Sunday, May 28, 2017

Sex and Gender are a Spectrum: And Here Is All the Non-Glamorus Proof

So, let's start at the beginning.

We have the penis. And we have the vagina. And when two people love each other very much...

Ok. Yes. We are all familiar with the most basic mechanics of reproduction. So how is any of this the big question right now?

When it comes to sex and gender, is that what it all boils down to? Scientifically, do we end the discussion at that macro-binary of a level, or is there a lot more to it? What does medical science say? What does biology say?

Let's get this clear. Both medical science and biology have long progressed, as disciplines, well past this simple macro question. To tell governments and societies how to organize their cultures is not the goal of biology or medicine. So finding a study that seeks to provide a definitive answer to a question that seems overly simplified to the professionals involved is going to be difficult. However, a recent study by Stanford University into the "Genetics of Sex Determination" does express that neither male nor female seem to be the "default" sex development pathway, and suggests that terminology needs to change in response to this information. 

Yet, when Bill Nye "The Science Guy" is making entire episodes about this subject, and even Adam Savage of Mythbusters so boldly tweeted recently, "Gender is a spectrum. The closer you look at anything the blurrier the lines get. Including gender", we continue to ask. Where is all the supporting evidence?

When defining sex--and by extension it's psychological and cultural component, gender--is this true? Is it a spectrum? Isn't it all just about about simple reproduction?

The latter sounds legitimate when you and your peers are all in that age group that's readily-to-relatively fertile. But let's take this a little further. What about the rest of the population? Where does everyone who cannot reproduce due to infertility or dysfunction fall into this idea that sex is solely defined by reproduction?

Think this is already starting out a little silly? Well. Keep in mind this whole debate that's going on regarding intersex and transgender people, especially non-binary transgender people, is about defining "sex" in completely rigid terms. So, we are going to discuss this using the strictly binary standards that have been proposed by many.

Strict and non-subjective, just how we want it, right? So don't walk away, please. Just hear me out.

Since on average, fertility and sexual function declines from a starting 92% down to mostly prohibitory levels in both women and men by age 55, it is probably safe to say that less than 50% of the human population is fertile at any one time.* With this being the case, do the other people who are unable to reproduce even have a sex? If there are only two sexes, and it's based on reproduction--forget about trans people and intersex people and anything that smacks LGBTQ for a moment--where do the seniors and the children fit in to this idea that sex has to be divided into reproductive norms? As a mom myself, that all feels a little creepy once you start thinking about it, if you ask me.... For just those over age 40 or 50, as well as children under age 14, do these people even have a gender or sex if they really aren't reproductive?

A little ridiculous and again, creepy taking the concept to such rigid extremes right? Am I implying that ideas of "male" and "female" applied to children may actually be harmful for their security and psychological development in ways we don't often think about? Think for a second about how exactly do all those pedophiles marrying children in the Middle East rationalize it? Oh, she's a female, so she is inherently valuable, and so then becomes an economic pawn to be segregated and bartered off by her own parents. Hmm...

So stop right there. Take a moment to rationally and seriously think about that point just as rigidly as we many want to think of the sex and gender of intersex people--both intersex adults and intersex children--who are said to have "reproductive abnormalities".  They cannot reproduce.

Now think of the fact that a large part, perhaps even the majority, of the human population cannot reproduce.

Chew on that for a bit and just hear me out.

If that's ultimately where this sort of rigidity takes us, is there any reason we can't suggest the following idea instead?

Reproduction is simply the most comprehensively anchored way to define two polar opposites of sex, with male on one side of a spectrum and female on the other side.   And between those two poles, the spectrum includes many varying combinations of modifying factors which each contribute to successful reproduction: endocrine, genetic, neurological, and physical sex modifiers.

For simplicity, we could easily compare this to a football field, with goalposts on either side. The game is human procreation. There are two sex "end zones", but those two halves of the field are connected by "yard lines", one after another, in increments of biological maleness to femaleness, with intersex perhaps around "the 50 yard line". Every "down" between two teams would symbolize sexual orientation and eventual intercourse. The "downs" happen all over, and you see a lot of qualitative action all over the field, but the polarized fertile heterosexual sex "touchdowns" are what typically progresses the game quantitatively on the scoreboard. And so, interestingly, we then come face-to-face with the ever-debatable question of all sports enthusiasts: Which is more important, winning or playing the game? Well, ultimately they both go hand in hand, don't they?

So while sex has two polar opposites, or "end zones", at each "yard line" in between there is, again, a lot more that happens endocrinologically, genetically, and neurologically.

And all of those facets do also add to reproduction. They influence a variety of things, some social and some biological: Who will you sleep with? What are your preferences? Who will you attract? What causes you to behave with those sexually-charged behaviors? Are you fertile? Do your attributes signal male fertility or female fertility, or a little of both, or neither?

All of these factors are a part of a much more intricate sex spectrum, with two opposite poles. Just like political labels go from liberal to conservative, with a hell of a lot in between, the same goes with male and female.

Since it was the middle-ground in our hypothetical football game, and this is a pretty controversial claim, now let's tackle that big topic: Intersex people. Genetic intersex "conditions" make up, at most, 2% of the population, right?

Outliers, right?

Well, it may seem like that, but what about the people who can't reproduce and aren't genetically intersex, and aren't specifically seniors or children? As I said above, there are loads of reasons as to why someone may not be able to reproduce, or may have low fertility (PCOS, low progesterone, low testosterone, Turner syndrome, Swyer syndrome, ect). If you're going to define sex at all, and if it's going to be rigidly about reproduction, then there are a lot of things you have to consider beyond the simple structure of someone's genitals.

Wait. Hold up. Wait just ONE minute. Those are health issues! You're trying to pull the wool over my eyes! If a healthy male mates with a healthy female, they should be able to conceive! That's just reproductive health, for you!

If you were thinking this, well, that's absolutely what I'm getting at.

However, what does it mean to be a "healthy" "male"?

Everyone becomes infertile at some point in their life. A male that has had a vasectomy is still healthy isn't he? His endocrine system and other things will still even function the same way... he just will not be producing sperm. Is this unhealthy? Not at all. He can still live a healthy, productive life and have healthy sex.

Also, for people who are typically overwhelmingly concerned about "feelings" tainting this issue, is "health" any better of an argument? Isn't health somewhat subjective on this subject?

If we are going to look at this with all seriousness, and without making a subjective "good vs bad" judgement call, like in the case of a vasectomy and the person that thinks it's a pretty good decision while some people think it's pretty bad and "unhealthy". When we consider this all objectively, you can't then think in terms of, Well that middle area is just bad and unhealthy.

The United Nation's Guidelines on Reproductive Health is in line with this, stating that reproductive health "is a state of complete physical, mental and social well-being, and not merely the absence of reproductive disease or infirmity. Reproductive health deals with the reproductive processes, functions and system at all stages of life."
Every individual has the right to make their own choices about their sexual and reproductive health. - See more at: http://www.unfpa.org/sexual-reproductive-health#sthash.FxI9eCGb.dpuf
Every individual has the right to make their own choices about their sexual and reproductive health. - See more at: http://www.unfpa.org/sexual-reproductive-health#sthash.FxI9eCGb.dpuf
Every individual has the right to make their own choices about their sexual and reproductive health. - See more at: http://www.unfpa.org/sexual-reproductive-health#sthash.2oYBJiRx.dpuf
Every individual has the right to make their own choices about their sexual and reproductive health. - See more at: http://www.unfpa.org/sexual-reproductive-health#sthash.2oY

So those people in the middle are not just "unhealthy", "emasculated", "effeminate" men, or "unhealthy", "masculine" "mannish" women... All of those are subjective terms based on the very first assumption: That sex is only about reproductive anatomy and influencing chromosomes. Every survivor of testicular cancer and every person with Klinefelter's syndrome understands their maleness is not solely tied down to these ideas. If you instead understand that fertility does not imperatively have to be an emotionally driven judgment call on your health--that many people are infertile and have many other sex differences, and these people can and are leading very happy lives--then you have no problem saying a person with a vasectomy is perfectly healthy, but might be considered, scientifically, just a hair right of male, if we are still looking at sex in reproductive terms.

And that is an infinitely small example of where that person exists on the sex spectrum, just to show what I mean when I say "spectrum" with all its tiny increments. And of course that guy with the vasectomy probably screams "male" in every other way conceivable, and he probably views himself as male too... So he's still male in the simplest of terms.

But really there are so many factors to consider when evaluating someone's sex and gender scientifically. Take that vasectomy example a step further to someone who has a penis and testes, is heterosexual, but has slightly elevated estrogen levels, for whatever reason. What are they?

Go further, to the LGBTQ community, with how many have endocrine differences and neurological differences which have been vastly studied, but vary substantially from person to person and can't quite be pinned down. We know there is a lot of variation in the group, with no true consistency when examining the population scientifically.

Of course, if we were to consider that perhaps our sexually-driven society (and here of course, I mean coitus) and, in turn, scientific research came at this from the complete wrong direction from the very beginning, that would add weight as well. Sex as a spectrum makes it much harder to exactly rigidly define each "down" of sexual orientation. Sexual orientation immediately becomes much tougher to define when sex has a lot of middle ground. It is important to understand in this argument that sexual orientation is probably the largest underlying reason for the all the backlash to this information, and why this is the big question right now, decried by both heterosexual and homosexual public figures who hold very emotional ties to their orientations and their surrounding traditions. And so it is important for all political camps to realize that none of the science surrounding sex need deconstruct someone's traditions surrounding their own sexual orientation, instead it simply recognizes all sexes and resulting sexual orientations as the valid life processes that they are. 

And when you consider all these examples I've mentioned in the post, end-on-end, you begin to see that those intersex people, those closest to the middle--the most agreeably intersex 2% we mentioned earlier--are not an abnormality, or even "outliers". Instead it's just part of a series of human conditions--climaxing at traditional intersex/hermaphrodite conditions in the middle--many conditions which have the chances of effecting anyone, at different levels and throughout different times in their lives. It's life, and to pathologize any of this 1. Doesn't really describe it very well and 2. Has been a source of real harm for many many people throughout our history.

And when you think about it, having all of this information to draw from regarding sex variation, and being able to define it and all of it's biological influences so intricately, means that if someone is experiencing something like infertility, or low libido, problems lactating, or anything else, doctors have a better understanding of what treatments will influence a person specifically toward the desired results while minimizing side effects that may be undesirable to that particular individual. Reproduction ultimately benefits from this understanding of the sex spectrum, as it encourages treatments that are more targeted to an individual's reproductive needs, as well as healthy, satisfying, and effective reproductive interactions.



Of course there is a lot of other evidence to consider when you start adding sex-change and transsexual studies to the information I've presented here. And it's even less glamorous. There is the history of human domestication, societal behavioral impositions, and the overall effects on the sexes which can be traced to the rise of civilization, including the biological and endocrine effects of  removing or stressing the sex glands, as well as the more recent introduction of cross-sex hormones and how they influence development. In our modern age, the further a eunuch, hijra, or a transsexual "male-to-female" crosses into the female side of the spectrum, if they are attracted to males, how homosexual are they, really? Is their attraction to males a typically female behavior or not? If it's not, then why define homosexuality in the first place? If it is than how can we not see orientation as just another incremental sex-defining attribute? Those long-standing sex-altering practices, which can be traced throughout human history, also may say something about transsexualism as the evolutionary adaptation of transgender people to civilization and it's norms. There are a lot of questions yet. It has been suggested by psychologists that gender dysphoria is a result of rigid binary gender roles and the expectations of binary cultures. This, again, does not validate a culture war over the small subset of the population afflicted by gender dysphoria, but the existence of all this information does say much more about the nature of sex itself and the validity of all sorts of transgender individuals. Yet, I provide this information as a footnote because I feel the evidence above is far more accessible, and broadly understandable in displaying the realities of the sex spectrum, without implicitly focusing on transsexual aspects of sex.


* Quickly calculating based on the available statistics, I came to a combined probability of 46.3% global fertility:

  • 13.8% of the global population is both in the 15-24 age group and fertile (7% infertility in "males" and 8% infertility in "females"). 
  • 32.5% of the global population is both in the 25-54 age group and fertile (7% infertility in "males" and about 14% infertility in "females")
 Still accounting for other considerations such as the original sample size and global representation, as well as for rare members of the global population who are outside of these age groups and still fertile, there isn't any evidence to account for even an additional 20% increase in probable fertility. Even if that were the case, probable fertility would amount to no more than 2/3 of the population, readily rationally allowing for at least three reproductive sexes--or two with a spectrum in the middle--each represented by 1/3 of the global population.