Far too few Americans understand the difference between gender and sex. And governors and legislators are now exposing their ignorance to the public.
In 1976, I was a high school teacher and I offered a 9-week elective human reproductive biology class. 46 students signed up, filling the 30 classroom seats and flowing into my lab stations. My principal, my headmaster (similar to our superintendent), and my wife sat in on some lessons. I used illustrations from the newly-released book by John Money and Anke Ehrhardt titled “Man and Woman, Boy and Girl”—now a classic in its field. All topics were handled with dignity. All student questions were answered.
Money had long before coined the term “gender”—taken from its use in language studies—to describe the scale from masculine-to-feminine that could be different from a person’s sexual orientation.
All of us should understand that not every effeminate boy is gay nor every masculine girl is lesbian. Money understood that these ranges of masculinity-to-femininity and heterosexual-bisexual-homosexual were not always linked because for 40 years, his clinic was the center of study for the many cases of gender and sexual ambiguity worldwide. While XX-XY chromosomes usually match the sexual anatomy that usually matches the hormone levels that usually matches the mental feelings of an individual, John Money had to figure out all of the various “syndromes” that occurred when these did not line up. That is why each student in my high school class came away from these lessons feeling very fortunate that these factors did all line up for him or her.
Money had solid clinical evidence for the chromosomal, anatomical and hormonal variation. But to determine whether a child’s brain had developed male or female, he had to wait for self-identification from the child. A child usually gains awareness of fitting into a gentler female role or more assertive masculine role by ages 4-to-6. But the fact that they may feel feminine but have been assigned a male name and role due to male or ambiguous anatomy is so disturbing that they keep silent about it (elective mutism). Money found that he could elicit the child’s true feelings through their first writings. A note that “I don’t wan be a boy. I wan be a girl my sister is” was evidence for the parents to allow surgeons to proceed with sex change operations and hormone therapy. Conducted before puberty, these procedures resulted in matching the anatomy with the brain gender identity.
Solid confirmation that brain gender identity and (usually) sexual behavior was located in the brain came from the initial work of R. A. Gorski in California. His team provided high dosages of testosterone or estrogens to rats during their pregnancy and found that this altered the pups behavior after they were born. Cross-sections of those rat brains detected structural brain differences due to those fetal hormones. This was published in June 1978 in the journal Brain Research as “Evidence for a morphological sex difference within the medial preoptic area of the rat brain.”
Dick Swaab in the Netherlands then led his team to find a similar male-female difference in the human brain. And when they examined transsexual brain samples, they found that male-to-female transsexuals had a “female brain” even though they had XY chromosomes and male anatomy. However, in the case of male homosexuals, this section of the brain was similar to heterosexual males, not females. This was further evidence that “gender” (feeling effeminate or female) is not the same as “sexuality” (who a person ideates having sex with). That research was first published in the journal Brain in 2008 as “A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity.” Additional confirming studies followed.
I described Money’s work to an audience of Kansas biology teachers over a decade ago. One Wichita teacher described how a student who was formerly male in middle school underwent the first surgery and hormone treatments over the summer and returned to begin high school that fall as a girl. The student’s classmates were fully accepting, having long before recognized “her” gender personality. It had nothing to do with a student’s prurient interests or sexual desire. But the situation was problematical for the administrators in the school and some parents.
Unfortunately, most of the combatants in this national debate don’t even understand the difference between gender and sexuality or even that a transsexual is someone with a brain gender identity that does not match their anatomy or legal assignment. It does not help that most of our laws relating to this topic were written in the single old terminology of “sex.” And with the abysmal level of U.S. science literacy due to inadequate science education, it is no wonder that many good-intentioned but ignorant persons reduce this issue to a simple-minded: “You were born with male (or female) anatomy. Live with it!”
But that is the point: some were born with ambiguous anatomy. Others with a brain that does not match their anatomy. Others with different hormone levels. The number of individuals with some form of sexual ambiguity is greater than the combined numbers of individuals with Down syndrome and cystic fibrosis—that amounts to thousands of K-12 and university students in each state.
It is not “a choice.”
Those spouting this 19th-century intolerance resent being described as “ignorant.” I would gladly use another term if it was more appropriate.