Showing posts with label non binary. Show all posts
Showing posts with label non binary. Show all posts

October 26, 2018

Why Sex is Not Binary and Why If You Are Educated You should Already Know There is More Than Two Sexes

No single biological measure unassailably places each and every human into one of two categories — male or

Two sexes have never been enough to describe human variety. Not in biblical times and not now. Before we knew much about biology, we made social rules to administer sexual diversity. The ancient Jewish rabbinical code known as the Tosefta, for example, sometimes treated people who had male and female parts (such as testes and a vagina) as women — they could not inherit property or serve as priests; at other times, as men — forbidding them from shaving or being secluded with women. More brutally, the Romans, seeing people of mixed sex as a bad omen, might kill a person whose body and mind did not conform to a binary sexual classification.

Today, some governments seem to be following the Roman model, if not killing people who do not fit into one of two sex-labeled bins, then at least trying to deny their existence. This month, Prime Minister Viktor Orbán of Hungary banned university-level gender studies programs, declaring that “people are born either male or female” and that it is unacceptable “to talk about socially constructed genders, rather than biological sexes.” Now the Trump administration’s Department of Health and Human Services wants to follow suit by legally defining sex as “a person’s status as male or female based on immutable biological traits identifiable by or before birth.”

This is wrong in so many ways, morally as well as scientifically. Others will explain the human damage wrought by such a ruling. I will stick to the biological error.

It has long been known that there is no single biological measure that unassailably places each and every human into one of two categories — male or female. In the 1950s the psychologist John Money and his colleagues studied people born with unusual combinations of sex markers (ovaries and a penis, testes and a vagina, two X chromosomes and a scrotum, and more). Thinking about these people, whom today we would call intersex, Dr. Money developed a multilayered model of sexual development.

He started with chromosomal sex, determined at fertilization when an X- or Y-bearing sperm fuses with an X-bearing egg. At least that’s what usually happens. Less commonly, an egg or sperm may lack a sex chromosome or have an extra one. The resultant embryo has an uncommon chromosomal sex — say, XXY, XYY or XO. So even considering only the first layer of sex, there are more than two categories.

And that’s just the first layer. Eight to 12 weeks after conception, an embryo acquires fetal gonadal sex: Embryos with a Y chromosome develop embryonic testes; those with two X’s form embryonic ovaries. This sets the stage for fetal hormonal sex, when the fetal embryonic testes or ovaries make hormones that further push the embryo’s development in either a male or female direction (depending on which hormones appear). Fetal hormonal sex orchestrates internal reproductive sex (formation of the uterus, cervix and fallopian tubes in females or the vas deferens, prostate and epididymis in males). During the fourth month, fetal hormones complete their job by shaping external genital sex — penis and scrotum in males, vagina and clitoris in females.

By birth, then, a baby has five layers of sex. But as with chromosomal sex, each subsequent layer does not always become strictly binary. Furthermore, the layers can conflict with one another, with one being binary and another not: An XX baby can be born with a penis, an XY person may have a vagina, and so on. These kinds of inconsistencies throw a monkey wrench into any plan to assign sex as male or female, categorically and in perpetuity, just by looking at a newborn’s private parts.

Adding to the complexity, the layering does not stop at birth. The adults surrounding the newborn identify sex based on how they perceive genital sex (at birth or from an ultrasound image) and this begins the process of gender socialization. Fetal hormones also affect brain development, producing yet another layer called brain sex. One aspect of brain sex becomes evident at puberty when, usually, certain brain cells stimulate adult male or adult female levels and patterns of hormones that cause adult sexual maturation.

Dr. Money called these layers pubertal hormonal sex and pubertal morphological sex. But these, too, may vary widely beyond a two-category classification. This fact is the source of continuing disputes about how to decide who can legitimately compete in all-female international sports events.

There has been a lot of new scientific research on this topic since the 1950s. But those looking to biology for an easy-to-administer definition of sex and gender can derive little comfort from the most important of these findings. For example, we now know that rather than developing under the direction of a single gene, the fetal embryonic testes or ovaries develop under the direction of opposing gene networks, one of which represses male development while stimulating female differentiation and the other of which does the opposite. What matters, then, is not the presence or absence of a particular gene but the balance of power between gene networks acting together or in a particular sequence. This undermines the possibility of using a simple genetic test to determine “true” sex.  
The policy change proposed by the Department of Health and Human Services marches backward in time. It flies in the face of scientific consensus about sex and gender, and it imperils the freedom of people to live their lives in a way that fits their sex and gender as these develop throughout each individual life cycle.

Anne Fausto-Sterling is an emeritus professor of biology and gender studies at Brown University.

June 27, 2018

Being Intersex and Non binary in a World of Male or Female


This piece is part of the Passing issue, a special package from Outward, Slate’s home for coverage of LGBTQ life, thought, and culture. Read more here.

From the very beginning, I was defined by my ability to pass.
Based on the results of an amniocentesis, my parents had been expecting a baby boy. When I came out, an apparently healthy apparent girl, the doctors told them, “We don’t know what’s wrong with it, or how long it will live.” My mother, who I’ve never seen cry, was in tears on the phone with her own mother, not knowing what to do.
Within days, my parents found a doctor who was able to diagnose me: I had Swyer syndrome, an intersex condition. It was treatable. I would live a long and healthy life, just like any ordinary girl—with only a few differences, which they could take care of. My parents were reassured.
I don’t mean to paint the doctors who treated me in a negative light. I did require medical treatment, and I’m lucky that I was diagnosed and treated so early on. (I was also lucky not to be born with atypical genitalia, and so to avoid the medically unnecessary “normalizing” surgeries inflicted on so many other intersex folks.) But the treatment was rarely, if ever, framed as being for my benefit. Everything, from the surgery I had as a toddler, to the hormones I started taking as a preteen, was so that I could be normal. So that I would look normal to the people around me. So that someday I could have a normal husband and a normal family. 
I don’t resent normalcy or passing—to the contrary, I appreciate passing all too much. Being able to pass as a cis woman has made my life easier, safer, and more comfortable. My willingness to hide part of my identity has allowed me to move in the world in ways that I never could have if I were obviously, gloriously queer.
As a Peace Corps volunteer living in West Africa, being openly queer could have been life-threatening. I adapted: I wore skirts, I got used to being called “mama” or “auntie”, I pretended to have a husband to ward off unwanted advances. But I’d always been intersex, and I’d recently started identifying as nonbinary—I needed some way to express that identity. Women in West Africa often wear their hair short, so I felt safe buzzing my hair to look more butch. I reveled in it every time someone called me “whiteman” (Westerner) or referred to me using pidgin English’s gender-neutral pronouns. 
Now that I live in Texas, I find it more difficult, not less, to walk the line of affirming my identity to myself while remaining safe. There are no cultural differences to exploit in deciding how to dress or express myself, so I find myself reverting to the mean—growing my hair long, letting it slide when people call me a woman or, worse, a girl. It makes me feel bad, especially when I spend time with queer friends who can’t pass or don’t choose to. Is my identity even real if I don’t express it in a constant, intentional way?
As much as intersex people face discrimination and misunderstanding, we do have the privilege of having physical proof of our identities. When I find myself doubting that I’m intersex enough, or nonbinary enough, I think of my hormone replacement therapy and the scars on my stomach. I think of the things my body can and cannot do, and how different I am from a typical, nonintersex person. I know who I am.  
And there’s something incredibly powerful—revolutionary, even—about challenging someone’s understanding of gender with your very existence. I hate when people use facts about intersex conditions to make a point without actually caring about or advocating for intersex rights, but I love bringing it up myself to educate. Surprising people with the information that I’m intersex when they were just explaining why nonbinary genders don’t exist is a powerful experience. Choosing to come out at the exact right moment makes me giddy, and it’s one of the privileges that I have only because I am able to pass.
But passing too well carries its own dangers. When I seek medical care, the quality of the care I receive depends on the doctor or nurse knowing basic facts about my body. Too often, health care professionals see the little sex checkbox at the top of the page and assume that they know everything they need to know. I’ve had doctors assume that my HRT was actually a contraceptive and suggest that I use a different method for a while. I’ve had doctors ask me if I’m pregnant minutes after I’ve told them that I have no ovaries. 
So there needs to be a balance, and I’m still not sure that I’ve found it, or that I’ll ever find it. Whether I try to pass is not a binary decision, because I decide whether to pass in lots of different contexts, with lots of different potential consequences. When I feel safe, I revel in expressing my identity and sharing it with the people around me. When I feel vulnerable, I allow people to assume what they will and try to get to a place where I can safely be myself. And when I interact with the medical community, I steel myself for the unpleasantness of having to beat someone over the head with facts that they’d rather ignore, just so that I can receive adequate care.
Like many people, I dream of a world in which the concept of passing doesn’t exist—a world in which there’s no societally imposed default to emulate or from which to diverge. But I live in this world, where I sometimes have to make compromises or put forth extra effort to ensure my safety. I have the time and energy and privilege to make sure that I stay safe, that I pass when I need to and don’t when I can’t. At such a distance from the dream, I only wish that every queer person could say the same. 
Read all of Outward’s special issue on Passing.

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