Gender, Sex and Intersex: A Primer

In part two of his series on natural law yesterday (Sex and Catholics 2: Gender perspectives and Evolution) , Chris deliberately did not go too deeply into trans or intersex issues, because as he says, he does not know too much about them. Few of us who are not personally affected, do. However, this is a complex, real – world phenomenon that directly challenges the simplistic, binary assumptions about gender underpinning both traditional Christian theology and secular marriage law. It’s appropriate therefore, that we try to learn what we can, to better appreciate this complexity, and its implications for traditional thinking on gender and sexuality.Over the weekend, I came across this post,  “M, F, X, The South African Passport Gets Progressive“, at The ctr-ALT-sex magazine, which is helpful. The writer, Avri, is a South African who begins by sharing the good news that South Africa will amend its passport regulations (as Australia did last year), to provide for gender classification as M, F –  or “X”, permitting intersex and transgender to select a gender option that may be more in keeping with their biology and identity than a simple M or F. This would be a sensible move for South Africa, where intersex issues came into national prominence three years ago, with the controversy over Caster Semenye‘s gold medal at the 2009 Athletics World Championships. Strong protections for sexual and gender minority groups have also been deeply embedded in the South African constitution since the birth of the new democracy in 1994.

So Avri’s announcement was credible – but not true. Sadly, ze ends the post hir post with an April Fool’s disclaimer. There’s a much more serious point to the piece though, than just some April Fool’s fun. That’s just the launching pad, for a useful,  extended exposition of some of the  issues around intersex. I share some extracts here, but I strongly suggest that to beef up your understanding, you read the full post – and follow hir links, for more.

Sex is not a black & white binary

The South African public dominantly holds to a very stereotypical and binary definition of anatomical sex. If you’re a ‘typical’ girl you must have XX chromosomes, a vulva, uterus, ovaries, boobs, make up, dresses, oestrogen, emotions, a boyfriend, and sex (but only in the context of baby-bound marriage). If you’re a ‘typical’ boy, you must have XY chromosomes, a penis, scrotum, testosterone, an Adam’s Apple, hair in funny places, aggression, a fine tuned mind for numbers and logic, a wife, and lots, and lots of sex all the time with many lovers. Our society supports this model of biological determinism with exclusive M / F forms, M / F bathroom signs and with procedures to “fix” people who don’t fit the mould. You’re either typically female or male…or you’re a problem child.

In reality though, these seemingly ‘natural’ gender identities are just social stereotypes. – which conflate sex and gender. Even more confusing is that they are also an oversimplification of the ways in which (1) sex, (2) gender, (3) sexual orientation, and (4) sex play are related to each other. So how are they all are related to each other? And what does each one mean? Sex positive trainer and performer Delene Van Dyk’s inspired “binary and boxes” model defines each of these four distinct, but inter-related, aspects of human sexuality:

1. Sex: A biological concept

2. Gender: A social construct

3. Sexual Orientation: An expression 

4. Sex Practices/Play: A physical and/or mental sexual/erotic activity :

 The ctrl-ALT-sex magazine.

Avri supplies an explanation of each of these, but concentrates on the first, biological sex. Before getting to that here’s hir description of “gender”, including transgender:

Masculine : Feminine: Transgendered: :Androgynous : Gender Bender : Twinks :Bois Gender refers to a set of societal expectations regarding “appropriate” learned behaviours, emotions and thoughts for people of a particular sex. In many cases a person’s gender identity matches their biological sex. For some people this is not the case. Transsexuals are people whose gender doesn’t match their biological sex. Their gender, how they present themselves to the world, is at odds with their biological sex, as if they were born into the wrong body. This can be incredibly challenging, confusing and traumatising especially in a society so preoccupied with traditional gender roles.

We need to understand that trans and intersex issues are not the same. “Transgender” and associated ideas refer to a mismatch between gender identity and biological sex (which may well be any of male, female or intersex), while intersex is a biological condition, where the simple “male” or “female” binary division simply does not apply.

This is because even the concept of biological sex is not as simple as we commonly assume. In the popular imagination, identifying someone as male or female is easily solved, by the crude but simple device of getting them to just drop their pants – but that can be misleading.

(Physiological) Sex 

The word “sex” refers to your physiological and genetic sex. Biological sex can be broken down further into four different but related processes:

  1. Chromosomal sex (XX, XY, and ‘non-typical’ chromosomal make ups like XO)
  2. Gonadal/hormonal sex (androgens, testosterone, oestrogen, progesterone)
  3. Genital sex: Internal & external genitalia (ovaries, uterus, penis, testicles, vulva)
  4. Sex differentiation of the brain (which happens in utero and at puberty in response to the sex hormones in your system)
For most people, chromosomes are either XX (female) or XY (male), and the other identifiers co-incide. For others, not so simple. Classifications based on any two of these criteria may not match, there are a number of chromosomal patterns which are not either male or female, and even external genitalia are not a definitive guide.

And what’s intersexed?

“Intersex involves human differences that challenge conventional notions of male and female and gender role paradigms” (Gender Centre, Australia).

The third sex: X

The more familiar word is “hermaphrodite”, based on the Ancient Greek word“hermaphrodites,” the half male, half female child of Hermes and Aphrodite. Over the last decade or so the word has been replaced with “intersexed” (between sexes) which more accurately describes the reality – and doesn’t make intersexed people sound like mystical ancient creatures hailing from the kinkier parts of Olympus. Intersexed has become an umbrella term for a wide variety of non-typical and ambiguous sexes. This can be evidenced as non-typical sex organs (1 in 50 babies) or non-typical chromosomal sex, hormonal sex, or sex differentiation of the brain (1 in 500 babies). There are some medical conditions that are related to intersexuality (eg. Klinefelters Syndrome). Although some intersexed people and critics argue that intersexuality is a Sexual Development Disorder (SDD) and not a third sex, more often than not there is no easy explanation.

To most new parents’ first question, “Is it a boy or a girl?”, the honest answer may occasionally be “we don’t know”. That’s because in some new babies, the external genitalia may be ambiguous, not easily identified as either an unusually large clitoris, or as a small penis. In these cases, our obsession with identifying everyone as either “a boy” or “a girl” can have tragic results.

Unnecessary and non-consensual medical treatment

One of the major problems with society’s black and white thinking is that intersexed babies are treated like medical emergencies. Ambiguous sex is operated on at birth to “fix” what is seen as a birth defect. A best guess about the baby’s gender identity is made and gender assignment surgery is used to typify the genital appearance of an “ordinary” baby female or male. Hormone treatment may be used later on. Growing up these children are socialised into their given gender role by parents and other care givers.

But surgically altered babies may not turn out later on to be the gender identity they were assigned at birth. This ‘best guess surgical strategy’ basically means intersexed children have little freedom to explore their actual selves, particularly if their identity conflicts with what’s in their pants. It can cause major confusion and distress for intersexed kids and teens who struggle to resolve what they look like on the outside (which may include physical scarring) with how they feel on the inside. Surgery at birth is simply premature and reinforces the myth that there are only two normal sexes.

Here are Avri’s recommended links (one of which, “Intersex, Women Bishops, and the Body of Christ” is my own, at Queering the Church, which is how I came across hir post in the first place):

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