Showing posts with label intersexuality. Show all posts
Showing posts with label intersexuality. Show all posts

Sunday, April 6, 2025

Banning Biological Reality is Ridiculous!


 What could be more ludicrous than declaring biology to be against the law?

Over the past few months, since Trump was inaugurated again, information has been disappeared by the administration. Datasets have been taken down, historical images removed from archives, websites have been removed or revised, research defunded, and books have been purged from libraries. In just one example, the United States Naval Academy--a college--has removed 381 books from its library thus far, having been so directed by Pete Hegseth, our current Secretary of Defense. Hegseth may be incompetent at actual military leadership, spilling secrets on Signal, but he's great at imposing his ideology that the military should be the preserve of cis straight white men. . .

The books removed include studies on the KKK and lynching, on women in the Holocaust, on trans issues, on 19th century masculinity, on slavery. Maya Angelou's I Know Why the Caged Bird sings was removed. All of these were framed as violating federal executive orders on "DEI" or "gender ideology," and thus figuratively to be burned.

You know what else was removed? Books on intersex statuses. Intersex statuses are inborn, and are found in all animal species-- humans and dogs and songbirds and mice and tropical fish. This is how nature works: sex is way more complicated and interesting than some singsong child's story!

But on his first day in office, Trump signed an executive order written by Project 2025 authors--radical Christian nationalists--titled "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government." The media reporting on this was shallow. (So much media reporting now is shallow, because there's so much chaos going on that nobody can keep up.) The EO was framed as an anti-trans statement, often with some discussion of popular opposition to the participation of trans women in sports. Then the story sank in the flood of developing news.

But that EO continues to have a powerful impact, being the basis of a huge, ongoing wave of purges of books and research projects and federal employees. So you should know what the EO declares to be law under President Trump. The EO states that is that there is no such thing as gender, only biological sex. And biological sex is stated to be a binary of male and female that is set at conception.

Thus, the EO does not just declare that people cannot gender transition, that nonbinary gender identity does not exist, that trans people must be detransitioned on their passports, that schools and prisons and scientific studies etc. etc. must not recognize gender transitions, and all the other transphobic discrimination it requires. It also declares that intersex statuses do not exist.

This is ridiculous and bizarre! You can no more erase the fact that intersex babies are born all the time than you can erase that curly-haired babes are born all the time by making a proclamation. The authors' vision of physical sex--that at the moment of conception, we're all either XX or XY, which will determine which of two gonads we develop, which in turn will determine what our genitals look like, is that singsong child's myth. Some embryos are XXY, some are XXYY, some are XX/XY. Some embryos that are XX develop into fetuses that look typically male, with phallus and testes. Some that are XY develop into fetuses that look typically female, with vulvas. Fetuses of any genotype can develop intermediate ovotestes. Fetuses of any genotype can develop intermediate genital configurations. That's how biology works!

But the EO declares this biology to be intolerable, to be ideology, to violate the Trump-declared reality of the singsong children's myth. And the federal government is taking action to impose this inversion of biology and ideology on the nation--for example, by banning books on intersex from the US. Naval Academy library.

All book bans are evil. But banning books on biology as "denying biological reality" has the cherry on top of being ridiculous.

Sunday, September 12, 2021

The Silly Idea of Your "Real" Binary Sex

 

Today, a lot of people insist that they can tell you what your "real (binary) sex" is. Let's talk about how strange that is.

Intersex is a fact of nature, found throughout the animal kingdom and across all of human history. Today, in Western societies, being assigned a binary sex at birth is a legal requirement--you need an M or F selected on birth certificates in most countries. This is so taken-for-granted that people are often astonished to learn that this is historically and culturally strange--that most world societies have traditionally recognized more than two sexes, allowing them to recognize and provide cultural places for intersex babies, and social roles for gender-variant people. This includes, by the way, Judeo-Christian societies, up until the Middle Ages. Jewish tradition recognizes four birth sexes: female, male, both (androgyne), and neither (tumtum), and early Christians followed this tradition.

But in the Medieval period, Christian authorities decided to abandon the Jewish halachic approach. They decided that the Biblical phrase "male and female created He them" was not a poetic phrase, but a prescriptive one: God demanded binary sex. 

The problem, of course, is that intersex people continued to be born. So you find court cases and church records in which judges and priests tried to decide what to do when there was a conflict over whether an intersex person (or even animal) was living in the "correct" binary sex, or "violating the law of nature" by being a man who menstruated or a rooster who laid eggs. Parties often fought vigorously, because the fact of the matter is that an intersex person or animal cannot be fit into the category "male" or "female" by definition, and what to do about that was a perpetual issue.

Then, in the 19th century, medical doctors seized on this issue and the social fascination with nature belying human ideologies of binary sex. The field of medicine was professionalizing and gaining status. And medical practitioners realized that they could gain social respect by claiming to be able to answer questions that laypeople could not. They said laypeople were confused when they saw a person with mixed sex characteristics, and could not categorize them as male or female. But medical doctors framed themselves as having impressive skills and arcane knowledge that laypeople lacked. They could dissect a person's body after death, examine their gonads, and usually, decide that those appeared to be ovaries or testes, only in rare cases finding those organs impossible to assign a binary sex status as indeterminate ovotestes.

Nineteenth century medical doctors seized on this process, as it proved successful in generating fascination and deference from the public. They proclaimed themselves teratologists (a term that literally means "having knowledge of monsters"), and declared that where unschooled laypeople saw intersexuality in a body before their eyes, doctors could determine a person's "true sex." And to do this, they announced that it was scientific law that one's "true sex" was defined by one's gonads. A person with a penis who had ovaries they named a "female pseudohermaphrodite," and a person with vulva and internal testes, a "male pseudohermaphrodite." Only people with ovotestes so intermediate doctors could not assign them as ovaries or testes, or those with one ovary and one testis, were "true hermaphrodites"--and this was rarely the case. 

And thus, long before they developed the ability to perform sex reassignment surgeries on intersex infants, medical doctors erased intersex people through classificatory sleight of hand. And in so doing, they both increased their professional prestige, and propped up dedication to binary sex ideology in the face of its obvious factual refutation.

Then, in the 1930s, scientists discovered the "sex hormones"--testosterone, estrogen, progesterone, etc.. Gonads as anatomical organs lost their luster, as it was the hormones they produced that were the new subject of fascination. And for the next several decades, the idea that testosterone was the "essence of maleness" and estrogen the "feminine essence" was all the rage. Doctors made all sorts of strange assertions: they could "cure" an abrasive, nagging, shrewish wife with estrogen therapy! Homosexuality was caused by a hormone imbalance, as men with too little testosterone mimicked female behavior and desired a husband to dominate and penetrate them! Testosterone "causes" leadership, and high testosterone would make one a politician or CEO or general! Meanwhile, low testosterone would impede mathematical ability or the capacity to read maps!

Only it turns out that people of all sexes produce and require all of the sex steroid hormones. And that women who are housewives tending young children produce more testosterone than women who are employed outside the home in business careers. And that there are no hormonal differences between people of differing sexual orientations. Yes, testosterone causes the growth of facial and body hair, and estrogen the growth of breasts and hips. But there are endosex cis men with very low testosterone who are elite competitive athletes. As a way to determine supposed "true (binary) sex," hormones didn't cut it.

So, scientists and medical doctors dropped sex hormone levels as the way to determine the "true sex" of an intersex person. And they switched their focus instead to chromosomes--particularly, the presumption that all females have the XX genotype, and all males XY.

Now, we should note that by this point, there were doctors and scientists arguing that no single factor could determine a person's "true sex." This camp would go on to develop the language of "best sex" rather than "true sex" in choosing a binary sex assignment for intersex infants (which sounds nice enough, though the outcome was the same--by this time, forced surgical sex reassignment was presumed "necessary" by doctors across the spectrum).

But there was great appeal to framing a person's "true sex" as based on their chromosomes for medical professionals desiring to hold onto the claim that their scientific abilities made them into oracles, able to perceive and proclaim a "true binary sex" where laypeople saw a spectrum. Chromosomes cannot be seen with the naked eye, so they make an impressive divination prop. Take a cheek swab, subject it to esoteric technical tests, and mysteriously out would pop the answer: XX or XY, female or male.

In fact, the claim of a neat binary sex division in chromosomes also proved quite false. There are so many variations, including people with the genotypes XXY, XYY, XXYY, XYYY, Xo, and more. There are people who are XX/XY, having some body cells with XX chromosomes and some with XY. This "macrochimerism" is accompanied by totally normative "microchimerism" in people who have gestated. It turns out that fetuses and their gestating parents exchange genetic material, so a typical XX woman who has gestated an XY baby will have XY cells found scattered throughout her body. Then there are people who have typical-appearing male bodies who are XX, and vice versa. 

In short, whatever tool medical science devises to divide the sex spectrum into two will always fail, because sex is not a binary.

However, there are those who are intensely devoted to the ideology of binary sex. These people have made a religion of it, and indeed, in the U.S. today they are often white evangelical Christians. But it can also be a secular faith--as we can see exhibited by TERFs. These are the trans-exclusionary radical feminists who screech that sex is an inborn binary that creates predator males and victim females, and frame trans women as males in dresses who pose a sexual threat to cis women. TERF ideology holds that sex cannot be changed, and that no matter what hormone therapies or surgeries a trans woman accesses, she will always remain "truly male" due to having an XY genotype that cannot be changed. This is a position of transmisogynistic bigotry, framed as "scientific fact." (That's hardly novel--the tactic of claiming one's bias is just a statement of scientific fact proved very potent in eugenics, culminating in the Holocaust. It's morally repugnant--but it's also effective.)

TERFs like to say that they have great sympathy for intersex people. They claim that most of us are disturbed by our status, and desire nothing but to have it corrected and to keep this medical past quiet, so we can lead normal lives. This position is the exact same one taken by doctors whose imposition of unconsented-to surgeries on intersex infants intersex advocates deplore. It also allows TERFs to frame intersex people who oppose their assertion that chromosomes determine "true sex" as at best unrepresentative, and as more likely charlatans--trans people pretending to be intersex to try to excuse their "delusional mindset."

But an intersex person need not be at all unhappy with their binary birth sex assignment to be appalled by Christian fundamentalists and TERFs championing the idea that one's "true sex" is determined by chromosomes. Consider a person with CAIS (complete androgen insensitivity syndrome). She has been assigned female at birth, having been born with typical vulva. Inside, she has no uterus, and what lie in the typical position of ovaries are testes. But because her body cannot respond to testosterone, and because some of the testosterone that those testes begin releasing at puberty is naturally converted to estrogen, she has developed breasts and broad hips in the course of a typical feminizing puberty, though she does not get a menstrual period. Her birth certificate says F, she was raised as a girl, her body looks like that of an endosex female, and she identifies as a woman. But according to the TERFs, because her chromosomes are XY, she is "really" a male.

This is just like how a 19th century teratologist would approach our intersex individual. Dissecting her body after death, they'd find that her gonads were actually testes, and declare her a "male pseudohermaphrodite." 

And this is violence. Sex policing and misgendering are always violence.

The fact remains that no matter what scheme devotees of binary sex ideology dream up to try to force the nature of sex into two boxes, it will always be silly, and it will always fail. By nature, sex is a spectrum of great diversity. Our intersex bodies are real, and they are not evidence of disorder or failure, but rather of the beauty and complexity of all of the natural world. Any claims that science can determine our "true (binary) sex" deserve no more than eyerolling.

Monday, August 20, 2018

Nonconsensual Intersex Surgery as Physical Conversion Therapy



Today, most people think of conversion therapy as a discredited practice of the past. Back in the bad old days, being "homosexual" was considered a mental disorder that psychologists tried to cure. But being gay was depathologized by the American Psychological Association back in 1972, and today, same-gender couples are socially accepted and have the constitutional right to marry. A small number of evangelical Christian "therapists" still attempt conversion therapy on LGBT people, but they are considered quacks by the medical profession and most of American society. The days of conversion therapy are seen as basically over.

They are not.

I am going to argue to you that "corrective," "normalizing" surgeries performed on intersex children who cannot give or withhold consent are conversion therapies. They are motivated by the same constellation of  ideas that produced conversion therapies aimed at LGBT people. And they take place way more often than most people think. Conversion therapies are alive and well and being imposed every day on unconsenting children in the U.S., harming them.

Mainstream medical practitioners in America today distinguish between LGBT conversion therapies and intersex "corrective" procedures. They frame conversion therapies for sexual or gender identity as wrong because they now agree there is nothing pathological about being queer, trans, or gender-nonconforming. These are minority identities, and trying to "cure" them is akin to doctors attempting to cure people of identifying as Jews or Muslims. It is not the place of the medical profession to impose the majority religious or sexual ideology on patients, and doctors who try to do so are violating professional ethics.

Intersex status, on the other hand, is pathological according to contemporary Western medicine. Physical sex variations are medically classified as "disorders of sexual development." It is the job of doctors to cure disorders. They sat that intersex people are born with tragic malformations, and we will live as social outcasts unless the medical profession heroically steps in to save us by converting our abnormal intersex bodies into endosex-appearing, normal bodies.

A Brief History of Conversion Therapies

The mid-20th century was the heyday of conversion therapies. This was an era of conformity, of faith in medical authority, and of optimism that social ills could be cured by science. It was taken as an article of faith that doctors should seek to convert deviance to normalcy. Funds were directed to developing a wide array of innovative medical interventions toward that end.

A key arena for the development of therapies was producing "normal sex." This midcentury umbrella term encompassed a wide array of matters related to sex, gender and sexuality. The goal was to ensure "natural sex relations." According to the scientific ideology of the time, evolutionary biology required that humans come in two opposite sexes--dominant, competitive men and gentle, nurturant women--who would be drawn by heterosexual attraction to form stable marital units, the necessary basis for parenting. The survival of humanity was believed to require bodies of binary sex, people who conform to binary gender stereotypes, and compulsory heterosexuality.

In the 1950s and 1960s, the medical profession made great investments in developing and institutionalizing conversion therapies, both psychological and physical. These therapies became mainstream and widespread. Doctors aimed to cure "hermaphroditism and pseudohermaphrodism" (i.e. intersex status), "sexual deviance and transvestism" (i.e. LGBT status), and gender nonconformity (under many labels, including "sissy boy syndrome" and  "neurotic penis envy").

The therapies doctors developed were deeply interventionist--often traumatizing and painful. To be converted from deviant to normal was seen as a positive outcome that justified a steep personal price. People with nonconforming sexual orientations, gender identities, and gender expressions were often institutionalized. Some were given electroconvulsive shock treatments. Many were treated with aversion therapies--for example, being given painful shocks, perhaps to their genitals, while being shown same-gender erotica. These "treatments" amounted to torture, and while they could not change people's identities, they could render people incapable of arousal or of sexual relationships. Today, we see such an outcome as tragedy, but at the time, being incapacitated by panic and nausea when triggered by sexual arousal was viewed as better than being able to engage in same-gender sexual relations.

In this same time frame, "corrective" surgeries on intersex children became the norm. The goal of these surgical, hormonal, and other interventions was to produce a person who appeared endosex and was capable of engaging in penetrative penile/vaginal intercourse. Sexual sensation, freedom from pain, and issues of gender identity were dismissed as irrelevant. The goal was to enforce "normal sex" by creating a person who appeared to be of binary sex, was gender-conforming, and who had heterosexual intercourse, whatever the costs. This was very much in line with the painful treatments being imposed on LGBT people at the time.

Prettying Up Conversion Therapies

After the Stonewall uprising in 1969 and the rise of second-wave feminism, conversion therapies came under attack for enforcing compulsory heterosexuality and gender conformity. Lesbian and gay advocates successfully got homosexuality removed from the DSM, the "bible" of psychological diagnoses, in 1972. And supposedly, since then, nonconsensual conversion therapies became a thing of the past.

But in reality, conversion therapies persisted--they just put on an acceptable mask. Homosexuality was no longer classified as a mental illness, but being unhappy about being gay was (this was "ego dystonic homosexuality"). So therapists could still practice conversion therapies on LGB people, so long as they got the patients' consent--or, if they were minors, their parents gave consent and told the therapists their children's "homosexual tendencies" were causing depression.

Meanwhile, mainstream sexual orientation and feminist advocacy organizations of the 1960s-1980s largely ignored or actively opposed trans people's rights. So being trans remained classified as a mental illness, "gender identity disorder." A small number of fortunate trans women and a tiny number of trans men were able to use this diagnosis to access gender transition services during these decades. These individuals had financial resources, bodies that doctors deemed would not be visibly trans after hormonal and surgical treatment, and a demeanor and gestural repertoire that would be gender-conforming after transition, in accordance with the ideology of natural sex/gender binarism doctors were still enforcing. But most trans people were refused access to transition services by medical gatekeepers. Having failed one or more of the enforced gatekeeping criteria, they were instead treated with conversion talk therapies intended to resign them to living in their birth-assigned genders.

As for physical intersex conversion therapies, to the extent they appeared at all on the radar of progressive political activists in the post-Stonewall decades, it was in a positive light. Dr. John Money became something of a celebrity in this period. Money performed intersex "normalizing" surgeries, but became most famous for "treating" one of a pair of identical twin baby boys. This child was the victim of a botched circumcision, in which he lost the head of his penis. Money gave that infant sex reassignment surgery and had the parents raise the child as a girl. In his reports on the case, Money claimed that by enforcing strong gender stereotypes in their parenting, the end result was that the identical twins became a happy girl and a happy boy, both of them gender-conforming. In fact, that was not the case--the surgically reassigned child was never happy, gender transitioned back living as a boy in his teens, and committed suicide in his 20s. But in the 1970s, feminists and progressives saw the case as a cause célèbre, because it was framed as illustrating that gender is socially constructed and not some natural or innate matter.

Money became so famous as a result of this that his paradigm for the treatment of intersex infants became universal in the West. Money held that visibly intersex children should receive genital reconstruction as early in life as possible, so that their parents would raise them as "normal girls and boys," producing well-adjusted heterosexual women and men. So unlike sexual orientation conversion therapies, which had to become much more polite and consensual, intersex conversion therapies actually became more invasive, ubiquitous, and less consensual. 

The Spread of Resistance to Conversion Therapies

In the final years of the 20th century, advocacy movements for sex, gender and sexual minorities pushed back at the persistence of conversion therapies. Sexual orientation advocacy organizations did this overtly. They fought active campaigns against the idea of conversion therapy for LGB people, and in 1987 "ego dystonic homosexuality" was removed from the DSM. Conversion therapy aimed at LGB people was officially disclaimed by the American Psychological Association.

Trans advocates also overtly pushed back at conversion therapies. They focused particularly on the diagnosis of Gender Identity Disorder of Childhood. There being no protocols for social transition for children at the time, children given the "GID of Childhood" diagnosis were all treated with conversion therapies. Some of these children we'd recognize today as trans kids, but often the youths being "treated" had never expressed a trans identity--they were your classic feminine boys and tomboys, or LGB teens whose parents opposed their sexual orientations. Many were institutionalized against their will by their parents. And punitive aversion therapies, often involving physical punishments, were commonplace. The goals of these treatments were to produce complete conformity to the child's assigned binary gender. Trans advocates pushed back against this, and were joined in this instance by LGB and feminist activists.

Trans groups were also engaging in other advocacy efforts that amounted to fighting conversion therapies, but were not framed as such. Trans people were struggling against the gatekeeping by doctors that kept so many trans-identified people from accessing transition therapies. They were pushing for a different pathway to accessing transition services--one now called the "risk reduction approach," in which a patient signs a declaration attesting to their gender identiy and is then allowed to access services after some simple screenings. This advocacy was pushing back at the channeling of a majority of patients wishing to gender transition into cisgender conversion therapies instead of their desired transition treatments. Success in this advocacy let to the bypassing of extensive medical gatekeeping, which in turn led to rapid growth in the number of people accessing transition services. Especially empowered were those who were excluded in the past because they had nonbinary gender identities, would be LGB or gender-nonconforming after transition, and/or would remain visibly transgender after accessing hormones and the surgeries they desired and could afford. For many, conversion talk therapies were replaced with access to transition services.

This pushback against conversion therapies in the 1990s led to the burst of trans visibility in the 21st century. But intersex people still remain largely invisible.

That's because our fight against conversion therapies lags decades behind LGBT battles on these issues. The first major intersex advocacy group wasn't even founded until the 1990s. Having heard no intersex voices of protest, most endosex progressives entered the 21st century thinking of intersexuality as vanishingly rare, and of infant genital reconstruction as some cool proof of the flexibility of gender.

21st Century Intersex Advocacy

Most people today remain unaware of how common intersex status is. I explain its prevalence here: about 1 in 150 Americans is diagnosed with a "disorder of sex development." The fact that people aren't aware of how commonplace intersex status is illustrates the effectiveness of repressive conversion therapies. The very point of intersex surgeries performed in infancy without our consent is to render us invisible. For decades, the treatment paradigm included keeping our medical histories secret from us--lying to us about the nature of our treatments to hide our intersex status even from ourselves. For decades, our parents were told that if anyone learned of our secret, our lives would be ruined, so we must be taught never to talk about our differences. There's been more openness in the last decade--but doctors' diagnostic categories themselves continue to seek to convert us to endosex by concealing the nature of our differences. Rather than being told we are intersex, these diagnostic terms often label us "boys with a penile deformity" or "girls with clitoromegaly." We're told these are embarrassing issues, but ones doctors can cure for us with a few simple surgeries, so nobody will ever know and we'll never have to have the embarrassing problem revealed.

We live in a culture of shame and stigma in which intersex people are still taught that if our variance becomes known, potential friends and mates will be repelled and we will be doomed to lives of isolation. Doctors present us with a solution: physical conversion therapy to erase our physical sex variance, and silence about this ever having occurred. And it works, at least on one level. Few contemporary Americans are aware of how many intersex people are all around them.

But conversion therapies continue to come at a severe cost. For us, these include physical costs: the loss of sexual sensation that accompanies so many infant genital reconstructions; pain; infections. We are forced to show our genitals over and over to strange adults who poke and prod us, and then we are expected not to talk about it, which is a great training regimen to make us vulnerable to sexual abuse. And there's the fundamental issue of agency and self-determination over our physical sex characteristics. For those of us who don't grow up to identify with the binary sex we were coercively assigned at birth, there's the betrayal of knowing our bodies once better matched our identities, but then doctors cut off parts of us with which we identify, and our parents just went along with it. And even if we are in the majority that do grow up to accept our assigned binary sex, all intersex children whose genitals and gonads are surgically altered have endured a forced sex change--something our society would find horrific in endosex children, but accept in our case--and that is very hard to deal with.

And the thing is, conversion therapies never solve the fundamental problem. The problem is that the patient is a member of a stigmatized group. Even if a perfect conversion of a patient to endosex, to cisgender identity, to heterosexuality, or to gender conformity were possible, it only allows that specific patient to escape a social problem that persists. The real solution is to end stigma and discrimination against the minority group, so that every member of the group benefits.

Rather than reducing stigma and discrimination, conversion therapies strengthen them. They naturalize the discrimination and blame the victim.

The young intersex advocacy movement has tried several approaches to addressing the social problems we face. We've formed support groups. We've tried to work with doctors, hoping that if we are polite and educated and assimilated and attractive, they will listen to us and at least delay surgeries to allow children to mature enough express an opinion about whether they want them. The medical profession has been happy to co-opt us and present their uninterrupted intervention practices as having our seal of approval. We've tried confronting doctors individually. They call us atypical malcontents who received outdated surgeries, while they present current surgeries as cutting edge and advanced, with zero data to show any improvement in outcomes. We've tried analogizing infant genital "normalizing" surgeries to the cultural practices Western doctors call "female genital mutilation" and deem barbaric. Both are medically unnecessary cosmetic practices meant to make our bodies appear culturally acceptable to potential mates that traumatize us and deprive us of sensation. This convinced the U.N. to call for an end to unconsented-to medically unnecessary infant genital reconstructions, but basically only tiny Malta banned the practice. In the U.S. and most wealthy industrialized nations, medical interventions continue unabated. Doctors just frame every surgery they do as medically necessary to correct "disorder."

Doctors will only stop performing infant genital reconstructions to enforce their ideology that bodies must conform to binary sex expectations when parents stop consenting to it. In the 21st century we've been trying to educate the population about intersex issues, so parents will cease consenting. But it's been hard to get traction. One problem is that the medicalization of sex variance turns every conversation about intersex issues into a complex story of 17 diagnostic categories, and what each means, and how to evaluate twisted medical claims that surgeries they perform are necessary to enhance fertility (which they mostly reduce) or prevent cancer (which occurs at rates way, way lower than breast cancer--and we don't preemptively remove all breasts like doctors want to remove all internal testes and ovotestes). Medical terminology confuses most average people, and we are trained to defer to medical authority, so listeners often give up trying to process what we are saying.

That's why I suggest we make clear what intersex surgery is. It is a conversion therapy. Doctors say it's necessary to cure disorder and prevent stigma. But they said exactly the same thing about LGBT conversion therapies, until social movements made them relinquish these (lucrative) practices. LGBT conversion therapies were practiced in service to the ideology of "natural sex;" the same is true of intersex physical conversion therapies. But homosexuality is not "unnatural;" same-sex sexuality is found throughout nature. Trans identities are not "unnatural;" gender-crossing is found throughout history. And intersexuality is not "unnatural;" empirically speaking, sex is naturally a spectrum and not a binary.

The public doesn't have to enter a debate about multiple complex medical treatment paradigms any more than the public needed to read psychological journal articles comparing the efficacy of different aversion therapies.

The simple fact is that no person should ever be forced to endure a conversion therapy. No intersex child should be forced to have medical interventions to convert their bodies to appearing endosex. Genital reconstructions should only be performed on mature people who ask for them--whether intersex or endosex, cis or trans.

Having an intermediate phalloclitoris is no more inherently medically dangerous than having a penis or vulva. The danger that comes with having intermediate sex characteristics is purely social and comes from living in a society that discriminates against people whose bodies don't conform to binary sex expectations. The way to protect people from that is to ban the discrimination, not to try to conceal an individual's nonconformity so that that one individual escapes the discrimination.

Stop nonconsensual intersex surgeries. They are conversion therapies, and they are wrong.


 

 

Wednesday, August 10, 2016

The Problematic Ideology of Natural Sex

What is human nature?

In the Western world today, science and religion are often understood to be enemies. It’s believed they offer two competing explanations of how the world works. What I want to show you is how when it comes to understanding human nature, Christianity and Science are in fact complete bedfellows. They both are deeply invested in a belief system, which I will call the Ideology of Natural Sex. And both have been shoring up that ideology, enforcing it brutally, and imposing it by force on others around the globe, for centuries.

What is this Ideology of Natural Sex? What do authorities from the Pope to our medical and scientific textbooks jointly believe, and insist we believe, about sex? It’s their unified theory of sex, gender and sexuality, and it goes like this:

“As ordered by God/evolutionary biology, humans come in two and only two physical sexes. This is the nature of things because a male and a female make a reproductive unit. The purpose of sexual interaction is reproduction. Thus, the determinative factor in dividing men from women is genitalia. Genitalia determine gender—the way society organizes people through gender roles, and the way people should properly identify and understand their place in the world. And this world is one in which men are (by God’s design or by biological imperative) the dominant sex, the sexual “aggressor,” while women’s interests center on nurturing families and offspring.”

Four things that are central to my own life pose challenges to this ideology. The first is that the empirical reality of physical sex is that it is a spectrum, and people, like myself, have always been born intersex. The second is that people around the world and throughout history have identified with genders other than male or female, and/or have been assigned to one sex at birth, and felt called to move to live in another. The third is that people engage in sex all the time that is not procreative. This is true of people who are infertile, people in same-sex pairings, and fertile men and women who do not wish to conceive with one another at the time of their sexual interaction. And the last is the reality that gender inequality is not inevitable. Patriarchy, the privileging of men over women, is a form of inequity that is successfully being reduced.

How have religious and scientific authorities dealt with these challenges over the past several centuries? They have periodically declared them to be “unnatural.”

Now, if ever you want to know when to suspect an ideology is at work, you can be sure it is the case when someone tells you something is unnatural and should not occur. Because here’s the thing about true natural laws: they function whether you want them to or not. Nobody needs to urge or force anyone else to obey them. Consider gravity. It’s a natural law, so nobody needs to enforce it. No religious tracts or psychological textbooks have been written urging people to obey the principle of gravity and refrain from floating about bumping into ceilings. Or consider this example: people may argue over vegetarianism, and whether it is healthy. But you have never seen a letter to the editor or an internet comment war complaining about how kids these days are engaging in the unnatural practice of giving up both meat and vegetables and choosing to engage in photosynthesis instead.

There is no #PhotosynthesisIsUnnatural hashtag because it truly is unnatural for people to turn green and live off sunlight directly instead of eating things for energy. Truly unnatural things do not occur, so they generate no outrage squads decrying their transgression.

As for the “laws of natural sex”—well, it’s another story.

Around the world, over the past four or five hundred years, people have been cajoled, threatened, forcibly re-educated, beaten, imprisoned, locked in mental hospitals, put in the stocks, publicly humiliated, mutilated, and burnt at the stake for violating one or more of the precepts of “Natural Sex.” That’s the sure sign of enforced ideology, not a true natural law.

And it’s not just a story of superstitious, ignorant days gone by. There is a war being waged over the ideology of “Natural Sex” today. And in that war, religion and science stand hand in hand on the same side. Who stands on the other?

Intersex people whose genitals are surgically mutilated without their consent to force their bodies to resemble binary sex expectations.

Trans people who are treated as having a mental illness, as delusional, as perverted, as pariahs.

People in same-gender relationships, who have made great strides in the West recently in terms of a right to secular marriages, but who are still not permitted to marry in many religious denominations, and who are not protected from perfectly legal discrimination of many sorts in many places.

Oh, and women pursuing sexual pleasure. Religious authorities frame women in particular as ruining themselves through seeking sex outside the context of marriage. Meanwhile, scientists continue to frame female orgasm as a puzzle as they state it is “unnecessary,” since women can conceive without it. Women, according to both religion and science, should want babies, and only engage in sex to make them, not for fun.

The extraordinary thing is, with so many groups fighting and suffering for recognition denied them under the ideology of “natural sex,” how incredibly powerful that ideology is, how amazingly resilient. We are taught the Ideology of Natural Sex so early, by parents and media and schools and churches, that we believe in it at the same fundamental level that we believe in things like gravity.

And even when individuals are persecuted in some way under the Ideology of Natural Sex, very often it never occurs to them to challenge the whole, as that seems unthinkable, but only one small part of the ideology impacting them particularly. Thus we have women who decry female genital mutilation as cruelly enforcing the belief that women should not have sex for pleasure, yet who see similar surgeries being performed on intersex babies as appropriate, as heroically “correcting malformation.” We have gay men and lesbians who frame themselves as natural and normal, wanting only to marry and reproduce like anyone else, while disdaining trans people as "crazies" who are making gay people look bad by association under the LGBT umbrella. We have people born with sex-variant bodies who reject the label intersex, and wish only to be referred to as “people affected by disorders of sex development.” Why? Because they are worried that the term “intersex” will make others associate them with trans people or think they have nonbinary identities or otherwise find them disturbingly transgressive of the Ideology of Natural Sex, and God forbid, they don’t want any of those things to be thought of them.

And everywhere, everywhere, we have ignorance of the long and violent history of the imposition of the Ideology of Natural Sex under European colonialism.

The genius behind framing an ideology as “natural” is that its history erases itself. Why would anyone study the history of something natural and eternal? We don’t study the history of covalent bonds in chemistry or cumulus clouds in meteorology.  And so we don’t study the spread of European binary sex ideology under colonialism. If you do, you’ll find that all over the world before European colonialism there were societies recognizing three, four, or more sexes and allowing people to move between them—but that’s a subject for another post. Suffice it to say that societies were violently restructured under European colonialism in many ways, and one of those was the stamping out of nonbinary gender categories and stigmatization of those occupying them as perverts.

Meanwhile, missionaries and European scientists spread the word that nonprocreative sexual practices—same-gender relationships, oral sex, masturbation—violated God’s will or the scientifically known purpose of sex, and were thus both sinful and sick. Christian missionaries even taught that the only acceptable intercourse involved a married man atop his wife, other positions being “unnatural.” Scientists concurred, saying that only in the missionary position would gravity lead semen to the uterus. Nature, colonized peoples were taught, requires men to be on top--of society, and in sexual activity, literally.

Most people today are ignorant of this history of the ongoing struggles to impose the Ideology of Natural Sex on reluctant nations and social groups. This ignorance allows each generation to believe that those who do not fit under the ideology, such as intersex and trans people, are rare freaks—or, if there are many challenging the ideology at that time, such as feminists demanding access to birth control and abortion, or the gay pride movement, as a brand new threat to an until-then-eternal system.

And for a system that is presented as eternal and inevitable, the Ideology of Natural Sex is also strangely framed as fragile and endangered, requiring vigorous defense. One example: the 20th century claim that “homosexuality is unnatural, and if it is tolerated, the human species will go extinct as procreation will stop.” This claim was made by opponents of the so-called gay liberation movement, many of them religious conservatives, but using the language of science. And after all, for many years, scientists had been claiming that homosexuality was a medical disorder that must be cured.

The really weird thing about the end-of-the-species claim, if you think about it, is that it presumed that if same-gender sexual activity were tolerated, then nobody would ever have mixed-gender sex again. Why would people who presumably happily identified as heterosexual think something like that? Well, it’s because each of the precepts of the Ideology of Natural Sex are seen as inextricably linked. The purpose of sex is reproduction; this requires men and women; people must accept their assigned gender roles. Allow two men or two women to have sex, and the other precepts will fall as well. Society as we know it will collapse, and in fact, we’ll die out as a species as we won’t reproduce anymore. Our nature will be destroyed and humans will suffer an apocalypse.

Today, in the early 21st century, intersex and trans issues are coming to the fore. And the same patterns emerge, as they have in the past of which we are unaware.

From science and medicine, what we see is the framing of bodies, identities and behaviors that fall outside the Ideology of Natural Sex as disorders to be classified and treated. The goal is to restore the “natural order” through techniques developed by science: eugenic programs, surgical “normalization,” and psychotherapies. Consider intersex status right now. There is a growing social movement of intersex people to put an end to the nonconsensual genital surgeries that have been imposed on intersex children since the 20th century. But doctors are extremely resistant to this movement. Living with a sex-variant body is presented by doctors as a fatal condition. It will lead to social death, which may lead in turn to suicide. Without a body that conforms to binary sex expectations, it will be impossible to find a mate, so even if one lives, it will be an empty life, a painful one full of strange nonconforming behavior and self-loathing. Surgeons claim they are compelled to continue intersex genital mutilation to preserve life and quality of life, dismissing the cry of intersex advocates that these “treatments” in fact degrade their quality of life.

From the religious side, what we see is an assertion that Natural Law created by God must be affirmed by all human laws. To do otherwise is not only an offense to God, but will destroy humanity. Speaking recently of the supposed danger of the trans rights movement, Pope Francis said, "We are experiencing a moment of the annihilation of man as the image of God." Natural law, understood as decreed by God, requires binary sex, and that gender conform to that binary sex. Worldly laws must not be enacted to acknowledge and support people's gender identities. In fact, say religious conservatives, to speak of gender at all is to offend God. There is only sex, and never before have humans suggested that one also has a gender identity and should express its inner truth! (The fact that gender identity recognition and gender transition are as old as humanity is a history that we’ve already seen has been erased by the “natural law” framing.) And fascinatingly, the Catholic church evokes science to “prove” its position. Sex, the Church states, is determined by DNA. DNA, unlike clothing or hormones or genitals, cannot be changed. Thus, one can never change one’s “true” sex. Gender transition is a wicked lie, a deception, and according to Pope Francis, as dangerous to humanity as nuclear weapons. It must be stopped and “nature” defended.

So science and religion walk arm in arm, trumpeting the ideology of the Natural Law of Sex. This gives everyone in the general population something to latch onto in framing the oppression of some group as necessary and good. Are you a socially conservative religious person who finds trans people disgusting? Claim that the statement “male and female created He them” in Genesis is not a generalizing poetic phrase but a morally prescriptive statement that must be socially enforced. Are you a radical cis feminist who disdains the Pope, but shares with him disgust for trans people?  Claim that DNA determines sex, that gender identity is a delusion, and that trans women are thus sick male threats to the safety of “biological women.”

There’s something for everyone.

What makes the Ideology of Natural Sex so powerful is that, like all deeply effective belief systems, it is so taken-for-granted that it is like water to a fish. Most people are unaware of the very concept of a sex/gender ideology. And therefore, merely to ask the question “How many genders are there in your society?” strikes them both infantile and very offensive. Show them a drawing of intermediate genitalia and they gasp in profound shock. Present them with a visibly trans body and they laugh or gag or feel incited to commit violence.  These strong negative reactions occur because having your ideology challenged is bad enough, but when you didn’t even know it was an ideology in the first place, it makes you question everything. And sadly, most people don’t want to do that at all.

But we have to do it.

If we truly believe in science, in a rational world where we look objectively at what is, rather than impose our beliefs onto reality, then we need to reject the Ideology of Natural Sex. We need to see the reality of the sex spectrum and stop framing intersexuality as a rare disorder that somehow violates natural law. We need to understand that different societies have divided the sex spectrum up into different numbers of social sexes, and that binary sex is no more or less arbitrary than trinary or quartic sex systems. We need to give up the silly idea that sexual interactions only serve reproductive purposes, when it is massively evident in nature that nonprocreative sex is everywhere in social species. We need to become aware of the omnipresent world history of gender transitioning, and let go of the myth that not until the 20th century introduced modern surgical transition procedures did “real” gender transitions occur.

And if we truly believe in religion, then we must adhere to the precepts of compassion that all religions teach, and stop using religion to oppress minorities or spread hate.

Intersex people, trans people, queer people, lusty women. . . we don’t violate natural law. In fact, we’ve always been a part of human nature. And accepting and respecting us as we are will not cause the end of the world. At all.

It could, however, spell the start of a kinder and fairer world. So please, just let go of the Western Ideology of Natural Sex.



Wednesday, February 20, 2013

Hypospadias: Intersexuality and Gender Politics

If you are looking around for information about intersexuality, one of the first things you're likely to read is that "most intersex children are assigned female at birth."  This is in fact false.  

In the U.S. today, according to the CDC, one in 125 children assigned male at birth is surgically modified to fit that binary sex status.  The percentage of children assigned female at birth who are genitally altered in infancy to feminize their genitalia seems to be lower.  Exactly how much lower is very difficult to determine, since nobody is gathering the data we'd need to have.  The reason we know the 1-in-125 figure is because these children assigned male are all given the same diagnosis: hypospadias.  Hypospadias is the diagnosis given to most children born with intermediate genitalia who have external testes.  Rates of hypospadias have been increasing, and the CDC is collecting data due to concern about that.

The reason people continue to say that few intersex individuals are assigned male is that doctors term hypospadias a "penile malformation" rather than an "intersex condition."

I've written about this before in this post.  I noted there, "medical diagnostic categories are not logical, despite our ideology that they should be so. The majority of individuals born with intermediate sexual anatomies [and surgically assigned male] are not given an intersex diagnosis. I believe that what underlies this is gender ideology. And that gender ideology is this: masculinity is fragile, especially when it comes to what a man has in his pants. To live as a man with an inadequate penis is seen as intolerable. To have one's status as a 'real man' challenged is viewed as psychologically crushing. Thus, doctors feel, if they were to categorize someone as intersex and then assign them male, they would be acting cruelly.  Women, on the other hand, are perceived as more gender-flexible. After all, it's reasoned, a woman isn't shamed by wearing pants or taking on a power career. [Doctors view] female-assigned people as more comfortable with androgyny and as better at dealing with emotional challenges."  Because of assumptions about fragile masculinity and flexible femininity, doctors feel more at ease assigning children they designate as intersex female. Those they regularly surgically alter to conform to binary male sex norms, they wish not to label intersex.

I was contacted by some people after writing that prior post challenging my assertion that hypospadias is an intersex condition.  They countered that it was simply a minor displacement of the male urethra.  So I wanted to make my case more clearly.

Let's start with some illustrations.

All children start out in the womb with the same set of genitals, an intersex form.  As a rule I will not post photos of children's actual genitalia because it is exploitative, but in this case, I feel a medical image of the standard genital form of a fetus isn't going to cause additional emotional trauma to any particular child, so here's a photo:


Our society expects this intermediate genital form to differentiate before birth into two "opposite" binary sex forms (penis and testes, or vulva), but in fact, babies are born with genitals on a full spectrum between these two socially idealized poles.  Let's look at how medical professionals illustrate this sex spectrum.

When a child is diagnosed as having some form of XX, CAH, congenital adrenal hyperplasia, the sex spectrum is described by the "Prader scale," and the "stages" of the "condition" evaluated using this chart:



When a child with XY chromomes is diagnosed as having a form of AIS--partial or complete Androgen Insensitivity Syndrome--the sex spectrum is termed the "Quigley scale," and is illustrated like this:

  
You can see that both of these illustrations include 6 forms, although they number them in reverse order and with different numerals.  What they both show is that between a genital form considered typically female and one considered typically male, there is a common spectrum of intermediate forms.

This is equally true for children who are diagnosed as having hypospadias.   But medical illustrations of hypospadias are very different.  They do not picture the genitals as intermediate in form.

Instead of picturing the same range of in-between forms shown in the Prader and Quigley scales, medical illustrations of hypospadias variations show something odd: a carefully illustrated "normal penis" with a series of dots superimposed upon it to indicate the level at which the urinal meatus/ vaginal opening are located.  

 
The penis is always illustrated as erect, and often with a lot of illustrative detail to emphasize the "reality" of this imaginary ideal penis existing instead of the intermediate genitals actually present in intersex individuals who have external testes.



Let us be clear here.  A child diagnosed with hypospadias of an "advanced degree," be it termed perineal or posterior or scrotal, will have an intermediate phalloclitoral form with a substantial invagination, not a large, erect phallus with a dot at the bottom.  They'll look more like the Prader 2 or Quigley 4.  I'd illustrate such a child's genitals more like this:



Why would medical illustrations of intermediate genitalia be representationally accurate in the case of intersex children diagnosed under the rubrics of AIS or CAH, but inaccurate if highly detailed in the case of intersex children diagnosed under the rubric of hypospadias?  Only gender ideology can explain this.  Children diagnosed with CAH and AIS are routinely assigned female.  But children with hypospadias are surgically "corrected" to male, and to undermine the "adequacy" of a male's phallus is treated as untenable.  Parents (and doctors!) must be reassured by looking at the erect, large, ideal penises drawn in the hypospadias illustrations that the genitally intermediate flesh of the child they see is illusory, and that an excellent penis will soon be revealed by the scalpel.  

So: medical illustrations of hypospadias, and the medical assertion that it is not really an intersex condition, relate to our ideologies of masculinity.

The differences in medical approaches to intersex children routinely assigned female and routinely assigned male extend further than illustrations and terminology.  They also determine all the tests and evaluations the child will receive.  If an intersex child lacks external testes--the determining characteristic of a hypospadias diagnosis--that child is routinely subjected to a battery of tests: genotyping, endocrine screening, medical imaging scans.  This is not the case when an intersex child has external testes.  In fact, even suggesting that a child with intermediate genitalia but palpable testes receive any sex-related tests at all is considered "controversial" by doctors.  Since hypospadias is defined as a penile malformation that is not an intersex condition, why would anyone wish to test sex chromosomes, hormone levels, or internal reproductive structures?  It's presented as an unacceptable waste of time and money, in an affronted tone.  

In fact, individuals born with hypospadias do commonly have other sex-variant characteristics.  An example is the presence of what is termed a substantial "prostatic utricle," a uterine structure that may be small or full-sized that connects to the vaginas present in these children at birth.  While the "pseudovaginae" are removed and closed during infant genital "normalizing" surgery, doctors do not test for the presence of a uterine structure.  People diagnosed with hypospadias and their doctors generally only become aware that there is a utricle present if something goes wrong, such as the development of uterine cancer or painful cysts--and then usually by accident during imaging scans for some other presumed cause of the patients' symptoms. 

I want to note that many intersex people assigned female at birth complain of all the invasive tests and screenings and procedures to which they are subjected in childhood, so the fact that intersex children with hypospadias diagnoses avoid these is not necessarily a bad thing.  But not even thinking of checking for a uterine structure in someone born with hypospadias who presents to a doctor with pelvic pain could have very negative health consequences. 

It is clear is that intersex children diagnosed with hypospadias are treated very differently than children with other intersex diagnoses.  Rather than being treated as bizarre and interesting medical cases that require a lot of medical study and intervention, they are treated as normal boys with a little urethral displacement issue.

The thing that children diagnosed with hypospadias have in common with other intersex children is that they are subjected to genital normalizing surgery that can have many negative consequences.  Medical texts list as unwanted consequences of hypospadias "repair" surgery urethral fistulae, strictures, and diverticulae, recurrent urinary infections, "excess skin," hair-bearing skin, persistent chordee, erectile difficulties, erectile persistence, chronic inflammation, and a condition called balanitis xerotica obliterans.  Textbooks are oddly silent on the issues of loss of genital sensation that are very common, and the fact that children born with genitals in the middle of the sex spectrum are particularly likely not to identify with the sex they are surgically assigned at birth.

Some children who are diagnosed with hypospadias have genitals that are quite close to the binary male ideal in our culture.  For them, medical interventions may be fairly minor, and the side effects may be modest.  They are very likely to see themselves as typical males, and are probably unlikely to wish to be identified as intersex because they share our society's pattern of fragile masculinity.  I am empathetic with their position.  But we should be able to support the gender identities and dignity of people born with hypospadias who identify as men without resorting to inaccurate medical illustrations and illogical medical taxonomies.  

Hypospadias is an intersex condition.  The surgeries we perform on unconsenting intersex children without their consent have lifelong consequences.  These can be profoundly negative for children whose genitals are dramatically altered--something that intersex advocates decry all the time.  But we should also question why we routinely risk the loss of sexual sensation in the glans of the male-assigned child whose urethra is in a slightly atypical place.

All of us born intersex deserve to be recognized as such, and to be granted autonomy to make our own decisions about what "normalizing" surgical alterations we wish, if any.  Putting an end to the routine genital reconstructive surgery performed on the many thousands of children diagnosed with hypospadias each year should be considered an important point of intersex advocacy.



Wednesday, January 2, 2013

Just-So Stories about Hermaphrodite Fish















A central issue that makes life hard for intersex people is invisibility.  Most people are unaware of how common intersex individuals are, something I’ve often discussed on this blog.  But there’s a larger setting in which the fact that sex is a spectrum gets erased, and that’s in descriptions of biology and the animal kingdom as a whole.  One way this happens is when biology textbooks fail to mention the fact that instances of intersexuality are found in all animals.  Another way it happens is through what we’re taught about those species in which hermaphroditism is the norm.  It’s the latter that I want to illustrate for you today, by examining about how we talk about a fish, the bluebanded goby. 

The bluebanded goby is a small and colorful fish, bright orange-red with iridescent blue stripes.  Bluebanded gobies are hermaphrodites, with the ability to produce either eggs or sperm.  Each bluebanded goby can switch from producing eggs to sperm or vice versa in the space of about two weeks; externally, there’s very little difference between an egg-laying or sperm-producing bluebanded goby.  They have a “sexual papilla” through which they can release egg or sperm, and it is a bit pointier when in sperm-producing mode and a bit wider in its opening when in egg-laying mode.   Most bluebanded gobies spend most of their lives in egg-laying mode.  They live in mating groups, and typically only one member of each group produces sperm, with the rest laying eggs, maximizing the number of offspring the mating group can produce.  It’s a neat arrangement.  It’s also not one that you’re likely to hear about if you are visiting an aquarium or keeping fish.

The intersex nature of the bluebanded goby is erased or distorted in most descriptions of the fish, because our society is so invested in the idea that sexual dyadism is natural and universal that we can’t see evidence to the contrary right in front of our eyes.  We don’t hear about it in our educations.  Say, for example, you’re a schoolchild going for an educational trip to an aquarium, and you see the pretty gobies there.  Here’s all you’d learn at the Cabrillo Aquarium in San Pedro, California about the sex of bluebanded gobies: “Recognized by an elongated robust body and two dorsal fins, males have longer dorsal spines and a suction-like disc that is formed by the connection of its pelvic fins.”  (See here.)  You’d hear yet another example of the “natural, universal fact” that all animals are male or female, not evidence of the sexual diversity of the natural world.  Not only does the hermaphroditism of the gobies go unmentioned, the “masculinity” of bluebanded gobies in sperm-producing mode is exaggerated—they are said to have “longer dorsal spines,” a phallic and aggressive description of a nonexistent difference.  In fact, scientists determining whether a bluebanded goby is in egglaying or sperm-productive mode do not look for any difference in dorsal spine length, only at the shape of the sexual papilla.  (Generally, a sperm-producing bluebanded goby will be on the large side for the species, and hence will have largish fins—but egglaying bluebanded gobies that are large have the same size dorsal spines, and the dorsal fins on a given fish do not change size when it moves between egglaying and sperm-producing modes.)

When popular educational sites do mention sex variance in the bluebanded goby, they don’t explain the fact that all bluebanded gobies are hermphrodites, capable of producing eggs or sperm.    They instead tell a story of rare and fascinating “sex changes” in fish that are otherwise binary in sex: “Males and females are similar in coloration, however, males have a longer dorsal fin than the females do. One interesting fact about blue-banded gobies is that if there is no male present, the dominant female in a group of blue-banded gobies has the ability to change her sex to that of a male.”  (See here.)  This description frames bluebanded gobies as sexually dyadic, existing as males and females, except for the occasional female who goes through a “sex change” in desperate times.  The fact that all of the bluebanded gobies are hermaphrodites, and that each time they move from group to group they have the ability to move from egglaying to sperm-producing mode or vice versa, goes unmentioned.  Rather than undermining the ideology of a natural sexual binary, the story of the rare “sex change” actually bolsters it.  “How bizarre and rare is this deviation, a one-time move between natural binary sexes!”

Not only do educational sites teach that bluebanded gobies are almost always “normal males and females” rather than always hermaphrodites, the way they present goby “sex changes” reflects ideas about human gender roles.  The BBC Science and Nature website states that bluebanded gobies “live in small groups with a single male and multiple females.  If the male leaves or dies, the largest female changes sex.”  (Link here.)  The story is one of a large, dominant male with his harem of smaller females, and a burly female fish changing sex to “rise” to male status and take over the harem.  This is how the story is told by most scientific articles about bluebanded gobies that’s I’ve seen.  Let me quote a passage from a 2005 article in the Biological Bulletin on “sex reversal” in bluebanded gobies, so we can examine this in more detail:

“Larger size often equates with increased success in aggressive encounters and therefore social dominance, providing a proximate mechanism for the size advantage hypothesis. In protogynous sex changers, the most reproductively significant resource that dominance affords is “maleness”; thus the reproductive payoff for dominance is extremely large, and females would be highly motivated to increase their aggressive behavior in times of social instability (i.e., in the absence of a dominant male).”  (See here.)

I’ll now restate that passage in clearer English and make overt its hidden assumptions: “Sex is binary but in some rare species ‘sex reversal’ can occur.  When it does occur, it is from female to male, because everyone knows it’s better to be male.  To be male is to be dominant and aggressive, which is good.  Usually in species where ‘sex reversal’ can occur, males keep the females in their place, but if there’s no male around, the females will all want to battle because the winner will get to be the male.”  This just-so story reaffirms all sorts of human gender stereotypes—and in so doing vastly distorts the objective reality of bluebanded goby life.

The first way the scientific fable distorts reality is by calling hermaphroditic gobies “males” and “females,” imposing binary sex language on fish that are born hermaphrodites and can shift back and forth between egglaying and sperm-producing modes multiple times in the course of their lives.  The term “sex reversal” also implies two opposite sexes rather than one sex continuum.  It would be much more reflective of objective reality to speak in terms of shifts in reproductive modes among hermaphrodites than about sex reversals between females and males.

The term “protogynous” used to describe gobies in the article means “starting out female,” which not only implies that the fish are not really intersex by nature, but also frames shifts in reproductive mode as only occurring in one direction: from “female” to “male.”  In fact, bluebanded gobies shift just as easily from sperm-producing to egg-laying modes when entering a group with multiple sperm-producing fish.  (See here.)  The idea that every bluebanded goby “wants to be the male” is a projection of human ideologies onto fish behavior.  The majority of bluebanded gobies at any given time are living in egglaying mode because this conveys a reproductive advantage for the group.  One could just as easily say that it’s obvious that most gobies “want to be female” since that’s what most of them do, but that one of them has to make the sacrifice and “be male” for the good of the group.  That would also be projecting emotions and motivations onto the fish, of course.  In fact, bluebanded gobies are just hermaphrodite fish reproducing in the most efficient way possible by operating in egglaying mode more often than sperm-producing mode.  But the story we read is one of enforced, devalued feminization and aspirational maleness, because that affirms sexist human gender ideologies.

Entwined with these male-privileging gender ideologies is a story about dominance and submission.  As the story goes, high status fish are dominant; low status fish are submissive.  The most aggressive and dominant bluebanded goby “gets to be the male,” while the rest have lower status that accords with their more timid female nature.  This narrative is so familiar in patriarchal society that scientists seem not to notice it’s an ideology they’re imposing on nature in their research and writing. 

Here is what we do know about bluebanded goby reproduction, stripped of human gender ideologies.  In this hermaphroditic species, the greatest number of offspring are produced when most of the fish are laying eggs.  So they form mating groups or families, typically of 3-7, in which one of the gobies’ bodies shifts to sperm-producing mode, and the rest shift to egg-laying mode.  The fish that takes on the inseminating mode needs to be robust, because it must continuously mate with the rest of the fish.  When mating groups form or change, the members all swim about actively, zipping toward one another.  (Actually, this behavior is quite common, and regularly occurs between all of the bluebanded gobies, including the egglaying ones in established groups.)  What determines which goby in a new group will take on the sperm-producing role is the behavior of the other fish.  A goby being zipped at by a zippier fish will dodge out of the way.  This gets called “submission” by scientists, but could just as well be termed “peacekeeping,” and would most accurately be simply called “getting out of the way.”  By engaging in this dance of zipping about, a new group of gobies determines which of the fish is the most energetic and robust.  Often it’s a large fish, but that’s not always the case.  That fish shifts to sperm-producing mode (unless it is already in that mode), and the others shift to egg-laying mode (unless that is already the case).

Oh, and by the way, bluebanded gobies that are in sperm-producing mode don’t “fight harder” to stay in that mode because they “don’t want to be female.”  If a group of bluebanded gobies is assembled completely out of fish that are in sperm-producing mode, all but one of them shift to egglaying mode.  This takes the same amount of time as it does for one sperm-producer to emerge from a group that is assembled out of gobies that are all in egglaying mode, and leads to the same rate of fertility.  (See here.) 

So: by nature, bluebanded gobies are intersex fish that form efficient mating groups of multiple egglayers and one inseminator, and shift reproductive modes as they move from group to group.  This is an interesting part of the wide diversity of sexual arrangements in nature.  I believe that teaching people about this natural diversity would make the world a better place for intersex people, as it would make it less likely for us to be perceived as “unnatural” and “disordered.”  But instead of teaching children about sexual diversity, educational sites either completely deny that bluebanded gobies are hermaphrodites, or only mention it as a story of rare and odd sex changes from dyadic female to dyadic male.  And scientists, educated like the rest of us in this context, impose all sorts of ideologies about binary gender roles onto what they observe about the fish, perpetuating the problem of distortion.

Nature is so much more interesting than the stories we tell ourselves about it.  It’s time to stop obscuring the objective fact of sexual diversity.