Contemporary understandings of sex and gender have changed considerably in recent decades. From the 1960s, feminist theorists problematised meanings of femininity and masculinity and helped distinguish culturally-constructed 'gender' from physical 'sex.’ 'Gender,' now understood as an embodied and socially performed aspect of one's own identity, has enjoyed a total absorption into the domain of the social sciences where it is regularly debated, analysed and taught. 'Sex,' on the other hand, remains deeply guarded from further scrutiny because of the perceived neutrality and authority of 'naturally occurring' biological categories.
A handful of researchers have taken up the task of critically analysing 'sex' as a cultural-biological construct and drawing it out from its biological fortress. For example, Anne Fausto-Sterling has written extensively on the implications a strictly male/female binary sex system has for people who identify as neither male nor female (1993, 2000, 2003). Fausto-Sterling argues that the two-sex, or dimorphic system of sex classification found in many medicalised societies does not accurately account for the full range of human sexual variation and she proposes the recognition of five sexes instead of two. Other notable mentions include Prof. Dr. Anelis Kaiser, who asks the question, “Where does ‘sex’ end and ‘gender’ begin in the brain?” The answer? It’s ambiguous. "It’s impossible to accurately conceptualise ‘sex’ and ‘gender’ either into a solely biological or a solely social component," says Kaiser (2012, p. 130). Following on from debate in the 1990s, which led to the deconstruction of the sex-gender dichotomy in gender studies, Kaiser (2012, p. 134) argues from a neuropsychological perspective that sex and gender should be seen as an inseparable unity and referred to using the double term 'sex/gender’ to express the impossibility of separating one term from the other. Also on brains, Daphna Joel (2011) has demonstrated the multi-morphic nature of human brains. What we observe neuro-biologically is a permanently changing, diverse mosaic of 'sex' and 'gender' characteristics on a continuum. This revelation of the multi-morphic nature of human brains dispels the common misconception that there is such a thing as a 'female brain' and a 'male brain.' Similarly, feminist theorist Judith Lorber (1993) argues that, “bodies differ in ways physiologically, but they are completely transformed by social practices to fit into the salient categories of a society, the most pervasive of which are 'female' and 'male'.”
'Sex' or biology does not exist in a vacuum. In their study on hormones, van Anders and Dunn (2009) argue that biological data can reflect innate as well as culturally-related influences (Kaiser, 2012, p. 134). Biology, or rather, knowledge about biology, is always informed by broader cultural understandings and researchers investigating 'sex' always have knowledge about 'gender' leaving traces on what is supposed to be a genderless and neutral biology (Kaiser, 2012, p. 131). If biology is neutral, its sex categories must account for the full range of human sexuality. This is not the case for societies dominated by a two-sex, or dimorphic, system of categorisation. For a small number of people, the binaries of 'male' and 'female' do not accurately reflect the physiological or chromosomal make up of their bodies. For ‘intersex’ people, their identity often comes to symbolise a disjunction between the 'neutral' sex categories found in most medicalised societies, and the reality of their own biology.
The Intersex Society of North America defines 'intersex' as, "a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male." An accurate accounting of the frequency of intersex births has been difficult to establish. A number of exceptions to the two-sex system remain undetectable without specialised testing or until the person hits puberty, and given the internal or chromosomal nature of some sex variations it's not entirely implausible that many people go through life never knowing that they could be considered 'intersex.' Despite these difficulties, Hull et. al. calculated that 0.3% of all births can be classified as ‘intersex’ (Fausto-Sterling, 2003). This figure accounts for all chromosomal, anatomical and hormonal exceptions to the dimorphic system of classification present in many medicalised societies.
The incidence of intersex births also varies significantly around the world. Some populations possess the relevant genes for intersex births at higher frequencies than others. Take the CAH gene (Congenital Adrenal Hyperplasia) for example. When inherited from both parents, the CAH gene leads to a child with male genitalia, two X chromosomes (as in a female) and the internal reproductive organs of a potentially fertile female. In New Zealand the CAH gene occurs in 43:1,000,000 births, while among the Yupik Eskimo of south-western Alaska, its frequency is 3,500:1,000,000 (Fausto-Sterling, 2000, p. 20). Conversely, other populations have lower frequencies of non-dimorphism. Research suggests that Chinese, Japanese and African populations are at lower risk for classic CAH compared to other populations (Hull, 2003, p. 114).
Regardless of the exact frequency of intersex births, the existence of people for whom the dimorphic system of 'male' and 'female' sexes does not apply reveals the culturally-constructed basis of biological sexual categories. This inability of our biological sexual categories to account for actual biological diversity challenges the assumption that biology is completely neutral and its categories 'naturally-occurring.'
Attitudes towards 'intersex' vary across cultures. In 1934, Anthropologist Ruth Benedict wrote an essay for the Journal of General Psychology titled, 'Anthropology and the Abnormal.' In it she made a strong case for ethical relativism by showing that human beings tend to refer to their 'habits-compressed-over-time' by using a simpler and more convenient term, 'morality' (Benedict, 1934, p. 4). Benedict argued that no one society could possibly utilise in its practices or beliefs the whole potential range of human behaviour, and that categories of 'normal' and 'abnormal' are culturally defined against each particular subset of the full range of human behaviour a culture just so happens to utilise. Benedict noted that the most spectacular illustrations of the extent to which normality may be culturally defined come from those examples from other cultures where an abnormality in ours constitutes a normal part of life for their society (1934, p. 1). An example of this, which relates to differing attitudes to 'intersex,' is that of the Navaho of North America.
While medicalised societies have typically approached 'intersex' as a problem that needs fixing through ongoing psychological therapy or surgery, the Navaho of North America provide for increased variation in human biology through the category of 'nadle.' Nadle are hermaphrodites, people with ambiguous genitalia and other 'intersex' people (Hill, 1935, p. 273). Nadle play an important part in Navaho emergence mythology. In the mythology, a quarrel between male and female ensued and when differences were deemed irreconcilable, the nadle sided with men. Because nadle can perform both male and female functions and duties, due to their unique bodies, their siding with men explains why male can overcome female (Hill, 1935, p. 274). Consequently nadle have a defined place in Navaho culture through Navaho emergence mythology. Nadle are looked upon favourably by all people in Navaho society, with a great respect that at times verges on reverence. For a nadle to be born into a family is a great cause for celebration and the future wealth and success of the family is almost guaranteed. Nadle children are shown favouritism not afforded to other children in the family. The very existence of the Navaho is contingent upon the nadle, with one of Hill’s informants saying, “They know everything. They can do both the work of a man and a woman. I think when all the nadle are gone, that it will be the end of the Navaho” (Hill, 1935, p. 274).
Contrast this to the sombre air of the typically Western hospital meeting room where the doctor relays to expectant parents the difficult news that their baby will be born with both testicular and ovarian tissue, or ambiguous genitalia. The lack of a social space in which the 'intersex' child can exist leads to a very different conversation between medical professionals and families, than would unfold between Navaho family and friends. As the Navaho have shown, acceptance, and indeed reverence for the same people many medicalised societies perceive as a kind of social emergency depends on the structures present in a society, and their ability to provide a social space in which intersex people can be accepted. Culture is dynamic and constantly changing. By purposefully muddying the waters, we can begin to understand the changing nature, content and complexity of what a society deems 'normal' and 'abnormal.'
Closer to home, Redfern, Sydney resident Norrie has recently been involved in a high profile case to do with sex/gender identity. New South Wales Registrar of Births, Deaths and Marriages v Norrie highlighted the disjuncture between non-dimorphic sexes and state institutions that deal with people of all sexes on a daily basis. Norrie was born in Scotland with male reproductive organs and underwent a “sex affirmation procedure” in 1989. Interestingly, the term ‘sex affirmation procedure’ implies a process of seeking to become 'male' or 'female;' the two culturally accepted sexes in most medicalised societies. Norrie considered that the surgery did not resolve any sexual ambiguity. 'Ambiguity,' in this sense, is defined in relation to the cultural categories of 'normal' and 'abnormal,' or 'acceptable' and 'unacceptable' sexes.
Because Norrie identified as neither male or female, hen applied in 2009 for hen sex to be registered as “non-specific.” NSW BDM approved Norrie’s application but later revoked the decision and reissued Norrie’s Birth Certificate recording Norrie’s sex as ‘not stated.’ Norrie appealed and the case eventually went to the High Court. Norrie argued that a sex affirmation procedure, which is required under s32DC of the Births, Deaths and Marriages Registration Act 1995 ("the Act") for a change in sex to be recorded, was carried out, but Norrie’s sex remained ambiguous so that to classify Norrie as male or female would be to record misinformation in the Registrar. The court found that there is nothing in the Act that suggests that the Registrar is entitled, or duty-bound, to register the classification of a person’s sex inaccurately as male or female, when they identify as neither.
While the case was indeed ground-breaking and set precedent for people in similar situations in the future, Norrie’s application, "did not give rise to an occasion to consider whether the Act comtemplates the existence of specific categories of sex other than male and female, such as ‘intersex’, ‘transgender’ or ‘androgynous.’" The court deemed that it was unnecessary to do so, "given that the Act recognises that a person’s sex may be neither male nor female." A healthy step in the right direction, nonetheless.
Ruth Benedict once said, "The role of anthropology is to make the world safe for human differences." We should continue to work towards opening up understandings of people who are not us. By muddying the waters of our own culture and reflecting on the ways others approach things we consider 'abnormal,' we can help make the world a safer place for human differences. And not just cultural differences, but biological differences too.
Benedict, R. 1934. Anthropology and the Abnormal (abridged essay). 1-4.
Fausto-Sterling, A. 1993. The Five Sexes. The Sciences, 33, 20-25.
Fausto-Sterling, A. 2000. The five sexes, revisited - The emerging recognition that people come in bewildering sexual varieties is testing medical values and social norms. Sciences-New York, 40, 18-23.
Fausto-Sterling, A. 2003. How sexually dimorphic are we? Review and synthesis - Response. American Journal of Human Biology, 15, 115-116.
Hill, W. W. 1935. The Status of the Hermaphrodite and Transvestite in Navaho Culture. American Anthropologist, 37, 273-279.
Hull, C. 2003. Letter to the Editor: How Sexually Dimorphic Are We? Review and Synthesis. American Journal of Human Biology 15 p112-116
Joel, D. 2011. Male or Female? Brains are Intersex. Frontiers in integrative neuroscience, 5.
Kaiser, A. 2012. Re-Conceptualizing "Sex" and "Gender" in the Human Brain. Zeitschrift Fur Psychologie-Journal of Psychology, 220, 130-136.
Lorber, J. 1993. "Believing is Seeing: Biology as Ideology."
van Anders, S., & Dunn, E. 2009. Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men? Hormones and Behavior, 56, 206–213.
Norrie's case: http://www.austlii.edu.au/au/cases/cth/HCA/2014/11.html
Norrie's facebook blog: https://www.facebook.com/faggyfaghag
Thanks to Norrie for the photo, and Avril for feedback and proof-reading.