Birth order and ratio of brothers to sisters in transsexuals

Carving the Biodevelopment of Same-Sex Sexual Orientation at Its Joints

Sexual orientation is a core aspect of human experience and understanding its development is fundamental to psychology as a scientific discipline. Biological perspectives have played an important role in uncovering the processes that contribute to sexual orientation development. Research in this field has relied on a variety of populations, including community, clinical, and cross-cultural samples, and has commonly focused on female gynephilia (i.e., female sexual attraction to adult females) and male androphilia (i.e., male sexual attraction to adult males). Genetic, hormonal, and immunological processes all appear to influence sexual orientation. Consistent with biological perspectives, there are sexual orientation differences in brain development and evidence indicates that similar biological influences apply across cultures. An outstanding question in the field is whether the hypothesized biological influences are all part of the same process or represent different developmental pathways leading to same-sex sexual orientation. Some studies indicate that same-sex sexually oriented people can be divided into subgroups who likely experienced different biological influences. Consideration of gender expression in addition to sexual orientation might help delineate such subgroups. Thus, future research on the possible existence of such subgroups could prove to be valuable for uncovering the biological development of sexual orientation. Recommendations for such future research are discussed.

The fraternal birth-order effect as a statistical artefact: convergent evidence from probability calculus, simulated data, and multiverse meta-analysis

The fraternal-birth order effect (FBOE) is a research claim which states that each older brother increases the odds of homosexual orientation in men via an immunoreactivity process known as the maternal immune hypothesis. Importantly, older sisters supposedly either do not affect these odds, or affect them to a lesser extent. Consequently, the fraternal birth-order effect predicts that the association between the number of older brothers and homosexual orientation in men is greater in magnitude than any association between the number of older sisters and homosexual orientation. This difference in magnitude represents the main theoretical estimand of the FBOE. In addition, no comparable effects should be observable among homosexual vs heterosexual women. Here, we triangulate the empirical foundations of the FBOE from three distinct, informative perspectives, complementing each other: first, drawing on basic probability calculus, we deduce mathematically that the body of statistical evidence used to make inferences about the main theoretical estimand of the FBOE rests on incorrect statistical reasoning. In particular, we show that throughout the literature researchers ascribe to the false assumptions that effects of family size should be adjusted for and that this could be achieved through the use of ratio variables. Second, using a data-simulation approach, we demonstrate that by using currently recommended statistical practices, researchers are bound to frequently draw incorrect conclusions. And third, we re-examine the empirical evidence of the fraternal birth-order effect in men and women by using a novel specification-curve and multiverse approach to meta-analysis (64 male and 17 female samples, N = 2,778,998). When analyzed correctly, the specific association between the number of older brothers and homosexual orientation is small, heterogenous in magnitude, and apparently not specific to men. In addition, existing research evidence seems to be exaggerated by small-study effects.

New Data on Birth Order in Homosexual Men and Women and a Reply to Vilsmeier et al. (2021a, 2021b)

The fraternal birth order effect (FBOE) is the repeated finding that older brothers increase the odds of homosexuality in later-born males. It has been our working assumption, based on the majority of previous studies, that a similar FBOE does not occur in females. In an elaborate quantitative review posted last year to a preprint server, Vilsmeier et al. (2021a) concluded that there is no valid evidence for an FBOE in men or women. Ablaza et al. (2022) subsequently published a study of population-level data from the Netherlands with conclusions completely opposite to those of Vilsmeier et al., namely, that there is robust evidence of an FBOE in both men and women. The present research was initially undertaken to refute the assertion of Vilsmeier et al. that there is no proof of an FBOE in men and to investigate how they obtained such a discrepant conclusion. We found evidence that the discrepancy may relate to Vilsmeier et al.'s use of the large and demonstrably unreliable sample published by Frisch and Hviid (2006). After the publication by Ablaza et al., we expanded our article to address their finding of an FBOE in women. We argue that our preferred explanation of the FBOE in men-that it reflects the progressive immunization of some mothers to Y-linked antigen by each succeeding male fetus and the concomitantly increasing effects of anti-male antibody on sexual differentiation in the brain in each succeeding male fetus-could plausibly be extended to female homosexuality.

Brain Sex in Transgender Women Is Shifted towards Gender Identity

Transgender people report discomfort with their birth sex and a strong identification with the opposite sex. The current study was designed to shed further light on the question of whether the brains of transgender people resemble their birth sex or their gender identity. For this purpose, we analyzed a sample of 24 cisgender men, 24 cisgender women, and 24 transgender women before gender-affirming hormone therapy. We employed a recently developed multivariate classifier that yields a continuous probabilistic (rather than a binary) estimate for brains to be male or female. The brains of transgender women ranged between cisgender men and cisgender women (albeit still closer to cisgender men), and the differences to both cisgender men and to cisgender women were significant (p = 0.016 and p < 0.001, respectively). These findings add support to the notion that the underlying brain anatomy in transgender people is shifted away from their biological sex towards their gender identity.

Meta-Analyses of Fraternal and Sororal Birth Order Effects in Homosexual Pedophiles, Hebephiles, and Teleiophiles

This study investigated the relations between numbers of older brothers, numbers of older sisters, and the odds of homosexuality in later-born males, including males who are most attracted sexually to prepubescent or early pubescent children (pedohebephiles) and males who are most attracted sexually to adults (teleiophiles). The authors meta-analyzed data from 24 samples of homosexual and heterosexual men, originally reported in 18 studies, and totaling 18,213 subjects. The results confirmed that older brothers increase the odds of same-sex preference in pedohebephiles as they do in teleiophiles. They also replicated the recent finding that older sisters have a similar but weaker statistical association with the odds of homosexuality. These findings have two theoretical implications. First, the findings for older brothers and older sisters indicate some commonality in the factors that influence sexual preference in teleiophiles and those that influence sexual preference in pedohebephiles. Second, the finding for older sisters confirms a prediction stemming from the hypothesis that male fetuses stimulate maternal antibodies that increase the odds of homosexuality in later-born males. Such immunization could result from miscarried as well as full-term fetuses, and number of older sisters should correlate with number of male fetuses miscarried before gestation of the subject.

Handedness and Birth Order Among Heterosexual Men, Gay Men, and Sao Praphet Song in Northern Thailand

Previous research has examined handedness and birth order to inform sexual orientation and gender identity/role expression development; however, sexual orientation and gender identity/role expression have rarely been disentangled to provide a more nuanced perspective. In Thailand, we investigated sexual orientation and gender identity simultaneously via comparison of 282 heterosexual men, 201 gay men, and 178 sao praphet song-i.e., androphilic, markedly feminine males recognized as a "third" gender. Handedness was examined as: extremely left-handed, moderately left-handed, ambidextrous, moderately right-handed, or extremely right-handed. Birth order was examined as numbers of older and younger brothers and sisters, by using Berglin's, fraternal, and sororal indices, and by examining the older brother odds ratio and sibling sex ratio. Compared with heterosexual men, gay men and sao praphet song were more likely to be extremely right-handed. Sao praphet song were also more likely to be extremely left-handed than heterosexual and gay men. Heterosexual men and sao praphet song had later sororal birth order compared with the expected Thai population value, suggesting stopping rules influenced when probands' mothers ceased having children. These findings provide new insights and replicate previous findings in a non-Western sample. Regarding handedness, in males, mechanisms related to extreme right-handedness likely influence the development of androphilia, whereas mechanisms related to both extreme right- and extreme left-handedness likely explain the combination of androphilia and feminine gender identity/role expression. Regarding birth order, similar to the conclusions of some prior research, stopping rules pose a challenge for testing the fraternal birth order effect.

A method yielding comparable estimates of the fraternal birth order and female fecundity effects in male homosexuality

The fraternal birth order effect (FBOE) is the finding that older brothers increase the probability of homosexuality in later-born males, and the female fecundity effect (FFE) is the finding that the mothers of homosexual males produce more offspring than the mothers of heterosexual males. In a recent paper, Khovanova proposed a novel method for computing independent estimates of these effects on the same samples and expressing the magnitude and direction of the effects in the same metric. In her procedure, only families with one or two sons are examined, and daughters are ignored. The present study investigated the performance of Khovanova's method using archived data from 10 studies, comprising 14 samples totalling 5390 homosexual and heterosexual subjects. The effect estimate for the FBOE showed that an increase from zero older brothers to one older brother is associated with a 38% increase in the odds of homosexuality. By contrast, the effect estimate for the FFE showed that the increase from zero younger brothers to one younger brother is not associated with any increase in the odds of homosexuality. The former result supports the maternal immune hypothesis of male homosexuality; the latter result does not support the balancing selection hypothesis.

Gender Nonconformity and Birth Order in Relation to Anal Sex Role Among Gay Men

Androphilia is associated with an elevated number of older brothers among natal males. This association, termed the fraternal birth order effect, has been observed among gay men who exhibit marked gender nonconformity. Gender nonconformity has been linked to gay men's preferred anal sex role. The present study investigated whether these two lines of research intersect by addressing whether the fraternal birth order effect was associated with both gender nonconformity and a receptive anal sex role (243 gay men, 91 heterosexual men). Consistent with previous research, we identified the fraternal birth order effect in our sample of gay men. Also, gay men were significantly more gender-nonconforming on adulthood and recalled childhood measures compared to heterosexual men. When gay men were compared based on anal sex role (i.e., top, versatile, bottom), all groups showed significantly greater recalled childhood and adult male gender nonconformity than heterosexual men, but bottoms were most nonconforming. Only gay men with a bottom anal sex role showed evidence of a fraternal birth order effect. A sororal birth order effect was found in our sample of gay men, driven by versatiles. No significant associations were found between fraternal birth order and gender nonconformity measures. These results suggest that the fraternal birth order effect may apply to a subset of gay men who have a bottom anal sex role preference and that this subgroup is more gender-nonconforming. However, there were no significant associations between fraternal birth order and gender nonconformity at the individual level. As such, based on the present study, whether processes underpinning the fraternal birth order effect influence gender nonconformity is equivocal.

Fraternal Birth Order, Family Size, and Male Homosexuality: Meta-Analysis of Studies Spanning 25 Years

The fraternal birth order effect is the tendency for older brothers to increase the odds of homosexuality in later-born males. This study compared the strength of the effect in subjects from small versus large families and in homosexual subjects with masculine versus feminine gender identities. Meta-analyses were conducted on 30 homosexual and 30 heterosexual groups from 26 studies, totaling 7140 homosexual and 12,837 heterosexual males. The magnitude of the fraternal birth order effect was measured with a novel variable, the Older Brothers Odds Ratio, computed as (homosexuals' older brothers ÷ homosexuals' other siblings) ÷ (heterosexuals' older brothers ÷ heterosexuals' other siblings), where other siblings = older sisters + younger brothers + younger sisters. An Older Brothers Odds Ratio of 1.00 represents no effect of sexual orientation; values over 1.00 are positive evidence for the fraternal birth order effect. Evidence for the reliability of the effect was consistent. The Older Brothers Odds Ratio was significantly >1.00 in 20 instances, >1.00 although not significantly in nine instances, and nonsignificantly <1.00 in 1 instance. The pooled Older Brothers Odds Ratio for all samples was 1.47, p < .00001. Subgroups analyses showed that the magnitude of the effect was significantly greater in the 12 feminine or transgender homosexual groups than in the other 18 homosexual groups. There was no evidence that the magnitude of the effect differs according to family size.

Male homosexuality and maternal immune responsivity to the Y-linked protein NLGN4Y

Gay men have, on average, a greater number of older brothers than do heterosexual men, a well-known finding within sexual science. This finding has been termed the fraternal birth order effect. Strong scientific interest in sexual orientation exists because it is a fundamental human characteristic, and because its origins are often the focal point of considerable social controversy. Our study is a major advance in understanding the origins of sexual orientation in men by providing support for a theorized but previously unexamined biological mechanism—a maternal immune response to a protein important in male fetal brain development—and by beginning to explain one of the most reliable correlates of male homosexuality: older brothers.

We conducted a direct test of an immunological explanation of the finding that gay men have a greater number of older brothers than do heterosexual men. This explanation posits that some mothers develop antibodies against a Y-linked protein important in male brain development, and that this effect becomes increasingly likely with each male gestation, altering brain structures underlying sexual orientation in their later-born sons. Immune assays targeting two Y-linked proteins important in brain development—protocadherin 11 Y-linked (PCDH11Y) and neuroligin 4 Y-linked (NLGN4Y; isoforms 1 and 2)—were developed. Plasma from mothers of sons, about half of whom had a gay son, along with additional controls (women with no sons, men) was analyzed for male protein-specific antibodies. Results indicated women had significantly higher anti-NLGN4Y levels than men. In addition, after statistically controlling for number of pregnancies, mothers of gay sons, particularly those with older brothers, had significantly higher anti-NLGN4Y levels than did the control samples of women, including mothers of heterosexual sons. The results suggest an association between a maternal immune response to NLGN4Y and subsequent sexual orientation in male offspring.

The Prevalence of Only-Child Status Among Children and Adolescents Referred to a Gender Identity Service Versus a Clinical Comparison Group

Several studies indicate that homosexual males have a high proportion of older brothers compared to heterosexual males. Natal males with gender dysphoria who are likely to be homosexual also display this sibship pattern. Until recently, there was little evidence linking homosexuality and/or gender dysphoria in females to unique sibship characteristics. Two studies have indicated that natal female youth clinically referred for gender dysphoria are more likely to be only children (Schagen, Delemarre-van de Waal, Blanchard, & Cohen-Kettenis, 2012; VanderLaan, Blanchard, Wood, & Zucker, 2014). However, these studies did not include control groups of youth clinically referred for other reasons. Thus, it is unclear whether the increased likelihood of only-child status is specific to gender-referred natal females. This study compared only-child status among youth referred to a mental health service for gender dysphoria (778 males, 245 females) versus other reasons (783 males, 281 females). Prehomosexual gender-referred males were less likely to be only children than clinical controls. Contrary to previous findings, gender-referred females were not more likely to be only children, indicating that increased likelihood of only-child status is not specific to gender-referred females, but is characteristic of clinic-referred females more generally.

BIRTH ORDER AND ANDROPHILIC MALE-TO-FEMALE TRANSSEXUALISM IN BRAZIL

Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

Birth Order and Sibling Sex Ratio in a Population with High Fertility: Are Turkish Male to Female Transsexuals Different?

Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.

Evidence against a typology: a taxometric analysis of the sexuality of male-to-female transsexuals

Previous theories and research have suggested there are two distinct types of male-to-female (MF) transsexuals and these types can be distinguished by their sexuality. Using the scales Attraction to Femininity in Males, Core Autogynephilia, Autogynephilic Interpersonal Fanasy, and Attraction to Transgender Fiction as indicator variables, taxometric analysis was applied to an online-recruited sample of 308 MF transsexuals to investigate whether such a distinction is justified. In accordance with previous research findings, MF transsexuals categorized as "nonandrophilic" scored significantly higher on Core Autogynephilia than did those categorized as "androphilic"; they also scored significantly higher on Attraction to Femininity in Males and Attraction to Transgender Fiction. Results of one of the taxometric procedures, L-Mode, gave slightly more support for a dimensional, rather than taxonic (two-type), latent structure. Results of the two other taxometric procedures, MAMBAC and MAXCOV, showed greater support for a dimensional latent structure. Although these results require replication with a more representative sample, they show little support for a taxonomy, which contradicts previous theory that has suggested MF transsexuals' sexuality is typological.

Birth order and sibling sex ratio of children and adolescents referred to a gender identity service

In adult male samples, homosexuality is associated with a preponderance of older brothers (i.e., the fraternal birth order effect). In several studies comparing gender dysphoric youth, who are likely to be homosexual in adulthood, to clinical or non-clinical control groups, the findings have been consistent with the fraternal birth order effect in males; however, less is known about unique sibship characteristics of gender dysphoric females. The current study investigated birth order and sibling sex ratio in a large sample of children and adolescents referred to the same Gender Identity Service (N = 768). Probands were classified as heterosexual males, homosexual males, or homosexual females based on clinical diagnostic information. Groups differed significantly in age and sibship size, and homosexual females were significantly more likely to be only children. Subsequent analyses controlled for age and for sibship size. Compared to heterosexual males, homosexual males had a significant preponderance of older brothers and homosexual females had a significant preponderance of older sisters. Similarly, the older sibling sex ratio of homosexual males showed a significant excess of brothers whereas that of homosexual females showed a significant excess of sisters. Like previous studies of gender dysphoric youth and adults, these findings were consistent with the fraternal birth order effect. In addition, the greater frequency of only children and elevated numbers of older sisters among the homosexual female group adds to a small literature on sibship characteristics of potential relevance to the development of gender identity and sexual orientation in females.

Biological markers of asexuality: Handedness, birth order, and finger length ratios in self-identified asexual men and women

Human asexuality is defined as a lack of sexual attraction to anyone or anything and it has been suggested that it may be best conceptualized as a sexual orientation. Non-right-handedness, fraternal birth order, and finger length ratio (2D:4D) are early neurodevelopmental markers associated with sexual orientation. We conducted an Internet study investigating the relationship between self-identification as asexual, handedness, number of older siblings, and self-measured finger-lengths in comparison to individuals of other sexual orientation groups. A total of 325 asexuals (60 men and 265 women; M age, 24.8 years), 690 heterosexuals (190 men and 500 women; M age, 23.5 years), and 268 non-heterosexuals (homosexual and bisexual; 64 men and 204 women; M age, 29.0 years) completed online questionnaires. Asexual men and women were 2.4 and 2.5 times, respectively, more likely to be non-right-handed than their heterosexual counterparts and there were significant differences between sexual orientation groups in number of older brothers and older sisters, and this depended on handedness. Asexual and non-heterosexual men were more likely to be later-born than heterosexual men, and asexual women were more likely to be earlier-born than non-heterosexual women. We found no significant differences between sexual orientation groups on measurements of 2D:4D ratio. This is one of the first studies to test and provide preliminary empirical support for an underlying neurodevelopmental basis to account for the lack of sexual attraction characteristic of asexuality.

Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms?

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.

Sibling sex ratio and birth order in early-onset gender dysphoric adolescents

Several sibship-related variables have been studied extensively in sexual orientation research, especially in men. Sibling sex ratio refers to the ratio of brothers to sisters in the aggregate sibships of a group of probands. Birth order refers to the probands' position (e.g., first-born, middle-born, last-born) within their sibships. Fraternal birth order refers to their position among male siblings only. Such research was extended in this study to a large group of early-onset gender dysphoric adolescents. The probands comprised 94 male-to-female and 95 female-to-male gender dysphoric adolescents. The overwhelming majority of these were homosexual or probably prehomosexual. The control group consisted of 875 boys and 914 girls from the TRAILS study. The sibling sex ratio of the gender dysphoric boys was very high (241 brothers per 100 sisters) compared with the expected ratio (106:100). The excess of brothers was more extreme among the probands' older siblings (300:100) than among their younger siblings (195:100). Between-groups comparisons showed that the gender dysphoric boys had significantly more older brothers, and significantly fewer older sisters and younger sisters, than did the control boys. In contrast, the only notable finding for the female groups was that the gender dysphoric girls had significantly fewer total siblings than did the control girls. The results for the male probands were consistent with prior speculations that a high fraternal birth order (i.e., an excess of older brothers) is found in all homosexual male groups, but an elevated sibling sex ratio (usually caused by an additional, smaller excess of younger brothers) is characteristic of gender dysphoric homosexual males. The mechanisms underlying these phenomena remain unknown.

Is homosexuality a paraphilia? The evidence for and against

Whether homosexuality should be described as one among many paraphilic sexual interests or an altogether different dimension of sexual interest has long been discussed in terms of its political and social implications. The present article examined the question instead by comparing the major correlates and other features of homosexuality and of the paraphilias, including prevalence, sex ratio, onset and course, fraternal birth order, physical height, handedness, IQ and cognitive neuropsychological profile, and neuroanatomy. Although those literatures remain underdeveloped, the existing findings thus far suggest that homosexuality has a pattern of correlates largely, but not entirely, distinct from that identified among the paraphilias. At least, if homosexuality were deemed a paraphilia, it would be relatively unique among them, taxonometrically speaking.

Birth order and ratio of brothers to sisters in Spanish transsexuals

Three Western studies have shown that male-to-female (MF) homosexual transsexuals tend to be born later than their siblings and to come from sibships with more brothers than sisters. The objective of this study was to determine whether these variables would be replicated in 530 MF and female-to-male (FM) Spanish transsexuals according to sexual orientation. The results showed that MF homosexual transsexuals had significantly more older brothers than the non-homosexual MF group. Compared with the expected rates in the general population, birth order was significantly higher in both MF (Slater's Index = 0.59; Fraternal Index = 0.61; Sororal Index = 0.58) and FM homosexual transsexuals (Slater's Index = 0.65; Fraternal Index = 0.68; Sororal Index = 0.67), and sibling sex ratio was significantly higher than expected in homosexual MF (sex ratio = 0.55) but not in homosexual FM transsexuals. No significant differences were found in the non-homosexual subgroups. The replication of the later birth order and sibling sex-ratio effect in MF homosexual transsexuals corroborates previous findings in a variety of groups from different cultures and may suggest a common mechanism underlying the etiology of transsexualism.

Sexual orientation, fraternal birth order, and the maternal immune hypothesis: a review

In 1996, psychologists Ray Blanchard and Anthony Bogaert found evidence that gay men have a greater number of older brothers than do heterosexual men. This "fraternal birth order" (FBO) effect has been replicated numerous times, including in non-Western samples. More recently, strong evidence has been found that the FBO effect is of prenatal origin. Although there is no direct support for the exact prenatal mechanism, the most plausible explanation may be immunological in origin, i.e., a mother develops an immune reaction against a substance important in male fetal development during pregnancy, and that this immune effect becomes increasingly likely with each male gestation. This immune effect is hypothesized to cause an alteration in (some) later born males' prenatal brain development. The target of the immune response may be molecules (i.e., Y-linked proteins) on the surface of male fetal brain cells, including in sites of the anterior hypothalamus, which has been linked to sexual orientation in other research. Antibodies might bind to these molecules and thus alter their role in typical sexual differentiation, leading some later born males to be attracted to men as opposed to women. Here we review evidence in favor of this hypothesis, including recent research showing that mothers of boys develop an immune response to one Y-linked protein (i.e., H-Y antigen; SMCY) important in male fetal development, and that this immune effect becomes increasingly likely with each additional boy to which a mother gives birth. We also discuss other Y-linked proteins that may be relevant if this hypothesis is correct. Finally, we discuss issues in testing the maternal immune hypothesis of FBO.

EEG analysis of male to female transsexuals: discriminant function and source analysis

A small series of consecutive, unmedicated male to female transsexuals were studied before hormonal treatment and prior to reassignment surgery. Quantitative EEG and LORETA source localization in the Eyes Open and Eyes Closed conditions were carried out, and they were compared to sinistral/ambilateral male and female controls, as the transsexual group was overwhelmingly sinistral. Discriminant function analysis and source localization showed that the transsexual group was similar to female heterosexual controls, with increased sources in the right hemisphere in the fast frequencies.

The sex ratio of older siblings in non-right-handed homosexual men

This study tested the prediction, based on prior research, that non-right-handed homosexual men will report fewer than expected older brothers. Participants were 2486 heterosexual and homosexual, right-handed and non-right-handed, male and female adults, representing five samples collected for various projects by the second author. Data on sibship composition, sexual orientation, and hand-preference were gathered in the original research using on-line (Internet) or self-administered paper-and-pencil questionnaires. The non-right-handed homosexual men reported 83 older brothers per 100 older sisters, which was significantly lower than the human sex ratio of 106 live-born males per 100 live-born females. In contrast, the right-handed homosexual men reported 125 older brothers per 100 older sisters, which was significantly higher than the expected ratio. One possible explanation of these results is that older brothers increase the odds of homosexuality in right-handed males but decrease the odds of homosexuality in non-right-handed males. A second possibility is that older brothers decrease the probability that non-right-handed homosexual males will be represented in survey research. The latter scenario could arise if the combination of some biological factor associated with older brothers and some biological factor associated with non-right-handedness is so toxic that it kills the fetus or predisposes the individual to a condition (e.g., mental retardation, major mental illness) that makes him less likely to be available for research recruitment at Gay Pride parades (etc.) than other members of the gay community.

The controversy surrounding "The man who would be queen": a case history of the politics of science, identity, and sex in the Internet age

In 2003, psychology professor and sex researcher J. Michael Bailey published a book entitled The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. The book's portrayal of male-to-female (MTF) transsexualism, based on a theory developed by sexologist Ray Blanchard, outraged some transgender activists. They believed the book to be typical of much of the biomedical literature on transsexuality-oppressive in both tone and claims, insulting to their senses of self, and damaging to their public identities. Some saw the book as especially dangerous because it claimed to be based on rigorous science, was published by an imprint of the National Academy of Sciences, and argued that MTF sex changes are motivated primarily by erotic interests and not by the problem of having the gender identity common to one sex in the body of the other. Dissatisfied with the option of merely criticizing the book, a small number of transwomen (particularly Lynn Conway, Andrea James, and Deirdre McCloskey) worked to try to ruin Bailey. Using published and unpublished sources as well as original interviews, this essay traces the history of the backlash against Bailey and his book. It also provides a thorough exegesis of the book's treatment of transsexuality and includes a comprehensive investigation of the merit of the charges made against Bailey that he had behaved unethically, immorally, and illegally in the production of his book. The essay closes with an epilogue that explores what has happened since 2003 to the central ideas and major players in the controversy.

Older-sibling and younger-sibling sex ratios in Frisch and Hviid's (2006) national cohort study of two million Danes

Frisch and Hviid (2006) recently reported a study of variables that predicted heterosexual and homosexual marriage in a national cohort of Danish men and women. They found no evidence that older brothers increase the probability that a man will legally marry another man. They concluded that their data raise questions about the universality of the widely confirmed finding that older brothers increase the probability that a man will be sexually oriented towards other men (the fraternal birth order effect). In the present article, Frisch and Hviid's data were reanalyzed using one of the procedures that have been used in prior studies of fraternal birth order. The results showed that the sex ratio of older brothers to older sisters was significantly higher than the expected value of 106 in all four of their study groups (heterosexually married men, homosexually married men, heterosexually married women, and homosexually married women). In contrast, the sex ratio of younger brothers to younger sisters approximated 106 in all four groups. According to this analysis, the only group whose data resembled data from previous studies was the homosexually married males. The writer concluded that one cannot interpret findings about the correlates of heterosexual and homosexual marriage as if they were findings about the correlates of heterosexual and homosexual orientation, and that this is underscored by comparing the markedly different older-sibling sex ratios obtained from heterosexually married persons (in the Danish study) and those obtained from heterosexually oriented persons (in previous studies). It is unclear what implications, if any, Frisch and Hviid's findings have for the study of sexual orientation in general.

Birth order and sibling sex ratio in homosexual transsexual South Korean men: Effects of the male-preference stopping rule

Two biodemographic variables - birth order and sibling sex ratio - have been examined in several Western samples of homosexual transsexual men. The results have consistently shown that homosexual transsexuals have a later birth order and come from sibships with an excess of brothers to sisters; the excess of brothers has been largely driven by the number of older brothers and hence has been termed the fraternal birth order effect. In the present study the birth order and sibling sex ratio were examined in an Asian sample of 43 homosexual transsexual men and 49 heterosexual control men from South Korea. Although the transsexual men had a significantly late birth order, so did the control men. Unlike Western samples, the Korean transsexuals had a significant excess of sisters, not brothers, as did the control men, and this was largely accounted for by older sisters. It is concluded that a male-preference stopping rule governing parental reproductive behavior had a strong impact on these two biodemographic variables. Future studies that examine birth order and sibling sex ratio in non-Western samples of transsexuals need to be vigilant for the influential role of stopping rules, including the one identified in the present study.

Supplementary analyses regarding Langevin, Langevin, and Curnoe's (2007) findings on fraternal birth order in homosexual men

A recent article by Langevin, Langevin, and Curnoe (2007) reported mixed results regarding the fraternal birth order effect, that is, the repeatedly observed finding that older brothers correlate with homosexuality in later-born males. Using a fraternal birth order index computed as older brothers minus younger brothers, Langevin et al. found that the "homoerotic" probands were born later among their brothers than were the "heteroerotic" probands in their full sample (N = 1194) and in their subsample over age 19 (N = 1122), but not in their subsample over age 31 (N = 698) or in their subsample with mothers over age 46 at the proband's birth (N = 727). The present writer concluded that the results obtained with the larger samples are more reliable, based on analyses demonstrating that (1) the larger samples are unlikely to be seriously affected by incomplete sibships, and (2) the smaller samples have poor statistical power. A separate analysis, based on an approximate reconstruction of Langevin et al.'s raw data, indicated that their heteroerotic probands reported a ratio of 104 older brothers per 100 older sisters, which is close to the normative population value of 106, whereas their homoerotic probands reported a ratio of 137, indicating a statistically significant excess of older brothers. These results suggest that Langevin et al.'s data showed significant evidence of a fraternal birth order effect and that their data were consistent with previous studies of this phenomenon.

Birth order and male androphilia in Samoan fa'afafine

The manner in which male androphilia is publicly expressed varies cross-culturally. As such, it is unclear whether distinct or common underlying causal processes characterize male androphilia in different cultures. Establishing the existence of cross-cultural universals in male androphilia is one means of ascertaining whether common biological bases underlie this phenomenon despite its culturally distinct forms. The evidence that the number of older biological brothers increases the odds of androphilia in later-born males has been well documented for Western samples (i.e. the fraternal birth order effect); but there is little evidence for this effect in non-Western samples. Here, we compare the birth order of androphilic males (i.e. fa'afafine) and gynephilic males from the politically autonomous Polynesian nation of Independent Samoa. Results indicate that relative to gynephilic males, fa'afafine tend to have more siblings and are generally later born when birth order is quantified using Slater, fraternal and sororal indices. More specifically, fa'afafine tend to have a greater number of older brothers, older sisters and younger brothers. We discuss the observed effects in relation to the differing reproductive patterns exhibited by the mothers of fa'afafine and gynephilic males, and to existing social and biological theories for sexual orientation.

Asexuality: classification and characterization

The term "asexual" has been defined in many different ways and asexuality has received very little research attention. In a small qualitative study (N = 4), individuals who self-identified as asexual were interviewed to help formulate hypotheses for a larger study. The second larger study was an online survey drawn from a convenience sample designed to better characterize asexuality and to test predictors of asexual identity. A convenience sample of 1,146 individuals (N = 41 self-identified asexual) completed online questionnaires assessing sexual history, sexual inhibition and excitation, sexual desire, and an open-response questionnaire concerning asexual identity. Asexuals reported significantly less desire for sex with a partner, lower sexual arousability, and lower sexual excitation but did not differ consistently from non-asexuals in their sexual inhibition scores or their desire to masturbate. Content analyses supported the idea that low sexual desire is the primary feature predicting asexual identity.

Birth order, sibling sex ratio, handedness, and sexual orientation of male and female participants in a BBC internet research project

This study investigated the relations among sexual orientation, fraternal birth order (number of older brothers), and hand-preference. The participants were 87,798 men and 71,981 women who took part in a Web-based research project sponsored by the British Broadcasting Corporation (BBC). The results yielded some evidence confirming prior findings that non-right-handedness is associated with homosexuality in men and women, that older brothers increase the odds of homosexuality in men, and that the effect of older brothers on sexual orientation is limited to right-handed men. The evidence was weaker than in previous studies, however, probably because the usual relations among the variables of interest were partially obscured by the effects of other factors. Thus, the homosexual men and women had higher rates of non-right-handedness than their heterosexual counterparts, but the strongest handedness finding for both sexes was a marked tendency for participants who described themselves as ambidextrous also to describe themselves as bisexual. The birth order data were strongly affected by a tendency for the male participants to report an excess of older sisters, and the female participants to report an excess of older brothers. Statistical analyses confirmed that this was an artifact of the parental stopping rule, "Continue having children until you have offspring of both sexes." In subsequent analyses, participants were divided into those who did and did not have younger siblings, on the grounds that the data of the former would be less contaminated by the stopping rule. In the former subsample, the right-handed homo/bisexual males showed the typical high ratio of older brothers to older sisters, whereas the non-right-handed homo/bisexual males did not.

Biological versus nonbiological older brothers and men's sexual orientation

The most consistent biodemographic correlate of sexual orientation in men is the number of older brothers (fraternal birth order). The mechanism underlying this effect remains unknown. In this article, I provide a direct test pitting prenatal against postnatal (e.g., social/rearing) mechanisms. Four samples of homosexual and heterosexual men (total n = 944), including one sample of men raised in nonbiological and blended families (e.g., raised with half- or step-siblings or as adoptees) were studied. Only biological older brothers, and not any other sibling characteristic, including nonbiological older brothers, predicted men's sexual orientation, regardless of the amount of time reared with these siblings. These results strongly suggest a prenatal origin to the fraternal birth-order effect.

Interaction of fraternal birth order and handedness in the development of male homosexuality

The present study investigated evidence for an interaction between two of the best established etiologic factors, or markers of etiologic factors, in the literature on male homosexuality: fraternal birth order and hand preference. By combining five samples, the authors produced study groups of 1774 right-handed heterosexuals, 287 non-right-handed heterosexuals, 928 right-handed homosexuals, and 157 non-right-handed homosexuals. The results showed a significant (P = 0.004) handedness by older brothers interaction, such that (a) the typical positive correlation between homosexuality and greater numbers of older brothers holds only for right-handed males, (b) among men with no older brothers, homosexuals are more likely to be non-right-handed than heterosexuals; among men with one or more older brothers, homosexuals are less likely to be non-right-handed than heterosexuals, and (c) the odds of homosexuality are higher for men who have a non-right hand preference or who have older brothers, relative to men with neither of these features, but the odds for men with both features are similar to the odds for men with neither. These findings have at least two possible explanations: (a) the etiologic factors associated with non-right-handedness and older brothers-hypothesized to be hyperandrogenization and anti-male antibodies, respectively-counteract each other, yielding the functional equivalent of typical masculinization, and (b) the number of non-right-handed homosexuals with older brothers is smaller than expected because the combination of the older brothers factor with the non-right-handedness factor is toxic enough to lower the probability that the affected fetus will survive.

A case-control study of family composition in anorexia nervosa

OBJECTIVES

The family compositions of patients with anorexia nervosa may inform consideration of the etiology of the disorder, and previous studies in this area have had methodologic weaknesses which we sought to address in a case-control design.

METHODS

The family composition of 259 females with anorexia nervosa was compared with that of 200 control subjects. Birth order and numbers of brothers and sisters were compared in unmatched and matched analyses using both univariate and multivariate statistical techniques.

RESULTS

In both the unpaired univariate and the matched conditional logistic regression analyses, the anorexic females were both significantly later in the birth order and had significantly fewer brothers than control subjects.

DISCUSSION

Although it is possible that these findings were affected by response bias among control subjects, it is more likely that they are informative with regard to the etiology of anorexia nervosa. Possible etiologic links are discussed in relation to biologic, family, and sociocultural factors.

Quantitative and theoretical analyses of the relation between older brothers and homosexuality in men

Meta-analysis of aggregate data from 14 samples representing 10,143 male subjects shows that homosexuality in human males is predicted by higher numbers of older brothers, but not by higher numbers of older sisters, younger brothers, or younger sisters. The relation between number of older brothers and sexual orientation holds only for males. This phenomenon has therefore been called the fraternal birth order effect. Research on birth order, birth weight, and sexual orientation suggests that the developmental pathway to homosexuality initiated by older brothers operates during prenatal life. Calculations assuming a causal relation between older brothers and sexual orientation have estimated the proportion of homosexual men who owe their sexual orientation to fraternal birth order at 15% in one study and 29% in another. The maternal immune hypothesis proposes that the fraternal birth order effect reflects the progressive immunization of some mothers to male-specific antigens by each succeeding male fetus and the increasing effects of such immunization on sexual differentiation of the brain in each succeeding male fetus. There are at least three possible mechanisms by which the mother's immune response could influence the fetus: the transfer of anti-male antibodies across the placenta from the maternal into the fetal compartment, the transfer of maternal cytokines across the placenta, and maternal immune reactions affecting the placenta itself. This hypothesis is consistent with recent studies showing that the quantity of fetal cells that enter the maternal circulation is greater than previously thought, and that the number of male-specific proteins encoded by Y-chromosome genes is greater than previously thought.

The prevalence of male homosexuality: the effect of fraternal birth order and variations in family size

The prevalence of male homosexuality probably varies over time and across societies. One reason for this variation may be the joint effect of two factors: (1) variations in fertility rate or family size; and (2) the fraternal birth order effect, the finding that the odds of male homosexuality increases with each additional older brother. Because of these effects, the rate of male homosexuality may be relatively high (at least in terms of sexual attraction if not behavior) in societies that have a high fertility rate, but this rate has probably declined somewhat in some, particularly western, societies. Thus, even if accurately measured in one country at one time, the rate of male homosexuality is subject to change and is not generalizable over time or across societies.