Go here for the first and second installments.
As Long As We’re Listening to the Science …
As mentioned, Dr. John Money didn’t get his start with convincing parents to change their child’s sex due to a botched circumcision. Before that, he was a proponent of “correcting” the bodies of intersex infants. And what is intersexuality? Well, strap in, because this will take some explaining.
Most of us learn a fairly basic model of sex development in high school biology. In the womb there is an egg, which always carries an X chromosome; sperm cells can carry either an X or a Y. If an egg is fertilized by a sperm cell with an X, it grows into a girl, while if it gets a Y, a boy develops instead. These chromosomes prompt the development of hormones like estrogen and testosterone, which in turn cause the formation of gonads (ovaries in girls, testes in boys) and genitalia (vaginas and penises); these are called primary sex characteristics. These hormones also cause the development of secondary sex characteristics, like the distribution of body fat, the pitch of the adult voice, facial hair, and so on.
This is a good basic model, and covers a great majority of people, so that we don’t usually need to step outside of it. But in a very small number of people—something like 1% at the outside, making it about as rare as red hair—sexual development isn’t so simple.
Intersex is the scientific term for a person who, biologically, presents a mixture of male and female traits, genes, and even organs. If any one of a person’s chromosomes, gonads, and genitalia don’t match the other two, that’s a form of intersexuality.
Most forms of intersexuality have little to no impact on a person’s daily life; a few do. Infertility is a side effect of some intersex conditions, and is occasionally how people discover that they’re intersex in the first place (by going to get treated while trying to conceive). Others cause ambiguity in the genitals, and may be visible from birth.
One of the most dramatic forms of intersexuality is complete androgen insensitivity syndrome. Androgens are hormones that prompt male development; testosterone is the commonest and most famous. Most people with XY chromosomes respond to androgens, but some are less responsive than others, and in extreme cases, androgens do nothing at all to their bodies. This results in what appears to be fairly normal female development, complete with breasts and a vagina (but no menstruation). Most intersex conditions aren’t this extreme, but this is how far a person’s body can get from their chromosomes, so to speak. “The science” isn’t simple.
One of the odd things about intersexuality is, it used to be fairly familiar. It’s never been common; but as recently as a few generations ago, it was the sort of thing plenty of people had heard of, and had been for hundreds of years. Both historical Catholic canon law and the gender-specific duties enumerated in the Talmud take intersex people into account.
So what changed? Basically, doctors started delivering babies in hospitals instead of midwives doing it at home. And one of the things those doctors began doing—Dr. John Money, for example—was performing surgeries on infants who didn’t neatly fit the male-female binary. (In most cases, as in the Reimer case, this meant turning a child who showed any sexual ambiguity into a girl.) This, in theory, made the children’s lives easier.
It also meant that intersex conditions vanished from the popular consciousness over the last century. What had been a rarity became wholly unknown. Until recently, it was common practice to conceal intersex diagnoses from patients themselves. Which meant that, when transgender and non-binary people gradually began gaining visibility in the last century, to a lot of people, they seemed to be coming out of nowhere …
Wait, Is This All Being Trans Is?
No. Being trans is different from being intersex in some important ways. But there’s an obvious relationship between the two: if the sex of the body can be, biologically, ambiguous, is it really so hard to believe that a person’s gender could be complex in other ways as well? That there is something more going on here than a fad or a mental illness?
I’ll be getting into the metaphysics of gender in my next post. Here, I just want my readers to stop and think about the implications here. Obviously the male-female binary covers most people, and allows us to make practical statements and generalizations. The existence of intersex people does mean they’re generalizations, but that’s true of most useful statements—even in theology—and it’s fine. “All human beings are sinners” is a generalization too. The point is not that the categories of male and female are fake or inherently oppressive or anything like that; the point is that, regardless of why, it’s possible that those categories represent most of the truth but not all of it.