Stigmas and Simplification: The Argument for Formal Recognition of a “Neurological Sex”

Stigmas and Simplification: The Argument for Formal Recognition of a “Neurological Sex”

- By Elijah

Coming out is an important and life-changing ordeal for an individual, but it is especially so for those existing outside the gender binary, as living authentically necessitates a costly and confusing undertaking. One must not only navigate a new lifestyle and one’s place within a deeply gendered western society, but also a legal name change, sex change, and the updating of relevant documentation in order to escape humiliating and harmful discordance. Not only does the current legal standard of biologically-based sex undermine the transgender experience of gender identity, it also completely excludes intersex people, who biologically differ from both the female and male sexes and have historically been forced into irreversible sex-change operations at birth. Transgender and intersex people, as well as many gender-nonconforming individuals, would benefit greatly from the adoption of a legal standard of sexual identification based upon gender identity rather than genitalia.

Transgender refers to someone who identifies with a gender other than the one they were assigned at birth. This includes transgender men (those assigned female at birth who presently identify as male, or AFAB men), transgender women (those assigned male at birth who presently identify as female or AMAB women) and in some contexts, non-binary individuals (one who identifies outside the male-female binary, who may have been assigned male or female at birth). Transgender people are referred to as such during and after the transitioning process, which is loosely defined and may include various aspects of socially and medically transitioning. Social transitioning may include informal and legally recognized changes to name, pronouns and gender marker, adoption of appropriate gender roles, and societally accepted lifestyles; while medical transitioning may include beta-blockers, hormone replacement therapy, top surgery (mastectomies for men/masculine non-binary people and breast augmentation for women/feminine non-binary people), bottom surgery (metoidioplasty or phalloplasty for men/masculine non-binary people or vaginoplasty for women/feminine non-binary people) as well as further masculinizing or feminizing aesthetic surgical interventions (e.g., procedures involving the face shape, throat shape, hair removal/transplantation, etc.). The transitioning process is undertaken in treatment of gender dysphoria, a condition in which one’s biological manifestation of gender (i.e., sex) is in conflict with one’s neurological presentation of gender (i.e., gender identity). In summation, as gender dysphoria exists on a spectrum of severity and one’s own gender schema is somewhat individualized, the transitioning process may include and exclude any aspects of social and medical transition as the affected individual sees fit. Thus, a transition for some may simply include a name and pronoun change, while for others it may be a lengthy process of various medical procedures involving prominent primary and secondary sexual characteristics.

An intersex person is one whose primary and secondary sexual characteristics and/or chromosomes exist outside the male-female gender binary, and includes a variety of conditions, such as androgen insensitivity syndrome (in which fetal cells fail to respond to androgen, often resulting in an individual with testes and an incomplete vaginal structure), ovo-testes (gonads with both ovarian and testicular tissue and a variety of possible genital manifestations), and XY gonadal dysgenesis (dysfunctional gonads resulting in underdeveloped or undeveloped secondary sex characteristics), among others. (Intersex Society of North America, “Intersex Conditions”). Historically, intersexuality has been completely concealed and erased by invasive and arguably non-consensual surgical procedures to ‘correct’ non-normative genitals. Many intersex individuals are raised as and/or surgically altered into apparently cisgender (i.e., non-transgender) females or males, often to the detriment of the affected person and sometimes necessitating transition upon later development of gender identity. Activism by the Intersex Society of North America and others has increased visibility of the condition and raised debate over the legal and moral implications of such procedures, often putting an end to sex-change surgeries on intersex infants. There is an argument to be made for the inclusion of transgender individuals under the intersexual umbrella, as research has indicated slight difference in brain structure between males and females with transgender people’s brains more closely aligning with their currently affiliated rather than previously assigned gender.

Historically and cross-culturally, transgender and intersex individuals have been identified collectively and accepted societally as a third sex. Many Native American tribes recognize the Two-Spirit people, and the Hijra are recognized throughout the Indian sub-continent. Additionally, examples of societally recognized transgender and intersex individuals exist across Europe, Asia and South America (pg. 247–248).

Both transgender and intersex peoples have suffered historical and cultural erasure by the spread of westernized Christianity, which purports a strict sexual binary that dictates acceptable gender performance based on heteronormative anatomical presentations and sexual practices. In addition to religiously-based discrimination, transgender and intersex people are subject to a biased medical and legal system in which they must be formally recognized by each upon conforming to a set of standards regardless of an individual’s personal identity. This may include intrusive, unwanted, and sometimes dangerous hormonal and surgical procedures, and a lengthy and expensive procession of often humiliating legal procedures including name and sex change. While gender-affirming actions may be positive changes for some individuals, others may be uncomfortable with associated risks, unfit medically for treatment, unsatisfied with results or unable to meet financial or other requirements — for these individuals, medical and legal “gatekeeping” prevents formal recognition and societal treatment aligning with their gender identity and often causes a variety of problems, from humiliating mis-gendering or dead-naming to accusations of fraudulence (e.g., difficulty in making credit-card purchases or providing accurate identity documentation) as well as frequent harassment within welfare systems (e.g., healthcare, housing, etc.) and the workplace.

Recognition of gender identity over physical sex characteristics simplifies the categorization of gender-nonconforming individuals and makes transphobic prejudices obsolete, thus completely erasing the debates over placement of transgender and intersex individuals within public gender-segregated facilities such as bathrooms and prisons, sports teams, and schools; as well as religiously-based medical and legal maltreatment and personal stigma against the gender-nonconforming minority. Presently, without a single standard of treatment for transgender individuals legal recognition of one’s gender identity involves an emotionally and financially draining process of researching all relevant state’s standards, applying for necessary legal and medical interventions, and providing documentation of these undergone procedures and proceedings. State standards vary widely — some may require only a doctor or other medical professional’s written approval, others a letter or statement from a clinic or therapist as well as a proven medical history involving gender-affirming surgeries or hormone replacement therapy, and still others requiring proof of previous transition-related changes to identity documentation — as well as some states not allowing changes to identity documentation such as birth certificates or state-issued driver’s licenses at all. This means that some individuals may suffer a humiliating but mercifully short name and gender marker change and some a lengthy and expensive process of paperwork and postage.

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