In 1986 Maria José Martínez-Patiño qualified to go to the olympics. She left falling over herself with joy. In order to compete as a woman at the Olympics, you must provide a certificate of femininity. This certificate is issued by a healthcare specialist of your choice previous to competing. Unfortunately, she forgot her certificate of femininity in all the excitement. No problem, the staff said, we’ll just do a chromosome test and you will be on your way.
That day, at 25 years old, Maria found out in front of the rest of her team, that according to the staff of the olympics, she was a man. The chromosome test had come back with XY chromosomes. And thus, she was ineligible to compete.
This was news to her. She had lived her whole life as a woman, she identified as one. Sure, she had never gotten her period, but lots of women don’t, especially athletes.
She was told to fake an injury and just go home. Save herself the embarrassment. Back at home, she continued the tests, and her karyotype was determined to be 46,XY: male.
Years later, she spoke out publicly, and all of a sudden, the world became aware of intersex people.
“Intersex people are born with physical sex characteristics that do not fit the normative definitions for male or female bodies. For some intersex people, these are apparent at birth, while for others they emerge later in life, often at puberty.” “Sex characteristics refer to each person’s physical characteristics relating to sex, including genitalia and other reproductive anatomy, chromosomes and hormones, and secondary physical characteristics emerging from puberty.”
Born Free and Equal - Sexual Orientation, Gender Identity and Sex Characteristics in International Human Rights Law Second Edition United Nations Human Rights Office of the High Commissioner
Maria was born with complete androgen insensitivity. She had been born with XY chromosomes, but doesn’t respond to testosterone due to a variation of the SRY gene, and as such simply never developed as a man would have. She has a vaginal opening and no ovaries. She was able to live her whole life, up until this point, without finding this out. If she hadn’t forgotten her certificate of femininity, she probably never would have.
This incessant need to turn away any intersex people has led to sports teams rejecting and turning away perfectly normal cisgendered women, out of fear of spending too many resources on someone who might end up with too much testosterone, or the “wrong” chromosomes. But isn’t the number of people with sex variations low? They’re hardly recognized by law, even less so in popular media or in the news. When’s the last time you met someone who was intersex?
Funnily enough, when you look up how much of the human population is estimated to be intersex, the number you find constantly is 1.7%. That is approx. 137.700.000 people worldwide.
This number was defined by Anne Fausto Sterling in her paper “The five sexes: revisited” and, double funnily enough, this number only accounts for intersex variations, found at birth.
Not someone like Maria, or a 67 year old father who found out his hernia was a uterus in 2021. Does this mean, that the number that you find fucking everywhere, is wrong? Well, it’s not wrong, it’s just lower than a full estimate for populations of intersex people should be.
There is no accounting for the amount of people who never find out they’re intersex and there is no accounting for the amount of people who develop differently during puberty and just never got counted or spoke out.
It has been made abundantly clear that gender is a social construct. But what if, I were to tell you, that sex is one too.
In this video I’d like to take a look at sex as a social construct and what that means for us.
“Sex refers to a set of biological attributes in humans and animals. It is primarily associated with physical and physiological features including chromosomes, gene expression, hormone levels and function, and reproductive/sexual anatomy.”
https://cihr-irsc.gc.ca/e/48642.html
That does not sound like a social construct you might say. My dick and balls are not a fucking social construct. But let’s pay close attention. When we ask what the sex of a person is we respond Male or Female. Not with a list of chromosomes, gene expression, hormones levels, etc. The Factors referred to in the definition however, are far broader than male and female.
Chromosomes aren’t really male or female. We refer to whether XY or XX is present, even though X, XXY or a fun mix of XY and XX are all possible. We could have, like Maria, XY chromosomes, and still present and develop with an outwardly phenotypically female body. The application of male to the XY chromosome, in this case, is wrong. It is the application of gender to a genotype. And it’s not even the gender she identifies with. During her development, there were additional factors that made the formation as phenotypically male impossible. This can happen to anyone.
So we binarize sex based on a multitude of categories - there’s bound to be variations of sex that don’t fit into the binary - we end up hurting people based on this falling out of the binary. Even people who would have fit into the binary are sometimes hurt by the chance they might not fit into it.
Variations from the binary are clearly problematic. In order to not open us up to this, let’s reduce sex differentiation down to one point. One category. Let’s say, your gametes determine your sex. I’ve seen this idea a lot. There’s only two types of them so this should be easy. However, right off the bat,
“Gametes are not used to “sex” people in any of the 195 countries worldwide. No government or military ID worldwide has ever been issued based on gamete type.”
https://cadehildreth.com/do-gametes-create-a-sex-binary/
Why is that?
“The reproductive organs have two primary components, the gonads (ovaries or testes) and the gametes they produce (eggs or sperm). In aggregate, men do have testes and produce sperm, while women do have ovaries and produce eggs. However, intersex people exist who have both male and female gonadal tissue, sometimes called an ovotestis. Additionally, intersex people can present with ambiguous gonadal tissue ranging from underdeveloped [...] abnormal [...] gonads to streak gonads. Streak gonads are named after their unclear morphological shape. Of course, testicular and ovarian cells can also be present at the same time, creating a gradation of cells that are both female and male. [...] In many of these individuals, no gametes are produced. For example, no gametes are produced in 85% of individuals with streak gonads.”
https://cadehildreth.com/do-gametes-create-a-sex-binary/
So should gametes be used to sex humans: The lack of gametes in a person would create a third sex and therefore not even support a sex binary theory - instead it would suggest a sex trinary. If we take into account people who produce both, we’d need to add a fourth sex. Thus we have a sex Quaternary on our hands. If we make the argument that people who produce neither or both are too rare to take into account, we miss the point of what a binary is.
A binary describes precisely two states and not a spectrum. So not even gametes can be used to create a sex binary, but at that - not even the way we already categorise sex can really be used to create a sex binary.
Okay, so Sex isn’t binary. Fine. What about it being a social construct then?
Let’s look at this via hormones.
The relevant hormones referred to in sexing human bodies are Estrogen and Testosterone. But what scientific factors determine that estrogen is female and testosterone is male? They’re both not really sex hormones, they’re growth hormones. While they are partially responsible for the formation of the human body as phenotypically male or female, they’re also present in the growth and function of other organs, which are not at all related to sexual function or reproduction. They are both present and relevant within a phenotypically male and phenotypically female body, intersex or not. So why, would either be male or female? Wouldn’t the presence of the male sex hormone in a female body be definitionally and normatively wrong? Isn’t it precisely the level of testosterone that can disqualify some cisgender phenotypically female women from sports events?
Sex is determined by a set of attributes, rather than just one. It doesn’t describe any of the attributes of a human separately, but it applies a gender to the whole set of attributes. Each set could be considered a “state of sex” and we have our two states then, but a lot of people don’t fall within those two states. Cisgendered phenotypically female athletes, often women of colour, naturally produce too much testosterone to fit into the “woman” set.
The issue with not being clear-minded about the state of sex as a social construct is that we can take normative features of the traits relevant to sex determination and treat them as being factual determiners for the social state of someone’s sex.
Normative values say that these values of hormones, these organs, these chromosomes are how men and women ought to be - regardless of whether real people actually have all of these traits.
The traits that these norms refer to are secretly also a part of external features. Fat distribution, muscle distribution, bone structure, hair thick or thinness, the places in which you have hair - there’s norms here too. When our bodies don’t fit those norms, we are punished. Either by exclusion, being sent home from sports events for example. It’s social ostracization, sometimes intimate partner violence or workplace discrimination. These things happen because we are normalising only two states that bodies can be in.
These norms are so relevant, we built a damn society around it. Male and female are baked into every social hierarchy. Into every product. Every baby shower and shower gel is gendered to be either male or female. This is the best thing that ever happened to kids' toys. From the moment we encounter society, we don’t encounter people, we encounter men and women. Our languages distinguish clearly between genders - you can hardly refer to someone in most languages without gendering them somehow. We justify all of this, with a binary of biological sex. Of course we immediately categorise people into the two camps we’ve been taught to consider - that’s how culture and upbringing works. It’s not an active decision. But we’ve determined so much socially and hierarchically on the questionable concept of a sex and gender binary.
And now we are living with the consequences.
The truly heinous thing about this is, you don’t even need to be intersex to be normatively othered in terms of gender and sex. You don’t even need to be trans. Your habits alone can make you normatively othered. The way you speak. The things you are interested in. Your clothes. Your hair. Your fucking eyes themselves can be wrong. And every time you adjust yourself to fit in and not be othered - you are upholding the system that made you change in the first place.
We can only understand the world on our own terms. It is easier to just ignore information that doesn’t fit the image we have of the world. It is difficult to understand something outside of our terms. So thinking outside of sex and gender is difficult. We have an image of binary sex, of men and women.
Intersex people are frequently used as the counterargument to binary sex. But that just doesn’t go far enough. Sex itself is the counterargument to binary sex.
We struggle to justify the numbers we apply to intersex populations. I’d argue they should be higher, especially considering the large mosaic of traits we use to determine sex. With so many categories, of course people are going to not fit in. We treat intersex people as the exception to the rule of the phenotypically perfectly sexed individual. Disregarding that you cannot even know who is phenotypically perfectly sexed until everyone’s DNA has been sequenced and they’ve been examined thoroughly. We force people into boxes, justified by our binary sexes, giving sex assignment surgeries to babies, to follow nature’s failed fucking plan. This is all to make sense of the terms of men and women we’ve constructed. Secret Symptoms of being intersex can include being tall or short, hairy or not, weight gain, weight loss. Too much to be listed in a meaningful way. The body is a complex beast, everything is linked somehow. Every hormonal imbalance you can witness somewhere else in your body. And so you get people discovering that all of their issues were caused by unexplainable non-phenotypically accurate hormone levels way too late in life. You can live a whole life not knowing about testicles in your abdomen. You can get tumors in your mystery ovary even though you presented phenotypically male your whole life. In your 40s you find out via mystery scars, that your extra cock was removed at birth. And to top it off: the Records of that operation were destroyed. Intersex people are swept under the rug, assigned some sex casually at birth and expected to live it, or finding out way too late that they’ve always just been different and at the end of the day: It could even be you.
Do you know how violating it is, to have an ultrasound rod shoved inside of you to inspect your uterus? To have someone look at you, more intimately than even your partner could and they walk away from it, knowing more about you than you have ever known. To discover all at once that you are full of cysts producing testosterone? Or to discover an unknown organ? Or to discover you don’t even have a uterus? And after that, you need to deal with the reality of being intersex, of understanding why you were being treated differently, of noticing how subtle and strange subconscious perceptions can be, and how much more violating, painful and complicated further interventions could be or the fact that you are going to have to walk home now and go grocery shopping and do the laundry and make your bed all the while your life has been changed. You’ve always had it. But now you know. And you know, what the world is like to people who are different.
In the bleakest honesty, it is in everyone’s best interest to be educated and demand legal and societal change in the interest of intersex people, because tomorrow or next week or 2 years from now or 50 years from now it could be you having that awkward conversation with your doctor.
It is relevant to call into question the position of biological sex as a fact, rather than a social construction. To quote Anne Fausto Sterling's book, Sexing the Body, which I recommend everyone read:
“What might the phrase ‘social construction’ mean in the material world of bodies with differing genitals and differing behavior patterns? [...] Bodies in the ‘‘normal’’ range are culturally intelligible as males or females, but the rules for living as male or female are strict. No oversized clits or undersized penises allowed. No masculine women or effeminate men need apply. Currently, such bodies are, as Butler writes, ‘‘unthinkable, abject, unlivable.’’ By their very existence they call into question our system of gender. Surgeons, psychologists, and endocrinologists, through their surgical skills,try to make good facsimiles of culturally intelligible bodies. If we choose to eliminate mixed-genital births through prenatal treatments (both those currently available and those that may become available in the future), we are also choosing to go with our current system of cultural intelligibility. If we choose, over a period of time, to let mixed-gender bodies and altered patterns of gender-related behavior become visible, we will have, willy-nilly, chosen to change the rules of cultural intelligibility.”
Sexing the body Anne Fausto Sterling
By performing surgeries on intersex babies, to normalise them, to assign a gender, we enforce the very system, which makes us consider normalisation as a necessity in the first place.
But I think we must also consider that change starts at home, and at school and on dating apps and in the street and at the grocery store.
There’s been research undermining the necessity of gender assignment of intersex babies at birth, as with some intersex people it creates unnecessary dysphoria, leading to further surgeries later in life. When asked whether to assign genders and to perform normalising surgery, many people responded yes, from the perspective of the parents, but no, from the perspective of the child. This shows that at least in part, we are willing to engage with the idea that a differentiation between male or female is not necessary for life.
On the flipside, in 2017, the German government began recognizing intersex people by law. Adding a third option for gender/sex on the passport: Diverse. This category is thus far only for sex (when referring to diverse) as transgender individuals can change their legal gender on the passport to Male or Female. German using sex and gender interchangeably could be why this dichotomy exists. Still, it is estimated that 150 intersex babies are born in Germany every year. In 2019 there were 11 babies registered to be diverse, in 2018 it was 15 and in 2017 it was 17.
While it is estimated that 160.000 people in Germany are intersex, only 300 are registered as diverse.
And sure, why would you. A doctor needs to confirm your status as intersex.
The diverse passport marker is only for intersex people, not nonbinary people, as it only refers to sex. It places a target on the backs of intersex people. Letting the world know. Letting employers know. And police when they check your ID and lots of other possibly uncomfortable situations.
“LGBT people and people with intersex traits are at risk of violence from family members, peers, intimate partners, and strangers as a result of their sexual orientation, gender identity, or intersex status.”
Understanding the health and wellbeing of LGBT populations Consensus Study Report
“Intersex persons are often subjected to discrimination and abuse if it becomes known that they are intersex, or if they are perceived not to conform to sex and gender norms. Anti-discrimination laws do not typically ban discrimination against intersex persons, leaving them vulnerable to discriminatory practices in a range of settings, including access to education, public services and employment. The available data show that intersex people may have high rates of poverty, associated with high rates of early school leaving, stigmatization and discrimination.”
Human Rights Violations Against Intersex People A Background Note United Nations Human Rights
When sex remains unquestioned as a social construct, intersex people remain on the fringes of society, ineligible to compete, unseen and barely heard. They are assigned a sex at birth, lest their bodies be “unthinkable, abject or unlivable”. Their number is too apparently small to be legally relevant, and yet intersex people seem to be coming out of the fucking woodworks.
We are increasingly feeling the problems of building on a weak foundation. The foundation of binary sex and the norms that come with it.
“The 2-bodied system is not a given - [...] people are responsible for it.”
Sexing the Body Anne Fausto Sterling (Footnote quoting an exchange with McKenna and Kessler
If people are responsible for its creation and upkeep, then people can be responsible for its destruction. It is ridiculous to assume that intersex existence is unlivable in itself. It is the society we built that makes it so. The systems in place which determine a sex binary, blue or pink, male or female. It is normative thinking, on what men and women ought to be. What they must look like, act like, function like. Your internal organs are not safe from scrutiny. It is precisely this normative function to a sex and gender binary that makes intersex bodies unlivable.
Metaphorically, we are in plato's cave. The shadows dance on the wall, showing us an imperfect reflection of the real world outside. The cave is everything we know, there is no way for us to disprove the shadows as being inaccurate, until we step outside. So I urge anyone to step outside the fucking cave.
