Q. Years ago I recall hearing you make a comment about “female brains in male bodies and male brains in female bodies.” I can’t imagine that so many mismatches actually occur between the brain and its housing. I assume, of course, that you were speaking of homosexuals.

A. I do recall having made that statement, and probably more than once.Your assumption that I was speaking of homosexuals, however, is off the mark.Who a person is sexually includes at least three components:

• Gender Identity – the sense of one’s core gender identity as being male or female (or in some cases half-and-half or neither)

• Gender Orientation – the preference one has for the gender of preferred sexual/erotic partners (both in actual behaviors exhibited and in fantasy or imagination)

• Gender Role – the types of behaviors that are culturally associated with gender or that exhibit sex differences

In the overwhelming majority of human beings these three components are present in harmony. That is, an individual with male-typical Gender Orientation also has male Gender Identity and tends to exhibit masculine Gender Role behaviors. A person who has female typical Gender Orientation also has female Gender Identity and tends to exhibit feminine Gender Role behaviors. At times, however, these three components are not congruent.

• A man with a masculine Gender Identity, who exhibits masculine Gender Role behaviors, may have a sexual orientation toward males, an orientation more typical of females than males. A woman with a feminine Gender Identity, who exhibits feminine Gender Role behaviors, may be attracted sexually to other women.

• A genetic male (XY) with masculine internal and external sex organs, may perceive he is a woman psychologically; while a genetic female (XX) with feminine sex organs may perceive she is a man psychologically. These types of individuals are considered to be gender dysphoric.

Gender Identity and Gender Orientation can diverge in differing brains. Some individuals decide to change their appearance to match their psychological Gender Identity. If they undergo hormone treatment and sex-change surgery, they are often referred to as transsexual persons. (Wikipedia defines a transsexual person as an individual whose identification with a gender is inconsistent or not culturally associated with their biological sex.) Some (e.g., genetic males who perceive that they are psychological females), may be interested in female sexual partners, whereas others are interested in male sexual partners.

How does this happen? There are any number of possible contributors, some of which are highly speculative. Currently there is little direct evidence, according to Dr. Hines, to support a hormonal contribution to the development of a transsexual person. In many parts of the world, transsexual persons are stigmatized. Discrimination and negative attitudes are often associated with specific religious beliefs or cultural values. There are cultures, however, that seem to have little difficulty integrating individuals who change gender roles.

So how does a person whose three components are harmonious relate to another whose three components are in disharmony? My brain’s opinion is that the topic would need clarification and investigation primarily when one person views another as a potential life partner. In that case, an exploration of each person’s gender identity, role, and orientation would seem to be of critical and long-term importance. Other than that, it reminds me of one of my little French grandmother’s favorite expressions: Tend to your own rat killin’ and let your neighbors tend to theirs.