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Friday, September 14, 2018

Transphobia Busting #1: The Myth of Biotruth

"It's just a fact."  From Assigned Male Comics.  (Updated.)

The idea that trans folks are irrevocably the sex assigned at birth is a myth, and a transphobic one at that.  The fact is, "biological sex" is a social construction; but to understand why this is, we'll need to go beyond high school biology.

There are two ways to demonstrate this:  the mosaic theory of biosex in particular, and the social construction of knowledge in general.  Wait, three ways:  a YouTube video of someone explaining the core concepts!  Riley J. Dennis has made two such videos, the latter of which clarifies and expands on the former:

Trans women are not "biologically male," by Riley J. Dennis.

Male and female are binary, but people aren't, by Riley J. Dennis.

But if you're like me, you can read faster than people can talk, and you might be at work and thus unable to listen to a video, and you might want text that's machine-searchable and copypastable.  That's why I'm here!

The Mosaic Theory of Biosex

We pretend most of the time in common parlance that biological sex is one objective and easily decidable characteristic of a person, but this is not so.  The concept of biological sex, as used by biologists, is actually composed of five completely different things:  chromosomes, genitals, gonads, hormones, and secondary sex characteristics.  Gender has all these in addition to gender identity, gender role, and erotic preference, but these are subjectively experienced and performed, not objectively measurable - interestingly, it also means that the criteria of biosex are part of gender taxonomy.  While the components of biosex are objectively observable facts, lay folks have this annoying habit of pretending A. they all go together (they don't, that's an erroneous oversimplification), B. they're supposed to go together (they aren't, that's bionormativity and it's dumb), and C. they can thus make valid inferences based on a quick glance on the street (they can't, but they rarely get corrected so the misconception persists).  Let's take it by the numbers!

Chromosomes are what a lot of people lean on when stating "just the facts":  that XX is female and XY is male.  The reality is not that simple.  In brief, people can be genetically XXX, XXY, X, or even XY and externally female, or XX and externally male.  Moreover, while conditions such as infertility can result from such chromosomal arrangements, they don't always:  there is a case of one XY female who gave birth to an XY daughter, which shows that the condition of being XY and female is unknowably prevalent without the costly method of at least karyotyping a huge number of people.  While all known cases of XX males are linked to infertility, these individuals were only tested as a result of said infertility, which means that any fertile XX males could easily go their whole lives without karyotyping.  The bottom line is that you just can't determine someone's genes by external observation, even if those people are cisgendered.

Genitals are externally visible, but sometimes ambiguous.  They are also the primary means of assigning a baby's sex at birth:  for a long time, doctors decided that an "acceptably long phallus" meant "male," and anything else was "female," because it's easier to give someone a mostly-working vagina than an even partially-working penis.  In the 20th century, when such cases arose, doctors would approach the parents with heavily loaded language and say that there was a complication that would result in social difficulties later in life, but there was a medical solution!  Let us do surgery on your kid, and they'll be fine.  (Source:  lecture notes from Sex, Values, and Human Nature, taught by a professor with joint appointments in biology, philosophy, and WGS.)  The doctors would then attempt to surgically normalize the infant's genitals, sometimes with follow-up hormone prescriptions without the patient's knowledge or consent.  Sometimes this went fine, but sometimes it went horribly wrong, as in the case of David Reimer*:  a botched circumcision led to doctors recommending vaginoplasty and hormones, which the parents accepted, and later in life David strongly identified as male and transitioned to reflect his identity; due to a number of issues, however, he ultimately committed suicide.  The point is that often such birth determinations need to be later overturned, so genitals are also out as sole determinants of sex.  Moreover, due to intersex conditions and surgical procedures, you simply can't tell what someone's genitals are without seeing them naked anyway; you have to guess, and while you'd be correct a large percentage of the time, it's still a guess and you can't tell when you're wrong without further examination that would constitute a huge privacy violation.  In other words, you assume and almost never get your assumptions corrected, so you have no idea how often you're wrong.

Gonads are the sex-cell-producing glands (such as testicles and ovaries) that are needed for reproduction.  These are sometimes streak or infertile, though, so they are also not a foolproof guide.  Additionally, you cannot tell the presence or state of gonads simply by observing someone on the street, and most people never get their gonads checked in any but the most cursory of ways, unless some issue comes up that requires such a check.  The point here is that, while gonads typically develop in certain ways, there's no deriving normativity from these bare statistics (which remain largely unknown due to the cost and non-necessity of diagnostic procedures) without smuggling in a whole pile of values that will predetermine such analysis.

Hormones are molecular messengers in our blood and other fluids that can do all kinds of things.  In humans, males typically have high testosterone and females typically have high estrogen.  However, these cannot be measured except through bloodwork, which again isn't free or common without a need to investigate**.  Women with PCOS report feeling crappy in ways that sound lots like gender dysphoria, and low testosterone predicts depression in men.  I've read anecdotes about similar dysphoria-like symptoms in cis people who take hormones for medical reasons unrelated to gender identity, and about rampant self-harm and suicide in female Soviet athletes injected with testosterone in the 70s and 80s, but haven't yet been able to turn up citations on those (will update if/when I do).  The point being that, to all indications and the best of our ability to tell so far, it looks like a mismatch between hormones and gender identity can cause problems, and transition is the best and only recognized treatment for resolving this mismatch (at least, according to the American Medical Association, American Psychiatric Association, American College of Physicians, National Association of Social Workers, Royal College of Physicians, and National Health Service - among others!).

Secondary sex characteristics are a pile of traits like facial hair, Adam's apple, muscle mass, body odor, and so on.  Quite frankly, these are a complicated pile and while they're affected by hormones, everyone's a shuffled mish-mash of 'em.  Moreover, on pretty much every single such trait, there is more variation within each group than between both groups:  e.g. men on average tend to be taller than women, but most men and women are in the same height range.

The tiny distance between the bell tops is just obviously more important than the massive
overlap between their bases and their overall extent - right?  From Perry Street Palace.

The point is that while general trends exist and are measurable, they're not useful in determining individual status.

Putting it all together, if you were to draw a line down the center of a piece of paper, and put male-typical biotraits on one side, and female-typical biotraits on the other side, you would have a whole pile of biotraits that could actually go either way.  Any trait a cis woman might have, another cis woman might not have, and a cis male might also have. And vice versa:  any trait a cis male might have, another cis male might not have, and a cis female might also have.  Some cis women are born with XY chromosomes or ambiguous/atypical genitals; some don't have a uterus, ovaries, or breasts; some have never menstruated and won't give birth; some have thick facial/body hair, large frames, big muscles, or high testosterone & low estrogen; some look androgynous or like cis men; some take hormones or get plastic surgery to improve their quality of life; some are even raised & socialized as boys, or new info comes up to make doctors rethink their birth sex days-to-years later.  In other words, none of these traits "go together," it's completely normal for every person to be a shuffled mish-mash of them.

The simple fact is, there is only one thing that all cis women have in common, and that's that they identify as women.  Any cis woman might have any number of the above conditions; trans women just have the misfortune of having more of them than average (some cis women have more than some trans women, though!).

If you're gonna say trans women are biomales, then you have to say why they are ("they just are" doesn't count); that reason will necessarily bring a lot of cis women into the biomale category (and cis men into the biofemale category) as well; this is an absurdity, so you have to do something to resolve the absurdity.  You can reject the idea that trans women are biomales, or you can decide there's a special rule that only applies to trans people, thereby engaging in special pleading just for the purpose of excluding trans women (i.e. textbook transphobia).

The Social Construction of Knowledge

The very idea of biosex is a social construct.  Importantly, "social construct" doesn't mean "total BS," it just means that humans decided where to draw dividing lines, and we're not "cutting nature at its joints."  Nature doesn't have joints. Also, everything we care about is a social construct as well, so it's not a knock, just a fact: we decided that certain differences were important enough to warrant an ontological distinction (i.e. "this difference makes a different kind of thing, not a different example of the same kind of thing").  These distinctions are very useful all the time, but they are made, not found. In summary: differences are found in nature, but all distinctions & categories are cognitive inventions.

So let's just take the category "human" as primitive ("human" is also a social construct, but we're not gonna worry about that right now).  We've got a pile of humans, all the humans who ever have or ever will exist. They have differences, but so what? These differences don't matter to us right now.  But then you say, "We should actually make two piles out of this one, and call them Male and Female." Like, why? Why do we need this distinction? Whatever reason you give to motivate the distinction, that makes it motivated reasoning ("Well, this is what it takes for reproduction to occur." OK, so you're reproductively motivated - but why is that important?). We could pick any criterion we wanted to divide people into piles, the list is literally endless.  So that's Problem Number One: any distinction is inherently motivated reasoning, and therefore not impartial/objective reasoning.

Moreover, whatever trait(s) you do pick to make the distinction, just aren't gonna line up cleanly with how you want the categories to go (see the mosaic theory of biosex, above).  You're going to drag some cis women into the biomale pile as an inevitable consequence of trying to get all the trans women into it. There just isn't a single trait or group of traits that will get all the trans women, and only the trans women, into the biomale pile.  You can't pick "transness," because we haven't even made our "male and female" piles yet, so there's no cisness or transness to do that with - in other words, sex comes ontologically before cis or trans, and thus has to be decided without referencing any categories we make later.  This is Problem Number Two: our dividing lines can't be made clean, no matter what we do, because everyone's a shuffled-up mish-mash of traits.

Finally, we can draw up these distinctions however we want (and quite frankly, we're going to get arbitrary if we're gonna decide all cases; picking which cases to decide or not is also arbitrary; and ultimately, even deciding to make any decision at all is also arbitrary).  So let's be trans-inclusive, because trans folks are people too. Oh, you don't want to be trans-inclusive? OK, that's transphobia. If you say, "Well, women are supposed to be this way," stop right there - says who? There is no "supposed to," that's imposing normativity on nature; we're just talking about what is, there is no "should."  Here we find Problem Number Three: there's just no Platonic standard to appeal to, we have to decide and monitor our motivations in doing so, without appealing to normativity in the process.

The bottom line here is that any way of deciding what kinds of things exist and how to group them (i.e. "ontology") is going to be necessarily motivated at root, so we have to decide what we let motivate our decisions.  We can go with permissive and inclusive ontologies if we want to be permissive and inclusive; saying No We Have To Go With THIS Ontology And It Excludes Transes Sorry I Don't Make The Rules It's Just A Fact, is plainly and obviously transphobic, because you're making a choice and then insisting that everyone has to make the same choice as you, and it's perfectly clear that you're making the choice that way because you don't want trans women to count as "real women."

With acknowledgment to reddit user tgjer's Master List of Trans Health Citations.

Notes
* - I am reluctant to use Reimer as a political football, however the case is simply too instructive and concrete to ignore.  As Reimer's case was used in his lifetime to validate the malleability of gender, I feel that undoing that damage by working against those misconceptions is a worthy purpose to which his legacy may legitimately be put.  Thus, Reimer joins the uncomfortable list of Inherently Problematic Yet Socially Invaluable Knowledge, alongside the likes of Henrietta Lacks, the Tuskegee syphilis experiment, and the Milgram obedience experiments.

**I, however, did need to get bloodwork done when I got my hormone consultation, and as it turns out my testosterone was way lower, and my estrogen way higher, than a typical male's.  While I was hormonally closer to a male than a female, I wasn't really clearly either; and as my dysphoria significantly reduced on starting hormone replacement therapy (HRT) and then went into remission after 18 months, as well as significant reduction in my already mild bipolar tendencies that multiple regimens of antidepressants and mood stabilizers exacerbated, I call that a winning outcome.  Hormones are part of biology, and so hormonally I am more female-typical, and in this respect I am biologically female.

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