Queer | Feminist | Doctor

Archive for January, 2015

Why women aren’t oppressed solely because of their biology

CW for mention of sexual violence, genital surgery and suicide, mention of trans-exclusionary viewpoints

I’ve been told multiple times this weekend that (“true”) women are oppressed because of their biology, that it is having a vagina that makes women targets of sexual violence, that it is not possible for a trans woman to be oppressed as a woman because she is “biologically male”.

I have already written a post on why the idea of “biologically male” is a bit more complicated than TERFs would have you believe, but one of the things that I got sent was a lot of links to scientific papers on brain differences between men and women. The people who sent me these links are adamant that there is no such thing as a “male brain” or “female brain”, but as usual, the reality is more complex than that.

In the past 50 years, there have been a lot of studies into what determines one’s gender identity. In the 1960s there was quite a concerted effort made to put forth the theory that we are born as a “blank slate”, and it is only the way that we are treated throughout our lives (“socialised”) that gives us a sense of what our own gender is.

There is one very famous study which was of a pair of identical twin boys, one of whom had his penis destroyed aged about 7 months, due to a surgical accident. Their names were Brian and David Reimer. Psychiatrist John Money saw this as an opportunity to do a case study in gender, which he hoped would prove his “blank slate” views were correct – he instructed that this baby have his name changed (from David to Brenda) and that he be raised as a girl.

The study was highly unethical for a large number of reasons which I will not go into here, but initially Dr Money reported that his experiment had been successful, and that the boy David had successfully been socialised as a girl. He did not report that David became more and more insistent that he was a boy, or that before age 18 he socially transitioned to live as a man.

The whole family was incredibly damaged by the study, and both boys killed themselves before age 40. In the end this case study showed that socialisation is not the be-all and end-all when it comes to gender.

This is a problem for trans-exclusionary radical feminists, as they claim that gender identity is not a real thing, that your internal sense of your own gender comes from the ideas patriarchy feeds you about what it is to be a man, or a woman, and that any sense of gender you have is due to your personality, not due to your gender.

Were this the case then transsexual people would be considered gender-atypical rather than transsexual. But if it really were true, then why would anyone be transsexual?

Many of the people that argue that trans women are “actually men” have no experience of gender dysphoria, how stressful and damaging it can be. In fact they try to use the fact that trans people are more likely to be diagnosed with depression and anxiety, as evidence that trans people are “just crazy”, that we are deluded in our sense of our own gender.

The fact that the levels of depression and anxiety, and suicide risk, improve dramatically with appropriate treatment of gender identity disorder (including but not limited to medical and surgical treatment) is an inconvenient truth they seem to ignore.

Gender IS socially constructed, in that there is no real reason why the activities and personality traits associated with a particular gender should be unavailable to someone of another gender. But gender is ALSO part of people’s identities, their sense of self.

Cis people claiming that their gender does not form part of their identity are speaking from a position of privilege, they have the luxury of viewing their experience of the world as the default. It takes emotional intelligence and empathy to realise that while you personally may not experience your gender as part of your identity, others do.

Many cis and trans people spend a lot of time reflecting on what their gender means to them, and how to interact with their deep seated sense of their own gender. For a cis person to object to being described as cis is comparable to a pale-skinned, brown haired person objecting to being called a brunette.

That person may not identify as a brunette, but since brunette is a descriptive term used to describe a particular complexion, it would not be factually incorrect to use that word to describe them.

Trans-exclusionary feminists claim that only “womyn born womyn” experience oppression as women. I find it difficult to understand why they believe this, as it is pretty clear to me that most people judge a person’s gender based on their appearance, and not their chromosome type or their genital or reproductive anatomy.

In a society that oppressed “womyn born womyn” due to their anatomy, it would be customary to examine someone’s genitals or take a DNA test on meeting them, so that you could tell their “true sex”. This is clearly not the case.

The VAST majority of people take a glance at what someone looks and sounds like, and instantly and subconsciously put them into a box, of “man” or “woman”. They then treat that person as the gender that they have guessed. Most of the time they are right.

Some people, cis and trans, do not “pass” as the gender that they are presenting themselves as. Some women are very tall and get mistaken for men. Some men have high voices and get misgendered over the telephone.

Being misgendered is something that happens a lot to trans people, but cis people do experience it too. A man trying to be polite by opening a door for a woman doesn’t ask for her full gender history first.

So, society does not treat women according to their biology, but according to the gendered behaviours in which they engage, plus their body shape, posture, and other factors which add up to their overall appearance to others. This is called “gender presentation”.

What does “biological sex” really mean?

So I’ve spent quite a lot of today attempting to discuss gender with people who are convinced that transsexual women are (despite the name) actually men. I’m not going to reproduce their arguments here as they are upsetting for many and triggering for some, so I’m just going to explain my views on sex and gender and what evidence they’re backed up by.

There will be some descriptions of medical syndromes including intersex conditions, but I will do my utmost to keep it simple.

If you’re interested in a more in-depth examination of biological sex as a social construct I highly recommend “Hermaphrodites and the medical invention of sex, by Alice Domurat Dreger”. I read it while working with Professor Sarah Creighton, a gynaecologist whose area of expertise is adolescent and adult women with disorders of sexual differentiation.

Those six weeks changed my life in more ways than one, but it is the gender and sex stuff I’ll be discussing here!

Full disclosure: I am a medical doctor, and identify as both trans and genderqueer, and am undergoing a gender transition which may include hormone and/or surgical treatment. If that information is enough to make you reject anything I have to say on gender and sex, then I guess I just saved you the bother of reading the rest of the blog post.

But I hope, like any good scientist, that you are interested in learning about the evidence, and letting that challenge your views!

What do people mean when they say “biological sex”?

On the surface of it it seems like quite a simple thing – are you male or female? But, like many aspects of biology, it is more complicated than it seems at first glance. Over the past 150 years or so, scientists (mostly highly privileged men, let’s be honest), have been trying to figure out what determines someone’s “true” sex, and as more discoveries have been made about how the human body works, our ideas of what “true sex” or “biological sex” means have changed.

Usually, now (2015), people mean whether you’re male or female, or as I’ve been asked “are you a boy or a girl?” It is usual when a baby is born to ask “boy or girl?” and a LOT of baby stuff (congratulations cards/balloons, clothes, toys) are made in pink for girls, blue for boys, and not many other options are available!

When a baby is born we look at the external genitalia to see whether the baby is “boy or girl”, but in many cases it is impossible to tell! For a number of reasons, a girl may be born with what looks like a penis and even a scrotum (this is called “virilisation” and “ambiguous genitalia” in medical practice). Or a boy may be born with a tiny penis that looks more like a clitoris.

When someone isn’t clearly male or female we call them “intersex” – and there are intersex conditions that show up at birth, and those which aren’t revealed until later life, often at puberty. It is estimated that as many as 1 in 1500 children are born with an intersex condition or “disorder of sexual differentiation”, although some are very mild.

Historically, it used to be  said that people who were attracted to women must be men, and vice versa. This seems like a ridiculous view seen from a modern perspective – now that we understand that sexual attraction, or sexuality, is not the same as gender (how you feel) or sex (what your body looks like).

Then, as science progressed and different biological features were discovered, it was said that your hormones were what made you male or female, or what appearance the cells of your gonads (testes, ovaries, or occasionally something inbetween) had under microscope. Chromosomes were discovered, giving us another way to try to find out someone’s “true sex”.

But the fact is, no one of these features can be used to tell whether someone is male, female, or intersex. It’s true that MOST women are born with a clitoris, vagina, uterus, fallopian tubes, and ovaries, have low testosterone and high oestrogen and progesterone, and have XX chromosomes.

But there are some women who are born without a vagina (vaginal atresia, which can be caused by Mayer-Rokitansky-Küster-Hauser syndrome, and complete androgen insensitivity), some women who are born with XY chromosomes (complete androgen insensitivity), some women who are born with genitals that look somewhat, or completely  like a penis (this can be caused by congenital adrenal hyperplasia for example). There are some women who have a high level of testosterone (for example in cystic ovarian syndrome).

In truth, it looks like there isn’t such a thing as someone’s “true sex” – rather than being a binary that you can measure from a single test, it is a spectrum, made up of a number of different characteristics, including hormone levels, reproductive tract, chromosomes etc.

I often hear people proclaiming that they are “XX” or “XY” but I wonder how many of them have had their chromosomes tested? There are people in the world who have intersex conditions that they’re not aware of, although some of this is because intersex conditions have been so stigmatised that the truth was hidden from them as children, and they have grown up without this important knowledge.

More recently, brain scanning has been used to try to figure out what gives someone a “female brain” or a “male brain” – some early differences were touted as being “the answer” to why some people have a “male body” but feel that they are a woman, or vice versa.

Some of these papers showed similarities between a cis woman’s brain, and a trans woman’s brain, even without any hormone treatment muddying the waters. Other papers were less certain of the differences.

One review paper concluded, surprisingly enough, that while there were characteristics share by men’s and women’s brains, there isn’t such a thing as a “true female brain” or a “true male brain” – just like with the rest of the body.

When it comes to biological sex, you can categorise yourself and others by how many of the boxes they tick from either the “male” or “female” list – but if you try to predict someone’s sex from just one of those characteristics, you aren’t going to be right every time. T

his relates to trans men and women, because some radical feminists (called trans-exclusionary radical feminists, although apparently some prefer the term radical feminist separatists) think that trans women aren’t “really” women, and that trans men aren’t “really” men – and the arguments they use usually related to biology and the idea of “true sex”.

I’ve written this post to show that like gender, “biological sex” is an idea that only exists because society agrees that it does – which is not to say that it does NOT exist, but that the idea of what it is is socially determined, and not based in “biological fact”.

For a comprehensive explanation of sex-related brain differences in relation to gender identity, you may find this article useful, although it does get somewhat technical at points: http://www.shb-info.org/sexbrain.html

Tag Cloud