Intersex Experience and Fears about "Gay Genetics"

Recently, results of a major genetic research study were published to substantial media attention. "Many Genes Influence Same-Sex Sexuality, Not a Single 'Gay Gene,'" wrote the New York Times.

The study, by Andrea Ganna and his large team, found that five genes were statistically significant in their correlation with whether a person reported ever having a same-gender sexual experience. But none accounted for more than 1% of the genetic association with same-gender sexual behavior. The study authors estimated that the total genetic contribution to same-gender sexual behavior was 8-25%.

The study was hugely controversial, and this is no surprise. In our society today, discrimination against people who are queer and/or trans and/or nonbinary is justified by bigots with claims that only cis heterosexuality is natural, and all else is disorder or sin. Opposing this, LGBT+ people employ "born this way" rhetoric, summarized in the Lady Gaga anthem: "No matter if you are gay, straight or bi/ Lesbian, or transgender life/ You are on the right track, baby/ 'Cause God makes no mistakes/ You was born this way, baby."

So, many LGBT-supportive groups fear that if scientific studies find that sexual orientation or behavior is not biologically set at birth, this will be used to justify homophobia. And that fear is rational; as soon as the Ganna study results came out, homophobic conservatives were claiming that they justified embracing conversion therapies, since people are "not born that way after all."

At the same time, other scientist-advocates fear that finding genetic markers associated with same-gender sexual activity would be terrible. They dread a eugenic outcome. That is, they fear that tests will be developed to screen for the marker genes, and parents will use selective abortion or selective embryo implantation to avoid having "gay babies."

Some reporters seem befuddled by the apparent contradiction here: LGBT-supportive commentators both fear that a genetic "cause" for same-gender attraction will be found, and that it it will not be found? So. . . is there something for everyone in this study, which found a genetic component to sexual behavior, but also found that it is pretty small in size? Actually, said some scientific critics, what the controversy shows is that this study should never have taken place. The findings were sure to have results that explained little, with the actual result would be that "a historically marginalized group has been left more vulnerable."

Well, the study took place and was published, and you can't undo that. For what it is worth, the study authors worked with LGBT+ groups to try to ensure the results would be presented in a respectful way. The authors stated that it was important that they do this study, if for no other reason than to preempt people with less sensitivity or active malicious intent from doing it instead.

So, how was the study finding of a small genetic effect "spun" in the media? Most of the major mainstream media and popular science reports on the study headlined the idea that there is no "gay gene." "No' Gay Gene' Can Predict Sexual Orientation, Study Says," wrote CNN."Search for 'Gay Genes' Comes Up Short in Large New Study," said NPR, and "The 'Gay Gene' is a Total Myth, Massive Study Concludes," announced LiveScience. As predicted by Forbes, the media chose to focus on the fact that there is no single gene determining sexual orientation, while all the complexities of why people might have the identities they do appeared, to use the newspaper metaphor, "below the fold;" that is, further down in the articles where only the careful or invested reader will bother to read or scroll.

So we know how the results were spun. But the debate remains: which finding would "really" hurt people who love people of the same gender? Would finding a "gay gene" protect people from discrimination? Or would it justify eugenic attempts to eliminate querity?

And here is where intersex experience can step in and advise LGBT groups about whether finding a biological "cause" for sexual orientation or gender identity would be a good thing or a bad thing. What our experience shows is that neither finding would be protective.

Intersex experience shows that the idea that finding a "gay gene" would protect people from discrimination is very naive. Our sex variance has nothing to do with identity or "choice," and there is zero doubt that we are "born this way." Has that made society embrace us? No, our birth status is flatly termed a disorder. Has knowing we didn't choose to be born intersex stopped the imposition of cruel conversion therapies? Absolutely not--the opposite is true. We are subjected to the cruelest of all conversion therapies: surgical sex changes imposed on us as children without our consent.

I wish more of the people who embrace the "born this way" LGBT advocacy position would learn about intersex experience, because we could show them that they are wasting their time. To be sure, it's not just intersex experience that can demonstrate that. Consider the Holocaust, during which millions of Jewish people were murdered because they were "born that way" (and so, for example, practicing Christians who were born to Jewish parents or grandparents were sent to the gas chambers, as "biological degeneracy" rather than religious belief was what counted in the eyes of Nazi eugenicists).

So, the "born this way" crowd is wrong, and the LGBT-affirming group with eugenic fears is right. Look what happens with respect to intersex traits. Some intersex statuses are genetic, and can be detected via amniocentesis. Selective abortion of these fetuses has caused the number of children born with genetic intersex statuses to fall substantially. Again, it's not just us; consider Down syndrome. Selective abortion of fetuses with Down syndrome has led the birth of affected babies to decline by a third in the U.S., and to be virtually nonexistent in some countries like Denmark.

I have no doubt that if there were a prenatally-detectable marker identified for same-gender attraction, and especially for trans identity, it would be employed eugenically by some parents to avoid producing children with such a marker.

My question for the Ganna et al. would be: what would have happened if you had actual made a dramatic discovery of the thing you sought?

To be sure, I think that is impossible, because looking for a "gay gene" is like looking for a "democratic socialist" gene or a "libertarian gene." The reasons people have the desires and interests and worldviews they do are immensely complex. There may be some biological contribution to those, but it will be small and indirect. For example, one of the Ganna et al. findings was that a gene linked with a tendency toward risk-taking was one of the five they found linked with subjects' reporting having had a same-gender sexual experience. The explanatory power of the gene was tiny--it explained less than 1% of why people reported having a same-gender experience. And I will bet you that the reason there is a linkage has nothing to do with whether people experience same-gender attraction, but with how likely they are to be willing to risk reporting it to a researcher, given that the British study subjects were all older people who grew up when homosexuality was criminalized in Great Britain.

That said, hypothetically, what would have happened if Ganna's group had found that five genes explained, not 1% or less of the variance each, but could collectively predict if a person had a same-sex encounter, say,  70% of the time? I know that Ganna's team worked with advocates to try to present the results in a manner that would be supportive of people with same-gender attractions. I'm sure they would have said, "Look! People are pretty much born this way! Therefore they deserve social respect and legal protection."

But I would ask Ganna's team: is having good intentions enough, given the evidence provided by intersex experience? Being known to be born this way means that the large majority of intersex people identified at birth are subjected to mutilating physical conversion therapies. Intersex people, indubitably born this way, are much more likely to be in the closet than endosex LGBT people. We live with crushing shame and secrecy, imposed by doctors and parents.

What would you have done, how would you have felt, if the result of your research was that same-gender-loving individuals experienced the same high levels of medical intervention that intersex suffer? If eugenic selective abortions became commonplace based on "gay genes," as they are today for genetic intersex statuses?

It's probable that the Ganna team would say this would never happen, because they were careful, and gay rights have progressed so far, and we will never go back. This is a hopeful but seriously naive position. LGBT rights are being eroded every day today, by state and federal actions.

Still, I expect Ganna's group would say, in the end, science requires us to understand the world, and we simply must know more about human identities and behaviors. But if a general desire for genetic knowledge is so strong, why are teams like Ganna's not looking for genetic causes of homophobia, or of a desire to police others' sex and gender variance? How about the genetic markers for people who seek simplistic explanations for complex human behavior? Those are phenomena that cause a great deal of social harm, and deserve at least as much scrutiny as why people experience same-gender attraction.

Perhaps I sound very cynical. But one of the fundamental lessons of intersex experience is that doctors and scientists will tell people they are acting in your best interests, while cutting up your genitals and lying to your face about what they did and why. That's why I may be a social scientist, but I am distrustful of scientists when they act in the realms of sex, gender identity, and sexuality.

Some LGBT people, particularly white, upper-middle-class ones, may not yet have had the bubble of privilege popped--the one that lets people believe that social institutions will always act to protect them. And they are still rooting for scientists to find a set of biological causes--genes, prenatal hormone exposures, physical anomalies--that will prove they were "born that way."

But intersex people know better.

On Sex/Gender Checkboxes

Day in and day out, sex and gender minorities are boxed in by being confronted with sex/gender checkboxes. This starts the moment we are born, when a binary sex must be checked on our birth certificates: “male” or “female.” For individuals who are born with visibly intersex bodies, this requirement causes a crisis. Families and doctors make hasty decisions about which box they'll force us into, and we have to live with the consequences all of our lives. Having checked off a binary “M” or “F,” those with authority over our infant bodies often feel that trying to reshape our bodies conform to the box they've picked is unavoidable. Thus, genital surgeries are routinely performed, despite the deep unhappiness so many intersex people voice about the results as adults. Great pain might be avoided if parents were allowed to acknowledge our physical truth on birth certificates which included an intersex checkbox, or if the gender marker requirement were simply removed.

For people who are trans gender, gender transitioning is made traumatic in large part due to the checkboxes we must face daily. Binary gender markers are everywhere: on our drivers' licenses and passports, on loan applications and job applications, and on websites everywhere (from Facebook to shopping sites to online radio stations). Once you've checked off one box, changing it is bureaucratically and legally difficult—and sometimes there's no way to change it at all. This leads to all sorts of hassles and embarrassment, as we're “outed” in odd contexts. Worse still, if the gender we're living in doesn't match the marker on our ID, we're subject to being banned from flying, arrested by bigoted police officers, and denied employment.

For folks who don't identify with a binary gender, the world of checkboxes constantly denies our very existence. We go institutionally unrecognized, with no way to even try to say “I am here!”

Sex and gender minorities have some protection in institutional settings that bar discrimination on the basis not only of sex, but of gender identity or expression. But often, such policies are adopted with no follow-through on what it really means for a university or company or city to protect gender identity and expression. Unaware of our needs, administrators think only of ensuring that trans people aren't being kicked out just for gender transitioning. While this is certainly important, there are many more needs that must be addressed. And central among these are that sex/gender checkboxes protect the rights of sex and gender minorities.

I have written a Best Practices guide that is under discussion at my university. It lays out a plan for rewriting sex/gender checkboxes that is meant to address the needs of intersex, trans gender, and gender variant people, in this case, in a university setting. There are some inevitable compromises in it between institutional desires for simplicity and brevity, and our desires as individuals to have our identities recognized in all of their fullness and uniqueness. But I wanted to share it here so that other people who are looking for a guideline to use in seeking to better the way institutions around them limit sex/gender choices would have something to start with. It doesn't address the problem of birth certificates, for example, since universities don't issue them. It does, however, address the question of how sex and gender and sexuality should be measured in research in some detail.

Please feel free to share and employ at will.

Best Practices for Identification of Sex/Gender

Compiled by Dr. Cary Gabriel Costello

I. Foundational Principles

Institutions which commit themselves to protecting against discrimination on the basis of sex and of gender identity or expression (GIE) must give individuals the right to self-identify their sex/gender.

Whenever data are gathered about sex/gender, the rights of GIE minorities (intersex individuals, trans men, trans women, and individuals with alternative gender identities) must be protected.

II. Definitions

“GIE minorities” include intersex individuals, trans gender individuals (trans men, trans women, and individuals with alternative gender identities), and people with variant gender expression.

Intersex Persons

While it is common to believe that sex is binary—that is, that all people are born either male or female—in fact, sexual characteristics exist as a spectrum. There is a great deal of variation in chromosomes (XX, XY, XXY, XYY, etc.), hormones (relative levels of estrogen, progesterone and testosterone), secondary sexual characteristics (breasts, hair distribution, etc.) genital configurations, and gonads (ovaries, ovotestes, testes). Intersex people are individuals whose sexual characteristics fall toward the middle of the spectrum. Approximately 1 in 150 people are intersexed according to medical diagnostic criteria. Most are very private about this status, though some are public about it.

Trans Gender Individuals

Individuals whose gender identity does not match the sex they were assigned at birth are deemed trans gender. A trans man was assigned female at birth but identifies as male; a trans woman was assigned male at birth but identifies as female; a genderqueer individual may identify as neither male nor female. Trans gender individuals often transition to their sex of identification, though they may do so in different ways. Some transition socially by changing name, pronoun, and dress. Others also take hormones (testosterone or estrogen/progesterone) to alter their bodies. In addition, some get surgery to change their chests or genitalia. Because surgery is quite expensive, may not be covered by insurance, and because it carries serious risks, many trans gender individuals in the U.S. do not seek or are unable to access surgical transition services.

Variant Gender Expression

People of any sex or gender may have an atypical gender presentation—male femininity, female masculinity, or androgyny.

III. Best Practices in Collecting Data about Sex/Gender

The best practices for collecting data about sex/gender depend on context. If collecting data about sex/gender serves no purpose for the individuals from whom it is collected, then eliminating the question is the best practice. If data are being gathered to protect the rights and well-being of individuals, then individuals should be given self-identification options that allow GIE minorities to self-identify. These options include a shorter form for ordinary uses, and longer forms to be employed in research contexts.

Eliminating Unnecessary Requirements for Individual Sex/Gender Identification

There are many institutional contexts in which people are routinely asked to identify their sex/gender based on common marketing practices or institutional tradition rather than an intent to protect the individuals from discrimination on the basis of their sex/gender. (For example, this is a common requirement in registering to use website services.) In this situation, the best practice is simply to eliminate the unnecessary requirement of declaring sex/gender.

Standard Best Practices Short Form for Sex/Gender Identifications

In contexts in which data is collected order to ensure equal treatment and respect for all, information about sex/gender should be collected in a manner that protects GIE minorities. The goal in implementing sex/gender categories for general data collection is to protect the rights of all people, whatever their physical sex status or gender identity, including intersex individuals, trans men and trans women, and individuals with alternative gender identities. Thus, the inappropriate single question (“Sex: Male__, Female__”) should be replaced with a three-stage approach.

1. Gender identity: Woman __, Man __, Alternate Self-identification (please write in) ______________.
2. Do you have an intersex condition (disorder of sex development)? Yes__, No__.
3. Are you trans gender? Yes__, No__.

In order also to ensure nondiscrimination on the basis of sexual orientation, best practices add a fourth question unrelated to GIE:

4. Sexual orientation: Heterosexual __, Lesbian__,  Gay__, Bisexual__, Queer__, Pansexual__, Asexual__, Alternate Self-identification (please write in) ______________.

AVOID poor practices which undermine individuals' identities instead of protecting them. A common poor practice is to use a single additional checkbox: “Male__, Female__, Transgender___.” This is inappropriate for several reasons. First, it does not allow intersex individuals a way to identify themselves. Secondly, it discriminates against trans men and trans women by framing trans gender identification as incompatible with “real” male or female status. And thirdly, it does not allow for recognition of the distinct needs and identities of individuals who identify as neither male nor female.

Best Practices Long Forms for Research Contexts

Data about sex and gender are often collected in the course of research. If data are to be analyzed along the dimensions of sex and/or gender, two sets of needs must be met. The first relate to the rights of research subjects, who must be protected from harm, including the harm of discrimination on the bases of sex, gender identity or gender expression. In conducting research with human subjects, researchers will inevitably recruit research subjects who are intersex, trans gender, or variant in their gender expression, and are ethically obliged to treat them with respect. The second issue relates to the need of the researcher to have research questions carefully worded in a manner that subjects will understand and respond to in a reliable and valid manner.

Many scientific studies today continue to use “sex” as an independent variable, and measure this in a binary fashion. This is a methodological flaw, as well as discriminating against GIE minorities. It does not allow the researcher to measure what actually accounts for observed variance in the dependent variable: is it physical sex status, internal gender identity, gender-conformity or nonconformity? Just as a study that uses religion as an independent variable is improved when it not only identifies subjects as “Christian,” but allows the subjects to identify a more specific denomination, asks them how religiously observant they consider themselves, and inquires as to how often they attend church, increasing the sophistication of sex/gender questions improves study results.  The following measures are suggested:

1. What gender do you identify with? Man__, Woman__, Other (please write in the identity)________________.
2. What sex category were assigned at birth? Male__, Female__.
3. As far as you know, were you born with an intersex or sex variant body? Yes__, No__.
4. Please indicate how masculine or feminine you are in your dress and manner on the following scale: (1) very masculine, (2) moderately masculine, (3) a bit masculine, (4) androgynous, (5) a bit feminine, (6) moderately feminine, (7) very feminine.

In order also to ensure the study is not discriminating on the basis of sexual orientation, and to gather better data, best practices suggest that subjects also be surveyed on their sexual identity. Problems are often raised by the traditional method of asking subjects if they are “heterosexual, homosexual, or bisexual.” For example, people who are gender transitioning or who identify as neither male nor female are often unable to use these sexual orientation categories to classify themselves. Furthermore, it is well established that there is a difference between how many people identify their sexual orientation and the sexual activities in which they actually engage. This may be addressed through questions such as the following:

1. To whom are you attracted, sexually and romantically? (1) only men, (2) mostly men, (3) a bit more toward men than toward women, (4) equally toward men and women, (5) a bit toward women than men, (6) mostly women, (7) only women.
2. With whom have you been sexually involved? (1) only men, (2) mostly men, (3) a bit more men than women, (4) equally men and women, (5) a bit women than men, (6) mostly women, (7) only women.
3. Are the people to whom you are attracted (1) very masculine, (2) moderately masculine, (3) a bit masculine, (4) androgynous, (5) a bit feminine, (6) moderately feminine, (7) very feminine.
4. Consider the idea of a partner who identifies as neither male nor female, but as some other gender such as “genderqueer.” Do you find that (1) very appealing, (2) moderately appealing, (3) a bit appealing, (4) I feel neutral about it, (5) a bit unappealing, (6) moderately unappealing, (7) very unappealing.

Researchers who choose specifically to study GIE minorities should consider them a vulnerable subject pool for IRB human subject protection purposes. In cases of studies recruiting intersex, trans gender, or gender-variant subjects, procedures should be set in place to protect these vulnerable subjects, and the questions asked about sex and gender carefully designed to accord all subjects with full respect for persons. Confidentiality should be strictly protected, data collected in a location where subjects will not be at risk of having others see or overhear their responses, and information sheets listing appropriate support groups and links to mental health resources distributed to those recruited to participate.