{"id":50,"date":"2017-06-05T15:47:04","date_gmt":"2017-06-05T15:47:04","guid":{"rendered":"http:\/\/www.publiconsulting.com\/wordpress\/women\/chapter\/gender-and-sex-transgender-and-intersex\/"},"modified":"2018-04-27T19:19:52","modified_gmt":"2018-04-27T19:19:52","slug":"gender-and-sex-transgender-and-intersex","status":"publish","type":"chapter","link":"https:\/\/www.publiconsulting.com\/wordpress\/women\/chapter\/gender-and-sex-transgender-and-intersex\/","title":{"rendered":"Gender and Sex – Transgender and Intersex"},"content":{"raw":"\n

A binary gender perspective assumes that only men and women exist, obscuring gender diversity and erasing the existence of people who do not identify as men or women. A gendered assumption in our culture is that someone assigned female at birth will identify as a woman and that all women were assigned female at birth. While this is true for cisgender<\/strong> (or \u201ccis\u201d) individuals\u2014people who identify in accordance with their gender assignment\u2014it is not the case for everyone. Some people assigned male at birth identify as women, some people assigned female identify as men, and some people identify as neither women nor men. This illustrates the difference between, gender assignment<\/strong>, which doctors place on infants (and fetuses) based on the appearance of genitalia, and gender identity, <\/strong>which one discerns about oneself. The existence of transgender people<\/strong>, or individuals who do not identify with the gender they were assigned at birth, challenges the very idea of a single sex\/gender identity. For example, trans women, women whose bodies were assigned male and who identify as women, show us that not all women are born with female-assigned bodies. The fact that trans people exist contests the biological determinist argument that biological sex predicts gender identity. Transgender people may or may not have surgeries or hormone therapies to change their physical bodies, but in many cases they experience a change in their social gender identities. Some people who do not identify as men or women may identify as non-binary<\/strong>, gender fluid<\/strong>, or genderqueer, <\/strong>for example. Some may use gender-neutral pronouns, such as ze\/hir or they\/them, rather than the gendered pronouns she\/her or he\/his. As pronouns and gender identities are not visible on the body, trans communities have created procedures for communicating gender pronouns, which consists of verbally asking and stating one\u2019s pronouns (Nordmarken, 2013).<\/p>\n

The existence of sex variations fundamentally challenges the notion of a binary biological sex. Intersex<\/strong> describes variation in sex characteristics, such as chromosomes, gonads, sex hormones, or genitals. The bodies of individuals with sex characteristics variations do not fit typical definitions of what is culturally considered \u201cmale\u201d or \u201cfemale.\u201d \u201cIntersex,\u201d like \u201cfemale\u201d and \u201cmale,\u201d is a socially constructed category that humans have created to label bodies that they view as different from those they would classify as distinctly \u201cfemale\u201d or \u201cmale.\u201d The term basically marks existing biological variation among bodies; bodies are not essentially intersex\u2014we just call them intersex. The term is slightly misleading because it may suggest that people have complete sets of what would be called \u201cmale\u201d and \u201cfemale\u201d reproductive systems, but those kinds of human bodies do not actually exist; \u201cintersex\u201d really just refers to biological variation. The term \u201chermaphrodite\u201d is therefore inappropriate for referring to intersex, and it also is derogatory. There are a number of specific biological sex variations. For example, having one Y and more than one X chromosome is called Kleinfelter Syndrome.<\/p>\n

Does the presence of more than one X mean that the XXY person is female? Does the presence of a Y mean that the XXY person is male? These individuals are neither clearly chromosomally male or female; they are chromosomally intersexed. Some people have genitalia that others consider ambiguous. This is not as uncommon as you might think. The Intersex Society of North America estimated that some 1.5% of people have sex variations\u2014that is 2,000 births a year. So, why is this knowledge not commonly known? Many individuals born with genitalia not easily classified as \u201cmale\u201d or \u201cfemale\u201d are subject to genital surgeries during infancy, childhood, and\/or adulthood which aim to change this visible ambiguity. Surgeons reduce the size of the genitals of female-assigned infants they want to make look more typically \u201cfemale\u201d and less \u201cmasculine\u201d; in infants with genital appendages smaller than 2.5 centimeters they reduce the size and assign them female (Dreger 1998). In each instance, surgeons literally construct and reconstruct individuals\u2019 bodies to fit into the dominant, binary sex\/gender system. While parents and doctors justify this practice as in \u201cthe best interest of the child,\u201d many people experience these surgeries and their social treatment as traumatic, as they are typically performed without patients\u2019 knowledge of their sex variation or consent. Individuals often discover their chromosomal makeup, surgical records, and\/or intersex status in their medical records as adults, after years of physicians hiding this information from them. The surgeries do not necessarily make bodies appear \u201cnatural,\u201d due to scar tissue and at times, disfigurement and\/or medical problems and chronic infection. The surgeries can also result in psychological distress. In addition, many of these surgeries involve sterilization, which can be understood as part of eugenics projects, which aim to eliminate intersex people. Therefore, a great deal of shame, secrecy, and betrayal surround the surgeries. Intersex activists began organizing in North America in the 1990s to stop these nonconsensual surgical practices and to fight for patient-centered intersex health care. Broader international efforts emerged next, and Europe has seen more success than the first wave of mobilizations. In 2008, Christiane V\u00f6lling of Germany was the first person in the world to successfully sue the surgeon who removed her internal reproductive organs without her knowledge or consent (International Commission of Jurists, 2008). In 2015, Malta became the first country to implement a law to make these kinds of surgeries illegal and protect people with sex variations as well as gender variations (Cabral & Eisfeld, 2015). Accord Alliance is the most prominent intersex focused organization in the U.S.; they offer information and recommendations to physicians and families, but they focus primarily on improving standards of care rather than advocating for legal change. Due to the efforts of intersex activists, the practice of performing surgeries on children is becoming less common in favor of waiting and allowing children to make their own decisions about their bodies. However, there is little research on how regularly nonconsensual surgeries are still performed in the U.S., and as Accord Alliance\u2019s standards of care have yet to be fully implemented by a single institution, we can expect that the surgeries are still being performed.<\/p>\n

The concepts of \u201ctransgender\u201d and \u201cintersex\u201d are easy to confuse, but these terms refer to very different identities. To review, transgender people experience a social process of gender change, while intersex people have biological characteristics that do not fit with the dominant sex\/gender system. One term refers to social gender (transgender<\/em>) and one term refers to biological sex (intersex<\/em>). While transgender people challenge our binary (man\/woman) ideas of gender, intersex people challenge our binary (male\/female) ideas of biological sex. Gender theorists, such as Judith Butler and Gayle Rubin, have challenged the very notion that there is an underlying \u201csex\u201d to a person, arguing that sex, too, is socially constructed. This is revealed in different definitions of \u201csex\u201d throughout history in law and medicine\u2014is sex composed of genitalia? Is it just genetic make-up? A combination of the two? Various social institutions, such as courts, have not come to a consistent or conclusive way to define sex, and the term \u201csex\u201d has been differentially defined throughout the history of law in the United States. In this way, we can understand the biological designations of \u201cmale\u201d and \u201cfemale\u201d as social constructions that reinforce the binary construction of men and women.<\/p>\n\n","rendered":"

A binary gender perspective assumes that only men and women exist, obscuring gender diversity and erasing the existence of people who do not identify as men or women. A gendered assumption in our culture is that someone assigned female at birth will identify as a woman and that all women were assigned female at birth. While this is true for cisgender<\/strong> (or \u201ccis\u201d) individuals\u2014people who identify in accordance with their gender assignment\u2014it is not the case for everyone. Some people assigned male at birth identify as women, some people assigned female identify as men, and some people identify as neither women nor men. This illustrates the difference between, gender assignment<\/strong>, which doctors place on infants (and fetuses) based on the appearance of genitalia, and gender identity, <\/strong>which one discerns about oneself. The existence of transgender people<\/strong>, or individuals who do not identify with the gender they were assigned at birth, challenges the very idea of a single sex\/gender identity. For example, trans women, women whose bodies were assigned male and who identify as women, show us that not all women are born with female-assigned bodies. The fact that trans people exist contests the biological determinist argument that biological sex predicts gender identity. Transgender people may or may not have surgeries or hormone therapies to change their physical bodies, but in many cases they experience a change in their social gender identities. Some people who do not identify as men or women may identify as non-binary<\/strong>, gender fluid<\/strong>, or genderqueer, <\/strong>for example. Some may use gender-neutral pronouns, such as ze\/hir or they\/them, rather than the gendered pronouns she\/her or he\/his. As pronouns and gender identities are not visible on the body, trans communities have created procedures for communicating gender pronouns, which consists of verbally asking and stating one\u2019s pronouns (Nordmarken, 2013).<\/p>\n

The existence of sex variations fundamentally challenges the notion of a binary biological sex. Intersex<\/strong> describes variation in sex characteristics, such as chromosomes, gonads, sex hormones, or genitals. The bodies of individuals with sex characteristics variations do not fit typical definitions of what is culturally considered \u201cmale\u201d or \u201cfemale.\u201d \u201cIntersex,\u201d like \u201cfemale\u201d and \u201cmale,\u201d is a socially constructed category that humans have created to label bodies that they view as different from those they would classify as distinctly \u201cfemale\u201d or \u201cmale.\u201d The term basically marks existing biological variation among bodies; bodies are not essentially intersex\u2014we just call them intersex. The term is slightly misleading because it may suggest that people have complete sets of what would be called \u201cmale\u201d and \u201cfemale\u201d reproductive systems, but those kinds of human bodies do not actually exist; \u201cintersex\u201d really just refers to biological variation. The term \u201chermaphrodite\u201d is therefore inappropriate for referring to intersex, and it also is derogatory. There are a number of specific biological sex variations. For example, having one Y and more than one X chromosome is called Kleinfelter Syndrome.<\/p>\n

Does the presence of more than one X mean that the XXY person is female? Does the presence of a Y mean that the XXY person is male? These individuals are neither clearly chromosomally male or female; they are chromosomally intersexed. Some people have genitalia that others consider ambiguous. This is not as uncommon as you might think. The Intersex Society of North America estimated that some 1.5% of people have sex variations\u2014that is 2,000 births a year. So, why is this knowledge not commonly known? Many individuals born with genitalia not easily classified as \u201cmale\u201d or \u201cfemale\u201d are subject to genital surgeries during infancy, childhood, and\/or adulthood which aim to change this visible ambiguity. Surgeons reduce the size of the genitals of female-assigned infants they want to make look more typically \u201cfemale\u201d and less \u201cmasculine\u201d; in infants with genital appendages smaller than 2.5 centimeters they reduce the size and assign them female (Dreger 1998). In each instance, surgeons literally construct and reconstruct individuals\u2019 bodies to fit into the dominant, binary sex\/gender system. While parents and doctors justify this practice as in \u201cthe best interest of the child,\u201d many people experience these surgeries and their social treatment as traumatic, as they are typically performed without patients\u2019 knowledge of their sex variation or consent. Individuals often discover their chromosomal makeup, surgical records, and\/or intersex status in their medical records as adults, after years of physicians hiding this information from them. The surgeries do not necessarily make bodies appear \u201cnatural,\u201d due to scar tissue and at times, disfigurement and\/or medical problems and chronic infection. The surgeries can also result in psychological distress. In addition, many of these surgeries involve sterilization, which can be understood as part of eugenics projects, which aim to eliminate intersex people. Therefore, a great deal of shame, secrecy, and betrayal surround the surgeries. Intersex activists began organizing in North America in the 1990s to stop these nonconsensual surgical practices and to fight for patient-centered intersex health care. Broader international efforts emerged next, and Europe has seen more success than the first wave of mobilizations. In 2008, Christiane V\u00f6lling of Germany was the first person in the world to successfully sue the surgeon who removed her internal reproductive organs without her knowledge or consent (International Commission of Jurists, 2008). In 2015, Malta became the first country to implement a law to make these kinds of surgeries illegal and protect people with sex variations as well as gender variations (Cabral & Eisfeld, 2015). Accord Alliance is the most prominent intersex focused organization in the U.S.; they offer information and recommendations to physicians and families, but they focus primarily on improving standards of care rather than advocating for legal change. Due to the efforts of intersex activists, the practice of performing surgeries on children is becoming less common in favor of waiting and allowing children to make their own decisions about their bodies. However, there is little research on how regularly nonconsensual surgeries are still performed in the U.S., and as Accord Alliance\u2019s standards of care have yet to be fully implemented by a single institution, we can expect that the surgeries are still being performed.<\/p>\n

The concepts of \u201ctransgender\u201d and \u201cintersex\u201d are easy to confuse, but these terms refer to very different identities. To review, transgender people experience a social process of gender change, while intersex people have biological characteristics that do not fit with the dominant sex\/gender system. One term refers to social gender (transgender<\/em>) and one term refers to biological sex (intersex<\/em>). While transgender people challenge our binary (man\/woman) ideas of gender, intersex people challenge our binary (male\/female) ideas of biological sex. Gender theorists, such as Judith Butler and Gayle Rubin, have challenged the very notion that there is an underlying \u201csex\u201d to a person, arguing that sex, too, is socially constructed. This is revealed in different definitions of \u201csex\u201d throughout history in law and medicine\u2014is sex composed of genitalia? Is it just genetic make-up? A combination of the two? Various social institutions, such as courts, have not come to a consistent or conclusive way to define sex, and the term \u201csex\u201d has been differentially defined throughout the history of law in the United States. In this way, we can understand the biological designations of \u201cmale\u201d and \u201cfemale\u201d as social constructions that reinforce the binary construction of men and women.<\/p>\n","protected":false},"author":1,"menu_order":1,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-50","chapter","type-chapter","status-publish","hentry"],"part":44,"_links":{"self":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapters\/50","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":1,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapters\/50\/revisions"}],"predecessor-version":[{"id":51,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapters\/50\/revisions\/51"}],"part":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/parts\/44"}],"metadata":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapters\/50\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/wp\/v2\/media?parent=50"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/pressbooks\/v2\/chapter-type?post=50"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/wp\/v2\/contributor?post=50"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/www.publiconsulting.com\/wordpress\/women\/wp-json\/wp\/v2\/license?post=50"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}