Ethics Alarms encourages long form comments, especially when they are as carefully reasoned, authoritative and well-written as the one presented here, by zoebrain, the Ethics Alarms expert on all things trans, gendered, re-gendered and more.
The new, complex and divisive ethical issues arising from gender matters have appeared here with increasing frequency, most recently in the post that inspired this comment—actually two comments—that attempts to enlighten the cyssies among us. I think it is required reading for anyone who wants to understand this complex subject, which is certain to generate more ethics dilemmas and controversies. I am grateful for all comments, but I want to send special thanks to the author, who obviously spent a lot of time and thought on what follows.
Here is zoebrain’s Comment of the Day on the post, “More Interview Ethics: Janet Mock Ambushes Piers Morgan”...
First, I better say why this is important, why the distinction between “used to be a boy” and “used to look like a boy” isn’t just some sterile, trivial and pedantic squabble.
“Used to be a boy” is all too easily answered by “you still are, just a mutilated one, DNA don’t lie”. Which in turn leads to “you’re a sick homo freak who deceives others, no better than a rapist”. Which in turn leads to “you rapists should be flayed alive then burnt at the stake, you filthy perverts”.
Which happens. The flaying and burning anyway, stakes have rather gone out of fashion. About a third of the murders of trans women involve extended torture and mutilation, some quite imaginative. It’s the lucky ones who just get shot.
Trans women have 17 times the rate of being murdered as the general population. Trans women of color, while only 13% of the group overall, account for over 50% of the victims. So for them, we’re looking at around 80 times the chance of being murdered compared to the general populace.
Clean up rate for homicide in the US is around 70%. The police know who did it, even if they can’t prove it. For trans victims though, the clean up rate is 30%, the homicide conviction rate even lower. “Attempted manslaughter” might be the charge when the perp was seen gutting the victim like a trout, and then caught disposing of the dismembered body parts.
This is improving, with more homicide convictions recorded in the last 5 years than the previous 50, but there’s still a number of infamous cases where the perp walked for no other reason than that the victim was Trans. It’s a brave prosecutor who doesn’t offer a very lenient plea deal.
The problem is though that “used to be a boy” is sometimes the only way of expressing the situation that ill-informed people will understand. To tell the whole truth takes too long, it can’t be done in 140 characters or a 5 second soundbite….
OK, let’s talk about sex – what defines it? Is it a matter of reproductive capacity, or of core identity, who one is?
First – reproductive capacity.
Scott, when you were born, you were a baby. Assigned male (I assume). Yet you had no reproductive capacity at the time, and wouldn’t have till you reached puberty..Similarly, women who have had hysterectomies, or men who have had vasectomies, or those born sterile or who have become sterile, through accident, disease, or just plain age.
So lack of reproductive capacity doesn’t preclude having a sex.
I know of two confirmed cases, one unconfirmed, where the patient had the capability (in theory at least) of reproduction either fathering a child or becoming pregnant. The Mayo clinic is studying one case, and I have few details, and those are confidential. My friend Petra Henderson, late of the Royal Corps of Signals and currently resident in Germany is the other – a botched hernia operation caused auto-fertilisation, though as most of the required structures weren’t present, the pregnancy couldn’t proceed very far.
She identifies as female anyway, despite having fathered children before genital reconstruction to approximate a female norm.
In view of these facts, while reproductive capacity might be a contributing factor to determining a patient’s sex, it can’t be definitive, and in a large number of cases, is irrelevant.
The only thing I assert is that if a patient has become pregnant, and identifies as a woman, then she’s female, and we can ignore all other complicating factors such as chromosomes, secondary sex characteristics, documentation, appearance, etc.
Similarly for patients who have fathered children and who identify as male. They’re men, regardless of other details.
Second – Identity
Scott – a thought experiment. Suppose you had fallen into the hands of a traditional “Mad Scientist” who gave you an involuntary “sex change operation” so you looked superficially female. Even gave you hormones, so parts of your brain changed, affecting your emotions to some degree.
Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure by Pol et al, Europ Jnl Endocrinology, Vol 155, suppl_1, S107-S114 2006
Many of the changes would be fully reversible, by the way, and the majority of the sexually dimorphic parts of the brain are unaffected – they’re set before birth.
Would you still be male? Your basic personality would be the same, as would your sexual orientation. You’d have no sex drive, the hormones will do that, but I think it likely that your main emotions would be utter misery at having been castrated and mutilated, and that you’d do anything in your power to reverse the process. You would have acquired “Gender Dysphoria”, just as Ms Mock had from early childhood.
Or maybe not. One in three are bigendered, with a Superior Parietal Lobule neither strongly male nor female, and could live with it without experiencing “Gender Dysphoria”. Maybe you’d merely be curious about this new life experience, though I think you’d soon become an ardent feminist when you realise just what used food women have to cope with.
Lest you think this is some “straw man”, a ridiculous fantasy hypothetical constructed just for argument – nope.
Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth by Reiner and Gearhart, N Engl J Med. 2004 January 22; 350(4): 333–341.
Intersex babies who had the misfortune to be born without genitalia used to be surgically and socially assigned as female, with very few exceptions.
Eight of the 14 subjects assigned to female sex declared themselves male during the course of this study, whereas the 2 raised as males remained male. Subjects could be grouped according to their stated sexual identity. Five subjects were living as females; three were living with unclear sexual identity, although two of the three had declared themselves male; and eight were living as males, six of whom had reassigned themselves to male sex. All 16 subjects had moderate-to-marked interests and attitudes that were considered typical of males. Follow-up ranged from 34 to 98 months.
I contend from this and other evidence that sex is best defined not by genital or chromosomal anatomy, but by neuro anatomy. An objective, measurable thing, set before birth, and immutable (unlike chromosomes, genitalia etc). This results in a gender identity, the gnosis that one is male or female, a product of objective biological fact.
Moreover, every other definition results in misery for patients. Thus, apart from the objectively factual aspects, because so many definitions are arguable, we are ethically bound to use the one that results in least harm, all other things being equal. While I don’t think they are equal, that neuro-anatomy is better for other reasons, I think it proven that it is at least as good as any other.