Physical Causes of Gender Confusion
By Joanne Highley
Because of our many visits to Liverpool to establish a ministry there at Frontline Centre in Wavertree, Liverpool, we had the distinct pleasure of spending a number of weeks in the beautiful home of Dr. and Mrs. Chris Holcombe. We had many lively discussions around their kitchen table including this discussion which we want to share with you.
The subject Joanne introduced was the problem in a number of men who were concerned about having breasts which had become so pronounced as to look like female breasts. This had confused the men in regard to their gender. It was fitting that we ask our host and hostess about this subject since Dr. Holcombe is the Consultant Breast Surgeon at the Royal Liverpool University Teaching Hospital and his wife, Mrs. Sue Holcombe, is a Breast Nurse Practitioner at the same hospital. They are both experts in the field and because of that fact, we hope this article will dispel many of the current misconceptions about this painful subject.
I first asked Chris his opinion on this subject, since he has done surgery on men with this problem. He told me the common cause of enlarged breast tissue is, in fact, fat, or gaining too much weight and can affect the man to a greater or lesser degree, depending on the weight. He said this is completely unrelated to gender. I asked if losing weight would make this go away and he answered yes.
He told me that in a smaller proportion of men, there is a true enlargement of the rudimentary breast tissue, and this is known as gynacomastia. This can occur at puberty and if small, disappears spontaneously. However, in some cases, there is greater enlargement which requires surgical removal, usually because of social embarrassment or the breasts are of different size. This is usually felt as a small firm disc of tissue behind the nipple. And when this disappears, no breast tissue can be felt, not even by a physician.
There is a long list of causes of benign (non-cancerous) gynacomastia. Some of the common causes would be prescribed medication such as indigestion medicine and heart medicines. Smoking pot (cannabis) and taking anabolic steroids for body building can also cause gynacomastia. This is not to be confused with the development of the pectoral muscles, which will also occur in body builders, but there is then no disc of breast tissue in that muscle. Rather it feels simply like a developed muscle.
There are then a number of medical causes of gynacomastia which need investigating or treating. The most important of these is breast cancer, which occurs rarely in men ( 1% or less of all breast cancers). This almost always occurs in elderly men and can be associated with a family history of breast cancer. However, any new localized lump behind the nipple particularly in an elderly man, should be seen by a physician. There are then a number of hormonal abnormalities which cause gynacomastia and severe liver damage, for instance, excessive alcohol intake, may also cause gynacomastia.
Sue added that there are many misconceptions around sexuality and sexual satisfaction which are never correctly answered and if only people were a little more bold about asking the right source, if they have any fears, worries or questions about sexual intimacy. Problems occurring during puberty can be embarrassing and there is a need for open and good quality discussion for those with any developmental problems.
In summary, some increase in size of the tissues around the nipple in men is very common with increasing age and increasing weight. This is not related to gender in any way. If, however, there is a firm localized lump of tissue, you should consult your physician. This is unlikely to be cancer, but should be investigated.
This ends our discussion with Dr. and Mrs. Holcombe and we thank them both for giving us this interview. The following thoughts have come out of my experience in counselling.
We have found that not only the problem of breast tissue enlargement in men but also the lack of breast development in women can cause problems of gender confusion. The greater the size does not mean the more of a woman you are. Some of the factors in breast size in women are based on DNA and generational gifting. There can be reduction of breast size with weight loss or extreme physical exercise. Hormonal supplements can affect breast size as well.
Many times any problems with sexual development that require examination of the sex organs at a young age can cause shame and questioning in the child's mind plus an emotional impression that "Something is wrong with me." Most times there is nothing wrong at all, but if not discussed, this can be an ongoing fear in the person. Also deformity, a botched circumcision or other factors can cause questioning about, "Will I be acceptable and able to function sexually." These fears need to be addressed so they will not hinder your development socially.
There is such a focus on the male sex organ in homosexuality, and size is equated with manhood, sad to say. As we have counselled hundreds of men, the size of the penis is not a factor in marriage because the female sex organ is created to adjust to the male size. So there is no worry about size in marriage. Only in the ungodly relationships of homosexuality, where there are comparisons and false concepts, is size carried to extremes and worshipped. Also in the filthy world of pornography we find the same misconceptions. Certainly we can see that we are being fooled by the evil one to be worried and ungrateful about a very private and precious part of our bodies.
Please discuss your worries or fears about sexual development with a trusted person so you can be free of the false concepts or write to us and we will keep your correspondence in the strictest confidence.
May we all give thanks for our bodies, wonderful creations that they are, and know that God has ordained that we use them as instruments of righteousness for Him.
Flee from sexual immorality. All other sin a man commits are outside his body, but he who sins sexually, sins against his own body. Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your body.
I Corinthians 6:18-20