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A recent proposal by the Trump administration’s Department of Health and Human Services narrows the definition of gender to a binary structure based on biological terms established at birth, and plans to handle disputes with genetic tests. This proposal has caught the attention of millions of transgender, intersex, and gender non-conforming individuals, as well as over 1,600 scientists, including over 700 biologists, who have signed a letter criticizing the proposition because it is “fundamentally inconsistent not only with science, but also with ethical practices, human rights, and basic dignity,” (“Transgender, Intersex, and Gender Non-Conforming People #WontBeErased by Pseudoscience.
There is a common conflation between sex and gender, therefore establishing a distinction between the two is essential to our discussion. We can define sex as the biological traits and characteristics, such as genitalia and genetic differences, while gender is the social construct derived by humans to define the cultural perceptions of these sexual characteristics. The Trump administration’s proposal presents a flawed perception that is outdated and inconsistent with the reality of today’s society.
The truth of the matter is that “the relationship between sex chromosomes, genitalia, and gender identity is complex, and [still] not fully understood,” (“Transgender, Intersex, and Gender Non-Conforming People #WontBeErased by Pseudoscience.”). Although this biological basis for sex and gender is in its early stages, recent research of human genetics has shown that gender should model a spectrum, rather than a strict, two gender structure. Further perpetuating this perception of a binary system is regressive, therefore I wrote this paper with the intent to spread current knowledge of the many complexities of sex and gender from a biological standpoint.
For a very long time sex determination was based off a simple theory introduced in the early 1900s which uses chromosomal makeup as the determinant for sex. Under this theory the presence of a Y chromosome determines whether a cell is male or female. More specifically, male cells are composed of an X and Y chromosome, while female cells are composed of two X chromosomes. This theory led scientists to believe that the Y chromosome must carry male determining genes; and this belief has served as the basis for research since then. Ultimately, this research has shown that sex determination is much more complicated than it seemed at first take. While this outdated, binary model could be used to explain the sexes of most humans, exceptions to this rule have been known for a very long time. Intersex conditions or disorders of sexual development are the terms given to people today who are born with anatomical or physiological traits that break the binary boundary between sexes. Although relatively uncommon, people born with intersex conditions do exist, and more and more research is being uncovered to explain these unusual variances.
Sexual development can be understood in a series of stages. In the first stage, we deal with chromosomal sex, which is determined when the sperm from one parent meets the egg from the other parent. Typically, an X or Y chromosome-bearing sperm fertilizes the egg, creating either a male or female. This is the basis of the sex chromosome theory. However, in rare instances, the egg or sperm may not fit this traditional chromosomal makeup, either lacking a sex chromosome or having an extra. This would result in an embryo with the chromosomal makeup XXY, XYY, or XO. In just the first stage of sexual development we can see that a binary structure is unfitting.
In the next stage of development, an embryo obtains a gonadal sex, developing either testes in males or ovaries in females. Following this stage is the development of hormones that also have a sex and further drive embryonic development down a male or female pathway. This lays the foundation for the next stage of sexual development: the reproductive system. This stage is characterized by the “formation of the uterus, cervix and fallopian tubes in females or the vas deferens, prostate and epididymis in males,” (Fausto-Sterling). In the final stage of sexual development before birth, external genitalia is formed, males having a penis and scrotum, females having a vagina and clitoris. However, just as there are inconsistencies in the first stage of sexual development that lead to a chromosomal sex that doesn’t fit the binary standard, there are variances in the other four stages that cause a small portion of people to not develop under strictly male or female terms.
Among some of the most noteworthy research contributing to this evolving understanding of sex and gender is “the discovery of genes that actively promote ovarian development and suppress the testicular programme,” (Ainsworth). For example, extra copies of a gene called WNT4 in XY individuals can cause them to develop abnormal genitals, as well as a uterus and fallopian tubes. Another example could be when a main ovarian gene, RSPO1, functions improperly, causing the development of “a gonad with areas of both ovarian and testicular development,” (Ainsworth). Findings like these have shown that while chromosomes may indicate male or female sex, it is in fact gene networks that are responsible for determining the identity of the gonad. According to an article in Scientific American, it is “changes in the activity or amounts of molecules,” like WNT4 and RSPO1, “in the networks [that] can tip the balance towards or away from the sex seemingly spelled out by the chromosomes.”
Opposing networks of genes are not the only source of sexual variance. Many DSDs are caused by changes in the stimulus that react to hormonal signals. For example, CAIS, complete androgen insensitivity syndrome, causes a person’s cells to be deaf to male hormones, which can cause a person with Y chromosomes to develop internal testes, but female external genitalia. Although a rare scenario, affecting 1 in 4,500, this ratio would mean there are nearly 73,000 people in the United States alone with this condition. Furthermore, more than 25 genes involved in DSD conditions like these have been identified; and DNA sequencing has revealed that small variations in these genes can create a wide range of effects in individuals. Another example is congenital adrenal hyperplasia (CAH), typically caused by an enzyme deficiency, which causes excessive production of male sex hormones. Individuals with an XX chromosomal makeup that experience this condition are born with ambiguous genitalia.
While the study of DSDs has led much of the groundbreaking research of sex and gender on a genetic level, leading to evidence supporting the notion that sex and gender being biologically defined more as a spectrum rather than a strict binary system, society continues to lag behind science, with the Trump administration leading the way. Although people who have these conditions are extremely rare in comparison to the total population, these people do exist. Unfortunately these people and their parents are faced with problem of conforming to the binary system and identifying as either a male or female. This presents a number of problems including parents deciding to have surgery to normalize their child’s genitalia before that child even has the chance to develop their own gender identity. This in turn can lead to them identifying as the opposite sex of their anatomical and physiological characteristics down the road. In an effort to further understand these concepts as well as reinstill the most basic of human rights to these people, we as a nation should not move back to the binary system, but instead we should abolish it and adopt a system with fundamentally different view of sex and gender: one that models a spectrum where a number of different variances are responsible for this determination.
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