Gender and sex beyond X & Y. [Credit: Niko McCarty | CC BY-NC-ND 2.0]
Welcome to Beyond X & Y! This blog will explore all things gender and sex, and there’s a ton of ground to cover. Just a few of the topics I aim to explore include the latest studies on sexual and reproductive health, psychology and gender, sex worker health policies and more — including the titillating stuff.
Let’s start with the bread and butter: genes.
Sex and gender are complex, and our understanding of both is constantly evolving. Even a quality as seemingly simple and binary as biological sex is a spectrum rather than an either/or. In fact, sex chromosomes — and how those chromosomes translate into physical features — can vary in quite a few ways.
Here’s what’s regarded as the “norm”:
XY chromosomes = penis & testes = man
XX chromosomes = vagina & ovaries = woman
Gender is subjective to each person, and sex organs don’t dictate gender. People with penises aren’t necessarily men, and people with vaginas aren’t necessarily women. The thing is, XX and XY chromosomes aren’t cut and dry, either. Actually, sex chromosomes and genetic expression vary widely, beyond a penis/vagina or XY/XX binary. XX and XY with the aforementioned expressions are the most common sex chromosomes and corresponding organs, but they’re not the only ones.
Some people have differing sex chromosomes, such as those who are born with an extra X chromosome (XXY) or who are missing an X chromosome (XO). Or, some people with XX or XY chromosomes might have physical characteristics that don’t seem to align with what’s typically expected of their DNA. All of this is to say that many bodies that exist outside of the assumptions that come with XX and XY sex chromosomes.
One word that often describes these bodies is “intersex.” Intersex is an umbrella term that describes any person whose sex characteristics do not neatly fit into binary categories. Intersex people might have sex organs that include both XX and XY sex characteristics. Babies born intersex are often subjected to superfluous surgery in infancy in order to make their genitals appear either male or female.
Being intersex itself is a spectrum. It’s not always clear-cut when someone is intersex. What’s considered an abnormal size for genitalia? What about when someone has sex organs that align with one binary, but secondary sex traits that do not? Like gender and sexuality, genetic expression varies, too. There is not just one way to be intersex. Here are just a few examples of intersex variations:
Klinefelter Syndrome (XXY chromosome)
A person with this condition has an extra X chromosome, and is usually socialized as male, meaning the doctor will say, “It’s a boy!” at the delivery, and the baby henceforth will be treated like a boy. Affecting about 1 in 650 newborn boys, this is one of the most common sex chromosome variations.
Turner Syndrome (XO chromosome)
While a functioning pair of X chromosomes is common, some people only have one functioning X. They are usually socialized as females (“It’s a girl!”), and have underdeveloped female sex characteristics.
Swyer Syndrome (XY gonadal dysgenesis)
A person with Swyer Syndrome doesn’t have functional sex glands, and typically appears female. The glands they do have are known as gonadal streaks — slightly developed gonad tissue. Those with Swyer Syndrome will not develop secondary sex characteristics (e.g., breasts, Adam’s apple) without hormone replacement because gonadal streaks cannot produce sex hormones characteristic of puberty.
Congenital Adrenal Hyperplasia (CAH)
CAH is the most common cause of intersex traits in those with XX chromosomes. It does not cause intersex traits in those with XY chromosomes. CAH results in an imbalanced production of hormones from adrenal glands, which are hormone-producing glands above the kidneys. The glands create an unusually high amount of virilizing hormones that can result in physical characteristics such as a deep voice, dense body hair and prominent musculature.
These sex glands include both ovarian and testicular tissue. One with this condition can be born with any combination of ovaries and ovotestes. The genitals of a person with ovotestes may appear more typically male, female or somewhere in between.
Some might argue that the fact these physical traits are called “syndromes” or “conditions” means there’s something wrong with the individuals; they have an illness or irregularity. Just because someone is different doesn’t mean there’s something wrong with them. Equating the two results in the stigma that often comes with being intersex.
Others might argue that intersex people might be sterile, which definitely indicates that something’s wrong or “not natural.” Equating fertility and humanity harms everyone, not just intersex people — plenty of cis men and women are sterile, but each one is no less of a person. Reducing a person to their reproductive organs, and even to their genes, and only rendering two viable options fails to recognize a swath of the population, harming our concept of human sexuality, and — sometimes literally — the people it tries to erase.