Whimsical, queer exploration of all things gender.

One of the most fundamentally obvious things people might think when they’re asked what ‘Gender Studies’ actually is, is that it may look at differences between men and women…in some way. An interesting question to ask might be what actually is it that makes a man ‘a man’ and a woman ‘a woman’? It’s not as obvious as one may think.

When this question was first asked in a legal context (roughly 50 years ago), three factors were used to define ‘biological sex': the chromosomes of an individual, what gonads (ovaries or testes) they possess, and their genitals. This is overly simplistic as it turns out that many different combinations of these three factors exist than the two categories everyone was assumed (or expected?) to fall into.

**Warning**

The rest of this post will contain science. This so-called area (pronounced ‘sky-ense’) is feared by many, however much like circumcision, is only to be feared when done badly*. For anyone apprehensive, I challenge you to read on. I double dare you.

We are all told in school that with regards to chromosomes, men = XY and women = XX. For many people this is true. On the Y chromosome, which is a small, stumpy little thing, lies a gene called SRY, which stands for ‘Sex Determining Region Y’. It is responsible for unspecified gonads in a foetus to develop into testes. Seems pretty straightforward. However this area of the Y chromosome can in rare cases cross over to an X chromosome. If this X chromosome is then inherited, an individual who is XX but in all other ways ‘male’ (gonadally, genitally, and in appearance when older) will result. If the SRY-less Y chromosome is inherited, then the foetus will be XY, but otherwise ‘female’. Because sex on a birth certificate is decided just from someone taking a cursory glance, these conditions may be undiagnosed until the age of puberty, or sometimes not at all.

Individuals who possess a SRY gene will develop testes. Testes then produce testosterone, which is responsible for the development of typically male external genital structures (penis and scrotum) and internal genital structures (the bits needed for reproduction inside that aren’t the testicles themselves – mainly specific tubes).

Before sexual differentiation, all foetuses possess two structures where their internal sex organs will be, called the Müllerian and Wolffian structure. Testes produce a substance called ‘Anti-Müllerian Hormone’ (AMH), which causes the Müllerian structure to regress. The testosterone produced by the testes causes the Wolffian structure to develop into male internal structures. Lack of testosterone prevents the Wolffian structure from developing and causes it to regress, and lack of  AMH allows the Müllerian structure to develop into ‘female’ parts.

The ‘triggering amount’ of testosterone needed to cause penis and scrotum development is lower than the amount needed to make Wolffian structures develop – so if a foetus has a condition that results in lower levels of testosterone (and there are quite a few that can), the result will be someone without the corresponding male internal organs to match the external ones.

Whilst there are many, many different genetic conditions that can make fitting clearly into a social sex box† problematic, there are a couple that illustrate the potential ambiguity in defining sex very well.

The first of these is called CAH, or ‘Congenital Adrenal Hyperplasia’. This is a mutation in a gene which causes a particular enzyme the body normally produces, to not work. This enzyme is essential for the production of the substance cortisol, and so people with CAH cannot produce cortisol. The result of this is that the hypothalamus (the region of the brain which monitors certain hormone levels amongst other things) says:

In normal circumstances such precursors would get made into cortisol – but because the enzyme responsible doesn’t work, the precursors end up getting made into testosterone and other ‘masculising’ hormones – giving even XX foetuses male genitalia. Due to not actually having testicles no AMH gets produced however, so female internal structures still form. Sometimes the genitals of such individuals are judged to be ‘ambiguous’, and tests are done at birth that reveal the condition. Some however look like entirely unremarkable boys, and may be completely undetected.

Another interesting condition is Androgen Insensitivity Syndrome, AIS. This is a mutation that occurs on the X chromosome, and happens in a gene that encodes a receptor (protein that senses when a particular thing is present) for testosterone. This means that in XY foetuses, even though testes are produced normally, and testosterone is then produced normally – none of the rest of the body can detect that the testosterone is there…so female genitalia develop. AMH is produced which prevents Müllerian structural development, but the Wolffian structures can’t develop either as the testosterone can’t be detected. AIS babies show no signs of being anything but female, though are XY and have testes. There’s no clearly agreed reason or way to decide whether possession of one trait or another is what indicates a foetus or babie’s ‘true’ sex, if such a truth can actually be said to exist.

AIS can be ‘complete’ or ‘partial’, with the ‘partial’ condition resulting in ambiguous genitalia. To quote from the book ‘Brain Gender’ by Melissa Hines:

The direction of sex assignment of individuals with PAIS depends to some extent on the appearance of the external genitalia; those judged to have a penis too small for success in the male role may be surgically feminized and raised as girls, whereas others are reared as boys and treated with andogens to try to stimulate penile enlargement and development of other male secondary sexual characteristics. In this syndrome and others involving undervirilization in XY individuals, however, additional considerations, such as the desire of the parents for a son versus a daughter can also influence the direction of sex assignment.

It’s fair to say that the result of accident or injury resulting in penile loss wouldn’t result in an individual who would be unable to have ‘success in the male role’, regardless of the fact that they have already been raised and socialised as male. This discussion hasn’t even touched on the importance of how personal understanding and identity of one’s gender can reflect on how one is defined. If an individual ‘feels’ strongly that they are a given sex, how is this necessarily any less biological? Whatsmore, is there even reason why choice of identity (particularly beyond the strongly binary male-female that is enforced by much of society) is ‘less valid’ as a way by which sex can be defined? It’s easy to get into some very tricky philosophical areas related to this, and certainly the arenas of biology and socialisation are virtually impossible to disentangle from each other.

When it comes down to it, none of these factors are how people judge the sex of people they see day-to-day. We look at what clothes people wear, their size, build, and where they have hair. We listen to what they sound like, and what their name might be. Most people rarely question what they’re presented with assuming they can easily put a person into one box or another. The questions asking why people feel the need to do this, and why people react the way they do when they can’t, are further huge areas to consider!

*More on this little gem in the future I think…

†If you’re into that sort of thing.

Comments on: "Is there a clear way to define a ‘biological’ sex?" (16)

  1. I fear circumcision even when it is done correctly. Other than that, I feel more informed by this excellent post. Well done!

  2. Deborah said:

    Yayyyyy skyense!! I find the question of assigning gender to an iffy biological sex so fascinating! I believe the real problem is that no one talks about it, though. Parents who encounter this sort of thing with their children just can’t talk about it – it’s taboo for some reason, even though I’ve heard it’s just as common as Down Syndrome! (Though I have no reference for that.) And the inability to put this sort of thing out in the open is what encourages arbitrary gender assignment. So thanks for writing about this and putting it out there to your readers! The more we know, the more we can know how to deal with it properly when it happens.

  3. Fascinating – I think I was only ever introduced to full blown chromosomal non-segregations in school, the whole Kleinfelters (?) and XYY sort of business. These subtle changes are much more interesting…

  4. Circumcision isn’t to be feared, it’s to be despised.

  5. [...] like to see patterns in things. In the last post about defining biological sex, I mentioned some of the things people look for in everyone they meet in order to make the [...]

  6. I suggest adding a “google+” button for the blog!
    Hellen

  7. Just a smiling visitor here to share the love (:, btw great design .

  8. [...] breasts? Oh hang on, little girls don’t have them. How about the other physiological markers? I’ve already talked about how this doesn’t really get one anywhere. Nicole identifies as a girl. Therefore, she has a girl’s body. Even if people ‘know [...]

  9. “When it comes down to it, none of these factors are how people judge the sex of people they see day-to-day. We look at what clothes people wear, their size, build, and where they have hair. We listen to what they sound like, and what their name might be. Most people rarely question what they’re presented with assuming they can easily put a person into one box or another. The questions asking why people feel the need to do this, and why people react the way they do when they can’t, are further huge areas to consider!”

    I disagree! In my opinion, you are confusing terminology. I think that people judge the gender of people they see day-to-day, rather than the sex. In most everyday situations, I like to think that people don’t care about the sex. The man/male and the woman/female distinctions are very important in this kind of question, and the context that it is asked in. In a medical situation, sex will often trump gender; a woman with testicular cancer will rightly be treated as male by the oncologist, in terms of treatments. In a social situation, gender will often trump sex. As yet, both gender and sex are two-box categories (with various “syndrome” sub-categories for sex), though I think the fact that sex is still two-box is very much a reflection of a social need for binary gender (rather than sex) assignment and the deep entanglement of sex and traditional gender. But then again, I don’t study these things =)

    I think gender is binary because sex is usually binary, and so that feed back into a need to classify sex binarily! All a bit silly, really. If gender can be cut free from sex, then maybe boxes or gradients or lack of caring so much can develop in both categories, and everyone can be happier and make more sense!

    • People conflate sex and gender when simply looking at the people around them day-to-day. Even in academic contexts the terms sex and gender are often conflated, as to try to separate out ‘biological sex’ from ‘social gender’ is ultimately naively reductionist in my opinion. A ‘sex binary’ isn’t a term that sees much, if any, use. I could just as easily have said that people judge gender on a day-to-day basis, but very, very few people will be making their observations on people’s genders and then considering that their ‘sex’ will be different from this. As you say, there is a deep entanglement of gender and sex, such that I would argue that ‘cutting one free’ from the other is essentially impossible.

      Talking about sex and gender as being hierarchical and ‘trumping’ each other in different contexts is extremely problematic. What does it mean to treat a woman as ‘male’? Of course she will require the specific treatment that the cancer would require, but this isn’t something that needs to be ‘gendered’. I don’t think you mean that she should be put into a male ward for example, because the distress and offense this could cause (I am making the assumption that we’re talking about a trans woman who identifies within the gender binary here) would be obvious.

      What makes a ‘medical’ situation distinct from a ‘social’ one? One can communicate essential medical knowledge without having to be put a ‘sex category’ that one feels uncomfortable with. I hold firmly to the fact that sex is not a simple product of a common combination of chromosomes, gonads, and secondary sexual characteristics. It entirely undermines the vital value of identity to talk about ‘male women’ or ‘female men’. It risks creating a sense of being ‘other’ from ‘normal’ men and women. Which is extremely damaging. There are differences in trans experiences to cis experiences which can be acknowledged and embraced without a basis in separatist definitions of sex and gender.

      In attempting to separate sex and gender, there is the serious risk of assigning an arbitrary greater ‘value’ to that which is understood ‘scientifically’. All too commonly trans people will hear highly offensive stuff like ‘okay so you identify as female/male, but what’s your *real* sex?’. The empirical presence of testicles, breasts, a uterus etc. can all be medically relevant. I don’t believe it’s an impossible or illogical social jump to talk ‘medically’ about someone who is of the male or female sex having any particular combination of organs. As the various conditions that exists show, this is done anyway. Unfortunately it is still the case where the decisions made by medical staff at birth can be given a great deal of power in ‘trumping’ individual’s own identities.

      The methodologies that allow for the appreciation of identity do not reduce to a molecular mechanism (at least with any meaningful consideration of science now or in the foreseeable future) but this doesn’t place them hierarchically lower than ‘scientific’ methods as ways to produce meaningful knowledge – which is all understood through social contexts anyway. Perhaps not so strikingly important when talking about something like the Polymerase Chain Reaction, but again it is naive to think that the human element of scientific research has no impact upon how things are considered. One only needs to look at Simon Baron-Cohen’s work to see this very clearly. After all, even if one takes a positivist view (that is, the claim that processes are reducible to physiological, physical or chemical events) then sense of identity must have a physiological, neurological basis – which is not taken into account when defining sex, simply because it isn’t ‘observable’ at birth. It is problematic in and of itself to require a biological legitimacy for the acceptance of identities.

      Also, gender is not ‘two-box’. It’s simply that mainstream society often only recognizes and talks about the two most common boxes, with a large amount of ‘invisibilising’ and discomfort surrounding everything and everyone else.

      You do raise an important area of consideration that deserves book’s worth of attention, and relates quite a bit to the interesting but challenging area of the philosophy of methodology, and how value is assigned to methods of knowledge production (which I was lucky enough to have some very sexy lectures on). Something I took away was that Positivism can be very problematic for a realistic and rational appreciation of things that interact with ‘the social’ – which is almost everything, really.

      Thanks for reading!

      • Kashi said:

        I am going to write you a long and very reductionist ramble about how I think about it all =)

        For the moment, I will tell you that I think the distinction between sex and gender is one that people do unconsciously make… people treat people the way they feel that that person wants to be treated, and a person’s gender, as opposed to sex, is on display partly as a signal of how they want to be treated. So in terms of how people interract with you, they are far more interested in how you want to be treated than the inns and outs (pardon the pun) of your own personal biology.

        It’s only when biology gets involved in interractions, like in medical situations, when sex necessarily becomes a consideration. No she shouldn’t be put on a male ward =P but she is inevitably in a sex category, rather than a gender category, that will continue to be medically relevent her because biology is biology and doesn’t care about social implications. There are racist drugs out there that work better for black people than white people. This means that race is being taken into consideration for many medical decisions, and people are put into race boxes. These should not be sources of discomfort… having your own sense of personal identity so linked to physical attributes that someone feels uncomfortable about putting any aspect of themselves in a box where they personally don’t feel they belong, because they don’t want to feel different, is a bit ridiculous when it comes to medicine. The relative “value” of someone’s biology and of someone’s personal identity is different in different situations, and placing personal identity unquestionably at the top of the list at all times doesn’t really make sense to me.

        As far as personal identity at birth goes, birth is the time from which gender is imposed on a child… in terms of personal identity, I’m farily sure babies should all be called “it” and wear beige until they get to an age where they can tell the parents who they want to be =P (not a serious suggestion). Anyway. Expect a naive but thorough essay some time in the near future =)

  10. “People treat people the way they feel that person wants to be treated”

    Okay, well, this is fundamentally untrue a depressing amount of the time. Plenty of people are well-meaning and will indeed do this, many people are not. A little exposure to various accounts of transgender experience will assure you of this. There is a lot of literature out there concerned with ‘passing’, and the fact that people can receive a horrific amount of discrimination and abuse if they attempt to present as their identified gender but are called out as ‘a man in a dress’ or ‘a mannish girl’. This happens. It is real, and it is common. It is also very sad.

    “Biology is biology and doesn’t care about social implications”

    But doctors and scientists should care about the social implications of the way biological fact is communicated and experienced. It is a much fairer model to say that it isn’t people in the category ‘men’who can receive treatment for testicular cancer, but people who are in the category ‘people with testicular cancer’. Sex category is just as socially important and judged as gender category, because these two things are not clearly distinguished. At all. This is a huge assumption that your argument rests on in regards to being applicable in the real world without furthering harmful gender policing.

    To say that sex ‘shouldn’t’ be a source of discomfort doesn’t confront the reality of the fact that it very much is for a significant minority, and that it is not remotely difficult to talk about the medicine that relates to traditional sex-defining physiology without putting people into categories they don’t want to be in. Saying that ‘science says that if you have these bits/chromosomes makes you this sex’ is, in practical terms, a really great way to deny trans identity, because of the fact that sex and gender are often used interchangeably and how commonly precedence is given to biology over identity in contexts which don’t involve doctors treating a condition.

    If you want to make the race parallel, then I think the most important factor to look at is that you don’t find people of Caucasian origin identifying as BME, or vice versa. Whatsmore, ‘race’ isn’t a category that has a related parallel which it is conflated with. You don’t have ‘biological race’ and ‘social race’. Indeed, in many languages there is only one word to refer to sex, or gender.

    “[H]aving your own sense of personal identity so linked to physical attributes that someone feels uncomfortable about putting any aspect of themselves in a box where they personally don’t feel they belong, because they don’t want to feel different, is a bit ridiculous when it comes to medicine.”

    My point is, one doesn’t need to be put into a box against one’s will in order to receive accurate medical treatment! It doesn’t involve ‘pretending to be something one isn’t’. It simply involves not putting anatomy into categories that results in social judgement. Call it sex, call it gender – it happens. To deny that sex and gender are indeed conflated is I’m afraid, naive. To not bear in mind that being put into a sex category can therefore be just as distressing and undesirable as being put into a gender category is not mitigated by referring to biological fact. To categorize like this is a social act, and as the article points out in the first place…sex does not have a definition that doesn’t have exceptions and problems.

  11. [...] of biological sex as dichotomous or oppositional is extremely limited and inadequate. The diversity of human biological sex simply cannot be described or conceptualized by attempting to position [...]

  12. [...] Well, that depends on where you are and what you’re doing. For example the extreme-right wing, racist, sexist, and homophobic UK political party the BNP was forced to change its constitution to accept people of colour. This was an obvious example of a group discriminating (illegally) against racial minorities. Whilst MWMF may not have breached Michigan or US law, this is still an example of a privileged majority (cis women) excluding a marginalized minority. The fact that cis women experience marginalization and discrimination doesn’t justify their performance of oppression in the name of safe space creation. The argument rests on viewing trans women as not being ‘real’ women. The very existence of the identity category ‘womyn-born-womyn’ makes the political statement that there are womyn who weren’t ‘born womyn’, and that they are therefore ‘other’. This ‘othering’ sets up a false dichotomy, that there are two distinct categories, those ‘born womyn’ and those not, and that your validity as a womyn is decided based on which category you fall into. I have written about the flaws with attempts to define identity based on biology here. [...]

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