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July 20, 2009 • 17 mins

As gender tests reveal, determining physical gender isn't as clear-cut as you'd think. Discover why and how gender can be ambiguous in this podcast from HowStuffWorks.com.

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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to Stop Mom Never Told You?
From housetop works dot com. Hey, welcome to the podcast.
This is Molly and I'm Kristin and Kristen. Something that's

(00:20):
been in the news a bit lately that's kind of
caught my eye is this couple in Sweden who have
a two year old that they call Pop, and they're
not telling Pop if he she is a boy girl. Basically,
they're holding back the gender from Pop and dressing him
in a variety of outfits, both dresses and what they

(00:42):
call masculine pants, um so that the child cannot have
to come into the world with this gender stamped on
his head, that he she will be free to develop
as it wants to. I'm screwing up the pronouns, I'm sure,
but that's probably not gonna be the last time happens
during this podcast. So I guess at some point down

(01:03):
the road, this child Pop will decide for him or
herself whether he or she would like to be labeled
as biologically male or female. That's sort of the thinking it.
It's sort of a grand psychological experiment that I don't
know if we we can't even guess how it's going
to turn out. That's sort of been the speculation on
all the blogs is how will it impact this child

(01:25):
to not know? And won't there come a time probably
fairly early on, when they say, you know, I am
boy or I am a girl? I mean, what when
what happens when the kid goes to school? Right? And
the fact of the matter is, Molly when it comes
to just picking a biological gender might seem easy to do,
you know, um, it's actually pretty hard to scientifically determine

(01:53):
whether or not someone is male or female. Yeah, and
that might sound crazy because you could just say, well,
do go to the bathroom sitting down or standing up
and call it a day. But it gets a lot
more detailed than that, which we learned in an article
on how stuff works called why would a female Athlete
Fail a Gender test? That goes over this lengthy process

(02:13):
of biological gender testing. Basically, what we learned is that
you know, not only is pop going to face the
difficulty of the social construct of gender, but a lot
of people are facing the difficulty of the biological construct
of genera. So the how Stuff works. Article that we
reference focuses on, uh, this issue that happened in the

(02:34):
two thousand and six Asian Games where twenty five year
old female Indian athlete was stripped of her silver medal
for the eight hundred meter race because officials claimed that
she might not actually be a female. So the case still,
as far as I know, hasn't been resolved. But the
fact that this has happened in two thousand six or
three years later, it's kind of staggering to think that

(02:55):
in three years you can't figure out whether someone's male
or female. And the whole reason they start are doing
gender testing for athletic events was because, uh, the advent
of steroids. When female athletes were taking steroids, they looked
more masculine, and people were wondering, if you know, men
might be competing in female events to have a better
chance of winning. So it used to be that what
happened before an athletic events, they take you into a

(03:17):
room and you would take off all your clothes and
you basically prove that you are a female just by looking. Obviously,
people weren't too thrilled about disrobing right before an athletic event.
I would think it can kind of throw off your concentration, right,
and and those types of gender testing or not routine
at all anymore, usually only takes place if a claim
is filed against a specific athlete, as in the case

(03:39):
of this two thousand six Asian Games incident. And we're
not exactly sure what what all the tests um this
athlete had to undergo, but uh, we've got about four
stages of the general gender biological gender testing that would happen.
And of course it would start with a physical exam
in which you would, like you mentioned, you just disrobe

(04:02):
and you check four secondary sex characteristics, obviously if you
have a penis or a vagina, and then they would
also look at the presence or absence of body hair
and other signals to whether or not you would be
a male or female. And we'll get back to that
in a second, because that's not that seems clear cut,
it's not right. So once you if the physical characteristics

(04:24):
can't conclusively determine anything, then they head to a blood
test to look at physiological differences. And this is where
they really examine levels of hormones in the blood, testosterone, estrogen,
The thinking being that men will have more testosterone. But
at the same time, there's no real rule for how
much testosterone and estrogen determines a man or a woman,

(04:46):
so I gotta keep going. So that's when they go
to the genes. You know, we are raised thinking from
high school biology that women have two X chromosomes and
men have an X and a Y. And so what
you would do is you would do a genetic test
to determine the pres sense of X and Y. How
they're kind of falling on the X X X Y
spectrum um and we think of that as pretty binary.

(05:08):
But what they're finding is that it is not right.
There is a possibility that female cell can have a
Y chromosome. So in that case, if if you're being tested,
and say if I was being tested and one of
my cells had a Y chromosome, a doctor would probably
then check to see if there is a certain thing

(05:29):
called an s R Y gene in that cell that
is either absent, mutated, damaged, or disabled, because this s
R Y gene is pretty important, right, Milly, Yes, I mean,
this gene discovered pretty recently, and the thinking is is
that it's one of the mini genes that starts working
on a fetus shortly after conception. They're thinking that there's

(05:50):
about fifty four genes that start working on the on
a fetus in the ten days after conception, even though
a fetus doesn't have a gender until about seven weeks in.
So what they think that s R Y does is
it flips on, uh, the ability to be male. Basically,

(06:10):
you know, XX was sort of thought of as a
default if nothing else happened to you, you would turn
out to be a female. If your s R Y
gene kicked in, then you would develop the y chromosome
and become a male. So, Molly, if I were being
tested for my biological gender and they found the Y chromosome,
the reason why they would look for that faulty sr
Y gene is because, first of all, in the absence

(06:32):
of a Y chromosome, it would trigger the development of femaleness.
But at the same time, of faulty sr Y gene
on the Y chromosome will have the same effect. Right,
is everyone confused yet, because we are a little bit.
But the thing about it is is that because for
so long people have thought of people as either male
or female, a lot is not known about these genes.

(06:55):
They're still doing a lot of work. For example, like
I said, it was thought that being female was sort
of default of something not getting switched on. But now
researchers are looking at something called d A X one
which may actually be the thing that does turn on
a female gender. So there's pro female genes, is what
they're thinking. There's anti male genes, there's pro male genes.

(07:18):
It's a hodgepodge. While I mean, you know, it's not
so easy it's x x and x y anymore. We
were reading an article in Salon where a guy was saying,
you know, they're xos There are all sorts of basically
spectrum of chromosomal identities we can have. Right. Doctors are
just now realizing how many combinations, genetic combinations that that

(07:39):
fetus in those first seven weeks can develop. Right. But
there are some people who have known that it's not
just a matter of X X and x y when
it comes to being male or female. And those are
people who are born with ambiguous genitals, which is estimated
to happen and about one in according to Scientific American Right,
and according to a New York Times article, that's about

(08:02):
the same prevalence rate as cystic fibrosis. Just to put
it in perspective, now, sort of a common thing, common
term that I know I was using before I found
it was incorrect is hermaphrodite. This is what we think
of when people who are born with both male and
female sexual organs. But the more proper term, according to
some is intersex. And according to the Salon article that
we referenced, which was an interview with the author of

(08:24):
the new book between x X and x y UM,
intersex is an umbrella term that includes people with a
tremendous number of genetic conditions, from those who are born
with an extra X chromosome to those with overdeveloped adrenal glands.
And in between all of that you have the ambiguous
genitals like we were talking about, So sort of the
standard of care for someone who was born with ambiguous

(08:45):
genitals for a long time was to kind of look
with what you had to work with and then assign
the gender, do some surgery so that they biologically fit
that gender, and then never tell the kid that there
was any sort of question about uh, their identity at
birth right and since since then, in in more recent years,

(09:05):
as these kids have been growing up, there have been
a lot of tragic stories associated with it, that's right,
and probably one of the most heartbreaking and most famous
stories about the situation UH is the case of Bruce Rymer,
who was born in n right h. What happened was
Bruce was had a twin male twin, and when he
was circumcised at eight months UH, something went wrong and

(09:30):
most of his penis was burned off in the process,
and his parents decided to give him reconstructive surgery and
to therefore make him more or less a girl. And
they did this along with Um a sexologist at Johns
Hopkins University named Dr John Money, and Money kind of

(09:54):
wanted to do this experiment to see whether or not
nature or nurture can truly determine your gender because they
had the perfect control, which was Um, Bruce's twin brother,
and then they would have Bruce, who was now living
as a girl, and so they could kind of see
what would happen with with the two. And according to Money,

(10:15):
things went fabulously well. The child loved being a girl,
he totally took to it, but behind the scenes things
were not going that smoothly. According to articles that were
written once Bruce Um was an adult, UH, and actually
changed back to a male. Living as a male. He
said that he never wanted to be a girl. He

(10:36):
would always try to play with his brother's toys, he
would rip off his dresses. He hated every many of
every minute of it. And there were some questionable things
that that doctor Money did as well to try to
teach Bruce and his twin brother about male and female relationships,
and they were just all all sorts of kind of

(10:56):
there's a huge dark shadow kind of in the corner
of of this whole story. And um, then I believe
it was in two thousand three he ended up committing
suicide due to maybe not necessarily this actual process there was.
It was a compound situation and it sounds like his
wife left dumbist brother died. And there's a book if
you want to learn more about this whole situation. It's

(11:16):
written by John cole Pento and it's called as Nature
Made him the boy who was raised as a girl
but now Kristen. This is an instance of someone being
born with male genitalia and then having you know, this
unfortunate situation happened. But what we're really kind of interested
in today is ambiggest genitalia. So let's talk about what
happened to Cheryl Chase. What she alights in her work

(11:37):
with Intersex Society is just the damage it does to
kids to alter their genitals at such a young age
and then to basically lie to them about who they are. Right.
It's very controversial because obviously, you know, if if a
baby is born with ambiguous genitalia, the parents want to
assign it some kind of gender for probably for social
reasons and also for sexual functioning, and Chase is arguing

(12:02):
that it should be left up to the child. Yeah,
what Chase wants to happen is uh in contrast to money,
is you would assign a kid a gender based on
kind of what you know, what your best guess was.
But then if you're going to do any surgery to
kind of reinforce that gender decision, you would wait until
the child was old enough to be part of that
decision so that they didn't have to find out, you know,

(12:24):
twenty years later when it happened to them as a child.
Obviously this is controversial. It's it's an easy thing to say,
but when you are holding, you know, a new baby
and you just want to have the best life possible.
It's hard to imagine that giving them a gender identity
isn't the best thing possible, I would imagine, right, But
it seems like the standard operating medical procedure is slowly

(12:45):
trending towards holding off on that surgery. Uh. In two
thousand and six, the journal Pediatrics published a paper that
was signed by fifty international experts that was promoting the
idea that the child should be a signed a gender
as soon as possible um and that it should be
done by the doctor examining the child's genes, hormones, genitalia,

(13:09):
internal organs, electrolytes, gonads, and urine, and then the doctors
would help make the best decision for assigning a child agender,
but then holding off on the surgery until a little
bit down the road when the child can have input
in it as well. Right, And you know, one thing
that Chase points out in a New York Times profile
from two thousand six is that a lot of it

(13:31):
has to do with parents hang ups that the kid
you know at seven might already be ready to tell
you boy or a girl. And then it's more just
sort of you know, the social problems with bringing home
a kid that you you know, you aren't quite sure
about that sometimes forces the parents to go ahead and
make the cut right. But at the same time, ALLI,
this is an almost impossible experiment to study because you

(13:54):
have no idea what the psychological ramifications are going to be.
If you leave a child with ambiguous genitalia and just
let them grow up and see what happens, you could
end up with another case similar to uh the sexologists
doctor money, where it turned out horribly for the child. Yeah,
there's basically no long term study of any of this,

(14:14):
and what we tend to have in the press are
the very negative anecdotes that the things where you know,
people committed suicide and just lived with this awful misery
of not knowing who they were or not being able
to endure what had happened to them when they were smaller.
You know, we don't have any evidence on people who
had surgery and we're fine with it. So, um, it's
very hard thing to study and determine. But I will

(14:35):
say that, you know, one of the main goals of
intersex organization is just to bring awareness to it, and
you know, to know that it happens and to know
that there's not necessarily something wrong with the child that
needs to be fixed. Um, it just needs to be
sort of recognized as part of the spectrum that we
were talking about earlier, right, and um, going back to
the Salon article with the author of Between x X

(14:58):
and x Y, his main thesis is everyone is intersex
because going back to those chromosome levels and levels of
hormones and secondary sexual characteristics, it is nearly impossible to
say someone is perfectly male or perfectly female because there
is no absolute standard for it. Now, perhaps this was

(15:21):
our subconscious attempt to broaden our listener base Kristen by
saying no one is perfectly male and no one is
perfectly female. That's everyone can listen to Sminty, which is
thought of a sort of a female podcast. But you know,
it's it's an interesting, interesting issue. Yeah, absolutely. And um.
On a side note, Uh, if you want to do
some fantastic summer or fall reading, I do highly recommend

(15:44):
the book Middle Sex, which is a fictional account of
a hermaphrodite by Jeffrey Eugenitys. And it is a fantastic
um fictional book. And speaking of summer and fall reading,
as you know, we recently data podcast on chick lit
and what are listeners are reading? And we decided that
we just had so many great reading lists that we

(16:04):
might start sharing one at the end of every podcast.
So keep them coming because we like them. Um My
wallet doesn't like getting them, but my brain does. Today
we're gonna share the reading list of Abby, who works
at a food magazine and so she's reading a lot
of food related books like Heat by Bill Beuford, My

(16:24):
Life in France by Julia Child, Cuisines of Access of
Evil that Chris Fair sounds interesting, Simple Cooking by John Thorne,
uh a novella shop Girl by Steve Martin. Also Trail
of Crumbs, Kim Sunny and Happy all the Time by
Laurie Cowen. So if you would like to send us
your reading list, or send us questions, comments, or really

(16:46):
anything at all, just want to share your thoughts, please
send me and Molly an email at Mom's Stuff at
how stuff works dot com. And as always, um, if
you would like to read the article that we referenced,
why would a email? Athletes fail A gender tests? And
many more articles about gender, biological gender and how gender

(17:09):
develops in the womb and outside of the womb. And
all of that in between, you should head over to
how stuff works dot com. And if you just want
a daily dose of Kristen and or me, head over
to our blog how to stuff at how stuff works
dot com. I think those are all the reasons you'd
want to go to how stuffworks dot com. But they

(17:31):
really are countless, aren't they, Kristen, Yes, so head on
over to how stuffworks dot com and we'll see you
next time for more on this and thousands of other topics.
Because it how stuff works dot com. Want more how
stuff works, check out our blogs on the house. Stuff
works dot com home page brought to you by the

(17:55):
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