Gender identity, sex-partner gender preference, hard wired into our brain, Also important insight do not push hard an agenda foreign and frightening to the middle majority .The opposite often ensues.

Gender identity, sex-partner gender preference (SXGP) in my opinion are hard wired into our brains: cognitive neuronal hard-wiring. Probably this is seated in the primitive central brain: amygdala, thalamus and surrounding with cerebral cortex extensions. I believe it is like microchip circuitry with at least low level current flowing constantly through those channels, impacting on everything we think and do. All our behaviors and thoughts affected by the constant background hard wired circuitry of gender identity and SXGP.

I fully realize that this topic is as controversial and divisive as they come, but I thought I would shed my own wisdom-sense and medical knowledge on the subject. The original version of this blog I had composed and kept as a draft for over 1 year. The current political environment of a dramatic pendulum swing in treatment of transgender individuals compelled me to modernize and now post it. So here goes:

There are two live birth genders, thinking patterns of these two genders is constantly flowing in a set central brain circuitry influencing everything we do. There are rare mixed gender versions at birth that can involve for example gonads of both genders being present in the individual at birth, perhaps the most interesting and a not uncommon gender variant is androgen-insensitivity syndrome ( AIS, formerly known as testicular feminization), where the tissues in a genetic (XY) male are insensitive to androgens (testosterone the most common) with the result that the individual has the outward phenotype of a female... but they don't have ovaries or a uterus. AIS occurs in about 1 in 50,000 live births. Overall the occurrence of the full range (which is a massive list) of mixed gender at birth is in the order of 1 in 2,000 - live births.

Gender identity as male or female is vastly the norm in XY, and XX genotype individuals, respectively. This would represent atleast 99.9% of the population. There are individuals with the outward physical appearance of one gender (eg: male appearance) but the true cognitive wiring of the other gender (eg: female) but this is relatively rare, maybe 1 in 50,000. Variant of other gender wiring probably occurs in 1 in 1,000 individuals. Full explanation of the larger group is beyond the scope of this blog, probably most commonly a reaction to parents or the peer group. Phases of activity of the other gender is extremely common in childhood, the most recognized is tom-boy behavior in girls

Sex-partner gender preference (SPGP) is a separate circuit wiring from gender identity and the circuitry also is constantly running.

I estimate based on available human and animal data:

phenotypic one gender (XX, XY) have opposite sex-partner preference in approximately 90% of humans

Phenotypic one gender (XX/XY) have same gender sex-partner preference in approximately 10% of humans. This is classic homosexual male and lesbian female.

Psychological true transgender occur in 0.01% of individuals, and sex-partner preference usually follows along the line of same sex to their own genetic gender (XX/XY). That is to say trans-women (genetic males) are usually attracted to males, but atleast 10% would be attracted to females, and this numbner largely higher than conventional homosexuality..

I do find it fascinating how durably and viscerally hard-wired these cognitive properties are, even in me. I am a heterosexual male, and am very open-minded in principle to everyone that they live and let live. I have many friends of same sex-partner preference and have no problem with their life style, and yet if I see on tv two men kissing, I do cringe. I take that as a reflection of my core central brain wiring. So as a moderate liberal-minded educated individual, I cringe when I see that, so I can imagine what more Christian conservative individuals would think. In this way large Pharma companies marketing HIV drugs, showing men kissing and flirting with each other on tv ads, have done as much to mobilize conservative voters, as any conservative political pack. Homosexual men do not need to see men kissing on tv to know what HIV drugs can do and who are the largest market, but Christian conservative voters are horrified by it. Simple solution for this: don't show men kissing on tv. Ofcourse actual sexual activity takes this cringing to a whole other level of revulsion.

One of the most politically divisive attitudes in modern US politics is the management of gender identity and gender sex-partner preference. As much as it makes wisdom-sense for both sides of the divide to let the other side live and let live. The more extreme one side becomes, especially the current relatively novel freedom of transgender individuals, espousing vigorously their rights (which I can understand why they would be so vocal, being repressed for essentially.. forever ) it comes at the cost of radicalizing the opposing faction. I wrote this above sentence in 2024, which has heralded the exact opposite extreme in the present political environment today in 2025. The foundation is fear, and in specific the frightened and horrified view that their 'normal' children may undergo conversion to an aberrant gender identity, and most people would do (almost) anything to prevent that. Numerically probably those with that fear gender conversion outnumber those who do not. Current 2025 polls show that at least 80% of the public oppose most transgender supportive . issues. Most people fear conversion therapy to a nontraditional status as unacceptable, which at some level may seem ironic as aggressive conversion therapy of homosexual children to hetereosexuality has been accepted in modern society for centuries and only recently has a large number of the population realized that attempted conversion therapy of homosexual individuals is cruel and ineffective... they are hard-wired as same gender SPGP. I will say, that even me, in my 'enlighted' state, would be fearful that my future grandchildren may be coerced into the nonstandard gender identity and SPGP, the gender identity being of somewhat greater concern.

On a societal level how to deal with this explosive subject of gender identity and SPGP. The wise position is to start with: calm down. Live and let live. But wisdom dictates, since the general thinking of the public and especially of the public self-describing as conservative, those others, who are in the vast minority, although they finally can enjoy some level of acceptance and even (more importantly) of safety; my advice is to not be too much in the face of the conservative thinking majority (which would include almost all Republicans but also most Democrats). Provoking them will not only serve to enrage those vigorously (and ignorantly often) opposed to your rights to be recognized, but also the silent majority of the public. Do not poke the bear because you now finally have freedom to be yourselves, because this carries with it the strong possibility of an enormous backlash, which will be devastating to you.opposed to them, I am not saying this because this is ethically correct, I am saying this because it is the wise recognition of human thinking. Somewhat quietly and progressively continue the march on the course of getting the recognition you deserve.

Additional notes:

In general I am nervous about sex change operation in those younger than 21, and also, but a little less concerned about puberty blocking drugs. I am not sure that the doctors performing these things are as cautious and wise as I am. I suspect a number probably are, but a sizable number are probably not.

Transgender (male to female physical conversion, trans-women) should not compete against women in sports, but at the same time they should be allowed to compete. There should be a separate category of transgender. This would calm down women and others (like me) who think that transgender (M-F) trans-women are not the same as (cis;)women and have an unfair strength advantage. Maybe they cannot compete at a school level, because of their relative rarity and few numbers, but they could compete at a state or regional level (in the circumstance their state would not support it). Maybe there should be 4 categories (M; F; M-F; F-M). Why not, that seems the most fair. Maybe also for schools and changing rooms there need to be separate facilities, or single room, like single room toilets, for transgender individuals, separate for each category. That also seems the most appropriate.

At some level, sure as a heterosual male I am a little concerned about the concept of conversion therapy, of all types. Many females when they are children act as 'tomboys' (as Margot Robbie even has said of herself) but the majority end up as heterosexual females and not lesbians or transgender. I think we also need to calm down about that, there is no factual evidence of a large conspiracy for conversion.

It would be interesting if in the future imaging methods like neural tractography can define the constant running neural network of gender identity and sex-partner gender preference.

So applying medical knowledge wisdom sense: there are two genders (XX and XY) with rare congenital variations (which are relatively numerous in the different types, but few in absolute numbers). The gender identity of the other gender is rare and is likely hard- wired in the central brain. It is both real and ok. Transgender children and adults should be able to compete in sports but in their own category and not as females.

Be sensible with education of children, what I write above is as correct as is presently known. Don't teach them crazy things, in either direction. To say 'gender identity is fluid' is both stupid and wrong. I am not sure how many lower school teachers say such stupid things. I suspect they are relatively few in number. They should be informed to stop saying stupid things to young children or they will be fired. Restricting books in school is also generally a foolish pursuit, unless the books are frankly pornographic or somehow endorse rape of women or children. Show wisdom-sense.

Calm down. Live and let live. But wisdom sense informs the ones who seek change not to be too much in the face of conservative ideology, because it will have the exact opposite effect of what you desire (and deserve). The Weimar Republic preceded Nazi-ism- read about that. What conservatives are afraid of is conversion of their own children, and concern for one's children is as central a protection drive as exists.

The bulk of what I have written above was crafted in Jan 2024.. You can now see where we are at, with the lack of heeding this type of wisdom-sense, the pendulum has swung aggressively in the opposite direction.

The new insight I have in March 2025, aided by attending the American Academy of Environmental Medicine meeting in February, and especially talking with the testosterone expert Ty, MD, it has occured to me, if AIS is due to insensitivity of cells to respond to androgen, and genetic males (XY)what about the circumstances that androgen production is decreased, or dysfunctional androgen is produced because of the greater background ambient pollution and toxicities. I am thinking that this may result in partial deficient androgen supply in developing male children. The primary treatment for male children with gender confusion may be the exact opposite of what is currently being done commonly in the USA, and progressively done less frequently in other developed countries. So rather than gender blocking drugs, the following should be done: 1. test for androgen levels, 2. first treatment is testosterone, and see if the gender confusion actually is secondary to deficient normal testosterone. If the individual remains feeling they should be the opposite gender after 1 year of therapy, then medical and formal conversion, and only then, should be considered.

Gender confusion in female children is less common as a dramatic situation. Many young heterosexual cis-girls are tomboys. True gender conversion F-M is however much less common than the other. It is less clear, but probably logical, , that the first treatment is increasing normal female hormones to age-appropriate levels to manage them.

As a finishing note. the most impactful political ad ever produced (probably much more impactful than the Reagan-era ad of the actor-actress pretend married couple opposing universal health care in a kitchen table discussion) is the Republican ad with the final words '(Kamela) is with They/ Them and not you, us', and the image is of a horrifying looking trans-gender (maybe a zombie actor from the Walking Dead series) with distorted facial features and bright red lipstick.

Maybe the most important point: it takes time for the large majority in the middle to accept other view-points that may be dramatically different than their own. This must be done quietly, but also I do not mean to downplay determination. Drag Queen reading hour for children, does not create the sense of 'Hey they are just like us', but rather 'we have to do whatever we have to do to make this conversion of our children stop' Remember the liberal excesses of the Weimar Republic, particularly in major cities like Berlin,, led to the reaction of support for the National Socialist party (Nazis) as much as anything else. Be respectful and understanding of what the majority in the middle may think. Perhaps even the European Dark Ages was also a reaction to the excesses of late imperial Rome.

Richard Semelka, MD.