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Robert Stoller

Robert Stoller (1924–1991), an American psychiatrist and psychoanalyst, developed the concept of "core gender identity" in 1968 in Sex and Gender (source). That concept underlies modern thinking about gender identity, but it has never been empirically tested as something measurable apart from self-report.

Core gender identity: a psychoanalytic hypothesis

Stoller held that every person develops a deep-seated, largely fixed "core gender identity" in the first two to three years of life, and that transsexualism arises when this core does not match the body. The hypothesis was psychoanalytic: based on clinical observations and interpretations of his own patients, not on controlled research with an objective measure.

The concept later became the core of the view that there is an inner "true self" that can justify medical interventions. If it cannot be established other than through the person's own statement, it is a metaphysical claim: not testable and not measurable.

Difference with Money — and the internal contradiction

Where John Money saw gender as largely learned (and applied that view with disastrous consequences in the Reimer case), Stoller assumed an inner given fixed early in life. Both views — gender as a construct and gender as an inner essence — live on side by side in today's debate, although they are hard to reconcile. See also circular reasoning and unfalsifiable.

Criticism: without evidence, without marker

There is no measurable marker — no brain marker, no genetic marker, no biomarker — that objectifies "core gender identity". Stoller's work consisted of clinical case descriptions with small numbers and no control group, and relied on self-report as a source.

Ray Blanchard and later J. Michael Bailey proposed a different explanation for part of transsexualism in males: autogynephilia, a paraphilia. That explanation, the Blanchard typology, is disputed.

Influence: from consulting room to global doctrine

The diagnosis "gender identity disorders" entered DSM-III (1980); in DSM-5 (2013) it was replaced by "gender dysphoria". In ICD-11, "gender incongruence" is no longer listed among mental disorders but in the chapter on sexual health (source; see ICD evolution). For the further history, see also the WPATH Standards of Care, the first clinics and the rollout.

The Cass Review (2024) calls care for young people with gender dysphoria "an area of remarkably weak evidence" (source). See also the evidence-based objection.

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