Alternative Sex and Gender Categories Cross-Culturally:
A Structural Anthropological Exploration
Erin Davidshofer
Illinois State University
Anthropology Department
May 2009
Abstract
In this paper, I argue that anthropology can make Western cultures more aware of their
sex/gender schema, which is based on the two sexes of male and female. I do this by examining
how the Western sex/gender schema differs from those in Non-Western cultures. Then I explan
how the ideas of structuralists help when looking at sex and gender because theres is the belief
that humans think in binary opposites, especially regarding sex and gender. Humans know these
binary categories are arbitrary, so they create intermediate categories. The hijra of India and the
“two-spirited” people in Native American tribes are intermediate sex and gender categories as
they do not adhere to the binary opposites found in Western cultures. Once I have explored some
intermediate categories, I will explain how sex and gender are constructed and upheld in EuroAmerican societies, which is referred to as the sex/gender schema. This schema is based on the
binary sex categories of male and female, and does not leave any room for ambiguous
individuals, such as intersexuals. In order to explain how physically and psychologically harmful
the sex/gender schema is on individuals who blur the lines between male and female, I tell the
story of David Reimer. Many intersex activists, including The Intersex Society of North
America, and the medical community have become aware of the harms created when society
cannot “make sense” of ambiguities, and have started to create laws and rights to improve the
lives of intersexed and ambiguous individuals. Western societies are slowly moving toward a
more accepting environment for individuals who may be considered ambiguous, and
anthropology has provided us with the knowedge of how other cultures think about sex and
gender, particularly those that have institutionalized third sex or gender categories.
Introduction
Have you ever seen a person walking on the street that made you wonder, “Was that a
man or a woman?” Or, do you remember “Pat” from Saturday Night Live, the androgynous
fictional character who audience members could never distinguish as a man or woman despite
looking for any sign of breasts or an Adam's apple?
People within Western societies never question a person's sex or gender unless it deviates
from the norm. When a person does not clearly fit into one of the two sex categories of male or
female, it is difficult to know how to interact with them. Structural anthropologists, including
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Claude Lévi-Strauss, believe that all humans think in terms of binary opposites, such as
light/dark, male/female, and culture/nature; however, these dichotomies are just an unconscious
process of the brain, and people know more categories exist, so they create intermediary
categories. Anthropologists have long studied these intermediary categories, especially
regarding sex and gender. Unlike Western societies, many cultures do not think in such strict
binary opposites. Many non-Western cultures have three or more institutionalized sex and
gender categories. Two of the more famous anthropological examples I will explore are the
“two-spirit” people also called the Berdache in Native American tribes, and the hijra of India.
The construction of sex and gender in Western societies strongly adheres to the
structuralist belief that humans unconsciously make sense of the world based on binary
opposites. Although many cultures have created intermediate sex and gender categories,
Western societies do not have these because they have a sex/gender schema that only relies on
the two sexes. When Euro-American societies think in such strict sex and gender categories, it
causes a lot of harm to the people who cannot be classified as either male or female; these
individuals are called “intersexed.”
Intersexed individuals have genitalia, or reproductive organs, that are not “typical” of
males or females. They are somewhere between the two sex categories. In Western societies,
the way people make sense of the world is based on a person's biological sex. A person's
biological sex determines their gender role within society. People interact with others based on
their sex and gender and this affects the gender traits one would acquire, which has a large
impact on their career choice. For instance, a female child is taught to be feminine by being
nurturing and caring, which may help her in nursing or teaching careers or being a mother. This
sex/gender schema in Western societies is based on only two sexes and two genders. When an
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infant is born with ambiguous genitals, Western societies feel it is imperative to make them ”fit”
into one of the two sex categories and our sex/gender schema. In order to make them fit, many
painful and dangerous surgeries are performed, not for their health, but for “cosmetic” and
“social” reasons. Because of this, many intersex individuals are suffering physically and
psychologically so we, as a society, can categorize them in the male/female binary opposites to
better “make sense” of them.
In my thesis, I will explore how the study of anthropology can make Western societies
more aware of the harms caused to intersexed individuals by thinking in binary opposites. I will
also explore how anthropology can help Western societies further understand how other people
and cultures deal with sex and gender. While exploring these issues, I want to find out if there is
a place in Western societies for individuals who blur the lines between male/female and
man/woman. And if there is, what is being done to help these individuals?
In order to address these issues, I will further explore the structural anthropological
theory of binary opposites and how humans, across several cultures, interpret sex and gender. I
will then describe two cultures that do not think in strict binary opposites, regarding sex and
gender categories. Native American tribes have a third gender category called Berdache or
“two-spirit,” and India has a third sex category called the Hijra. Once I have explained
alternative sex and gender categories in these two cultures, I will explain how sex and gender are
constructed and upheld in many Western societies. The best way to study the construction of sex
and gender in Western societies would be to study how people “manage” and “make sense” of
individuals who blur the lines between male and female, also known as “intersex” individuals.
The story of David Reimer provides a good example of how individuals who do not clearly fit
into the binaries of male and female are treated. I will then explain what is being done to protect
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the rights of intersex individuals and what the medical community and intersex activists suggest
to alleviate the physical and emotional pains many intersex individuals endure. Finally, I will
explain the influence anthropology has on sex and gender in Western societies. I will also
explore the possibility of whether or not additional sex and gender categories are possible in a
society that thinks in strict binary opposites.
Gender in Anthropology
What do anthropologists think about sex and gender?
Many anthropologists believe that gender, which is the behavior, roles, and activities
performed by men and women, is constructed by society. In Euro-American societies, there are
two genders, man/woman (masculine/feminine) and these are based on the two sexes of
male/female, but other cultures do not view sex and gender the same way Western cultures do.
In order to gain a better understanding of how gender is constructed, anthropologists have started
studying alternative sex and gender categories in non-Western cultures. They have discovered
that there are many cultures with genders that extend beyond the two binary opposites of male
and female in the West. Although there is evidence that other societies have additional
sex/gender categories, “Western science, as well as popular thought and culture have been
extremely resistant to rethinking Western sex/gender systems” (Nanda 1999b:xii).
Sexologists and anthropologists believe sexual dimorphism is essential in assigning sex,
which extends to the assignment of gender based on that sex. Sexual dimorphism has dominated
Western thinking since Darwin’s work on evolution. “Interpretations of hermaphroditism have
likewise tended to obey a presumed natural law of dimorphism, encoded in cultural reasoning,
that assigns all things sexual to biological types, male and female” (Herdt 1994:422).
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During the past century, sexologists and anthropologists have discovered individuals in
non-Western cultures that blur the lines between male and female, masculine and feminine.
These cultures do not use reproduction as a determinant of sex, but rather cultural roles and
sexual desires determine sex and gender (Herdt 1994:422).
There are two explanations for why these individuals do not conform to the two sexes of
male and female. One explanation is that they biologically do not fit into these categories, they
are intersexed. Another explanation is that an alternate gender role is socially constructed in a
way that does not challenge the two-sex system in Western societies. Even the relationship
between biology and culture is problematic in determine sex and gender in that 1) do societies
assign a third sex at birth? If so, that leads to a hermaphroditic gender identity. And 2) Do
societies implement the third gender developmentally? If so, this does not allow for a change in
gender later in life, and this third gender category could include both “normal” males and
females as well as intersexed individuals (Herdt 1994:423).
Margaret Mead once said, “sex assignment may be far more complex in other cultures
than our own,” largely because gender can change throughout ones life, and Mead noted eleven
examples of this cross-culturally (Herdt 1994:423).
Clifford Geertz has argued that the Western system of assigning sex and gender is not
shared by other cultures and is not a reliable way to understand ambiguities cross-culturally. He
views “gender categories as the workings of a cultural system of meanings and perceptions
applied to ‘commonsense’ formulations” (Herdt 1994:423).
Biological sex is relatively easy to classify in a two-sex system, but gender is not (Herdt
1994:424). Western cultures use sexual dimorphism to determine gender-identity, but this is an
essentialist and restricted way to classify and “make sense” of individuals (Herdt 1994:424). It
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seems that the more gender is determined by biology and sexual dimorphism, the stronger the
fear and hatred for ambiguities and anomalies that do not clearly fit into the categories of
male/female, man/woman, as I will explore later. Cultures with third and alternative gender
categories are more accepting of ambiguities and even give them a positive or ritual role within
society (Herdt 1994:424).
What is structural anthropology and the idea of binary opposites?
In order to gain a better understanding of how people, across all cultures, think of sex and
gender, it is important to study their unconscious brain processes, as many structural
anthropologists have done. Structural anthropology focuses on the structures of human thought
processes across cultures by examining kinship, myth, and language. They also study how
human thought is expressed in terms of cultural acts. In other words, structuralists believe that in
order to study the surface structure, it is necessary to study the deeper psychological and
unconscious structure of the mind and the influence that has on the surface structure. Crossculturally, these human thought processes exist in binary opposites, including hot/cold,
male/female, and culture/nature.
What do structural anthropologists think about sex and gender?
One of the most well-known structuralists in anthropology is Claude Lévi-Strauss
(McGee 2008:324). Lévi-Strauss’ structuralism was influenced by Émile Durkheim, Marcel
Mauss, and The Prague School of structural linguists. Linguists try to study language by
discovering the unconscious, and Lévi-Strauss takes the same concept of studying the
unconscious and applies it to culture. He views culture, as he does language, as a collection of
symbols. He is not interested in the specific meaning of symbols, but rather how they are all
interconnected within a system.
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Lévi-Strauss believed that culture was a product of the mind, so in order to further study
culture, it is necessary to study the brain and its mental thought processes. Since all human
brains are biologically similar, he argued that there must be deeply-rooted similarities between
cultures (McGee 2008:325). He gained popularity because he believed the savage mind was
equal to the civilized mind and he refused to see Western societies as privileged or more
civilized.
Lévi-Strauss discovered that all human minds think in binary opposites, but he also saw
a problem with thinking in terms of binary opposites, which was that they are arbitrary. People
establish these binary opposites, but they are not real, just a product of how the brain operates.
To fix this problem, the mind creates mediators, or in between-categories that have
characteristics of both opposites (Mascia-Lees 2000:71).
Lévi-Strauss studied binary opposites and the mediators in the concept of nature/culture.
In this pair of opposites, it is understood that things that are natural cannot be cultural and things
that are cultural cannot be natural. But, what if humans are both natural and cultural? This
problem is solved by the creation of incest taboos. Incest taboos prohibit an individual from
mating with kin, and this is something that can be seen in all cultures. “The incest taboo works
to overcome the randomness of mating found in nature by establishing orderly kinship relations
required for cultures to function” (Murphy as seen in Mascia-Lees 2000:71). The incest taboo
acts as a mediator between the nature and culture as it still allows the natural act of mating to
occur while having cultural regulations.
The incest taboo also creates marriage rules in society, requiring individuals to marry
outside of their social group. Marriage is seen as an exchange of women by men. This exchange
creates alliances between unrelated groups (Mascia-Lees 2000:72). “Lévi-Strauss argues that
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women are the objects of exchange that cement group affiliation because they can fulfill the
biological sexual urges of men” (Mascia-Lees 2000:72). Since women are the “objects” being
exchanged, it is men who benefit.
Lévi-Strauss also believes that marriage and kinship systems operate only because there
is interdependence between man and woman, or a sexual division of labor (Mascia-Lees
2000:72). In this sexual division of labor, duties and tasks are divided up based on whether a
person is male or female. Since men can only perform certain tasks, and women perform
different tasks from men, they both need to work together to complete all the tasks necessary for
survival. According to Lévi-Strauss, “the sexual division of labor is nothing more than a device
to institute a reciprocal state of dependency between the sexes” (Lévi-Strauss as seen in MasciaLees 2000:73).
Lévi-Strauss argues that women are oppressed because social systems use women to
create alliances between groups. So, women are subordinate to men, who are the social
initiators, even though the two sexes rely on each other because of the sexual division of labor
(Mascia-Lees 2000:73).
Lévi-Strauss believes that the subordination of women is rooted in the fact that they are
used as objects in the exchange of marriage and because of this, men are more valued. They are
not more valued because of their physical strengths or abilities, but rather it is because of the way
the human mind divides the world into binary opposites. Some critics have argued that LéviStrauss' structuralist approach to the oppression of women is Euro-centric because many Western
societies think this way, but there is no evidence that humans in all cultures and at all times in
history think in binary opposites (Mascia-Lees 2000:74).
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Sherry Ortner further expands on Lévi-Strauss' argument about the oppression of women.
She believes that it is women who are associated with nature because of their ability to create life
and this perpetuates the belief that women are inferior to men. Because women's bodies are able
to give birth and care for children, they are considered to be closer to nature. Men do not have
the ability to procreate, so they must participate in other activities outside of the family. These
activities “create” culture (Mascia-Lees 2000:75). Just as in the incest taboos, cultural
institutions transcend nature, which is why women and nature are seen as inferior to men and
culture.
Ortner also argues that women are the mediators of culture and nature. Although women
are natural beings, they are also cultural beings. Not only do they give birth to children, but they
socialize them based on societal norms and because of this, women are seen as an in-between
category of nature and culture. This intermediate position of women creates an ambiguity in
how they are represented. They are negatively portrayed in myths and religions as witches, or in
the United States they are portrayed positively as seen by The Statue of Liberty (Mascia-Lees
2000:76).
Ortner also argues that the nature/culture dichotomy is linked to the self/other dichotomy.
Men are associated with “self” because they know what they are based on what they are not.
They are not women. Therefore men are associated with “self” and women with “other.”
Women are defined by their bodily functions, while men are defined by a self that is free of
bodily functions. Men benefit from women's “otherness,” because women are trapped and
defined by their bodies while men are more transcendent and associated with the mind (MasciaLees 2000:76). The dichotomies of culture/nature, man/woman, self/other can clearly be seen in
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Western thought, where these oppositions are used to deprive women of autonomy and define
men as the central creators of culture (Mascia-Lees 2000:76).
Who else has studied binary opposites?
Jacques Derrida (1967) was a poststructuralist who studied binary opposites; however,
his ideas are slightly different from those of Lévi-Strauss. He believes that since binary
opposites are constantly changing, their meanings will eventually overlap and then contradict
each other, which is what he refers to as “destruction” (Manji 2005). In this belief, words do not
have any meaning, they just relate to other words and the mind just creates meanings for these
words. He does not believe that the opposite of male is female, but rather not-male.
Derrida also argues that within binary opposites, half of the pair will be more valued than
the other: one is positive, one negative. With the good/evil binary, good is valued over evil, light
is valued over dark, etc… Children learn about these opposites and their value without even
knowing it, and as adults they create opposites in their mind with almost everything.
Derrida (1967) examines the relationship between speech and writing and discovers that speech
is always more valued than writing. Speech is often regarded as the primary form of language
and writing is the transcription of speech, thus making it a secondary form. He also states that
speech is associated with a presence because for there to be spoken language, a person has to
speak (Klages 2008). Presence brings up another binary opposition: that of presence/absence,
where presence is valued over absence. Speech is more valued because it is associated with a
presence, and presence is more valued than absence, therefore speech is more valued than
writing.
Presence/absence and the value placed on each half of the pair can also be applied to sex.
Men have the presence of a penis; women have the absence of a penis. Since presence is more
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valued than absence, a penis (man) is more valued than a vagina (woman).
Binary opposites are often interconnected, where one pair can deeply impact the meaning
of another pair. The binary opposite of male vs. female is common in almost all cultures and
societies. When looking at these two categories, it is impossible to ignore the idea of gender
roles. Females are typically nurturing, emotional, and caregivers of the young and elderly. Men
are typically strong, protective, and the ruler of the house. A common binary opposite in
feminist theory is rational vs. emotional. In our society, it is more beneficial to be rational than
emotional. Since men are seen as rational and women as emotional, more value is placed on
men and their roles within society (Manji 2005).
Are there any non-Western societies that have a third sex or gender category?
Structural anthropologists believe that the human brain makes sense of the world by
creating binary opposites. Humans realize that these opposite categories arbitrary and just a
result of the unconscious thought process, so they create intermediary categories that fit inbetween the two opposites. An example of one of these intermediate categories could be cultures
that have sex and gender categories. All societies have the two basic sex and gender categories
of male/female, man/woman, because the brain creates these binary opposites. But some
cultures also have categories that fit in between these two sex and gender dichotomies. In fact,
anthropologists have studied cultures with alternative sex and gender categories for many
decades.
Margaret Mead “once warned about the preoccupation of Americans and differentiating
male from female, of placing too much emphasis on initial sex assignment rather than on
subsequent gendered achievements that altered gender-role assignment” (Herdt 1994:63). The
presence of only two categories – a dyad – creates an inherent relationship of potential conflict,
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that is oppositionality (anthropologist Gregory Bateson referred to this relationship as
“symmetrical schismogenesis”) (Herdt 1994:19). With the introduction of a third category – a
triad – there is an “abandonment of absolute contrast” (Herdt 1994:19).
Anthropologists tend to believe gender is a social construction (Herdt 1994:421). By
believing this, anthropologists know that different cultures will view gender differently than
Western cultures. “In almost all modern Western discussions of the relationship of biological
sex to gender and of the female gender to the male, the presumption is made that there are two
biological sexes, man and woman and two genders, male and female. But this is not so in all
cultures” (Trumbach 1994:111). There are many examples of non-Western cultures that have
either a third sex or a third gender. Third gender categories are common, but true third sex
categories are rare (Herdt 1994:51).
A third sex is an additional sex category and should not be confused as a same-sex or
homosexual orientation. Sexologists since the nineteenth-century have assumed that a person of
the third sex is attracted to members of the same sex (Herdt 1994:47), but today third sexes and
genders are better understood. The cultures and third sex and gender categories that I will be
exploring are the “Two-spirit” in Native American Tribes and the hijra in India.
Who are the “Two-Spirit”?
The “two-spirit” is a third gender category among Native American Indian tribes. When
the Europeans first “discovered” this third gender category, they could not “make sense” of these
individuals because they only knew of the two sexes: male and female, and the “two-spirit”
seemed to blur these lines, which is where the name “two-spirit” came from. Originally, they
were called, “Berdache,” which means a male prostitute in French but since that has a negative
connotation, referring to this third gender category as “two-spirit” has become more common.
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During colonialism, the “two-spirit” were viewed by Anglo-Americans and the Spanish
as “freaks, monsters, demons, deviants, perverts, sinners, or corrupters” (Herdt 1994:64).
Spanish conquistador Alvar Núñez Cabeza de Vaca wrote about the “two-spirit” in the sixteenth
century when he encountered Native Americans. He wrote, “during the time I was among them,
I saw something very repulsive, namely, a man married to another. These are impotent and
womanish beings who dress like and do the work of women. They carry heavy loads but do not
use a bow. Among these Indians we saw many of them. They were more robust than other men,
taller, and can bear heavy loads” (Cabeza de Vaca and Augenbraum 2002:71).
Although “two-spirit” is the term most commonly used to refer to the third gender
category in Native American tribes, this term has a Euro-centric bias as it implies that these
individuals perform two gender roles, as opposed to being a third gender category altogether.
Anthropologists like Nanda (1999a) refer to these individuals as “gender variants” because they
do not fully cross over to an opposite gender nor do they have “typical” gender roles. It is
important to note that “two-spirit” is a third gender category and not a third sex category because
it is not based on the appearance of the genitals, but rather by culture (Nanda 1999a:18-19).
There are many different types of “two-spirits,” and they have been found in 110 to 150
different Native American societies. They vary in terms of their degree of integration in society,
norms of behavior, how the role is publicly acknowledged, but there are some similarities as
well. All “two-spirits” display: transvestitism, cross-gender behavior, same-sex sexuality, and
associations with spiritual powers (Nanda 1999a:13). They also have a role that is central to
society and are highly valued, not marginalized as third genders are in some societies (Nanda
1999a:12). Gender variants had a special ritual function within society, some were even paid to
act as “go-betweens” in marriage (Nanda 1999a:16).
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There are societies that have both male and female gender variants, while some have
variants in only one gender. A male gender variant is a biological male who acts like a female.
He does this in terms of dress, hairstyle, performing domestic housework and crafts (Nanda
1999a:15). They may also cut their genitals so the blood symbolizes menstruation or pretend to
be pregnant by being bloated or constipated (Herdt 1994:67). Female gender variants are more
common as women often performed “male” roles in terms of hunting or warfare (Nanda
1999a:23).
Although “two-spirits” exist in many different Native American tribes, there are many
common features that are typically found in all tribes. Some of these norms are:
1) The “two-spirit” is a recognized third category in daily tasks and cultural transactions,
both at the level of genitals and personal pronouns.
2) They are spiritual leaders.
3) They are not stigmatized, nor is their behavior reduced to a sexual act, and it is not
viewed as immoral or illegal.
4) It is recognized that sexual arousal depends on a person of the same biological sex, but of
an opposite gender (Herdt 1994:65).
In order to get a better understanding of the broad categorization of “two-spirit,” I will
now explain the role they have within the Mohave tribe. The Mohave are located in the
southwest desert along the Nevada/California border and are one of the most studied tribes for
third gender categories. They have two “gender variant” roles in their culture, in addition to the
roles for men and women. A male gender variant is called alyha and the female gender variant is
a hwame.
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In the Mohave tribe, pregnant women often had dreams about the gender of their future
child. Mothers who had dreams about an alyha would often dream of a child that had male
characteristics such as arrow feathers that symbolize a male birth but also receive hints about
their future gender status (Nanda 1999a:21). An alyha child might start acting strange around
age ten or eleven, before puberty rituals occur for boys (Nanda 1999a:21). They would also
avoid “typical” masculine activities such as hunting or shooting bows and arrows and instead
participate in “typical” female activities such as playing with dolls or wearing a “bark skirt rather
than a male breechclout” (Nanda 1999a:21). The alyha's family members may have ambivalent
feelings toward the child's behavior, but if it continues long enough, they would begin preparing
for the transvestite ceremony, which is a surprise to the boy as it tests his inclination and
initiation (Nanda 1999a:21). People from the community were invited to attend this ceremony as
a way to get used to seeing the boy in women's clothes. At this ceremony, the boy is led into a
circle by two women while the crowd sings a transvestite song. If the boy starts dancing in a
fashion similar to the women, he is confirmed to be an alyha and is then bathed in the river and
given a skirt (Nanda 1999a:21). He would then go by a female name and insist he has female
genitalia. Alyhas generally married males and made great housewives, sometimes better than
females. The married couple practiced both oral and anal sex with the alyha in the receptive
role. Alyhas were often embarrassed if they had an erection (Nanda 1999a:22).
Alyhas would imitate menstruation by scratching their genitals with a stick and emulate
pregnancy by stuffing rags in their skirt and then drinking a concoction around the time of birth
that causes constipation. A few days later he would then defecate in the birthing position and
“the feces would be treated as a stillbirth then buried” (Nanda 1999a:22). The alyha and her
husband would cut their hair, which is a sign of mourning.
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Alyhas were known as peaceful people, they did not participate in military fighting, like
other Mohave men. They were rarely ridiculed or teased because everyone believed that they
could not help it and that a child's inclinations in this direction could not be resisted” (Nanda
1999a:22). They have powerful healing effects, especially for sexually transmitted diseases (also
called “alyha”).
The Mohave and the alyha clearly illustrate three gender roles instead of the usual two
gender roles, but the gender category is distinct and separate from that of women and men.
Although they imitate “typical” female roles, “they were also recognized as different from
women” (Nanda 1999a:23). They are also not viewed as homosexuals (as Westerners would
view it), despite having relations with men.
By studying alyhas and other types of “two-spirits,” it is clear that this is a recognized
third gender in Native American societies, and not just a combination of traits from two different
genders. The concept of the “two-spirit” is an intermediate category between man and woman.
In some Native American societies, there are not just two genders, but three and sometimes four
(the alyha in Mohave tribes). In Native American societies, individuals of a third (or fourth)
gender are not viewed as “monsters” or “freaks” as intersex or ambiguous individuals are in
Western societies. Third gender individuals in these societies are accepted within their
communities and even highly regarded for their spiritual power and their ability to understand
both sexes.
Who are the hijra?
Gender in India is not egalitarian like in the West, but rather it is hierarchical and
patriarchal (Nanda 1999a:27). In India, males and females are in complementary opposition,
much like in the West, but “Unlike Western cultures that try to resolve, repress or dismiss sexual
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contradictions and ambiguities, Hinduism allows opposites to confront each other without
resolving the opposition” (Nanda 1999a:28). O’Flaherty also notes that “celebrating the idea that
the universe is boundlessly various, and...that all possibilities may exist without excluding each
other” (O'Flaherty as seen in Nanda 1999a:28).
Hinduism has been characterized as having androgynous thinking. It allows for
alternative genders and gender transformations, which provides a positive meaning to individuals
who may be stigmatized by society because they do not fit into the binary opposites of
male/female or man/woman. In Hinduism, they can be accepted for their ambiguities.
There have been additional sex and gender categories in India since the eighth century
BCE. Ancient Hindu texts divide the third sex into four parts: the “waterless” male who has
dessicated testes, the “testicle voided” males who has been castrated, the hermaphrodite, and the
“not woman,” a woman who does not menstruate (Nanda 1994:377). All of these third sex
categories were impotent and unable to procreate; therefore they were thought to be “defective.”
The Kama Sutra, which is a classic Hindu manual on love, makes references to what kind
of sexual practice members of this third sex should participate in. Evidence of a third sex from
these historical texts provides a positive meaning for those in India who have a mixed gender
identity. Today in India, the gender variant that is most “visible and culturally institutionalized
[is] the hijra” (Nanda 1999a:28).
“Hijra” is translated to “eunuch,” which means intersexed, in the sense that they are
impotent. This differs from the Western definition for intersex, which is a person who has
biologically traits of both males and females, and they may or may not be fertile.
Hijra are often referred to as “neither man nor woman.” They distinguish between “real”
hijras, who are born with an intersex condition and “made” hijras who are biologically male but
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through a “ritual surgical transformation” (Nanda 1999a:29) become member of the third sex
category. Hijras have their penis and testicles removed but they do not construct a vagina
(Nanda 1999b:ix). It is important to understand that hijras, whether “real” and “made,” are
impotent males, which is the main reason they are considered “not men.”
Hijras are also not men because they are unable to perform the role of “inserter” in sexual
intercourse. They claim to be sexually impotent because of defective genitals. Much like the
“two-spirit,” the hijra have sexual relations with men. They take a receptive role in intercourse,
but it is not their homosexuality that defines them, rather it is their sexual impotence and their
“in-between sex and gender status” (Nanda 1999a:29).
They are also not considered men because they adopt clothing, behaviors, and
occupations that are typical of women. They have female-typical hair, dress, voice, and names.
They have sex with men (like ordinary women), sit in the “women-only” area of the bus, and
often are regarded as women in census. However, despite these typical feminine traits, they are
also “not women.” This is because their feminine clothing and gestures are overly exaggerated
and they are sexually aggressive as opposed to being sexually submissive like ordinary women.
Hijras dance at marriages and births and often use abusive speech, both of which are not allowed
for women. They are also not women because they do not have female reproductive organs and
cannot bear children (Nanda 1999a:30).
The exact number of hijras in India is unknown because in the census they are not
counted separately; however, it is estimated that there are 50,000 hijras. They are mostly found
in Northern India, but they are scattered all over the country. Hijras' have an important ritual
role in society. Their main form of employment is singing and dancing at births and marriages to
bless the newborn or newlywed couple with fertility, and for this they receive money, food, and
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clothing (Nanda 1999a:29). These performances can be quite humorous because of the hijras'
“burlesque” portrayal of women and aggressive sexuality. During ceremonies for births, the
hijra checks and confirms the child’s genitals, and if the child has ambiguous genitals, the hijra
insists s/he join their community, and it is widely accepted that this offer cannot be turned down
(Nanda 1999a:34).
In India, gender plays an important role in becoming a full person. In order to become a
full person, one must marry and have children (especially males who will carry on the family
name). Therefore an infertile man, a woman who does not menstruate and someone who does
not marry cannot be a full social person and are excluded from society (Nanda 1999a:33).
Ambiguous individuals are able to transform this incomplete personhood into a complete
transcendental one by identifying with an ascetic role, or one characterized by abstinence. “As
ascetics, hijras transcend the stigma of their sex/gender deficiencies” (Nanda 1999a:34).
Hijra sexuality is a source of conflict in India. Hijras role as an ascetic is to refrain from
sex, and by doing so, they are able to perform a more sacred role. This rarely happens though, as
many hijras still have active sex lives with other men and prostitutes. Hijra prostitutes work in
the “red light district” of cities like Bombay, or work from their homes. Some hijras earn their
living by prostitution rather than by performing at births and marriage. Despite being prostitutes,
hijras also have long-term relationships with men, who are referred to as “husbands” (Nanda
1999a:37).
Hijras normally live in households with five to twenty others, and there is one elder who
acts as a manager. These houses provide hijras with a physical and social identity as well as a
lineage affiliation (Reddy 2005:9). Each hijra makes a contribution to the household, whether it
is financially or by doing domestic duties.
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The Hindu belief of dharma, is important to understanding the acceptance of hijra and
other gender variants within society. Dharma is the belief that everyone has a different life path
because they have different morals and abilities, and this leads to an acceptance of different
occupations and behaviors. Many different personality traits are accepted, including traits that
are considered pathological or criminal in Western cultures (Nanda 1999a:34). This belief of
dharma applies to everyone, including hijras and other gender variants.
Although Hinduism provides acceptance for members of an alternative sex or gender,
there is still a feeling of ambivalence toward the hijras. They are sometimes embraced with a
sense of compassion and respect, and other times, they are victims of fear and mockery (Nanda
1999a:36). There are many reasons the hijra are feared. One is because in a patriarchal society,
where men are associated with semen and sexual potency, hijras have neither. They are also
feared because the do not have the “normal” family life and they are outside caste-system, both
of which threaten the social order (Nanda 1999a:36). Hijras cannot only bless a family, but they
can curse one too, by taking away their potential to procreate. They do this by lifting their skirt
to display their mutilated genitals and “this is both a source of shame and a contamination of the
family's reproductive potential” (Nanda 1999a:36).
It is clear to see that the role of the hijra is filled with contradictions:
“hijras are both men and women, yet neither men nor women; their sexual identity is that
of chaste ascetics, yet they widely engage in sexual relationships; they are granted
the power of the goddess and perform rituals in her name, but they are held in low
esteem and are socially marginal. Yet, with all its contradictions and ambiguities,
the hijra role continues to be sustained by a culture in which religion still gives positive
meaning to gender variance and even accords it a measure of power” (Nanda 1999a:3940).
In Western societies, when there are biologically intersex individuals, or those whose
sexual preferences are for the same sex, they are made to fit into the categories of male/female or
20
man/woman because if they do not fit into these categories, “there is no place for them in
society” (Nanda 1994:393). In India and Hinduism, these individuals are accepted into society.
Although they are regarded with ambivalence, they nonetheless have their own sex/gender
category that is distinct and separate from the dichotomies of male/female and man/woman.
Sex, gender, and the treatment of ambiguities in Western societies
How is gender constructed and maintained in Western societies?
There is a “Western belief that there are only two sexes and two genders, each naturally and
permanently biologically determined and each exclusive of the meanings and characteristics of
the other. This emphasis is signaled by the choice of John Money, best known for his
controversial work on children on intersexed children and his role in promoting a “healthy”
dual gender system in the United States” (Reddy 2005:31).
Now that you have read about different gender roles and categories in non-Western
societies, it is important to understand how this differs from the sex/gender schema in Western
societies. In almost all Euro-American societies, there are normally two recognized sexes: male
and female. Sex is determined by sex markers. Everything with the presence of a penis is a
male and everything with the absence of a penis is a female. There are many researchers and
scientists who believe that gender is a social construction which means gender is something
individuals “do” or “perform,” based on their sex (male or female). Several examples of social
construction are discussed below. There are also biological determinists who believe genes,
hormones, and biology determine gender (Fausto-Sterling 1987:76). Below, I will explore social
constructionist beliefs about gender.
Lorber (1994) is a social constructionist who believes gender is an “act” that humans
perform daily but do not realize it is an act because it has become a routine that just seems
normal. She argues that “Most people find it hard to believe that gender is constantly created and
re-created out of human interaction, out of social life, and is the texture and order of that social
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life. Yet gender, like culture is a human production that depends on everyone constantly 'doing
gender'” (Lorber 1994:1).
As Bailey (2008) notes, there is a division of labor based on the two sexes: male and
female. Males typically have jobs that require them to do heavy labor (construction worker), or
provide for their family (father, husband) or protect their country (soldier). Females generally
have roles that are “other-focused,” where they care for other people in society. This domestic
labor includes such duties as cooking, cleaning, nurturing, and providing for the young and
elderly. Since society needs these two different types of labor, we “train” and condition our
children to fulfill these roles. To condition them, it is necessary to provide positive and negative
reinforcement to them for gender-appropriate behavior. For example, society expects little boys
to be strong, aggressive, rational, and in charge of their emotions, so it is important to praise
these behaviors. Little girls are expected to be caring, nurturing, passive, and emotional, so
society encourages these behaviors. From a very early age on, children learn the socially
accepted gender behavior; and this gender behavior is based on their biological sex. Since they
“do” gender their whole life, they become what they practice being. Females “do” the part of
woman, girl, and feminine. Males “do” the part of man, boy, and masculine.
The sex-gender schema mentioned above gives rise to common sense lenses (CSL),
which are like invisible eyeglasses that everyone wears. These glasses shape how we see gender
and they are used assemble the logic of how men and women should interact. These CSL stem
from the sexual division of labor and the way society is organized. CSL are “invisible” because
the way we distinguish between men and women is obvious to us and comes naturally, that we
do not realize we are doing it.
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The CSL give society a way of carving up the world turning it into a self-fulfilling
prophesy, where we become what we practice being. Since men and women get treated the way
our CSL tell us they should be treated, they behave in ways that society and our CSL expect
them to. The way men and women behave is similar to a performance where they “perform”
gender roles dependent on their sex and based on societal expectations of gender-typical
behaviors for that sex. Since men and women are treated (and behave) differently, this reinscribes the sex differences and social organization of the sex/gender schema.
Judith Butler (1988) is also a social constructionist, but her theory on gender is slightly
different than Lorber’s. Butler argues that we “perform” certain gender behaviors, and gender
behaviors are also performed on us. These are referred to as “performatives” of speech and
gender acts (Butler 1988:519).
According to Butler, a speech act is a performance--by saying something, we do
something (1988:521). According to J.L. Austin (1975), perlocutionary speech acts attempt to
change the attitudes of a person, by persuading, convincing, or scaring them to do or realize
something (Austin as seen in Stiles 1981:227). For example, “you really ought to get married” is
a perlocutionary act. By saying that statement, the person is not automatically married. The
effect of the act is external to the performance. An illocutionary act is internal to the
performance and has an intended recipient. These acts can also change the state of a person or
force them to do a certain thing as the illocutionary force is directed at a specific recipient (Stiles
1981:228). For example, “I now pronounce you husband and wife” is an illocutionary act. By
proclamation, the priest has given two bodies a marital status. In this case, the effect of the
speech act is internal to the performance.
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Butler feels gender acts are similar to illocutionary speech acts, for example, when a
doctor says, “it's a boy” in the delivery room, he has, by simple proclamation, assigned a gender
to a body (Butler 1988:223-224). Butler believes that bodies are not the source of gender, but
rather “gender acts” are the source of gender. There are many different gender acts that people
do everyday, but some simple ones are the type of clothing one wears, the way they speak, or the
way they do their hair. These performatives rely on social agreements of what it means to be a
“boy” or to be a “girl”. In other words, the type of hairstyle a “boy” chooses is based on what
society deems acceptable for his gender—typically boys have short hair while girls have long(er)
hair.
Butler also argues that sex is also determined by society and as a result, sex is also part of
the gender performative, thus the two (gender and sex) are inseparable. She believes that there is
no substance that gender wraps around; instead, both sex and gender are social constructions.
She believes that through the gender “doings,” there will emerge not only a gendered self, but a
sexed being (Butler 1988:523-524).
Performatives should not be confused with performances. In a theatrical performance,
there is an underlying subject who performs a role for a time being. In a performative, there is
no underlying substance. For Butler, gender is a performative because there is no substance
(biological sex) underneath. Through the performance of a gender, a sex will emerge.
Butler differs from Lorber on her view of gender because she believes there is no
substance or “core” that gender wraps itself around. Lorber believes gender is a “doing” that
wraps itself around a substance, and that substance is a sexed body underneath (Lorber 1994:1).
For Butler, both gender and sex are socially constructed, where Lorber believes only gender is
socially constructed based on sex.
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Along with the construction of gender are certain norms or expectations. Garfinkel
(1967) came up with a list of these gender norms and they are: (as seen in Kessler 1978:113114).
1. There are two and only two genders.
2. One’s gender is invariant.
3. Genitals are the essential sign of gender.
4. Any exceptions to the two genders are not to be taken seriously.
5. There are no transfers from one gender to another except ceremonial ones.
6. Everyone must be classified as a member of one gender or the other.
7. The female/male dichotomy is a natural one.
8. Membership in one gender or the other is natural.
It is important to note that these norms reinforce the two gender/sex system and
demonstrate that a particular gender is “mapped onto” individuals based on our sex. There is no
mention of a third sex or a third gender, and even switching genders is unheard of unless it is for
a ceremony.
The sex/gender schema is a system where a society transforms the biological category of
sex and turns it into a product of human activity (Herdt 1993:52). Lorber believes a person’s
gender is based on their sex, and in Western societies, we only have two sexes, so there can only
be two genders. Butler believes both sex and gender are social constructions and cannot be
separated.
These theories on the social construction of gender can only be understood in Western
societies, where there are two sexes and two genders and they cannot be applied to cultures that
have more than three or more sex or gender categories. Westerners often do fully not understand
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alternative identities, such as the “two-spirit” or hijra, because they have a sex/gender schema
that is based on two sexes and do not know how to “make sense” of a third sex or gender.
The societal expectations and social construction of gender have a large impact on how
Western societies “make sense” of individuals with ambiguous genitalia and do not fit into one
of the two sex categories. The largest and most harmful impact that these gender norms have is
on the treatment and management of intersexed individuals, which will be discussed in detail
below.
Who are intersexed individuals and how long have we known about them?
The sex/gender schema in Western cultures is a perfect example of how we make sense
of the world based on the binary opposites of male and female. But what happens when a child
is born that cannot be placed into those two sex categories? This occurs more often than one
may think, as approximately four percent of births could be categorized as intersex (FaustoSterling 1993:21).
When a child is born, the main determining factor of its sex is based on the genitals.
Western societies have cultural expectations of what male babies’ penises should look like and
what female babies’ vaginas should look like. There is much variation that exists even within
the categories of penises and vaginas. The size of the clitoris varies greatly as does the size of
the penis or shape of the scrotum, but there are societal norms for each category and when an
infant is born that does not fit the social “norm,” they are intersex.
Even the category “intersex” is socially constructed because genitals that are not
“normal” are automatically classified as intersex. There is no clear measure of what is
considered normal and what is not, therefore even the category of intersex is a production of
societal expectations.
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Intersex individuals used to be referred to as “hermaphrodites,” which “comes from the
Greek name Hermes, variously known as the messenger of the gods, the patron of music, the
controller of dreams or the protector of livestock, and Aphrodite, the goddess of sexual love and
beauty” (Fausto-Sterling 1993:22). These two gods were the parents of Hermaphroditus.
Hermaphroditus became half male and half female at the age of fifteen. He fell in love with a
nymph and his body fused with hers.
Hermaphrodites have been around since the beginning of time and can be found in
numerous sources of literature. In fact, some biblical scholars believe Adam was a
hermaphrodite who later divided into two, a male and a female. Plato even believed there were
three sexes: male, female, and hermaphrodites. The Jewish books of law, the Talmud and
Tosefra have regulations on individuals of mixed sex. For example they cannot inherit the estate
like daughters would and if/when they menstruate, they have to isolate themselves from men like
women would, and they could not hold the position of priest, since they were not a man. In
Europe during the Middle Ages, hermaphrodites were required to pick a gender and stick with it
(much like the belief today) (Fausto-Sterling 1993:23).
In 1937 Young did an influential study of hermaphrodites and their sexual experience.
One of Young's patients was a hermaphrodite named Emma. She had a both a vagina and a
penis-sized clitoris. She was able to have heterosexual sex with both males and females. Emma
had many girlfriends as a teenager but married a man at the age of nineteen, she was; however,
never sexually satisfied, so she kept a few girlfriends around. Emma always told Dr. Young
about how s/he sometimes wished to be a male. Dr. Young informed her that a simple surgery
could take care of that, and her response was, “Would you have to remove that vagina? I don't
know about that because that's my meal ticket. If you did that, I would have to quit my husband
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and go to work, so I think I'll keep it and stay as I am. My husband supports me well, and even
though I don't have any sexual pleasure with him, I do have lots of girlfriends” (Young 1937 as
quoted in Fausto-Sterling 1993:23).
What are some conditions associated with intersex?
Even within the category of intersex, there are many variations. For example, an
individual may be born with genitalia that resembles a “typical” female’s, but have the internal
anatomy of a “typical” male, and vice versa. An infant could be born with genitals that are a
combination of both male and female. A girl may have a noticeably large clitoris or the absence
of a vaginal opening. A boy may have a small penis or a scrotum that is split to resemble a labia.
Intersex individuals may not be classified at birth as they could have anatomy that does not
develop until puberty. Intersex could also be indeterminable. Some individuals go their whole
life not knowing they are intersex. Although there are many reasons, the most common intersex
conditions are Androgen Insensitivity, Congenital Adrenal Hyperplasia, Hypospadias, Klinfelter
Syndrome, Ovo-testes, Aphallia, and Turner and Swyer Syndromes (ISNA.org).
Androgen Insensitivity Syndrome (AIS) occurs in XY infants, yet they appear to be
female genitally, but they may have undescended testes with a short vagina and no internal
female reproductive organs. Upon puberty, the testes produce testosterone, but the body
converts the testosterone into estrogen which may stimulate the development of breasts and a
female body shape. A girl with AIS does not menstruate and is incapable of reproducing
(Fausto-Sterling 2000a:52).
Congenital Adrenal Hyperplasia (CAH) is where a female with XX chromosomes is born
with a noticeably larger clitoris that may resemble a penis and labia that resembles a scrotum;
this is one of the only intersex conditions that require immediate medical attention and/or surgery
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upon birth. CAH occurs when the adrenal glands, instead of making cortisone, produce high
levels of other hormones that virilize. Virilization occurs metabolically after birth producing
androgen that results in male sex characteristics such as body hair, deep voice, and large
muscles. Boys may also be born with CAH, but they will have normal genitalia yet can die if
their condition is not detected. Cortisone is necessary for the body to heal when stressed,
whether with a cold or a broken bone, so medical treatment is necessary to prevent further
complications that occur with the absence of cortisone (ISNA.org).
Hypospadias is a condition where the urethra (the hole through which pee escapes) is
located somewhere other than the tip of the penis. It could be located on the underside of the
penis, mid-shaft, or somewhere behind the penis. This condition is relatively common, resulting
in one out of every seven hundred births (ISNA.org).
Klinefelter Syndrome is a condition that occurs in males where they pickup an extra X
chromosome so they have an XXY chromosomal makeup. Individuals with Klinefelter
Syndrome are infertile, have relatively small testes, and produce little-to-no body hair with some
breast development. In order to treat Klinefelter, testosterone shots are given (Fausto-Sterling
2000a:52).
Ovo-testes used to be referred to as “true hermaphroditism” and occurs when an
individual possesses any combination of both ovaries and testes. Genitally though, they could
appear typically male, typically female, or somewhere in between (ISNA.org).
Swyer Syndrome occurs to girls who appear to be female genitally but possess neither
testes nor ovaries, which are referred to as streaked gonads. Girls with streaked gonads will not
develop secondary sex characteristics as they are not able to produce sex hormones (ISNA.org.
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Turner Syndrome occurs when females are lacking their second X chromosome, so they
are XO. These girls are usually short and do not have and secondary sex characteristics;
however, this can be treated with estrogen and growth hormones (Fausto-Sterling 2000a:52).
Aphallia is where a boy will have typical male anatomy, but he is missing his penis.
Micropenis is a condition where a boys penis is 2.5 deviations smaller than “average”
(ISNA.org).
What is the difference between transgenders, transsexuals, and intersexuals?
It is important to note that there is a distinct difference between intersex and transgender
or transsexual individuals. Intersex individuals are born intersex and they come to the attention
of medical personnel because their bodies do not fit society's expectations of what a typical male
or a typical female body should look like. Transgender and transsexual individuals are born with
male or female genitalia and have an internal conflict with their gender identity at some time in
their life. Transgender individuals feel as if they have been born into the “wrong body.” They
may have a desire to change their external anatomy to “match” their internal gender identity, and
this is when a transgender individual becomes a transsexual. Transsexuals often take hormones
and have a sex assignment surgery but it is important to realize that just because they have
surgery performed on their genitals does not mean they are intersex.
Many people often assume that intersex and transgender/transsexuals are the same
because they are both able to choose their gender. This is certainly true for transgenders and
transsexuals, and intersex may fall into this category, or they may not. An intersex individual
might feel as if they have been assigned the wrong gender. They may feel as if they are trapped
in the wrong body and they have a strong desire to alter their external anatomy to match their
30
inner feelings. While this does make them a transsexual, it does not mean all intersex people
switch genders (ISNA.org).
How are intersexuals in Western societies “treated”?
The sex/gender schema found in Western societies is a great way to understand how sex
determines gender, but this system can cause a lot of harm to individuals whose sex is
somewhere in between male and female. I will now share some stories of individuals whose
lives were negatively affected by attempting to “fit” them into the strict sex and gender
categories of male and female.
In the 1950's at John's Hopkins University, a team of scientists came up with a theory
called the “optimum gender of rearing” that was used to treat children with intersex conditions.
At the head of this team was a psychologist by the name of John Money (ISNA.org). Money
believed that a child's gender was based all on nurture, like both Lorber and Butler. He and his
team believed that all that was necessary was to make an intersex child into an anatomically
correct little boy or girl by the age of two and a half years and convince the parents of the gender
assignment. The John’s Hopkins team also wrote that it was necessary to make the child aware
of their intersex condition through age-appropriate conversation and to be open and honest with
family. Honesty was far from what the medical doctors and practitioners were conducting. In
fact, many textbooks at the time gave advice on how to lie to patients and their parents about
intersex conditions (ISNA.org).
The Hopkins model gained popularity and started spreading throughout the world.
Surgeons were performing surgeries on infants without the consent of the parents and
endocrinologists were manipulating the hormones of the patients not for their physical wellbeing, but for the social reasons, so the body would develop and look sexually “normal”
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(ISNA.org). Many intersex individuals, once they discovered they had been lied to about their
condition, ceased all medical treatment, even if it had an adverse affect on their health. Many
not only suffered from physical harm, but psychological harm as well. They felt like freaks
because not even their doctors would be honest with them about their condition.
In addition to being dishonest, the Hopkins model was also sexist. It emphasized the fact
that little girls and little boys should be treated differently. For intersex “girls,” the main concern
of doctors was to preserve fertility, not sexual sensation and for “boys” it was the size and shape
of the phallus (ISNA.org).
The Hopkins model was also based on arbitrary and societal “standards” for genitals, not
on the health or physical well-being of the patient. Girls who were born with enlarged clitorises
underwent surgery that took away some of their healthy genital tissue. Boys who were born with
penises that were deemed “too small” were automatically made into little girls, even though there
was medical evidence that boys would be relatively normal through the use of hormones and
genital surgery.
Kiira Triea is an intersexual who had genital surgery and a sex reassignment. She is
currently an activist who was one of the founders of the Intersex Society of North America
(ISNA), whose goal is to change intersex policies and bring awareness to intersex issues. She
also founded the Coalition for Intersex Support, Activism, and Education (CISAE), which
provides peer support to intersexuals.
Triea also created a “Phall-o-meter” based on Suzanne Kessler's work with intersexuals
(see figure 1)
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Figure 1 – image ratio ~2:1
The Phall-o-meter is a piece of laminated paper (about the size of a bookmark) that
intersex activists use to explain to people how crazy the “treatment” of intersex individuals really
is. The Phall-o-meter is meant to be humorous, although many surgeons did not find it so.
Because of its historical and cultural importance, there are copies of the Phall-o-meter at the
Smithsonian Institute to explain the history of intersexuality (Dreger 2008).
Although the Phall-o-meter is somewhat funny, there is some truth to it. If an intersexed
infant is born with a penis that is 2.5 cm long (1 in.) or shorter, “he” is usually given a female sex
reassignment (Dreger 1998:28). If a girl is born with a clitoris that is longer than a centimeter, a
clitorectomy is performed in order for her to look more like a “typical” female.
A child who is born with ambiguous genitalia is a psycho-social problem, not a medical
issue. There are very few cases where having an intersex condition puts an infant’s health at
risk, but since the parents and society do not know how to deal with a child who does not fit into
the categories of male or female, man or woman, surgery is performed to ease the distress
everyone else suffers. The intersex individual has to bear the pain just so society can feel more
comfortable around them. There has been evidence that intersex individuals who do not have
their genitals altered do much better psychologically than those who undergo a sex reassignment
surgery. Many individuals who have been treated according to the “optimum gender rearing”
model have suffered not only great physical harm, but psychological harm as well (ISNA.org).
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A good example of this psychological harm is the John/Joan case, where an individual suffered a
lifetime of difficulties when treated according to this model.
Who is David Reimer?
In the summer of 1965, in Winnipeg, Canada, Janet Reimer gave birth to twin boys,
Bruce and Brian. Within six months, the two boys began having trouble urinating, so on April
27, 1966, Janet took them to the hospital for a routine circumcision. The doctors decided to try a
new procedure where the skin would be burned off; however, the procedure went horribly wrong
and Bruce’s penis was burned beyond repair. The urethra (the pee hole) was gone and doctors
had to insert a catheter just so Bruce would be able to urinate (CBC 2004).
Over the next few months, the Reimers discussed the issue with many doctors, and none
were able to offer them any glimpse of hope. Janet and Ron felt like prisoners in their own
home. They could not even leave the house for fear the babysitter might see Bruce’s penis and
start gossiping (Colapinto 2000:17). One night shortly after the twins first birthday, the Reimers
saw a special report on television in which John Money discusses his theory that any boy could
be raised as a girl if he is “treated” early enough. According to Money, gender is malleable and
determined by nurture and not nature. The Reimers took a trip to Baltimore, where John Money
deemed Bruce a good candidate for the procedure. At the age of 21 months, Bruce’s testicles
were removed. Money told the Reimers to raise Bruce as a girl and not say anything to anyone
about the situation. So, the family referred to Bruce as Brenda (see figure 2).
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Figure 2
Janet did her best to raise Brenda as a girl. She would put her in dresses and show her
how to apply makeup, but Brenda was just not acting like a girl. She would always play with
other boys, often getting into fist fights. Kids called her names like “freak” and “it,” and the
situation got so bad she did not want to attend school anymore. Teachers noticed she was
developing more slowly than her peers, and she was held back in the first grade (Colapinto
2000:64).
By the age of nine, the family was starting to doubt whether the procedure was
successful; however, John Money was strongly convinced otherwise. In fact, he even published
an article that claimed the procedure was a resounding success. He said, “Behavior is so
normally that of an active little girl, and so clearly different by contrast from the boyish ways of
her twin brother,” and Brenda’s sex reassignment was “dramatic proof that the gender identity
option is open at birth for normal infants” (Money 1975:65-71).
Dr. Money visited the Yolngu tribe in Northern Australia in 1969 where he heard about
two eight year old children participating in the “nigi-nigi,” which was sexual intercourse. The
Yolngu have no instances of gender confusion and was largely heterosexual, so Dr. Money
attributed a healthy gender identity to Yolngu children participating in this “sexual rehearsal
play” (Colapinto 2000:88-89). He implemented this “sexual rehearsal play” on the Reimer
35
children so that Brenda could develop a healthy gender identity. He forced Brenda, at the age of
six, to get on all fours while her brother Brian placed his crotch against her buttocks. The
children also did this in many different positions while Dr. Money took Polaroids (Colapinto
2000:87).
By the time puberty hit, it was evident the procedure was not working Brenda refused to
take her hormones, she would flush them down the toilet. She was starting to get broad
shoulders and a thick neck and Dr. Money was encouraging the Reimers to bring Brenda to the
clinic so he could create a vagina. Brenda rebelled and threatened suicide if they ever took him
back to Baltimore to see Dr. Money (Colapinto 2000:141). That is when her father told her the
whole story. Brenda then decided to have a mastectomy and plastic surgery to try to make his
penis look more masculine.
Brenda was angry that her/his whole life had been a lie and s/he suffered major
psychological trauma. S/he was even quoted as saying, “What they did to you in the body is
sometimes not near as bad as what they did to you in the mind—with the psychological warfare
in you head” (Colapinto 2000:xii). S/He suffered from depression and attempted suicide three
times, the third of which left her/him in a coma. S/He recovered and eventually started living
life as a “normal” man. He cut his hair, changed his clothes, and re-named himself David (see
figures 3 and 4).
36
Figure 3
Figure 4
David refused to talk about his story if his identity was going to be revealed; he was very
secretive until in 2000, John Colapinto wrote a book on his life entitled, As Nature Made Him,
The Boy Who Was Raised as a Girl. A media whirlwind occurred, and at the same time, John’s
Hopkins University released two studies that put an end to the nature/nurture debate. The studies
found that it is a prenatal exposure to male hormones that makes babies into boys. The studies
“seriously question the current practice of sex-reassigning some of these infants as females...”
(CBC 2004). Janet said David’s going public with his story was difficult, but he wanted to make
people aware of the situation and provide some support for others who may be suffering from
similar procedures.
David eventually married a woman and had three children via adoption, but when he lost
his job and became separated from his wife, he committed suicide on May 4, 2004.
Before his death, David made a comment about not fitting in, despite going to many
different schools as a child. He said, “It didn’t matter what kind of school it was. If you’re not
comfortable, you’re not going to be comfortable no matter what school you go to. You can go to
a thousand schools, and it’s always the same. Because the standard rule of thumb is: There’s the
girls over here and there’s the boys over there. Separated. Which direction [do I go]? There’s no
37
belonging. So you’re an outcast. It doesn’t change. School to school to school. It doesn’t change”
(Colapinto 2000:101-102).
David is referring to the way Western societies think in terms of the binary opposites of
male/female. In school, it was always the girls vs. the boys and there was no category for him.
Western societies do not have a sex category for intersexuals that is why Dr. Money spent so
much time and effort trying to turn Bruce into Brenda.
David’s story is a good example to show that gender is both socially constructed and
biological. It is dangerous to perform a sex-reassignment surgery and not take into consideration
how a person’s hormones will affect them later in life. Although David Reimer was not an
intersex individual, his story is still important to understand the correlation between sex and
gender. Gender is not only socially constructed, as the Hopkin’s team believed, so in regards to
intersex individuals, medical professionals cannot perform a sex reassignment and tell the
parents to raise the child with a different gender, because that has been proven to be
unsuccessful, and even harmful with the John/Joan case.
Western societies do not have a sex category and a correlating gender category for
someone who is not male nor female. When David Reimer lost part of his penis during a
botched circumcision, doctors applying societal norms determined that his penis was too small
for him to be in the “male” sex category, so he had to be made into a female, this is because
Western societies have rigid two sex and gender categories, which does not allow any room for
ambiguities. After the circumcision, David Reimer’s genitals were in a “grey zone” (they no
longer fit into the black and white categories of male and female). People in Western Societies,
do not know how to deal with “grey zones” or ambiguities especially in terms of sex, so society
38
feels they need to “make him fit” into the binary sex categories before they know how to interact
with him.
The reason Western societies cannot interact with people like David Reimer and intersex
individuals is because we have sex/gender schema that is based on the two biological sexes of
male and female and we do not know how to “make sense” of anything that is not one of these
two sexes. This sex/gender schema includes a division of labor based on sex. Males are strong,
protective, and aggressive, so they have jobs that require these traits, and women are nurturing,
other-directed, and passive. In this schema, people get treated with the Common Sense Lenses,
and if a person gets treated a certain way, it becomes a self-fulfilling prophesy. They are
rewarded for behaviors and actions that correlate with their gender and discouraged from those
that are typical of the other gender.
What are some problems or risks associated with performing surgery on intersexed
infants?
In most Western societies, there are two sexes: male and female; and we make sense of
the world thinking in terms of these binaries. For example, these two sexes are used to make
sense of individuals and their gender roles within society, so when an infant is born with
ambiguous genitalia, the medical community deems it necessary to perform surgery on their
genitals so they can “fit” into one of the two socially accepted sexes. Society feels it necessary
to maintain clear distinctions between the two sexes and two genders and having individuals that
do not fit into either category is viewed as a social problem.
Society may benefit from having the two distinct, yet separate sex categories, but it
comes at a cost to the ambiguous individual. While it may be easier to know how to interact
39
with and make sense of the world with two sexes, those who do not fit into one of the accepted
sexes end up paying the price, not only physically but psychologically.
Dreger believes that a “psychological problem should [not] be handled medically or
surgically” (1998:30). Intersex infant’s health is not at risk (except in the case of CAH) so the
main, and only reason genital surgery is performed is to make the child, parents and society more
comfortable. Cheryl Chase, the founder of the Intersex Society of North America (ISNA) has
posed an interesting response to this problem, “When a baby is born with a severely disfigured
but largely functional arm, ought we quickly remove the arm and replace it with a possible
functional prosthetic, so that the parents and child experience less psychological trauma?”
(Dreger 1998:30). If society and the medical community’s response to this is “no,” then why are
genitals any different? In fact, genitals can be (and usually are) more hidden than an arm.
Sex reassignment and infant genital surgery are not good solutions to solve society’s
“psychological problem” as irreversible physical and psychological harm is caused to the
intersexed individual. For example, intersexed “girls” may have residual pain in the clitoris,
excessive scarring, clitoral hypersensitivity, inability to orgasm, loss of sensation, and an overall
unsatisfactory appearance. Stenosis is a narrowing of the vagina that requires repeat surgeries
later in life. In order to prevent stenosis, parents are advised to insert a dildo into the vagina so
the “hole” does not close up (Fausto-Sterling 2000a:86). The insertion of a dildo into a little girl
can inflict psychological harm, the child may not know when it is or is not acceptable to insert
something into their vagina. If her parents enforce the idea that it is alright to insert an object,
she may become sexually promiscuous at a young age or susceptible to rape or abuse if clear
boundaries are not enforced.
40
According to surgeons, the only criterion for vaginal surgery is that the “hole” is large
enough to fit a typical-sized penis and this re-inscribes a heterosexual norm. The reconstructed
vagina is not required to produce lubrication, have any sensitivity, or change its shape when
sexually aroused (as “typical” vaginas do). All that is required of a vagina is a receptive “hole”
(Dreger 1998:29). A surgeon once stated that “it is easier to make a hole than to make a pole,”
implying that anyone can construct an insensitive hole, but to attempt to create a fully
functioning and proportionate penis is more difficult.
Intersexed individuals who are turned into “girls” suffer from numerous vaginal
infections because the vagina is not able to “clean” itself without natural lubrication. If an infant
is born with “inadequate” male genitalia and turned into a “girl,” s/he will no longer be able to
procreate since they have a reconstructed vagina that will not be connected to any internal female
reproductive organs. Intersexed infant “boys” may have painful scars and trouble urinating or
having an erection.
In addition to many physical risks associated with infant genital surgery, there are exists a
plethora of psychological issues. Intersexed individuals are often subject to repeated medical
exams that border on the line of abusive. The exams often include explicit procedures in the
presence of medical students, interns, and doctors. Doctors will often take pictures of the
genitals and the individual feels like they are in a freak show and being isolated because of the
way their genitals look. “Boys” have had to masturbate with the assistance of a doctor in order
to show penile growth (Fausto-Sterling 2000a:86). All of these examples mentioned above have
long term affects on an individual as they feel that the appearance of their genitals are more
important than their mental and physical well-being.
41
There is a lack of long term follow ups on surgeries performed on intersexed infants;
therefore there is little evidence to know how the surgeries affect the individuals into adulthood.
From what the medical community has learned from the few adult intersexed individuals that
have “come out” about their stories in adulthood is that the surgery and the lies surrounding it
have had a negative psychological impact on their life (Dreger 1998:31).
As the child gets older and needs more surgery to keep up with their changing bodies, the
parents and surgeons lie to the child about the procedure. For example, they will tell the child
that she has twisted ovaries and that she is going to get that corrected, when in actuality they
removed her testes. Medical books written in the 1950s and 1960s would give doctors advice on
how to lie to both the patient and their parents about their sex (Dreger 1998:31). Recently, there
have been many debates about the ethics behind lying to a patient about their condition, but in
1995, a medical student received a cash prize in medical ethics from the Canadian Medical
association for an article he wrote that advocated lying to AIS patients. The prize-winner
argued, “Physicians who withhold information from AIS patients are not only actually lying;
they are only deceiving.” Physicians do not lie to the patient, they just withhold necessary
information or only tell the partial truth. (Dreger 1998:31).
One person whose life was adversely affected by the lies and deceit was David Reimer
(John/Joan). David Reimer was lied to his whole childhood about his real sex and gender. He
suffered from depression, attempted suicide three times, and on the fourth, was successful.
Cheryl Chase is the founder of the Intersex Society of North America and an intersex
activist and she has devoted her life to raising awareness to intersex rights and while many admit
that the treatment of intersexed individuals today is better than in the 1960's, Chase disagrees.
Clitorectomies are still performed today as well as the withholding of information, even after the
42
age of 18 (Fausto-Sterling 2000a:94). The story of Angela Moreno proves this is still occurring
today. At twelve years old, in 1985, she had a clitoris that was 1.5 inches long and her mom was
shocked so she took her to the doctor, who informed Angela that she had ovarian cancer and
needed a hysterectomy. When she awoke from surgery, her clitoris was gone. At the age of
twenty-three, she learned that she actually had XY chromosomes and testes, she never had
ovarian cancer. Today Moreno is an activist for ISNA, which has helped her recover from the
lies about her condition. She said, “If I had to label myself man or woman, I'd say I am a
different kind of woman...I'm not a case of one sex or another, nor am I some combination of the
two. I was born uniquely hermaphroditic—and from the bottom of my heart, I wish I'd been
allowed to stay that way” (Fausto-Sterling 2000a:94).
Cheryl Chase, Angela Moreno, and others are protesting the lies that surround
intersexuality. From their stories, it is evident that they suffered greatly, not just from the
surgeries themselves, but from the lies and deceit. They want to prevent any further unnecessary
suffering to intersexed individuals in the future.
In the practice of Western medicine, there is an arrogance that tends to create harmful
results (as seen with the David Reimer case). Professor Carol Black, the new female president of
the Royal College of Physicians (and the second woman to have that job in 500 years) stated,
“Medicine has a reputation as a chauvinistic profession led by powerful male consultants with
giant egos,” these men feel they know what is best for their patients based on their own beliefs
and theories (as seen in Adams 2004). This has been an unfortunate truth in the case of Dr.
Money and David Reimer. Despite evidence that Brenda was not “accepting” her new gender,
Dr. Money insisted that his theory on the “optimum gender rearing” was correct and the parents
43
should continue treating Brenda as a girl. It is also common for patients and their families to
place all of their trust in their doctor, and follow what they say, which is what the Reimers did.
Since Western societies think in terms of the binary opposites of male and female, there
is no room for intersex individuals, therefore it is necessary to “fix” them by performing painful
and unnecessary surgeries just so they can fit into one of the two sex categories. Having
ambiguous genitalia is viewed as wrong and physicians feel that they have to lie to the patient
about their condition in order to not make them feel ashamed about their condition.
Unfortunately, society has created this sense of shame because they cannot make sense of
intersex individuals. There are individuals who wish they were able to live as an intersexual, but
instead had a life full of lies and painful surgeries, just so society could be at ease when dealing
with them.
What happens to intersexed individuals who do not have “cosmetic” genital surgery and/or
a sex reassignment?
There is evidence that honesty and non-surgical alternatives toward intersexed conditions
could have a positive impact on the individual's life (Fausto-Sterling 1993:24). In the 1950s and
1960s, before surgery became the “cure” for intersexuality, there were cases where individuals
who were intersexed spent their whole childhood unaware that they were different from the other
children. There were reports that these children even showered in gym locker rooms and there
were no cases of suicide or depression (Fausto-Sterling 1993:24).
Fausto-Sterling (2000) identified eighty individuals (since the 1950s) whose gender does
not match up with their sex, and only one of eighty is psychotic and that may be the result of
having a psychotic parent and not his ambiguous genitalia. Many of these individuals end up
marrying and having an active sex life, even men with small penises enjoy sex even without
44
penetration. The majority of intersexed men have a heterosexual lifestyle, and 55 of the 80
intersexed individuals lived as women, and most were heterosexual (Fausto-Sterling 2000a:9495).
Many intersexuals who have not had any surgeries in childhood, choose not to have
surgery in adulthood. They are comfortable with their sex and sexuality and actually like being
able to perform both sexual roles of males and females. Recall that Emma, discussed earlier,
liked having sex with both men and women, and when given the choice, she did not want surgery
to “fix” her genitals.
Many intersexuals who had a gender reassignment as children, when asked whether they
would have chosen the surgery for themselves, say “no.” David Reimer converted back to his
biological sex after being very unhappy for decades with his assigned sex. Both Cheryl Chase
and Angela Moreno have said that they wished they had been able to live life with the genitals
and sex they were born with.
Suzanne Kessler (1998), a psychologist, interviewed non-intersexual college students
about what treatment they would prefer, had they been born with an intersex condition. The
female students were asked, “Suppose you had been born with a larger than normal clitoris and it
would remain larger than normal as you grew into adulthood. Assuming that the physicians
recommended surgically reducing your clitoris, under what circumstances would you have
wanted your parents to give them permission to do it?” A quarter of the women said they would
not want a clitorectomy under any circumstance. Half said that they would want the clitoris
reduced if having a larger clitoris posed health problems. And another quarter could imagine
having the surgery to reduce the size only if it did not result in a loss of pleasure (Dreger
1998:33).
45
Kessler then surveyed men and asked them “to imagine being born with a smaller than
normal penis and being told that physicians recommended phallus reduction and a female gender
reassignment.” All but one student said they would not want the surgery under any
circumstance. The one individual stated that if his penis was smaller than 1 cm and he was
sterile, then he would want to have the surgery (Dreger 1998:33). These results are an excellent
example to show that when given a choice, most people would not want genital surgery and a sex
reassignment.
Intersexuals who had a sex reassignment would have preferred not to have the surgery,
and intersexuals who have not or did not have the surgery have no desire for the surgery as
adults. Even non-intersexed individuals would prefer not to have a sex reassignment, so when
given a choice, it appears that everyone would opt out of “cosmetic” genital surgery and/or a sex
reassignment. If this is the case, why are physicians still performing sex reassignment surgeries,
when no one, not even intersexed individuals themselves want the operation?
To answer the question, one has to think back to the binary opposites and how humans
think of the world. In Western societies there are only two institutionalized sexes: male and
female. If an infant is born who clearly does not fit into one of those two sex categories, it is
difficult to make sense of them since sex determines gender, and gender determines the role(s) a
person will have within society, whether they are a nurturer or a protector, etc... Since there is no
sex in between male and female, it is imperative to make the child fit into one of those two sexes;
otherwise society is unable to uphold the sex/gender schema and division of labor based on sex.
The future of sex and gender in Western societies
Are there any alternatives to infant genital surgery? What does Fausto-Sterling suggest?
46
Fausto-Sterling states that intersexuality is rooted in the ideas of what it means to be male
and female. “In the idealize, Platonic, biological world, human beings are divided into two
kinds: a perfectly dimorphic species” (Fausto-Sterling 2000b:19). Thinking in these binaries has
complications as there are females with facial hair and males who have none, females with low
voices, and males with higher voices, among many other variations.
Starting in the 1990s and still continuing today, there has been an increase in awareness
and advocacy of these intersexuals to avoid harmful and painful “cosmetic” surgeries.
Organizations and individuals have proposed alternative treatment options for intersex
individuals as well as seeking to establish a set of gender rights.
Fausto-Sterling proposed in 1993 that Western societies adopt a 5-sex system. She
“argued that the two-sex system embedded in our society [was] not adequate to encompass the
full spectrum of human sexuality” (Fausto-Sterling 2000b:19). Her 5-sex system would include
the categories of male, female, “herms” (they possess one testis and one ovary), “merms” (male
pseudohermaphrodites) who have testes and some female genitalia but no ovaries, or “ferms”
(female pseudohermaphrodites) who have ovaries and some male genitalia but no testes
(Fauston-Sterling 1993:21). The 5-sex system was controversial and she stated that ”Right-wing
Christians were outraged” (Fausto-Sterling 2000b:19). But despite its controversy, her 1993
article encouraged others, like Cheryl Chase, the founder of the ISNA and intersex activist, to
change the treatment of intersexuals. Even on a broader level, Fausto-Sterling feels “the
boundaries separating masculine and feminine seem harder than ever to define” (Fausto-Sterling
2000b:19).
Psychologist Suzanne Kessler criticized Fausto-Sterling's proposal to adopt a 5-sex
system by stating that “[it] still gives genitals...primary signifying status and ignores the fact that
47
in the everyday world gender attributions are made without access to genital inspection...What
has the primacy in everyday life is the gender that is performed, regardless of the flesh's
configuration under clothes” (Fausto-Sterling 2000b:22). After Kessler's criticization, FaustoSterling realized that her theory of a 5-sex system still focuses too much on the genitals, and
even within the five sexes, there exists variations. Fausto-Sterling has since “revisited” her 5-sex
theory and suggests living in a more gender-diverse world, and this could be made easier by
removing the term “sex” on documents such as passports and driver's license and instead using
more visible attributes such as height, weight, hair color (Fausto-Sterling 2000b:23).
Since Fausto-Sterling's 1993 article, there have been many changes in the treatment and
theories of intersexuals as pediatric endocrinologists, urologists, and psychologists study the
effects of early genital surgery (Fausto-Sterling 2000b:21). Medical ethicist, Laurence
McCullough proposed a more ethical way to treat intersex infants. He suggests that because
there are so many variations in biology and gender roles, that intersex conditions should be
viewed as “normal” and not as diseases (McCullough 2002:156). He also believes that
physicians should avoid irreversible surgeries and sex assignments until the patient is old enough
to consent (McCullough 2002:170). He urges medical professionals to avoid treating infants
with ambiguous genitalia as a “medical or social emergency” (Fausto-Sterling 2000b:21).
Instead of performing surgeries, the medical community should provide intersex patients with
therapy.
Fausto-Sterling strongly agrees with the principles McCullough has outlined but FaustoSterling feels surgery on intersexed infants should only be performed in real medical
emergencies, in order to save their life or to improve their physical condition. She urges
physicians to assign a sex based on the child's genitals, but remain open and understanding if the
48
child wishes the switch later in life (Fausto-Sterling 2000b:21). She also believes parents should
be fully informed about their child's condition as well as all the options for treatment available.
What does the medical community suggest for the management of intersex individuals?
The Intersex Society of North America (ISNA) and Alice Dreger, an intersex activist and
medical ethicist, support a patient-centered approach when dealing with intersex individuals, as
opposed to the concealment-centered approached that Dr. Money advocates. In the patientcentered approach, intersexuality is not an abnormality, it is just an anatomical variation from
“males” and “females.” They believe gender is not created solely by nurture, but rather by a
combination of both nurture and nature. Supporters of the patient-centered approach believe
ambiguous genitalia is a social problem, not a medical problem; they also believe that everyone
should be able to make choices regarding their body and any surgeries to “normalize” the
genitals should be delayed until the individual is old enough to give consent. They suggest
assigning a sex and gender only after hormonal, genetic, and chromosomal tests have been done
with the realization that the assignment is preliminary and the child may choose to switch later in
life. In the patient-centered approach, it is recommended that the individual have long-term
counseling, support, and peer groups to deal with sex and gender issues (the concealmentcentered approach does not recommend peer or professional counseling). The ISNA and other
supporters of the patient-centered approach believe the individual should know any and all facts
related to their condition, whereas John Money and his supporters feeling that being truthful will
create even a greater sense of gender confusion (Dreger as seen at ISNA.org).
The American Academy of Pediatrics have many of the same suggestions as the ISNA
such as assigning a sex based on the potential of fertility, capacity for normal sexual function,
49
and endocrine function. They support long-term psychological treatment for both the parents
and intersex individual (American Academy of Pediatrics 2000:141).
The Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric
Endocrinology have suggested; 1) assigning a gender only after expert evaluation, 2) providing
long-term management with a multi-disciplinary team consisting of surgeons, endocrinologists,
urologists, psychologists, gynecologists, geneticists 3) assigning a gender to all infants based on
genital appearance, surgical options, and fertility, 4) having open communication with the
individual and their families, and 5) addressing patient and family concerns confidentially (Lee
et al. 2006:e490).
The ISNA, American Academy of Pediatrics, and The Lawson Wilkins Pediatric
Endocrine Society, and The European Society for Paediatric Endocrinology all support open and
honest communication with the intersex individual and family. They suggest assigning a gender
based on genitals, hormones, and chromosomes; and they all support long-term psychological
support. This more “modern” management of intersex is vastly different from what was
practiced by Dr. Money and his team in the 1950's and 1960's.
What is the International Bill of Gender Rights and how does it empower intersexuals?
In 1995, the International Conference on Transgender Law and Employment Policy met
in Houston, Texas. During this meeting they created the International Bill of Gender Rights that
contains ten “rights” one has, including the right to define their gender, change their physical
gender, and marry whomever they desire. The legality of these rights, especially same-sex
marriage, are currently being discussed in courts (Fausto-Sterling 2000b:23).
The International Bill of Rights “strive to express human and civil rights from a gender
perspective. However, the ten rights...are not to be viewed as special rights
applicable to a particular interest group. Nor are these rights limited in application
to persons for whom gender identity and gender role issues are of paramount
50
concern. All ten sections of the IBGR are universal rights which can be claimed
and exercised by every human being.”
The rights are not enforced by law, but rather they are a tool used to “liberate and
empower humankind” (International Bill of Rights 1995).
The rights are:
1) The right to define gender identity
2) The right to free expression of gender identity
3) The right to secure and retain employment and to receive just compensation
4) The right of access to gendered space and participation in gendered activity
5) The right to control and change one's own body
6) The right to competent medical and professional care
7) The right to freedom from psychiatric diagnosis or treatment
8) The right to sexual expression
9) The right to form committed, loving relationships and enter into marital contracts
10) The right to conceive, bear, or adopt children; the right to nurture and have custody of
children and to exercise parental capacity (International Bill of Gender Rights 1995).
These ten rights are applicable to everyone within society, but are also helpful for
intersex individuals as five of these rights speak specifically to issues of gender. Number two is
the right to choose your gender and this is important for intersexuals because it states, “the
individual's sense of self is not determined by chromosomal sex, genitalia, assigned birth sex, or
initial gender role” (International Bill of Gender Rights 1995). According to this right, gender is
not linked to sex, and it is something an individual can choose or change throughout their life.
Number five is the right to change one's body and gives every human the freedom to control their
51
own body. This right implies that surgeons should not perform unnecessary “cosmetic” surgery
on intersexed infants, except in the case of a medical emergency.
These gender rights, although not enforced by law, provide empowerment for not only
intersexuals, but transgenders, transsexuals, and homosexuals. Some of the rights are currently
in the process of becoming “legal rights” and this is extraordinary evidence that Western
societies have been increasingly more accepting and understanding of gender and sexual identity.
Insert heading
From what I have discussed, it is clear that Western societies think of sex and gender
according to the structural theory of binary opposites. We have a sex/gender schema that only
allows for two sexes. This schema teaches us at an unconscious level how to interact with
people based on their sex and their sex determines their gender. Gender affects how people
interact with them and also impacts what kind of behaviors a person will inherit. These
behaviors determine what job would best suit a person of that sex. This system seems to work
well, but when we dig deeper and learn about how individuals who do not have a clear cut sex
are treated, it is apparent that this sex/gender schema actually causes physical and emotional
harm to many individuals, like David Reimer. There has recently been a movement to try to
alleviate the suffering caused to intersex individuals by thinking in terms of these binary sex
opposites of male and female, but as long as we have a sex/gender schema based on two sexes,
the suffering will never fully be eradicated.
Analysis
Through the anthropological study of alternative sex and gender categories, Western
societies have become aware of the fact that other cultures have a different sex/gender schema
than we do. Although many non-Western cultures still use the categories of male and female to
52
define and describe individuals, they realize that those are not the only two sex categories.
Western societies cannot switch their sex/gender schema overnight, but many have started taking
steps in the right direction. Fausto-Sterling suggested switching from a 2-sex system to a 5-sex
system, and although this idea may seem radical to some, and impossible to others, it is
something that is slowly being implemented. There has been a recent realization in Westernsocieties that sex and gender come in many different varieties: the medical community has
started to become more accepting of individuals who do not clearly fit into the categories of male
and female. Physicians and surgeons have started to refrain from infant genital surgery on
intersexed babies (unless medically necessary), which means there are many individuals today
who have ambiguous genitals and do not clearly fit into the sexes of male and female. There has
also been the creation of sex and gender-neutral bathrooms in schools and public locations for
people who do not considered themselves to be “male” or “female.” Although we still do not
have an institutionalized third sex or gender, progress has been made to accept and incorporate
ambiguous individuals into society.
Western societies do not have an institutionalized third sex or gender, but there is the
“queer community” and “queer culture.” Individuals who are members and activists within these
groups clearly do not fit into heteronormative society. The “queer culture” is a broad category
that encompasses many different individuals including: gays, lesbians, bisexuals, transgenders,
gender-queers, transsexuals, and intersexuals, all of whom break Western society's rules for sex
and gender and blur the lines between male/female and masculine/feminine. Membership in
these groups and communities provide individuals with a sense of ambiguity, as they do not have
to be labeled by society's strict sex and gender boundaries. Since these individuals are not
labeled or defined by societies two sexes, this could be the start of a third sex or gender category.
53
Members of the “queer community” have been fighting for equal rights and treatment,
despite their ambiguities in sex and gender. Activists within the “queer community” have been
successful in creating laws and rights protecting individuals who may have an ambiguous sex or
gender. For example, it is now illegal to discriminate against a person based on their sex,
gender, and sexual orientation for jobs or education. The International Bill of Gender Rights was
created to allow individuals to choose and define their own gender, allow them to have control
over their body, as well as the freedom of sexual expression.
It is clear that although Western societies tend to think in the strict binary opposites of
male and female, there has been a recent revelation that these two categories are not working,
and they are causing harm to many individuals. Because of this, there has been a push to create
an intermediate category between the two sexes. Although this topic would require further
research, the “queer community” could, in the future, become an institutionalized third
sex/gender category, and/or an intermediary between male/female and men/women, if it is not
already.
It seems that Western societies are slowly moving toward a more accepting
environment for individuals who may be considered ambiguous, whether by sex or gender.
Although we still have do not have institutionalized third sex and gender categories like India
and the Native American tribes, it is good to know that we are moving in the right direction, and
this can be seen with the creation of laws and rights established to protect these ambiguous
individuals, and the attempts the medical community have made to refrain from harmful and
unnecessary genital surgeries.
Conclusion
54
As you have learned, sex and gender have been studied cross-culturally for many
decades. Within structural anthropology is the belief that human brains “make sense” of the
world by thinking in terms of binary opposites, such as male/female. People know these
categories are arbitrary and often created intermediate categories. Anthropologists have studied
these intermediate categories regarding sex and gender in many non-Western cultures that have
three or more institutionalized sexes and genders. The “two-spirited” people in Native American
Indian tribes are men who perform “female-typical” roles. They are not stigmatized for their
behavior and they highly valued within their communities. The hijra of India is a third sex
category for intersex individuals and castrated men, and like the “two-spirit,” the hijra perform
“female-typical” roles.
Euro-American cultures do not have an institutionalized third sex or gender because we
have a sex/gender schema that is based on the two sexes of male and female. A person’s gender
is based on their biological sex. Problems arise when an intersexed infant is born and they do
not fit into the categories of male and female. In order to “make sense” of them, it is necessary
to perform harmful and unnecessary genital surgeries so they can fit into one of the two sexes.
The unfortunate story of David Reimer proves that these surgeries tend to do more harm then
good. Recently, intersex activists and the medical community have become aware of the
psychological and physical damage created when trying to make a person fit into one of the two
sexes. The medical community has started to refrain from unnecessary surgeries on intersex
infants, and rights and laws have been established to protect these individuals.
Anthropology has made Western societies more aware of the idea that sex and gender
are created by society, and vary cross-culturally. Although Western societies do not have an
institutionalized third sex or gender, one could argue that the “queer community” could be
55
considered an alternative sex and gender category, as members blur the lines between
male/female and man/woman.
Western societies have improved the way they treat ambiguous individuals, and it seems
to keep improving as we learn more about sex and gender in other cultures, and become aware
that our current sex/gender schema is inflicting unnecessary harm on many
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