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Boy, Girl ... or Other?

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In terms of sex and gender identity, we are one multifaceted world.

Caster Semenya
Click here for an important update to this story.

Dr. Wendy Walsh: It's the first three words that bring enormous excitement to any parent. Whether it's read on an ultrasound, after an amniocentesis or CVS, or in the delivery room, hearing the sex of your child heralds an expectation of your parenting future. But what if the announcement is "other"?

Lately there has been much in the news about gender, particularly as it pertains to the world 800-meter women's champion, South African runner Caster Semenya. The female track star with the masculine physique is currently undergoing gender tests, while her parents and some members of the South African media insist she's a woman. Caster Semenya's finish time was more than two seconds ahead of the second-place finisher, so Semenya's gender has become the subject of an international investigation.

Many in the fields of psychiatry, psychology, and endocrinology have long acknowledged that human beings may fall into a third gender category: that is, a catch-all group of people whose gender is not clearly defined based on chromosomes, external genitalia, and gender identity. Human cells contain 22 pairs of matched autosomes and one pair of sex chromosomes. A classic female has two X chromosomes, and a male has an X and a Y.

However, over 70 different variations of the sex chromosomes have been identified, and prenatal hormonal processes can be affected as well. The two most common chromosomal variations are Turner syndrome (1 in 2,000 female births), where a baby is born with normal female genitalia, however their reproductive organs do not develop and they do not grow breasts at puberty. These gals are actually missing one chromosome, but they tend to always self-identify as a woman.

Then there's Klinefelter's syndrome (1 in 500 male births). These guys are born anatomically male, however they have an extra female chromosome that impedes the continued development of their male, ahem, structures. As you can imagine, people with Klinefelter's have a high incidence of gender identity disorder.

Hormones play a role too. In this category, the two most common variations are fetally androgenized females, who are born with ovaries and a womb and, a bonus, an external genitalia that looks more male than female. Or, how about DHT-deficient males who look female before puberty and become masculinized at puberty, with testes that suddenly descend?

The point of this article is not to give you a biology lesson nor speculate on the chromosomal makeup of Caster Semenya. Rather, it is to pose the question of whether it makes continued sense to lump all people into two neatly stacked categories of gender.

Historically, when a newborn was born with ambiguous genitalia, the parents were often asked to make a choice and the child endured a series of painful "cosmetic" procedures. These days, there's a movement, mostly led by fetally androgenized females, to educate parents and discourage them from mutilating their precious bundle of joy until after puberty when gender is more set, and children can have a say in things.

And gender isn't only biological. No matter what our chromosomes and genitalia indicate, gender identity is an individual matter. Some people feel more like a man. Others more like a woman. And some feel somewhere in the middle. It's also important to separate this discussion from sexual orientation -- being gay, straight, or bisexual can happen with any chromosomal combination.

In terms of sex and gender identity, we are one multifaceted world. And that will surely be reflected when I finally see a school form that reads, Sex: Male? Female? or Other?


next: Back-to-School Shopping with Hooligans
104 comments so far | Post a comment now
Kristin September 10, 2009, 2:26 PM

I have been trying to explain this to people to years. It seems to be a very hard concept to grasp from the majority of people though.

For the record, I’m a female. Anatomically and otherwise. I cannot imagine having to deal with this AND deal with the stupidity of others on top of it… I hope the awarness group is successful…

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