Sexy Science Symposium
October 27, 2024
Let’s talk about sex. Not the kind of Dr. Ruth Westheimer, but the kind that’s on the ballot. And pre-emptive apologies for going long with the blog, but sometimes we have to play the long game. Before we do, here’s a little background: The United States is in the throes of election season, and political ads are running endless loops of bunk. While we don’t know the election’s outcome, we do know one thing: Voters have been consistent that they are most interested in the economy. Yet, it is gender and anti-trans rhetoric that is dominating the repeating cycle across media platforms. Our government is attacking us. According to the Human Rights Campaign, as of 2023, over 520 anti-LGBTQ+ bills have been introduced in state legislatures and over 200 bills specifically target transgender and non-binary people. Non-binary is a term that describes a person’s identity that doesn’t fit squarely into male or female. To be clear, these bills target human beings. These bills target people who are citizens of the United States of America. These bills target individuals deemed as “other” when there is no such thing where humans are concerned. Recall that in addition to Jewish people, Black people, people with disabilities, and “other” select groups, Adolph Hitler and the Nazi regime also targeted and dehumanized people of the LGBTQ+ community. Nazi Germany was defeated in 1945, and the Defense Casualty Analysis System estimates that 405,399 American service members died in World War II. Did our ancestors die in vain?
Project 2025, the 922-page blueprint for the next Republican president, targets LGBTQ+ individuals and refers to Trump 270 times. Moreover, in Agenda 47, Trump’s 16-page GOP Platform to Make America Great Again, Chapter 9, item 5 states: “Republicans Will End Left-wing Gender Insanity.” In addition to attacking its own citizenry, these laws and platforms do so without a complete understanding or knowledge of human biology. However, biology really shouldn’t matter, because in American democracy, people should not be targeted by their government. Note that in states with anti-trans laws, suicide attempts by youth identifying as trans and non-binary increased 72%. These are our children. Perhaps understanding a little basic science and applying some human kindness might help calm the chaos. This particular topic is complex because humans are complex. Yet, the underlying fact is that there are no abnormal people.
No law aimed at people identifying as LGBTQ+ has any foundation in science or medicine. To help in our understanding of a complicated issue, let’s focus on a few key words and phrases that come up in discussions, political ads, and legislation. The paragraphs that follow are a distillation of the complexity of human development, genetics, anatomy, and physiology. It’s like trying to explain the unified field theory by describing it as “the theory of everything” without providing the supporting math and physics. The first common phrase is “sex assigned at birth.” This is merely a label given to an infant shortly after entering this world based on visual examination of external genitalia. The healthcare provider typically records male or female in the birth record. Before reading further, review the opening image, labeled karyotype. A karyotype is a picture of a person’s chromosomes. But chromosome count is variable. At birth, no karyotyping is done.
Humans have 23 pairs of chromosomes, with the last pair called sex chromosomes that are labeled X and Y. Sex is used to divide humans into two groups, male and female, on the basis of reproductive function. And is written as:
•XY, male; assigned male at birth (AMAB)
• XX female; assigned female at birth (AFAB)
In each case, someone else is making the decision about a newborn’s sex by just looking at the body. However, this can be wrong. One reason is because some infants (about 1 in 2000 births) are born with ambiguous external genitalia and cannot be clearly identified as male or female. Another reason is that a person’s sex is not always determined by external anatomy. We have internal anatomy, too. Furthermore, some individuals are born intersex, meaning that sex characteristics, genitals, reproductive organs, and chromosomes may not match the binary XY or XX. So, including “sex assigned at birth” into legislation creates problems because not all humans are XY or XX. We are a rich tapestry in which there can be a mismatch between sex chromosomes and anatomy. Such is the case with “differences of sex development (DSD)”, a group of conditions in which an XY individual is born as female, and an XX individual is born as male. This means that a person whose genotype is XX born as male, has testicular tissue instead of ovaries or gonads or a mixture of both. Then, there are individuals who are intersex meaning they have a mosaic karyotype in which some cells have one karyotype, and other cells have a different karyotype. And this is just the beginning of a very complex topic. Many variations aren’t known until teenage years or upon dissection in a cadaver lab. If you’re interested in learning more about anatomic variations in humans, my colleague, Dr. Kevin Patton, has a great podcast exploring this topic (link at bottom of page).
Let’s wrap up by discussing gender identity, sexual orientation, and transgender.
• Gender identity is more nuanced than sex; it is the person’s internal sense of being male, female, both, or neither and how they should conform to social norms.
• Sexual orientation is a person’s emotional and/or sexual attraction to another person and is independent of gender identity.
• Transgender is an umbrella term describing people whose gender identity, internal knowledge of self, gender expression, or behavior is different from the sex they were assigned at birth or grew up thinking they were. Some transgender people choose to medically transition so that their personal gender identity can match their outward appearance. This is known as gender affirming care. Medical and other professional organizations, including the World Health Organization (WHO), American Medical Association, American Academy of Pediatrics (AAP), American Psychological Association (APA), and the World Professional Association for Transgender Health (WPATH), offer guidelines, policies, and support for access to evidence-based health care for a transgender world.
Because humans are products of a long evolutionary chain, nothing described in the previous paragraphs is new. It’s merely that language has also evolved, and science has advanced. Recall Hermaphroditus from Greek mythology: Hermaphroditus was the two-sexed child of Aphrodite (Venus) and Hermes (Mercury). In fact, an outdated term for intersex is hermaphrodite. The animal kingdom also offers countless examples of our sexual spectrum: male seahorses give birth; clownfish can change their sex depending on circumstances; and giraffes and bottlenose dolphins routinely engage in homosexual activity. The natural world has multitudes of other examples.
The overarching theme: We humans are who we are. Stop legislating hate.
References
• The A&P Professor, “Anatomic Variations in Humans”, TAPP Radio Episode 43
theAPprofessor.org/podcast-episode-43.html
• Human Male Karyotype Image
Courtesy: National Human Genome Research Institute, Public domain, via Wikimedia Commons
https://commons.wikimedia.org/wiki/File:Human_male_karyotpe_high_resolution.jpg
• Project 2025 Presidential Transition Project
https://www.project2025.org/