether this mismatch disappears during the transition.

“When you show subjects in a scanner a photograph of themselves, then one region clearly lights up. If you do so with a transgender women, so someone who was declared male after birth but who identifies himself as a woman, then I expect a much more diffuse image. Many transgender people have an aversion towards their own bodies. The question is whether this brain activity becomes less ambiguous after the transition.”

It won't be easy to find sufficient test subjects, forty transgender men, forty transgender women and a control group. She is going to contact the hospitals in Gent and Amsterdam, where many sex change operations are carried out. At the same time, she does ‘fieldwork’ in LGBTI circles and regularly visits Café Rosé in de Bogaardenstraat.

Kennis sometimes gets critical notes there when she talks about her research. “Some feel that my research into transgender men and transgender women is too binary. It confirms the established pigeon-holes, while there is a whole spectrum of gender-fluid people in between, of people who one day feel like a man and the next like a woman, or non-binary people, who feel completely different.”

That is why Kennis dreams of a large study in which gender-fluid and non-binary persons could also participate. “Varying from people who go through binary transition, with hormone therapy and a sex change operation, to transgender men who only have their breasts removed or transgender women who only choose a social transition, and not a medical one. Can you see changes in the brain? But also: how happy are they? I would follow the entire group for twenty years.”

The Dutch ‘gatekeeper model’ should also be looked at. A sex change operation can only be carried out after a psychologist has diagnosed gender dysphoria. “That model was established with the best of intentions, but it can take up to five years before it's your turn. In many cases that means five additional unhappy years. We do our very best to prevent people from making a regrettable choice and maybe don't see the despair caused by having to wait for a very long time.”

Kennis’ dream research is unfeasible at the moment. “From a statistical point of view, the various gender-fluid groups will be too small to be able to make any statements. Besides, where it concerns gatekeeping you would preferably have to make one group wait five years and send another group on for immediate treatment. Ethically, that would not be right.”

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