Biology Says There Are More Than Two Sexes, More Than Two Genders.

Let’s start with what makes me qualified. Aside from living my best genderqueer life, I am a pharmacologist with both a bachelors and a masters in the field. Across both of my degrees, I studied a whole range of different biology based modules, not just pharmacology. One such module included the biology of sex and gender, and how that affects medicine. I nailed that module. So with that out of the way, let’s jump in to debunking some myths about sex and gender.

"There are penises and vaginas. Two sexes."

There is so much more than just penis or vagina. It’s estimated that at least 1% of the population are intersex or have intersex traits, which can result in ambiguous genitalia. These babies, sadly, are often surgically forced into one box or another, based on outdated practices and outdated ideals of what genitals “should” look like. The barbaric practice of Infant Genital Mutilation needs to end. Genitals do not fit in just two simple boxes, and babies shouldn’t be mutilated to hold up this ideal.

Genitals come in a whole range of shapes and sizes, and this diversity is beautiful. They aren’t tied to two very specific types. There are a whole range of penis lengths, colours, shapes, and girths. Likewise with vulvas, the size of someone’s labia, someone’s clitoris, the colour, the shape, all varies person to person. Genitals vary, and they’re never just “either or”. Hormones also play a huge role and can change the shape, colour, etc. of people’s genitals at any point in their life. At what point do these changes render you having “changed sex”? Genitals exist on a sliding scale.

"You’re either XX or XY."

Again, no. Sex chromosomes aren’t routinely tested for at birth, as there isn’t always a visual marker that there is a deviation. You can’t tell someone’s chromosomes just by looking at them. Babies are often born with two X chromosomes, but have a penis and develop “typically male”, who don’t find out about it until genetic testing later in life for conditions. And vice versa, there are people born with vaginas who have XY chromosomes. There are also way more than 2 configurations of sex chromosomes. There’s the two you’ll be familiar with, XX, XY, but there are also XXY, XYY, XXX, XO, XXXY to name a few, and these all produce different bodies, different genitals, different organs, different hormones.

"But testosterone…"

Hormones are fickle, like cats around tuna. Hormone levels are so subjective that it’s impossible to use them to categorise someone’s gender. If we used testosterone levels to categorise people into two distinct boxes, there would be a whole lot of adjusting to do. Cis women often have higher levels of testosterone that you might expect, and that also depends on where in their menstrual cycle they are- if they menstruate. There are women and people with Polycystic Ovary Syndrome who have higher testosterone than even cis men. This doesn’t mean they should all be called men. Plenty of men have low testosterone, that doesn’t make them women. Hormones panels are like fingerprints: unique to each person. And hormones are irrelevant to how many genders there are, because that isn’t how they work, so stop trying to use them like that.

"You can’t rewire your brain though, there are male and female brains!"

Possibly one of my favourite pieces of research on the topic is by Gina Rippon. She debunked the myth of the gendered brain. The idea that there are female brains and there are male brains, and those are the only two options. Brain structure does not dictate gender, it is in fact the other way around. Gendered brains are a product of a gendered society. Just like how the brains of London taxi drivers have a larger hippocampus as a product of their profession, rather than a cause. Her research showed that the brains of trans women matched up to the brains of cis women, and the brains of trans men matched up to the brains of cis men. Even nonbinary brains diverted from the idea of binary brains. Brains change depending on how we use them. We build neural pathways in the areas of the brain that we use the most. And they don’t stay that way. The hippocampi of London taxi drivers shrunk after they retired.

"But that’s just how it is!"

Not everywhere! In your world maybe, but that doesn’t make your world correct. Society is not biology, and society is different everywhere you go. So many cultures around the world have more than two genders, who are we to say that that’s wrong?

"But what about medically?"

I hear you! But what we really need to know medically is risk factors, and anything relevant. Do you have a penis? Do you have ovaries? Do you have a prostate? What are your testosterone levels? Are all relevant questions to ask with relevant answers, but as we’ve said, none of these actually dictate your sex. Your medical records can say male, but that doesn’t stop you from having a uterus, and doesn’t necessarily mean you have testicles. Medically, the erasure of other sexes is far more dangerous. Not looking in the right place can cost lives. Ignoring obvious symptoms because they don’t fit the sex on record can lead to things being missed. Patients with breasts and undescended testicles are at risk of testicular cancer, for example.

What’s also fun is the way women are treated by doctors- often fat shamed or called hysterical, with their symptoms being brushed off as anxiety or “menstrual”. Social stereotypes alter the way people are treated in medicine, and this is a detriment. Trans people are further discriminated against by binary medicine too. Trans Broken Arm Syndrome gets in the way of patient care. And for me personally as a trans person, it’s extraordinarily difficult for me to get the cervical smear test that I need just because of my trans status. Medicine doesn’t actually care about the important facts, they care about the social boxes.

"So… What?"

There are more than two sexes, and more than two genders. Sex refers to biology- biology that isn’t binary, and gender refers to who you actually are. Gender is socially constructed ideas about behaviour, actions, roles, and beliefs. It is not possible or wise to categorise these into two boxes. There are more than two sexes, and more than two genders, and someone else’s sex and gender has no impact on anyone else.