Faces Transforming: research on female-to-male transsexuals

As I study the photographic images before me, the boy’s face radiates innocence and boldness. He looks like a bit of an imp. I look at his adult face, and can still see the impishness in his expression. He is middle aged now, balding, with ruddy, coarse skin and beard shadow. This is rather astounding – because this person started out life as female.

He is one of a growing number of transsexuals in Scotland and, as such, is one of my research subjects. In the Centre for Anatomy & Human Identification (CAHId) at the University of Dundee, my PhD project is documenting for the first time the changes that take place in the faces of FTMs (female-to-male transsexuals) when they take testosterone. 

I too, am a female-to-male transsexual - I am an ‘embedded’ researcher. A late starter, I began my transition at age 37 in Canada. My background is in social, and more recently, forensic anthropology.

Female-to-male and male-to-female (MTF) transsexuals are commonly grouped under the Transgender ‘Umbrella’. The trans in transgender means to “cross over”. Transgendered individuals may express a gender presentation and behaviour that does not match their ‘assigned sex’, or the norms of culturally conventional roles. Having said this, categories of gender, sex and sexuality are frequently controversial. More often than not, the most vociferous arguments over labels take place among those on the transgender continuum. This loose collation may embrace a range of identities that resist the male/female binary, such as transvestites, drag Queens and Kings, cross-dressers, and the genderqueer.  

At some point or another in their lives, often as young as two or three years, but also as late as their 50’s and 60’s, transsexuals experience overwhelming feelings of dysphoria - a profound sense of disconnection between the sex of the body and a self-perception of gender. Depending on their geographical location and the entrenched concepts and bureaucracy of their society, they may change their bodies hormonally and surgically to reflect the gender identity which defines them. 

Sex and gender, it is argued, are different from one another and arise from different origins. Our sense of self (and others) as gendered beings is attributed to the psychosocial realm. Our sex is the result of biological, genetic templates. Sex and gender as concepts have suffered from a slavish devotion to the binary model. Many now disagree with the reductionist view of gender as existing on a spectrum, with masculine and feminine as opposite terminal bookends. Human sexual dimorphism is regarded in much the same light, but without the benefit of any space for a spectrum between biological male and female – or at least, one that is not pathologised. Fortunately, a rising number of intersex voices have begun to put this institutionalized over-simplification of human variance to the test.

Analysing the dramatic facial transformations in FTMs requires the use of some high tech imaging hardware/software. To capture their post-transition facial image their faces are scanned with a portable infrared laser scanner that produces a very accurate 3D model. This model can then be manipulated in a computer generated virtual reality environment. Six-degrees-of-freedom in the virtual field allows the 3D face model to be superimposed with a photograph of their face before they started taking testosterone. The 3D model is posed to match the pre-transition facial photograph and superimposed using a combination of 3D modeling software and Photoshop. Differences in the proportional distances between features, and the size and contours of the features themselves can then be assessed.

In Scotland, female-to-male transsexuals are presenting to clinicians for assistance with transition in record numbers: about 35-40% of individuals at one Scottish gender clinic are FTM. In addition, the increase in the total number of transsexuals (FTM & MTF) applying for hormonal and surgical assistance with gender transition is increasing by 15% per year in the UK. 1,500 people a year are referred to specialist gender clinics, and it is estimated that about 1,200 transitions a year occur. The fastest growing age group of those requesting gender reassignment is among the young – those who are under 18.

So….why is studying the masculinizing effects of testosterone on transsexuals important? Firstly, very little research exists on FTMs. The need for information on how testosterone works in the bodies of FTM transsexuals is significant to their welfare generally – not much is understood about how testosterone affects their health in the long term.  

In a broader sense, such research also serves the needs of the larger human population. Transsexuals are walking, talking experiments. They afford access to concrete, tangible evidence of the ontogenetic effects of hormones on the living body, often unavailable for study. Information gained from research on them may, for instance, add to knowledge about skeletal changes in menopausal women and the influence of androgens (of which testosterone is one) in the development of osteoporosis in males.

Increased visibility, particularly in science and medicine, emphasizes disagreement among transsexuals on what that visibility offers, either to them individually, or to the transsexual community as a whole. My hope is that this project, in some way, offers FTMs access to a shared humanity that comes with being known. Transsexuality can be a very big closet, especially for FTMs who, because of the nature of the changes that occur in their bodies during transition, pass unequivocally as men, especially in Western societies. In this research, they can choose between complete or partial anonymity as participants. Whatever their choice, they are contributing to a groundbreaking endeavour generating original data in the larger scientific arena.