LUST

Lust is perhaps the most complex of the seven primary affects.  It is easy to see that FEAR, for example, is an emotional affect because it produces undeniably robust emotional feelings and it generates actions like freezing and running away. But LUST has a homeostatic effect like hunger and thirst. The homeostatic system means the system wants to maintain a balance and return to normal when it gets too high or low or too thirsty or hungry. Think of a thermostat that keeps the temperature constantly returning to the same temperature. And then LUST has a sensory effect like the pleasure of taste or a good massage. So LUST is all three: primary, homeostatic, and sensory.

And LUST gets much more complicated because physical and psychological expressions of gender have distinct but overlapping controls: Gender of the body and the gender of the mind develop somewhat independently. And this relatively independent development of the mind and body start to take place in utero – in the developing mammalian embryo– long before organisms can have any thoughts about sexual matters.

Female and Male Brain Circuitry

The subcortical sex networks of females and males are basically the same within the hypothalamus of the brain. The difference is the difference in the size of two areas -the POA and the VMH – of the hypothalamus. In males, the POA is larger. The initials are used in most journals;  the actual names are tongue twisters. 

Sex Networks of Males and Females

The brain is a pulsing blob. You can’t see the difference between the POA and the VMH as it appears in drawings. Surgeons locate areas with electrical stimulation. That is how the entire brain was mapped.

The VMH is more influential for female sexual responsivity. Female urges for sexual receptivity originate in the VMH. Sexual urges for males originate in the POA. Damage to the VMH severely impairs female receptivity, while damage to the POA affects males.

Biologically, we define females as those born with an XX chromosome and males as those who are born with an XY.   Female-type brain circuitry is stronger in the majority of biological females and male-type brain circuitry is stronger in biological males. 

Genes

But when the mind/body, gender/sex are mixed we get a female brain in a male body or a male brain in a female – transgender.

A male transgender has XX chromosomes, so is biologically female. But instead of the stronger VMH for receptivity, the POA is dominant, so the person has a female body, but a male mind. A female transgender has XY chromosomes with VMH dominance, so the person has a male body with a female mind. 

Then we combine these complex biological phenomena with the equally complex personal, social, and cultural world and arrive at our identity.

Homosexuality implies the desire to have erotic, sexual relationships, in a variety of forms, with members of one’s own externally apparent biological sex. It does not necessarily mean that a person with a man-typical body feels like a woman or that a woman with a woman-typical body feels like a man inside their mind. Homosexuality may or may not (in some or all instances) have a biological basis at the primary-process MindBrain level. We have no easy way of knowing.

Transgender is where mental feelings about maleness or femaleness fail to match up with one’s physical appearances and/or chromosomal biology. A female brain in the male body results in a person who feels like a woman in the body of a male, and a male brain in a female body produces a person who feels like a man in the body of a woman. This is a basic definition of the state of being transgendered. The biology of the brain has profound implications for one’s sexual identity and destiny. And so we must not ignore the little boy or girl who feels like they are in the wrong body. Some parents feel if they give it time this feeling will go away. It most likely will not.

Gender Dysphoria versus Body Dysmorphic Disorder

I might never have thought much about Gender Dysphoria had I not come across a young woman in her twenties on a site called PsychForums. The title of her post was “Some days I feel insane.” She starts by saying that her Body Dysmorphic Disorder became apparent from puberty, but her gender identity since birth. She views herself as having a very beautiful androgynous face, though, from her photo, I don’t detect the androgyny.

She swaps back and forth between genders, injecting herself with testosterone to become more masculine since her body is normally thin. As a guy, her BDD centers around her small overall size and her face, neck, eyes, and midsection, which she perceives to be feminine. 

When she takes estrogen, her BDD centers around her lean muscular shoulders, toned back, arms and legs, and what she calls pectus excavatum, a slight dip in the chest, causing the rib cage to flare out. She admits her pectus excavatum is very mild, but it is there and that is enough to upset her.

She contemplates surgery to make her body more feminine at times, and surgery to make her body more masculine at other times. Her condition seems to be stable 60-70% of the time and then all of a sudden she is anxious, stressed, depressed, and ambivalent in regards to her appearance and gender. At these times she focuses on her perceived flaws, obsessing, searching the internet to see others with the same problem to try to make herself feel better.

That is how complex gender issues can become. Gender dysphoria is not a mental illness. Therapy needs to address the understanding of brain circuitry versus the chromosomal biology mix. What needs to be addressed are stress, anxiety, and depression, and the individual decision of lifestyle. 

Body Dysmorphic Disorder

I wanted to reach out to her, but she was no longer posting on the site. I guess I would tell her that though I am 82 and she is 28 and we are different genders, I understand what she is experiencing as far as her BDD. I hated my body every day of my life since puberty. I compensated by bodybuilding, obsessively. I lost the chance at becoming an executive of a large company early on because I had to leave at 5 p.m. each day to go to the YMCA and lift weights for three hours. Including the commute and showering after the workout barely left time other than preparing for and eating supper, then sleeping.

Ironically, I would go out on a date and resent a girl for feeling and admiring my muscles. If I got into a relationship I felt weird jealousy. It was as if she were being unfaithful to me. I was not the muscular man she was attracted to. In my mind, I was still slender and completely nonmuscular. The weightlifting gave me temporary muscles. 

I longed to find a girl who would love me for who I was. But if I continued to body build, I would never be able to know that. And if I stopped bodybuilding, I could not walk into a bar or dance and pick up a girl. The answer was a never-ending series of extremely short-time affairs.

Too fat, too thin, too muscular, not enough muscle, too much hair, too little hair, too ugly, too masculine, too feminine. Thoughts pop into your mind like garish, uninvited guests. You mostly hear about body image problems with girls and women. But it starts with men early on.

I think it took root with me back in the 1940s when I spent much of my time reading comic books. At the back of these comic books, Charles Atlas’s Dynamic Tension advertisement first appeared early in the 1940s. The “97-pound weakling” sits on the beach, his girlfriend beside him. Along comes this hunk who laughs and kicks sand in his face. He is helpless to defend himself and sits there humiliated. That potent, emotional image got reinforced and layered with comments over the years like, “Why are you so skinny?” 

In high school, I could not stand my body. Dumbo ears, my nose had a sharp, evil slant, my lips and chin unacceptable. At puberty, my body did not develop muscularity. I was thinner and more hairless than any of the girls in my class. I spent hours standing naked before the mirror, detesting what I saw.

At Rutgers, I sat deep in the library stacks with William Sheldon’s collection of four thousand male nudes photographed from every angle. Sheldon devised a standardized numerical measurement classifying body types into ectomorphs, mesomorphs, and endomorphs. I lifted weights and looked for indications I might be morphing into a mesomorph. I spent so much time in the stacks with Sheldon, I flunked most of my first-year pre-pharmacy classes, ending up on probation. I solved that by changing my major to psychology and receive college credit for my obsessions.

BDD is a life centered on safety-seeking behaviors of weight-loss, weight-gain diets, workouts, mirror viewing, and constantly comparing bodies. Weight lifting creates a shield, my first psychoanalyst said. But not only is bodybuilding a safety-seeking behavior, but it also sets up a condition for preconditioned self-acceptance. You accept yourself when you look in the mirror and appear buff, but when the bodybuilding comes to an end, so does conditional self-acceptance.

Therapy for BDD had best include working on unconditional self-acceptance. This means accepting yourself fat, skinny, ugly, old, masculine, feminine, as you are. Precondition sets you up for trouble. It is irrational not to accept yourself unconditionally. Why would you do otherwise? You are the decider. But we are not rational and it is not easy to accept ourselves unconditionally. I never could give up weight training. At least it gets me out and very occasionally interacting with people.

But Cognitive Therapy alone may not be sufficient. I found Metacognitive Therapy and Insight Meditation helpful for my BDD.

Self-help books that help:

Total Self-Renewal through Attention Therapies and Open Focus

The Open-Focus Brain: Harnessing the Power of Attention to Heal Mind and Body