Question: Which of these models was born 'male' and is transgender?

In the 1990's a rather masculine looking woman would be given the benefit of the doubt, twenty years later people are much quicker to leap to the conclusion that she might be transgender.  The signs that are being subconsciously being examined have gradually moved on from major indicators such as voice, height, and shoe size, to more subtle indicators such as jawline, finger length, and scalp hair.

Question: Cis female, transwoman, gay man?  ...   The photo is of Prof. Kathleen Stock, who has faced abuse for expressing supposedly transphobic views.

As result, with each iteration of the quiz I had to include yet more attributes.  These were often interlinked or even contradictory, for example short blond hair can emphasise the femininity of some faces, whilst long dark hair works much better for other women.  Another example is that long legs are attractive when young, but a modest height will always greatly assist passability at any age.

The End (Almost)

From the beginning the quiz had subjective element, but it also had a core of hard facts such as age, height, shoe size and figure. 

Question: Which of these young women was born 'male' and is transgender?

After feedback (often harshly worded) I downgraded or removed these criteria but despite years of effort I have since found it impossible devise a revised quiz that when tested I consider having a reasonable degree of accuracy and fairness.  In 2017 I arrived at the conclusion that it was impossible to incorporate all the complications into a static quiz and therefore have deleted the quiz from this page.

What is required is a dynamic quiz with many complex rules, linkages and dependencies built-in, ideally including the use of Artificial Intelligence to assess photos, videos and voice clips based after being trained using millions of examples.  The restoration of considerations such as age and stature are probably also essential.  Sadly, constructing such a quiz is beyond my skills, although I would be happy to contribute and make constructive suggestions to anyone who wants to take on such a project.

A Corollory

After I gave up on my quiz, I realised that some medical papers were essentially attempting the same difficult task, i.e. judging the appearance and passability of a male-to-female transwoman.  The two scales below are based on extracts from these - in particular Body Satisfaction and Physical Appearance in Gender Dysphoria, published in 2015  by Tim C van de Grift and collaborators.  The criteria listed in these two scales are restricted to physical characteristics, however some of studies used scales that included or considered criteria such as age, sexual orientation, education, job, and social role - all of which I had excluded from my quiz after complaints.   

Body Image Scale

Back in 1975, Lindgren and Pauly proposed a Body Image Scale (BIS), with subscales for primary sex characteristics, secondary sex characteristics, and neutral characteristics. Additional subscales have since been added to allow for comparisons per body area, as shown in the table below.  The Cronbach alphas (α) on the subscales give an indication of the subscales consistency and reliability, 0.0 being useless and 1.0 being perfect.  It is recommended that decisions should not be taken based solely on a criteria where this is less than 0.7, and important decisions require it to be over 0.9.

Table 1: Body Image Scale and Subscales

 

Subscale	Items	Construct analysis
Proposed by Lindgren and Pauly
Primary sex characteristics	Body hair, breasts, facial hair, penis/clitoris, scrotum/vagina, and testicles/uterus	α = 0.65 6 items
Secondary sex characteristics	Appearance, arms, body movement, bottom, chest size, figure, hair, hips, muscles, thighs, upper arm muscles, voice, waist, and weight	α = 0.84 14 items
Neutral characteristics	Adam’s apple, chin, eye brows, face, feet, hands, height, legs, nose, and shoulders	α = 0.81 10 items
Additional body area subscales
Social and hair items	Appearance, body hair, body movement, facial hair, hair, and voice	α = 0.72 6 items
Head and neck region	Adam’s apple, chin, eye brows, face, and nose	α = 0.74 5 items
Muscularity and posture	Arms, feet, hands, height, legs, muscles, shoulders, upper arm muscles, and weight	α = 0.79 9 items
Hip region	Bottom, figure, hips, thighs, and waist	α = 0.82 5 items
Chest region	Breasts and chest size	NA
Genitals	Penis/clitoris, scrotum/vagina, and testicles/uterus, and ovaries	α = 0.85 3 items

Physical Appearance Scale (PhAS)

In 2005, Smith et al developed the Physical Appearance Scale (PhAS) to measure physical appearance.  The scale scores the observer’s appraisal of the masculinity/femininity of a person’s physical appearance, rated on a 5-point scale ranging from most congruent (aligned) with the experienced (aka preferred) gender (1) to most incongruent with the experienced gender (5).  The scale contains 14 items, and scoring differs per natal sex. Higher scores effectively represent a physical appearance that doesn't match the desired gender.

The table below includes the results of a survey 374 male-to-female transsexuals diagnosed with GID but still pre-GCS who had been accepted for medical treatment in Holland, Belgium, Germany and Norway.  Their mean age was 34.1 (standard deviation of 12.6), 81% were taking hormones, 52.6% had transitioned full-time (another 34.4% had partially transitioned, e.g. appeared socially as a woman), and 38.1% worked as a woman (another 52.9% worked as a man and 9.1% were not in paid employment).  Additional analysis was conducted excluding the participants (19%) who were on hormonal therapy prior to admission, as hormones induce physical changes, and consequently may influence both femininity/masculinity of body parts and satisfaction with one’s physique, however no major differences in the overall and subscale scores were observed after excluding these.

Table 2.  Body image and physical appearance scores in Male-to-Female GID patients

Scores range from 1-5.  Add yours!

1 = Excellent Appearance; 2 = Good; 3 = Acceptable; 4 = Poor; 5 = Awful

Item	Self-reported BIS Mean Score (SD)	Clinician-reported PhAS Mean Score (SD)	Your Score! (1-5)
Social and hair items
Appearance	3.37 (1.13)	NA
Body hair	4.33 (0.96)	NA
Body movement	2.99 (1.11)	2.44 (1.00)
Facial hair	4.66 (0.77)	3.10 (1.05)
Hair	3.14 (1.37)	2.46 (1.24)
Speech	NA	2.59 (1.04)
Voice	3.99 (1.09)	3.22 (1.10)
Head and neck region
Adam’s apple	3.62 (3.62)	3.40 (0.84)
Chin	2.98 (1.04)	3.16 (0.81)
Eye brows	2.86 (1.11)	NA
Face	3.27 (1.08)	NA
Jaw	NA	3.21 (0.82)
Nose	3.03 (1.21)	3.24 (0.85)
Skin	NA	2.98 (0.89)
Muscularity and posture
Arms	2.64 (0.90)	NA
Feet	3.14 (1.13)	3.27 (0.95)
Hands	2.93 (1.11)	3.27 (0.95)
Height	2.62 (1.14)	3.16 (1.03)
Legs/calves	2.54 (0.97)	NA
Muscles	3.01 (0.98)	3.06 (0.80)
Shoulders	2.92 (1.04)	NA
Upper arm muscles	3.20 (1.02)	NA
Weight	2.88 (1.18)	NA
Hip region
Bottom	2.89 (1.08)	NA
Figure	3.13 (1.14)	3.00 (1.06)
Hips	3.25 (1.11)	NA
Thighs	2.75 (1.03)	NA
Waist	3.09 (1.12)	NA
Chest region
Breasts	4.20 (1.05)	NA
Chest size	3.54 (1.10)	NA
Genitals
Penis/clitoris	4.55 (0.82)	NA
Scrotum/vagina	4.62 (0.68)	NA
Testicles/ovary	4.64 (0.68)	NA
Total	101.27 (15.66) Max: 160	42.28 (9.55) Max: 75	Max: 165
Average	3.37	2.82	(Divide by 33)

On the BIS items, the highest dissatisfaction scores by transwomen are on the socially related body parts (such as voice), but also on their hair, their face and neck, and posture. Unsurprisingly as the participants are all pre-GCS, dissatisfaction with their [male] genitals is also very high. For the PhAS items, clinicians generally assessed the appearance of transwomen compared to their preferred gender as being poor. Their appearance was generally not congruent with the desired gender regarding motor movement, speech and voice, hair, facial features, and muscularity. Other significant problems included Adam’s apple, feet/hands and figure. After reviewing the raw data, the researchers arrived at several additional conclusions:

• Age was significantly correlated with higher physical incongruence scores.

• For MtFs, pronounced features, such as jaw line or facial hair growth, may impede their feminine appearance. These body attributes, which are most difficult to hide, are the ones with the highest dissatisfaction scores, when compared to the other sex.

• Masculine body characteristics (e.g., hair growth, facial characteristics) are ... difficult to mask and, therefore, it may be more difficult for MtFs to present themselves in a feminine way.

• Transition in both private and work life before they entered the clinic corresponded with significantly lower reported body dissatisfaction.

• Living in the social role of the experienced gender may contribute to a more positive attitude toward one’s body.  On the other hand, the ones who already have a more positive body image may also be the ones that transitioned earlier.

Also:

• We could not confirm a relation between prior hormone use [19% of applicants] and the degree of body (dis)satisfaction.

• Although (self-)administration of hormones is expected to influence the congruence of physical characteristics with the experienced gender, the results may have been unsatisfactory, because these individuals applied to a clinic to receive further gender-confirming treatment.

Thank You

Below is a montage of fifteen wonderful transsexual women varying in age from their 20's to over 60 whom I used to test this quiz.  Many thanks to you all.

 

Two Final "Can I Pass" Puzzles

Since the early 2000's no reality TV show has been complete without at least one participant eventually being revealed to be a transwoman.  Participants in UK shows are too easily identified, so below are photos taken from two European TV shows where one or two of the participants are transwomen.  Clearly, rather different standards on acceptable nudity are applied compared to the UK!

 

Let me know your comments and I will respond as far as I can.