Beyond Male and Female: Gender Trouble, Biology Trouble

There is neither Jew nor Gentile, neither slave nor free, nor is there male and female, for you are all one in Christ Jesus.

– Galatians 3:28
In the context of religion, Christians should be familiar with the quotation from Galatians (even if some, such as in the Catholic Church, are unwilling to take the words literally, and apply them to ordination). From the world of science though, it is becoming clear that there is a truth in the words that goes way beyond a theological concept, and is instead, a substantial measure of quite literal truth. It may well be that there really is “neither male nor female”, at least not in the absolute binary sense that modern Western culture assumes. This has major implications for Christian sexual and gender theology.”


Judith Butler’s “Gender Trouble” was a seminal work in the early development of feminism and queer theory, and later of queer theology.  Butler’s central achievement was to demonstrate the fluidity of gender, which she described as “performance”.  The fluidity of gender however, also extends to biology. Far from a simple binary world composed of biological males and females, with perhaps a smattering of people with indeterminate gender (once described as hermaphrodites), modern science has shown that there are a far greater range of conditions that may be loosely described as “intersex” than previously realized – and that there are a surprising number of these people, some of whom will not even know of their true sex until they meet a need for some kind of medical testing (as with the case of the South African athlete Caster Semenya, who had no idea she was not fully female until she won a medal at the Beijing Olympics, competing as a woman). The same problems beset Sally Gross, who was raised as a male and ordained a Catholic priest, until the discovery that biologically she was in fact primarily female.

What is a Male?

To illustrate some of the complexities around biological sex, I want to share with you some extracts from two books that I have found helpful in extending my own understanding, Brian McNaught’s “Sex Camp”“, and Virginia Mollenkott’s Omnigender.

“Sex Camp” is a fictionalized presentation in novel form, of a real-life program that used to be run in New York state, in which groups of people from diverse backgrounds were brought together  in a secluded rural setting each summer, for serious training and discussion of matters around sexuality, gender, and faith.

In one chapter,  ”Bill” delivers a presentation to the group on “Gender Identity & Expression”.  This is from his introduction to the topic:

“When we talk about “Biological Sex,” and ask the question, we’re asking about it chromosomally, hormonally, gonadally, as well as with reference to the internal and external genitalia, and to brain dimorphism,” he said, writing the words on the whiteboard. Chromosomally, we are talking in terms of xx equalling a girl, and xy equalling a boy. Hormonally, we’re talking about ovaries for girls, and testicles for boys. With regard to internal genitalia, we’re talking about the Mullerian Structures for girls (fallopian tubes and uterus), and the Wolfian structures for boys (prostate, seminal vesicles, and vas deferens). Externally, we’re talking about the clitoris for girls, and the penis for boys. Brain dimorphism refers to the differences in the male and female brains.” 

Let’s pause, to digest this. I count six different methods of determining  a person’s sex.

  • chromosomes
  • hormones
  • gonads
  • internal genitals
  • external genitals
  • brains

The results of applying all of these to a single person will not always coincide. If they do not, how are we to decide, is this person “male” or “female”?

Furthermore, these measures do not yield simple binary opposites.

The problem with all of this is that not all girls are XX or boys XY, we all have the same hormones but in different level, we’re all born with clear gonadal or genital differences, and brain dimorphism isn’t a reliable indicator. So the question remains, “What is a male?”


Some of this is familiar. External genitalia can be ambiguous (as they were at birth for Sally/Selwyn Gross, whose story I presented earlier). In these cases, parents and doctors typically make a decision to impose one or other gender on the child, and raise her/him accordingly. But the assigned gender may differ sharply from the other, less easily visible determinants. But let’s consider for now, just those hormones.

The male hormone testosterone and the female hormone oestrogen are familiar, and popularly taken as markers for masculinity or femininity. (Just consider the verbal expression, “testosterone-fuelled….”) to describe actions taken to be unequivocally masculine).   Some men take testosterone hormone supplements to adjust their physical appearance to a more conventionally “masculine” model, or to excel at masculine sports. For transsexuals, hormone therapy is commonly a major part of the transitioning process. But we all know that “men” differ in their degree of testosterone – and have a modicum of oestrogen too, and “women” differ in their oestrogen levels – but have some testosterone, too. Using hormonal measurement alone as a criterion, does int make any sense at  all to even think of someone as wholly male, or wholly female?


Chromosome patterns also do not fit the simple “xx” or “xy” binary split we are familiar with. In addition to x and y chromosomes, there are “blanks”, indicated as “o” – and some people have more than the usual two.

“With chromosomes”, Bill continued, “the male sperm determines the outcome. What happens, however, if instead of adding an “x” or a “y” chromosome to the female’s “x”, the male shoots a blank sex-determining chromosome and the child is born “xo?” 

The answer is –  Turner’s syndrome. There are many other variations from the simple xx/xy of popular understanding.

One out of every 1600 live births are “xo”. You can also get “xxx,” which will be a female, but there are a significant number who may have mental retardation. You can also get an “xxy”, which will often be a tall, infertile male.  We call this Klinefelter’s Sybdrome. You can get an “xyy”, and you can get an “xxyy”, which is a pure, bilateral hermaphrodite.”

And you can get an “xyxo”, which will be a short male whose gender and orientation are up for grabs”.

“The point is”, Bill said with a satisfied look, “that nature is not neat. Biological sex is not an easy issue. Further, when we talk about “male” and “female”, we’re talking about “sex”, “sexual identity”, and “sex role”. When we ask the question, “What is a male?” we’re not just asking about chromosomes, hormones, gonads, genitals and differences of the brain. We’re asking about sexual identity and sex role. We’re asking about both the assignment and rearing, as well as gender identity differentiation. ”  

Sex Camp”” is about much more than the ambiguities of biological sex and gender identity – this topic is just one of many in a a book which is packed with helpful, reliable information about sex and sexuality, and is also (as you would expect from the title) great fun to read.

I turn now to another book, in a more conventionally serious manner, by a respected theologian – and focussed exclusively on this topic.


Intersex is just one of several terms sometimes included (incorrectly) in the umbrella term, “transgender”. In her book “Omnigender”, the theologian Virginia Mollenkott provides a useful summary of the distinctions between these several descriptors.

“The transgender movement is still so relatively new that trying to supply definitions is like aiming a cannon at a moving target.

At first, the term transgender referred only to people who had changed their gender, but not their genitals. (Now, such a person would be called a non-operative transsexual). But gradually, that definition has been extended to include intersexuals, transsexuals, cross-dressers, drag queens and kings, androgynes, and anyone else who feels “otherwise” from society’s gender assumptions.

I do not want to go into the definitions and distinctions between these – but I do want to explore Mollenkott’s description and explanation of the range of intersex conditions.

According to the best estimate of the Intersex Society of North America, “about one five intersexed children have their genitals cut into in US hospitals every day for cosmetic reasons. Some operations are necessitated by life-threatening conditions…..but Western medicine has taken pains to protect the male-female binary from the challenges of intersexuality.

The fact is that “anatomical sex differentiation occurs on a male/female continuum”. And it seems to me that the anatomical continuum forms a good model for an omnigender paradigm in which people locate and enact the gender presentation that seems fulfilling to them at any given time….

To complicate matters further, “intersex” is not a  single continuum, but several.  For example, let us begin with what “everybody knows” about biological sex: that males have an XY chromosomal pattern, and females XX. In fact, one person in every 500 has a type which differs from that pattern.

About one in 1000 women has three X chromosomes instead of the usual two; some people have had as many as four X chromosomes – plus two Y’s.

Noting that there are seventy different intersex syndromes, Mollenkott names and describes five major categories.

  • Androgen Insensitity Syndrome
  • Partial Androgen Insensitity Syndrome
  • Progestin Induced Virilization
  • Adrenal Hyperplasia
  • Klinefelter Syndrome
But more important than the clinical descriptions of (chromosomal) intersexuality, Mollenkott continues with a presentation of the human costs of forcing people who are born somewhere on a biological continuum, into one or other pole of the binary divide.


Born in 1961 (genetically male but with a tiny penis), Heidi has contemplated suicide more than once, not because she is intersexual but because of unrelenting medical pressure to make her appear “normal”. When she was three months old, doctors cut open her abdomen to inspect her reproductive system.  At seventeen months, they went back into her abdomen to remove her ill-formed testes. When she was five years old, her penis was removed without her prior knowledge.  But as a teenager, she refused to let doctors create a vagina. She lives now as a lesbian but has never had an orgasm, since a lover’s touch feels like “40-grit sandpaper”.  
By contrast, twelve adults with intact micropenises reported having normal erections and orgasms.


 Angela, an intersexual who seemed to be a “normal” girl until her clitoris began to enlarge into a penis when she was twelve says she loved that penis and remembers the six months before surgery as being “in the pleasure garden before the fall ” She regards the loss of that penis (which the doctors describe as giving her a normal -looking female clitoris) as the loss of her “unique hermaphroditic sexuality”.

Similarly, Heidi describes the destruction of hermaphroditic eroticism as genocide, not through k illing people, but through taking from them that which is unique to them. To Angela, this was the theft of her “sacred sexuality”.

Applying the Golden Rule

Morgan Holmes, who was subjected during childhood to “clitoral recession” surgery that removed most of her clitoris, writes that she would have liked to have grown up in the body she was born with. “Someone else made the decision of what and who I would always be before I even knew who and what I was.”  The vast majority of intersex surgery involves normal little girls whose clitoris has been deemed too large by doctors, often because the doctors fear they girls will grow up to be masculinized lesbians. In the context of the Golden Rule, I wonder how many surgeons would like to have been rendered sexually dysfunctional for no other reason than to fit cosmetically into a binary male/female social construction.

A handful of anecdotes about real people put flesh on the theory – but do nothing to upset the popular misconception that intersexuality, or gender ambiguity, may affect only a tiny number of people (who might once have been thought of simply as “freaks”, and easily dismissed. The reality is that while intersexuality is clearly a minority condition, it is one that affects a surprisingly large proportion of the population.

William O. Beeman, associated professor of anthropology at Brown University, has written that “between 3 million and 10 million Americans are neither male nor female at birth”. Beeman quotes Dr Anne Fausto-Sterling’s estimate that intersexul births range from one percent to four percent of all children today.  Therefore, says Beeman, “there are perhaps millions of XX males and XY females living in the United States today. There are cultural males with male genitalia who are genetically female, and cultural females with female genitalia who are genetically male.”

Social Implications

When I wrote about Selwyn / Sally Gross and her difficulties as an ordained Catholic priest when it emerged that she was not, in fact, genetically male, as she had been raised and as her documents and  external genitalia indicated, but primarily female, I put the question: If the priesthood is to be restricted to “males” – which criterion shall apply? The same question should be applied equally in the secular realm, in every instance where biological sex is currently assumed top be important. The most obvious of these are in the laws governing marriage, and regulations governing sport.

What is “Same-sex” marriage?

I am fascinated by Beetman’s observation that there probably exist millions of people who are culturally and genitally of one sex, but genetically of another. A large proportion of these, just like any other group, will be in conventionally heterosexual marriages. Some may even be prominent in the campaigns against gay marriage. Genetically however, if testing were to be done on them, it would be found that they are in fact in same-sex marriages themselves.

We already know that an obsession with preventing same-sex marriage creates a difficult legal conundrum for some states when it comes to transsexuals who marry. If the birth gender is taken as definitive, then a transsexual person is free to marry a person of the same gender as that in which s/he lives and identifies. If the current, lived gender identity is paramount, then a transsexual is free to marry someone of the same birth gender. Either way, any marriage of a transsexual, unless to another transsexual of opposite gender, will be in one or other sense a “same – sex” marriage.  Perhaps the best way to illustrate the futility of the current gender restrictions on marriage would be to require all prospective brides and grooms to undergo genetic testing before being granted a marriage licence, just to ensure that the prospective brides and groom really are of the biological sex they appear to be. The results would produce many surprises – and a number of very red faces among the opponents of equality.

The Intersex Challenge for Sport

The difficulties of the binary sexual divide in sport were brought into sharp and very public focus when Caster Semenya won the gold medal in the women’s 800 metres at the 2009 athletics world championships. When questions were raised about her gender, she was (controversially) subjected to medical tests, amid vociferous complaints of racism. (These tests found that although she is not male, she is also not “fully” female”. The delay in releasing the findings led to her exclusion from a later athletics meeting in South Africa – but she was happily able to compete (as a woman) in the next world championships in 2011, where she won silver.  One can only imagine the impact of the fuss on Caster herself, who had been raised in simple rural surroundings, and had never for a moment considered herself to be anything other than fully female.

Well before the Caster Semenye debacle, athletics bodies had already been forced to grapple with the issue. In 1996, eight women in the Atlanta Olympic Games tested as “not women”. But some of these at least really were female, with atypical chromosomes. One of them later gave birth to a healthy baby, after being disqualified from competition as “not female”.

One in every five or six hundred female athletes has the Androgen Insensitivity Syndrome, which means that she is genetically male, possessing both X and Y chromosomes.  But as this confers no competitive advantage, it is cruel to disqualify her. Such cruelty is typical of what occurs when a culture attempts to force everyone into a single Procrustean bed of binary gender. 

Intersex and theology

Omnigender is a book packed with information about biological and gender diversity, and personal stories of the harm that is done to people by ignoring the complexity of this diversity, and the artificiality of an absolute  male/ female divide. However, Mollenkott is primarily a theologian not a specialist in biology. The greater value of her work lies in her theological reflection on the implications of these facts of biology.

Susannah Cornwall’s  ”Sex and Uncertainty in the Body of Christ” is even more closely focussed on intersex issues, and the challenges they present to traditional theologies focus on rigid distinctions between male and female.

That discussion, however, I leave for another time – except to return once more to the opening idea that began this post. As Christians, we (and Biblical literalists who oppose gay marriage in particular) really ought to take seriously the message of Galatians:

There is neither Jew nor Gentile, neither slave nor free, nor is there male and female

The evidence from biological science is that this is, quite literally, true.

Recommeded Books:

Cornwall, SusannahSex and Uncertainty in the Body of Christ: Intersex Conditions and Christian Theology 

McNaught, Brian: “Sex Camp”

Mollenkott, Virginia Ramey: Omnigender: A Trans-Religious Approach

Thatcher, AdrianGod, Sex, and Gender: An Introduction

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