Anyone who doubts that genes can specify identity might well have arrived from another planet and failed to notice that the humans come in two fundamental variants: male and female. Cultural critics, queer theorists, fashion photographers, and Lady Gaga have reminded us— accurately—that these categories are not as fundamental as they might seem, and that unsettling ambiguities frequently lurk in their borderlands. But it is hard to dispute three essential facts: that males and females are anatomically and physiologically different; that these anatomical and physiological differences are specified by genes; and that these differences, interposed against cultural and social constructions of the self, have a potent influence on specifying our identities as individuals.
That genes have anything to do with the determination of sex, gender, and gender identity is a relatively new idea in our history. The distinction between the three words is relevant to this discussion. By sex, I mean the anatomic and physiological aspects of male versus female bodies. By gender, I am referring to a more complex idea: the psychic, social, and cultural roles that an individual assumes. By gender identity, I mean an individual’s sense of self (as female versus male, as neither, or as something in between). [...]
In fact, such humans existed—although identifying them was a much more complicated task than anticipated. In 1955, Gerald Swyer, an English endocrinologist investigating female infertility, had discovered a rare syndrome that made humans biologically female but chromosomally male. “Women” born with “Swyer syndrome” were anatomically and physiologically female throughout childhood, but did not achieve female sexual maturity in early adulthood. When their cells were examined, geneticists discovered that these “women” had XY chromosomes in all their cells. Every cell was chromosomally male—yet the person built from these cells was anatomically, physiologically, and psychologically female. A “woman” with Swyer syndrome had been born with the male chromosomal pattern (i.e., XY chromosomes) in all of her cells, but had somehow failed to signal “maleness” to her body. [...]
David Reimer’s case was not unique. In the 1970s and 1980s, several other cases of sexual reassignment—the attempted conversion of chromosomally male children into females through psychological and social conditioning—were described, each troubled and troubling in its own right. In some cases, the gender dysphoria was not as acute as David’s— but the wo/men often suffered haunting pangs of anxiety, anger, dysphoria, and disorientation well into adulthood. In one particularly revealing case, a woman—called C—came to see a psychiatrist in Rochester, Minnesota. Dressed in a frilly, floral blouse and a rough cowhide jacket—“my leather-and-lace look,” as she described it—C had no problems with some aspects of her duality, yet had trouble reconciling her “sense of herself as fundamentally female.” Born and raised as a girl in the 1940s, C recalled being a tomboy in school. She had never thought of herself as physically male, but had always felt a kinship with men (“I feel like I have the brain of a man”). She married a man in her 20s and lived with him—until a chance ménage à trois involving a woman kindled her fantasies about women. Her husband married the other woman, and C left him and entered a series of lesbian relationships. She oscillated between periods of equanimity and depression. She joined a church and discovered a nurturing spiritual community—except for a pastor who railed against her homosexuality and recommended therapy to “convert” her.
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