They defy clean distinction but remain worth distinguishing
In Australia, when you turn 50, you get a card and a present from the government. Well, the card is actually a letter informing you that you’ve entered a higher risk category for bowel cancers, and the present is a do-it-yourself kit for gathering a couple of small samples and sending them in for testing. The whole process, from simple instructions to custom-designed sample tubes, is really quite impressive. Only one step in the process confused me.
Question 4 on the ‘Participant Details’ form asked me, “What gender do you identify as?” The options were Male, Female, and Other. I’m a scientist who studies sex differences and the complexities of gender, and I wasn’t surprised to see a question about gender. I was, however, confused because the categories of male and female are usually reserved for sex. Questions about the genders people identify as usually provide options like ‘Woman’ and ‘Man,’ or more variegated options we will get to later.
I’m sure most participants find it as easy to answer question 4. Most men tick ‘male,’ and most women tick ‘female’ without a second thought. But innocuous as question 4 might seem, it belies a tangled mess around questions of gender and sex. That tangle can lead to conflict, misery, and, possibly, worse outcomes for cancer screening patients.
Sex
Put simply, sex refers to biological status as male or female. In species where individuals produce one of two different kinds of reproductive cells, those that make big cells (called eggs) are considered female, and those that produce small cells that move about looking for eggs (sperm) are the males. This straightforward convention proves easy for biologists looking at other species to follow.
In humans and other mammals, egg-producers have two copies of the X chromosome, and sperm-producers have an X and a Y. More specifically, they have a gene on the Y called Sry, which stands for ‘sex-determining region on the Y chromosome.’ With a working copy of Sry, an embryo develops as a male; without it, the embryo becomes female.
All of this packs most humans into one of two boxes: female or male. We tick those boxes when we fill out forms that ask our sex.
Except when we don’t. Male or female development involves far more genes than Sry. A fascinating variety of genetic variants contribute to the fact that as many as 1 in 100 people have what scientists call a difference or disorder of sex development (DSD). So-called intersex conditions form part of the spectrum of DSDs. Often they defy attempts to categorize individuals into unambiguous biological sexes.
….. continue reading the unpaywalled version on Medium
