Our Sex Starts in the Womb, Our Gender As We Toddle On

Richard Feynman remarked “for Nature cannot be fooled,” hearkening back to Isaac Newton—a reminder that Nature’s laws are indifferent to what humans think or wish those laws might be.

The same goes for biology, which we ignore at our peril.

Sex genes appeared some 180 million years ago in mammals. Not only do they make natural reproduction possible, but they also cause variation in dimorphism—in other words, variation in characteristics other than genitalia, such as weight, height, body mass, and pitch of voice. Notably, the sex of an individual appears in the womb; after birth, the specifics of individual development and gender formation are affected by cultural factors—from the clothes we wear and their color, to the ways in which we are instructed to interact with each other, to the dolls and trucks we are given to play with, and so on.

Today, the subject of gender, more so than sex, has become an integral part of ethnic studies courses. That may be curious to many—how does one’s gender find its way into a study of race and ethnicity? The connection is easy to see when we keep in mind Kimberlé Crenshaw’s concept of intersectionality, which she developed in 1989. That framework considers how marginalized groups are oppressed and discriminated against, understood through the “intersection” of an individual’s various identities, including race, gender, sexual orientation, class, physical ability, and the like.

Today’s teaching of gender and sexual orientation minimally touches on, if at all, sex and sexual dimorphism. However, from an anthropological perspective, these belong together. Consider Ernestine Friedl’s time-honored definition: “The biological nature of men and women [should be seen] not as a narrow enclosure limiting the human organism, but rather as a broad base upon which a variety of structures can be built.”

This cross-cultural comparative view works well when examining cultural variation. What is normative in other cultures contrasts with our own cultural understandings. The Etoro in New Guinea practiced ritualized homosexuality, seeing women in more threatening terms; traditional (primarily pre-colonial) Azande in North Central Africa had a flexible marriage pattern (young boy marries older warrior, who then becomes a warrior and marries a younger boy, and then later takes on a woman as a wife).

In contemporary America, we continue to negotiate the boundaries of what and when gender is normative. In 2016, for example, the New York City Commission on Human Rights issued a list of 31 genders that included “gender bender,” “third sex,’ and “drag-king.” Facebook listed 56 gender options in 2014, and now there are more.

One thing is clear: “gender” can be kaleidoscopic, and part of a spectrum.

Scientific American undertook a visualization of sex and gender. The intricacies of both were seen as spectra. However, the author, Amanda Montañez, reveals a moral overlay to the science of sex: “I am hopeful that raising public awareness of intersex, along with transgender and non-binary identities, will help align policies more closely with scientific reality, and by extension, social justice.”

Here we have a significant problem. Academic disciplines and scientific analysis have been reluctant to lump sex into a spectrum, even if contemporary progressive morality demands it. The binary distinction of male and female is the rule, with a small percent of variation.

Anne Fausto-Sterling argues for a more nuanced view of sex in Sexing the Body (2000), especially with regards to intersex individuals. Nevertheless, she acknowledges that “Our data on humans show that anatomically and physiologically, humans are almost dimorphic with regard to genitalia and chromosomes but that when one considers intersex conditions, there are infrequent intermediate states. Strictly speaking, these are still discrete, not continuous.”

Clearly, the debate over sex is not the debate over gender; the former is about the universality of the human body and is nearly discrete, while the latter takes on many forms across and within cultures.

Just how important are the genetic determinants of male and female? 98%, perhaps more, are either male (XY) or female (XX), while less than 2% represent intersex variants. Intersex does not represent a spectrum, but rather discrete differences. School curricula generally omit this predominant genetic component of sex-gender, leaving one to think that it is minimally important. A spectrum of differences does come into play, however, when considering skills, behaviors, and secondary characteristics such as the pitch of voice.

There have been a flurry of articles and school curricula that have mischaracterized this biological reality, stating that sex is not binary.

However, if one accepts modern biological science, these ideas are questionable. See, for example, Colin M. Wright and Emma N. Hilton’s 2020 article in the Wall Street Journal:

In humans, reproductive anatomy is unambiguously male or female at birth more than 99.98% of the time. The evolutionary function of these two anatomies is to aid in reproduction via the fusion of sperm and ova. No third type of sex cell exists in humans, and therefore there is no sex “spectrum” or additional sexes beyond male and female. Sex is binary.

There is a difference, however, between the statements that there are only two sexes (true) and that everyone can be neatly categorized as either male or female (false). The existence of only two sexes does not mean sex is never ambiguous. But intersex individuals are extremely rare, and they are neither a third sex nor proof that sex is a “spectrum” or a “social construct.” Not everyone needs to be discretely assignable to one or the other sex in order for biological sex to be functionally binary. To assume otherwise—to confuse secondary sexual traits with biological sex itself—is a category error.

So, sex comes first, then gender follows. And yes, there is individual and cultural interaction—a continuous feedback between what we are born with and what we become by participating in society.

Let’s take an example with which we are likely not familiar in order create some distance between our personal biases and an evidentiary framework.

First, the Bugis ethnic group of Indonesia, numbering about 3 million, retain their pre-Islamic beliefs about sex-gender identity. There are five such identities: makkunrai, oroané, bissu, calabai, and calalai. The foundation of each gender refers to one’s sex: male, female, or intersex. Variation is reflected in one’s gender choice of male (oroané) and female (makkunrai) at the ends of the sex-gender spectrum; the central intersex identity (bissu) is often occupied by a valued cultural role of shaman or priest. Along this spectrum are anatomical females who take on expectations of males (calalai) or anatomical males who take on female expectations (calabai). Keep in mind that these gender identities are in relation to male and female.

It is worth repeating that gender is not a free-floating concept, but one that references biology as well—at times minimally, at other times in far more significant ways. Each part of the LGBTQI acronym for lesbian, gay, bisexual, transgender, queer, and intersex references gender and sexual orientation identities on a foundation of biological sex. Sex is discrete, not a spectrum. Set this central fact aside, and all the aforementioned identities become unmoored.

One highly publicized example that compels us to understand the difference between sex and gender centers on whether one’s personal gender belief overrides a physical sex difference. This is especially pertinent in light of Title IX, which was enacted to protect against sex discrimination specifically.

So, how do we protect both the biological female and the transgender male? Must one suffer at the expense of the other? Or is it simply a matter of creating more alternatives, fostering more awareness and tolerance going in both directions?

One female high school athlete explains her frustration when her hard work and determination in running events is upended by biological boys who compete as transgender:

Maybe worst of all: When girls try to object—when we point out the truth that biological differences in strength and speed between boys and girls are massive and real—we’re called bigots. Administrators, teachers, coaches, and other students tell us to just keep quiet and take it. We’re told a girl’s place is to be seen and not heard. (Selina Soule)

Even with a statistical spectrum of physical differences between males and females—in weight, height, physical agility, and so forth—we all know that from high school sports to the Olympics, males dominate in speed, weight, and strength.

Meanwhile, Allyson Felix, winner of numerous awards for being the fastest woman, is outshined by high school boys. Felix held the 400-meter time of 49.26 seconds, but more than 300 high school boys in the U.S. ran faster; across the globe, 15,000 men and boys beat that record. This is not an exception. If one looks at female records in the various running events, the long jump, and the pole vault, numerous boys under 18 beat those records. This is a matter of genetics that evidences the dimorphic advantage that males have over females. Other species, of course, yield different results.

With this in mind, why would one accept a physically identifiable “boy,” with his attendant athletic advantages, to run in female events? Some argue that the “boy” identifies as a “female,” and so he should be allowed to run. Case closed. But, as we recall, “Nature cannot be fooled.”

Protecting female sports, whether in terms of the legal framework of Title IX or of biological reality, does not take away from anyone’s identity. Transgender boys who identify as females are entitled to their identity, but their choice should not override biological norms and existing law. The law can be changed, but Nature cannot be fooled.

The sex-gender debate merits further consideration when it comes to the maturation of children through high school. There is no argument that young boys and girls may take on the idea of being or playing the opposite gender. Some will maintain that other gender into adulthood, but reportedly, the large majority return to that which corresponds to their biological sex.

The sense of being “born in the wrong body” is referred to as “gender dysphoria.” Some aim to align their “true gender” with their misaligned sex at birth through “sex reassignment surgery” or “gender affirming surgery.” That path requires hormones and major operations.

In a 2018 New York Times article, Andrea Long Chu describes his transformation into a female:

Next Thursday, I will get a vagina. The procedure will last around six hours, and I will be in recovery for at least three months. Until the day I die, my body will regard the vagina as a wound; as a result, it will require regular, painful attention to maintain. This is what I want, but there is no guarantee it will make me happier. In fact, I don’t expect it to. That shouldn’t disqualify me from getting it. …

I still want this, all of it. I want the tears; I want the pain. Transition doesn’t have to make me happy for me to want it.

Chu was 26 when he underwent his transformation. As adults, we are allowed, even entitled, to make those choices. Surgeries to complete a male-to-female transition include: Orchidectomy (removing the testicles to reduce testosterone production); clitoroplasty (the construction of a clitoris); labiaplasty (creating a labia taking skin from the scrotum); prostatectomy (removing the prostate); urethroplasty (reconstructing the urethra); penectomy (removing the penis); vaginoplasty (creating a vaginal canal from penile tissue or a colon graft); Adam’s Apple reduction; voice surgery (to change the pitch of the voice); facial feminization; and corrective surgeries (such as vulvar reconstruction and genital scar revision).

That said, becoming a woman is not just a matter of external transformation. Chu is missing other elements that separate him from becoming a true biological female, such as the reproductive organs and the ovarian artery, not to mention female-specific medical issues: endometriosis, polycystic ovary disease (PCOS), and diabetes and high blood pressure that develops during pregnancy. Medical treatment pays attention to anatomy.

When we speak of those under eighteen, when we think of school curriculum, counselors, and clergy that preach the acceptability of sex reassignment surgery before adulthood, we should consider the consequences of a body that is still developing biologically.

According to the American College of Pediatricians, dangers from hormone treatment include osteoporosis and increased risk of blood clots, cancers, stroke, and heart attacks, not to mention mood disorders, depression, seizures, cognitive impairment, and sterility when using cross-sex hormones. Girls who “transition” take anabolic steroids in high doses. They receive double mastectomies at age 13 and hysterectomies at age 16. Boys get castration and penectomies at age 16 to 17. The result in both cases is sterilization.

As an alternative, and forgoing surgical alignment, Native American and other cultures offer positive roles for those who have both male and female sensibilities. Native Americans reimagined in the 1990s the negative French word (berdache) with the word “two-spirit.” Thinking back to the 19^th century, we find the Zuni two-spirit (Ihamana) We’wha, who represented what we might call a third gender (not a third sex). We’wha was respected within the community, was known also as an artist, weaver, and potter, and even traveled to Washington, D.C. to speak to Congress and meet with President Grover Cleveland. Not everyone, of course, can be We’wha, but we can reflect on the image and positive persona that our culture offers to our own two-spirits.

We have only opened the door to a frank discussion of sex-gender identity and social roles. School curricula and teachers can muffle the discussion of sex—either because they are wedded to a (mistaken) non-binary framework or because they claim they are not teaching biology. A school district does well when it follows the legal notion of a shield, of a defense, against bullying and negative stereotyping. However, when a school district decides to follow the legal notion of a sword, of being a social justice warrior, questions abound about ethical practices, mischaracterizations of sex-gender biology, and advocating for drastic surgical changes for minors.

What do we want for our children? What do our children know about trying to “fool Nature”? And who makes the decision?

Image: Paul Hanaoka, Public Domain