et tu, DES?

Like many of us, I have agonized off and on over the years about why I am this way.  Society's conventional wisdom is that it issinful -- whether they use the theological term or not -- that it is perverted, and that it's something we choose to do.  So pervasive are these beliefs that we ourselves become convinced of them, and keep it all hidden, often from our closest loved ones.  All of which leads to a huge wad of shame, closed up lives, and increasingly dysfunctional relationships. 

 Of course, theories abound about the origin of trans, from the psychological -- dominant mother, nebbishy father, etc. -- to the physical, such hormonal anomalies in the womb.  In recent years, there has been increasing evidence that Diethylstylbesterol (DES), administered prenatally to millions of women over a period of three decades, may play a role.  Approved in 1941 for a variety of gynecological conditions, it's use was expanded in 1947 to women with a prior history of miscarriage.  In the early 1970s, it was linked to a rare form of cancer in women who were exposed prenatally, and was discontinued.  In that time, between the late 40s and early 70s, five to 10 million women are estimated to have been exposed to it, either prenatally or during their pregnancies.

DES is a powerful estrogenizing drug, so its role in the feminization of biological males has always been suspected.  However, though the effects of prenatal DES have been well-documented in women (so-called "DES daughters), that is not the case with the estimated one to three million "DES sons."  Over the years, researchers have reported structural abnormalities of the male reproductive system, links to "psychiatric" phenomena, such as anxiety and depressive disorders, and suspected ties to gender-related issues. However, due to a variety of factors, sample sizes have been so low that no definite conclusions could be reached, especially with respect to gender issues.

In 2005, Dr. Scott P. Kerlin published a paper based on surveys of the "DES Sons International Network," an organization of men exposed prenatally to the compound.  The results were stunning:  in the survey of 500 DES sons with confirmed or strongly suspected exposure, the three most frequently "core health concerns," in descending order, are (a) gender-identity (over 150 reports);
(b) psychological issues, especially depression and anxiety disorders (100 reports); and (c) hormonal/endocrine issues (at least 75 reports).  Amazingly, nearly one third of all respondents listed gender identity as a major health issue.

Here's the breakdown: Of the 158 reporting gender-identity issues, 

1. 90 (57%) self-identified as pre-or-post-op transsexual
2. 48 (30%) self-identified as transgendered
3. 17 (11%) self-identified as gender-dysphoric
4. 3 (2%) self-identified as intersexed

For me, this is revelatory: besides being transgendered, I have had anxiety disorder and at least one of the physical an mother omalies reported elsewhere in the paper.  Further, I was born in 1953, at the height of DES use, and my mother had a miscarriage prior to my birth.

Although I have no idea if she was treated with DES, you can bet I will be finding out soon.

 Thanks to Christen Bustani who, in her marvelous blog, pointed me to this issue.
There is an earlier version of Kerling's paper here.