By Maanasi Shyno
Graphics by Sophie Williams
Acknowledgement: The following is written by a cisgender, endosex woman who is not by any means the most qualified to write on this subject. That being said, it’s very important to recognize that it is not the responsibility of intersex folks to teach others about sex and that allies should also be doing that work.
For the last two decades, we’ve been reworking the understanding of sex and gender established by eighteen and nineteenth century medicine. Sex is considered the biological, phenotypical presentation of the body, a categorization assigned at birth. Gender, on the other hand, is now understood as the cultural role an individual identifies with internally and expresses externally in a social context. The movement towards understanding gender as existing on a spectrum is wonderful. Because the concept of gender was differentiated from sex specifically to convey that people choose to express themselves in ways that do not fit into a binary, it has been a relatively easy distinction for most people to grasp. Apart from understanding that transgender folk have a gender identity that does not match their assigned sex, society is begining to recognize people who are genderfluid, nonbinary, and agender.
Now it’s time for the next step: acknowledging that sex also exists on a spectrum. The world is complicated. What are the odds that, when nature and chance brought about humanity, they created something as simple as a binary to categorize us? The sex binary is far too confining to truly represent the true nature of sex: the binary excludes intersex people who are forced into categories that can not accurately describe their reality. In addition to psychological harm, this can result in physical harm when surgery is conducted to alter an infant’s appearance to fit into the binary.
Understanding Intersex
According to the sex binary, there are only two sexes: male and female. However, there are many possible genital, internal organ, and chromosome combinations that differ from what we know as ‘male’ and ‘female’ bodies. The term used to describe these variations is intersex. Some intersex traits, like ambiguous or atypical genitals, are identified at birth. Other traits develop with age or are discovered later on. Approximately 1.7% babies are born intersex, but there are likely more, as intersex traits often go underreported. Intersex also refers to the community of people possessing these intersex traits. (Explaining DSDs)
Intersex is also considered a biological condition known as “disorders of sexual development” (DSDs). The term DSDs, specifically the disorder part, is harmful to intersex people because it insinuates that the intersex traits are conditions to be treated. On the contrary, intersex is a natural variation of human sex and are not disorders. (Explaining DSDs)
Social pressure to fit into the sex binary has shamed intersex people into altering their intersex traits via surgery, even when they are perfectly functional. Parents of intersex children also feel this pressure and opt for intersex infant surgery when the intersex child isn’t able to consent to what could be a life-altering or even damaging surgery, violating bodily autonomy and self-determination. Although parents are told that their children will struggle not only socially, but medically from intersex traits, this is often simply not the case. Many if not most challenges faced by intersex conditions can be addressed by non-surgical, non-invasive methods. Other challenges, like difficulties with hormonal regulation, can not be adequately addressed with surgery anyways. Rather, these surgeries can cause more harm than good: removing ovaries or testes disrupts puberty from occurring naturally, scar tissue from surgery can make penetrative sex more difficult, and surgery can increase risks for urinary tract infections. Most of the time, infant intersex surgeries are unnecessary and deny intersex people of an opportunity to explore their identities. Intersex activists consider these surgeries immoral and a form of mutilation. (What Is Intersex?)
The Sex Spectrum Proposal
As contrary to binary sex classification, intersex people provide evidence against the binary sex system and for the sex spectrum. The sex spectrum indicates that there is an inclusive continuum between and beyond male and female, upon which any individual existing between each end of the spectrum is intersex. Seeing sex on a spectrum is vital to affirming the existence and experiences of intersex people, and to other people too!
Debunking the Binary with Biology
While intersex people were previously considered “deviations from the norm” due to the supposed rarity of DSDs, recent research illuminates that this is likely a gross misconception.
One popular talking point of sex binary proponents is that we see a binary in sex chromosomes, XX denoting females and XY denoting males. We’re taught that these chromosomes correspond to phenotypic features that are categorized as male or female (ie. genitalia), but the relationship is not nearly so simple. Recent studies suggest that the presence of XX chromosomes and female phenotypic features are not consequential, but just highly correlated. As you’ve been taught in every stats class ever, correlation does not indicate causation. In other words, XX chromosomes may help predict physical features, but do not code for such. For example, it was found that out of the genes that code for prostates, 6.9 percent are located on the X chromosome, but only 2.7 percent of ovary and mammary tissue genes were located on the X chromosome. This is surprising because we are taught that the X chromosome is ‘female’ — yet it contains more genes that result in what is considered ‘male’ features than ‘female’ ones. While the difference is not statistically significant, it goes to show that the relationship between our chromosomes and our physical features is not so binary, nor so simple. Furthermore, variations in sex chromosomes such as XXY, XYY, and XXX exist. Their existence itself is challenges the sex binary because they present alternatives where by definition, there should only be two options. (Lercher)
Another biological misconception used to justify the binary that is often misused is hormones. There are no “male” and “female” hormones, plain and simple. All bodies produce estrogens and androgens, which are secreted not only by reproductive organs, but adrenal glands and fatty tissue. At least one of these is possessed by everyone. We’re taught that males have much more testosterone than females, yet research shows that distributions of testosterone levels between males and females show much more overlap than generally understood. We’re also taught that most females being able to give birth while males are not signals a hormonal binary for these functions to occur. In reality, the difference in estradiol and progesterone levels in pregnant women differs greatly from non-pregnant women, whose levels are much closer to those of men. Additionally, research suggests that certain hormones are also affected by social modulation. Progesterone, for instance, is increased by social closeness. All of this demonstrates that hormones are not an accurate predictor of assigned sex due to similarities between males and females as well as their fluctuation throughout life. Rather, the lack of dimorphism in hormones is a mark against the binary. (Hyde, et al)
Ultimately, the sex binary isn’t proven by biology; in fact, biology deconstructs the binary itself and questions whether the sex binary accurately reflects the true nature of human sex, or is simply a convenient generalization.
Detangling Sex as Socially Constructed
We sometimes joke that everything is socially constructed, but this isn’t far from the truth and sex is no exception. As argued by philosopher and gender theorist Judith Butler, the idea that sex is inherently biological suggests that there are certain physical attributes that are sexed, categorized into the binary centuries ago. Butler argues that there is nothing ‘male’ about a body defined as male. We created this label by attributing physical features like the penis to ‘males’. But in doing so, we also created a circular definition in which to have a penis means to be male and to be male means to have a penis. Similarly, to be ‘female’ is to have a vagina and breasts with the ability to produce large quantities of milk, and to possess these features is to be ‘female’. This circular logic is easily disrupted when considering a person with both breasts and a penis. How do we categorize such people into the binary? Currently, there are no advanced rules, and this determination falls solely upon medical professionals (and apparently twenty-seven-year-old transphobes on YouTube, Twitter, and the GenderCritical reddit). This can be a challenging and subjective task, so it’s unsurprising that there are discrepancies between doctors in categorizing intersex individuals into the binary at birth. According to Butler, this shows that sex is socially constructed. When paired with the fact that there isn’t much evidence for the sex binary existing in nature, we have to consider that the concept could be an inaccurate portrayal of real life. It’s just good science to rethink our paradigms, especially when it could help us be more inclusive. (Beauvoir)
How to Advocate for the Sex Spectrum
Advocating for the sex spectrum can be as simple as educating oneself from a wide array of sources and having conversations about it with others. Normalize the existence of the sex spectrum and intersex individuals through the language used when discussing sex. Start dismantling the idea that a person’s sex must correlate to their gender or gender expression or that it must fit into the binary. Little steps like these can go a long way to be inclusive of intersex people.
Sources
Beauvoir, Simone de. The Second Sex. New York: Vintage Books 1989, c1952. Print.
“Explaining Disorders of Sex Development & Intersexuality.” HealthyChildren.org,
aining-Disorders-of-Sex-Development-Intersexuality.aspx.
Hyde, Janet Shibley, et al. “The Future of Sex and Gender in Psychology: Five Challenges to the Gender Binary.” American Psychologist, vol. 74, no. 2, 2019, pp. 171–193.,
doi:10.1037/amp0000307.
Lercher, M. J. “Evidence That the Human X Chromosome Is Enriched for Male-Specific but Not Female-Specific Genes.” Molecular Biology and Evolution, vol. 20, no. 7, 2003, pp.
1113–1116., doi:10.1093/molbev/msg131.
“What Is Intersex? Frequently Asked Questions.” InterACT, InterACT, 4 Aug. 2020,
interactadvocates.org/faq/#definition.