Harry Benjamin Syndrome

Harry Benjamin Syndrome (HBS) is a discrepancy between neurobiology and physical phenotype. Despite the fact that much of the nomenclature referring to HBS employs the terminology of identity politics, such as 'gender identity disorder' and 'gender dysphoria', HBS is not a gender issue, nor is it another word for transsexualism.
It should be noted that the proper form is Harry Benjamin Syndrome. In naming medical conditions, it is not considered proper to use a possessive form. The condition is named in honor of someone, usually the person who identifies or describes it. It is not owned by them.
American Endocrinologist, Dr. Harry Benjamin, originally described HBS, known then as true transsexualism, like this:
"True transsexuals feel that they belong to the other sex, they want to be and function as members of the opposite sex, not only to appear as such. For them, their sex organs, the primary (testes) as well as the secondary (penis and others) are disgusting deformities that must be changed by the surgeon's knife." Harry Benjamin, The Transsexual Phenomenon. (Ch. 2).
Simply put, "true transsexualism or Harry Benjamin Syndrome relates to individuals who experience a life-long conflict with their anatomical sex. The condition is characterized by early childhood sensations of wrongful embodiment and a powerful, often self destructive, discomfit with their reproductive function as adults." Early childhood manifestations of inappropriate 'gender role' behavior are not necessarily a component of this condition.
The words sex and gender mean different things. Sex refers to the biological and physical anatomy. Gender is used to describe the social and cultural expression of maleness or femaleness. The difference is commonly known as the sex-gender distinction.
Indications are that HBS is more akin to an intersexed state with a prenatal developmental pathway involving differentiation of male and female brain structures.
HBS advocates argue that these new findings remove Harry Benjamin Syndrome from the gender side of the sex-gender distinction and turn it into an issue of biological sex.
According to Dutch estimates the incidence of transsexualism is around 1 in 10,000 live births overall. Other estimates place it much higher. .org/wiki/Transsexual However these statistics are based on the number of individuals accessing genital reconstruction surgery. That means many people who do not have HBS are included. Such data should be treated with suspicion regarding the occurrence rates for HBS.
Two possible reasons for accessing feminizing genital reconstruction in persons without HBS are autogynephillia and male homosexuals undergoing genital feminization whilst still identifying and presenting socially as men. (Warning. Content may offend some people)
HBS advocates claim that a woman or girl with HBS would have a female neurological pattern, but a male phenotype. Conversely, a man or boy would have a male brain pattern, but the outward phenotype of a female. These experiences are restatements of the classic description of, "woman trapped in a man's body and vice versa, and represent clearly different situations to autogynephilia, its female equivalent, autoandrophilia and the "mangina" phenomenon.
At present, it is not possible to diagnose this condition at birth. Therefore, the children are raised in the gender role opposite to their developing psycho-sexual biology. As with other forms of biological variation in sex formation this often leads to psychological problems unrelated to the HBS itself.
In some cases an identity has been successfully implanted by cross-gender role upbringing However for most people, psychosexual status appears to have a neurobiological origin, which develops independently of behavioral or environmental influences. Consequently neurological factors are now thought to be more determinative of both psychosexual and cognitive function than either genitalia or upbringing.[http://www.sfu.ca/~dkimura/articles/NEL.htm]
According to this scenario, Harry Benjamin Syndrome is just one of the many naturally occurring variations in sex formation that can and do arise from time to time. It is neither a psychological condition nor a lifestyle choice. It cannot be remedied by changing gender roles.
Compared to the traditional intersexed conditions, HBS may be up to ten times less frequent than Klinefelter’s Syndrome,(XXY). It is also thought to be many times less common than either Turner’s Syndrome (X0) or partial androgen insensitivity syndrome (PAIS).
Most diagnoses of HBS occur when the individual is between 20 to 45 years of age. However it is becoming more common for the diagnosis to be made when individuals are in their pre-teens, and some cases are detected in early childhood (four to five-years old). That accords with the accounts of HBS adults who often report experiencing the sensations prior to beginning school.
Regardless of the age of diagnosis, affected individuals will usually begin a process of anatomical correction with hormonal treatment. For HBS advocates, sex-affirmation surgery (SAS) replaces the earlier terms, sex reassignment and genital reconstruction surgery (SRS or GRS). Sex affirmation recognizes the mismatch between the brain and the anatomical sex, and is always indicated if the individual's health permits. Research carried out on adolescents in the Netherlands, shows that early intervention with corrective hormone treatment followed by SAS, leads to lowered distress and significantly improved outcomes for patients.
Again it should be noted that the nomenclature used in the two citations above are out of step with the sex-gender distinction, and indicate a need for researchers to change the way they interpret and present their data.
The level of stress induced by societal pressures concerning gender norms and behavior differs widely from one individual to another. The expectations of most societies regarding gender-specific actions do not suit everyone, and many engage in some sort of cross-gender role identification and behavior. Transiting gender roles (transgender) is not a reliable indication of HBS.
The overwhelming majority of people place much importance in the expression and congruency of their and others’ social gender. Most take their gender roles for granted, and it is so deeply rooted in human behavior and expectations that they do not think of it consciously.
Conversely, those born with HBS experience a steadily growing dissatisfaction and distress with the discontinuity between their neurobiological sex and their anatomical sex, due to the dissonance between the two. Relief occurs when the physical anatomy and the neurobiology are harmonized.
Alternatively, the stress of an anomalous psycho-gender/anatomy can often drive individuals to suicide in the absence of medical correction.
Hostile attitudes can exacerbate the distress of those with HBS. There is often disbelief and anger directed towards those who reveal the presence of the syndrome. Also many people who do not have the experience believe that any medical correction of anatomy is contrary to all reason and good-sense. Some target persons they presume have gender incongruity and subject them to verbal threats and harassment, physical intimidation and violence. Others use discrimination and ostracism to socially isolate. Sadly, these responses are all too common-place in western 'liberal' societies when an individual is found to, or even believed to, possess some form of biological variation in sex formation.
Science has not yet uncovered all the ingredients of this syndrome. However, as research unlocks the secrets of the brain it is becoming increasingly obvious that HBS is a physiological condition that can be easily remedied, allowing affected individuals to fulfill their natural potential. A top ranked HBS website with an overview of current knowledge can be found here.

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