The Course and Duration of 246 Completed Voluntary Sex Changes Among 198 Citizens of GSV Terms And Conditions Apply, 1702–1749 CE

1. Introduction

Culture citizens change sex at will, and many do so more than once in a life of three or four centuries (Okkaris, 1741 CE). The change is a bodily project that takes months, not an event. The Culture treats it as an ordinary choice (Marsteyn & Teskavel, 1726 CE) and not a medical matter: a citizen decides when to begin, may stop at any point, and asks nobody's leave.

That ordinariness has left the physiology thinly described. Case reports give the duration loosely, as a matter of months (Haddorane, 1713 CE). We know of no study that reports how long a set of completed changes actually took, how widely they vary, or what the variation depends on. Three candidate factors are discussed in the clinical literature. Plasticity is thought to decline with age (Perrimont, 1722 CE). Citizens may support a change with a glanded secretion or leave it to deliberate control of the body alone (Quillaby, 1688 CE). And experience of an earlier change may shorten a later one (Okkaris, 1741 CE).

This paper measures the course and duration of voluntary changes in one clinic's records and asks how duration relates to age at the start, to gland support and to the number of earlier changes. We write from a vantage of 1750 CE, and the records we use end in 1749 CE. The first and second authors work in the clinic's parent Faculty. The dataset, the completion criterion, the age bands and every figure below are this paper's own construction, and nothing in them is offered as a rule or norm of the Culture, which has none on this matter.

2. Methods

The Pan-Human Genetics Faculty of GSV Terms And Conditions Apply runs a clinic that follows changes of sex for citizens who invite it to. Attendance is by choice, as is the record, and the clinic reads nothing beyond what an attender tells it and the examinations the attender accepts (Sunthrael, 1704 CE). We took every record opened between 1702 and 1749 CE for a voluntary change. There were 291.

A change starts on the day the citizen declared that they had begun, noted at the first visit. Visits then took place every two weeks. The end is the first day on which two Faculty clinicians, each working separately from the visit record, judged that the citizen's measured profile had reached the stable pattern of the target sex and held it through the following two visits. Each clinician placed the day by interpolating between visits, and we used the mean of the two dates. Duration is the number of days from start to end. Of the 246 completed changes, 60 were chosen at random for a check of how well the two clinicians agreed, in the manner of Valdrenne (1734 CE).

We coded three exposures. Age at the start was grouped as 20–99, 100–199, 200–299 and 300 years or more, bands chosen to give usable group sizes across a life of roughly 350 to 400 years. Gland support was coded as present if the record shows that the citizen used a glanded secretion to support the change at any point in its course. The records do not name compounds, and we do not either. Prior changes were the number of completed earlier changes in the citizen's recorded history, coded 0, 1, or 2 or more.

Duration is continuous, positive and right-skewed, so we modelled its natural logarithm by linear regression on the three exposures together and report exponentiated coefficients as duration ratios. A ratio of 0.90 means a change 10% shorter than the reference. Some citizens contributed more than one change: 150 contributed one and 48 contributed two. We therefore estimated standard errors clustered on the citizen, with 95% confidence intervals and p values from the normal approximation, which is adequate with 198 clusters. The p values were computed from the unrounded estimates, so they can differ slightly from values back-calculated from the rounded intervals shown. The reference group is a first change begun at 20–99 years without gland support. We report medians and interquartile ranges for the raw durations, with durations given to the whole day although the visit schedule resolves them only to about two weeks.

3. Results

Of 291 records opened, 246 (84.5%) described a completed change. Twenty-two (7.6%) were stopped by the citizen before completion and 23 (7.9%) were lost to follow-up when the citizen left the vehicle. The 246 completed changes belonged to 198 citizens. Gland support was recorded in 127 of them (51.6%). The 60 changes in the agreement sample agreed closely: the intraclass correlation (two-way, absolute agreement, single rater) was 0.99, the median absolute difference between the two dates was 4 days, and the largest was 13.

The median duration was 141 days, or 4.6 months (interquartile range 113–178). The shortest change took 49 days and the longest 303, or 1.6 to 10.0 months, and the middle 90% lay between 78 and 247 days. Twenty-seven changes (11%) were complete within 90 days and 6 (2%) took 270 days or longer. Medians rose across the age bands, were lower with gland support and fell with each earlier change (Table 1). Gland support was less common in the oldest band, at 18 of 48 (37.5%), than in the three younger bands, at 35 of 63 (55.6%), 46 of 80 (57.5%) and 28 of 55 (50.9%).

After adjustment for the other two exposures, the three associations held (Table 2). A first, unaided change begun at 20–99 years had a modelled duration of 164 days (95% CI 148–181). Gland-supported changes were 25% shorter (ratio 0.75, 95% CI 0.69–0.81, p < .001). A second change was 13% shorter than a first (0.87, 0.81–0.95, p < .001) and a third or later change 17% shorter (0.83, 0.74–0.92, p < .001); the two estimates are close and their intervals overlap. Age lengthened changes gradually. The band from 100 to 199 years did not differ detectably from the youngest (1.06, 0.96–1.18, p = .26), the band from 200 to 299 was 14% longer (1.14, 1.02–1.27, p = .02), and the band from 300 years was 20% longer (1.20, 1.07–1.35, p = .001).

4. Discussion

Older descriptions of a change as taking months are borne out, with a width they did not report. In this clinic the typical completed change took a little over four and a half months, and the usual spread ran from about two and a half months to eight. Nothing in the records points to a fixed duration, and we do not propose one. Whether the same range holds for citizens who do not attend a clinic, or on other vehicles and Orbitals, is outside what these records can say.

Gland support went with shorter changes, by about a quarter. Support was chosen by each citizen and not assigned, so the figure describes who finished sooner and does not show what support does to a given body. A citizen in a hurry may be more likely both to use a secretion and to report a clear start. Past experience may also select: citizens who change repeatedly may be those whose bodies respond readily, and the data cannot separate that from a learning effect, which is the reading Okkaris (1741 CE) favours.

Age has a modest effect. Changes begun at 200 years or later ran 14% to 20% longer than those begun before 100, and the band between them could not be told apart from the youngest. That pattern fits a slow decline in plasticity (Perrimont, 1722 CE), but our bands are broad and we have no measure of plasticity itself. Even in the oldest band the median was 153 days, so age at the start did not move a typical change out of the range seen at other ages.

We did not measure how much of the spread the three factors explain, and the records suggest other candidates we could not code, such as the direction of the change and the starting body.

5. Limitations

Our records come from one vehicle's clinic, used by invitation, and the citizens who attend may differ from those who do not in age, circumstance or confidence with their own bodies. Duration is observed only for completed changes. Forty-five of 291 records (15.5%) were left out, 22 because the citizen stopped by choice and 23 because they left the vehicle. If the changes that stopped or were lost would have been slow, the figures here understate how long a change can take, and we cannot test this.

Gland support was recorded as the citizen reported it, with no compound or dose, and it was not assigned. The two clinicians who dated each completion read the full record, including whether support was used, and were not blinded to it. Dating was by interpolation between visits two weeks apart, so the whole-day durations in this paper carry a real uncertainty of about that size, and the agreement figures describe the two clinicians' reading of the same record, not the biology.

We treated the logarithm of duration as linear in the exposures and the errors as roughly normal, and did not examine interactions between age, support and prior changes. Standard errors allow for citizens who appear twice, but 48 pairs of changes are too few to study how one change relates to the next in the same body. Finally, the first and second authors work in the Faculty that runs the clinic, and readers should weigh the completion criterion with that in mind.