Gender / by Mandy Wintink

My name is Mandy. I use the pronouns she/her and they/them.

I used the pronouns she/her for most of my life until recently when I added “they” and “them” to my list, thanks to the many efforts of the queer community who have asked for these terms and both the queer and non-queer community for (slowly, but more recently) embracing this new way of introducing ourselves. Although I have referred to myself as a girl/woman/female for most of my life, I recently explored gender non-binary but now think that ‘epi-gender’ is a better gender identity for me, mostly because I am a huge critic of the gender binary and will spend lots of time below explaining why that is the case, mostly from a biological perspective, while also claiming my own space beyond the binary. If all of this terminology is new to you, then thank you for reading and learning and I’m happy to have conversations with y0u about it if you want to learn more and/or I can point you in directions to learn more. Or you can start here: https://www.mypronouns.org/. 

I struggle with the idea that gender is a binary, largely because I know that biologically, male versus female is a false dichotomy. Personally, I also struggle with the binary because I don’t completely identify with being a “woman”. I don’t feel like a prototypical woman in a binary world, where the binary ideology often dictates women as people who are beautiful, curvy in very defined ways, sexualized, and occupying only certain professions, most of which include caretaking roles (e.g., teacher, mother, nurse, daycare worker, doula, midwife, cashier, or food caterer). I don’t feel like that type of woman. My legs are too thick and muscular and I don’t like the looks of my legs in certain skirts or pants. I prefer yoga pants at the moment (even before the COVID pandemic). I like some skirts. But not skirts that are too frilly or flare too much. I like A-line skirts, which feel a tad bit more masculine and appropriate for me, particularly when paired with a crisp white blouse. I can't imagine holding my own in an argument if I was wearing a frilly dress. I feel less confident and less strong. That’s not to say some women or men or gender non-conforming people can’t feel strong and confident in frill or flare. But I just don’t. I never have really liked frilly dresses according to my mom even as a kid. I don’t mind dresses now but I like them fitted and  I don’t like crinoline. (Does anyone actually??) 

I’m not particularly decorated. I never used to like my nails painted except in the summer of 2012 that changed. Maybe because the style became short-nails with color, which I could appreciate. I never liked long nails, with or without color. I like some jewellery, but simple, classic, and elegant. Nothing big or flashy. I really liked choker necklaces back in undergrad (circa 1997). I felt more goth-like then. But not really goth. Just like a hint of goth. My wedding ring is a silver band. No diamond. Someone once told me that an engagement ring was like being put on layaway. So I never wanted to be on layaway. I like some high heals (edited to read: I can tolerate some heals) but I don’t know how to walk very well in them. In grade 12 I was in the “Grad Fashion Show”, which was a really big deal (and totally out of character), mostly because I had to learn how to walk in heals on stage. My god, that was one of the scariest things I had to do. And I think they were not even real heals. But to learn how to walk slowly and femininely and let my male escort lead was challenging. I don’t know what prompted me to be part of except a bit of peer pressure and then I think partially I was trying to prove that I could be feminine, if needed. To whom? IDK. The heals I do like are the ones that you can run in. Some of you know those type right? They are usually expensive because they are made very well. Sturdy and comfortable enough that a person could run in them. Shouldn’t ALL women's shoes be like that… for obvious reasons? 

I have almost always had long hair, except in grade 5, which ended up being the year I lost my popularity and was picked on the whole year. By grade 6 I was “back in demand” by the boys (and maybe the girls too IDK) mostly because I had grown my hair out by then. I like my long hair for various reasons, including that it keeps my neck warm, it’s easier to tie back, and, yes, I feel more feminine and pretty with long hair. I also love long eye lashes, in me and in others. So I wear mascara. When my son was born, he had very long eye lashes, which resulted in so many people commenting on them and adding how girls would die for his eye lashes or they would say that the eyelashes were wasted on a boy. So clearly, eye lashes hold a feminine quality. I have never been a heavy make-up wearer but I do like my simple “touch ups". I will resist the temptation to rant about make-up as being just another example of how society tells women how they/we should look. I admit that I do like a touch of sparkles, glitter, shinny things, especially shiny hair. Now, none of these things actually define a woman. But they are things that I have battled with in my own identity as a woman and not feeling entirely connected to what society seems to deem as a woman, at least the way my brain understood it being born in 1975. 

There are other less superficial things that people could argue are also representative of being a woman. Motherhood is a good first example. I am borderline maternal. I like to take care of my dog and cat. I was terrible with plants but since having a baby, I have been better at that, mostly because I don't think I live in my head as much. Being a mom to a human has been difficult though, much more difficult than having furbabies. I once had a friend offer advice to me when I was going back and forth with whether I wanted to have children. She — being a mom herself to 3 kids — told me that it was what I was born to do and that if I choose to continue to just be a wife and dog-owner that I would be living an easy and trivial existence. Fertility is another example of something that seems to constitute womanhood, but I have seemed to pass that test. I was fertile and still am a bit I assume since I haven't yet entered menopause. I got pregnant naturally, without any conventional medicine. That's something these days as many people struggle with fertility. Being a homemaker might still feel like a defining feature of being a woman to some cultures, including some here in Canada. Before being a mom, I would have failed that one. Now, I cook, clean, and take care of laundry more than ever before. But that actually just feels like a weird control thing in a life with a child that feels much more out of control than before. That being said, there is some hormonal basis to that behaviour. 

This list is obviously not exhaustive — nor is it representative of many cultures or has little ethnic diversity. These are things to came to mind for me, as a white, North American woman. But using some indicators from my own upbringing’s sense of womanhood, I fail. So, am I woman? What does it feel like to be or identify as a woman? I still don’t know. Gender non-conforming? Not really… that still implies a gender with which not to conform. It’s still implies an accepted sense of what gender is in order to not conform. The jury remains out, which is one of the many reasons I critique the gender binary. 




Gender vs. Sex

I do not use the terms sex and gender interchangeably. When I say “sex” I am referring to a person’s biological sex, which could include their sex chromosomes (i.e., genetics) or the sex someone has been assigned at birth based on their genitalia. I explain all this below. For sex, I use the terms “male", “female”, or “intersex”. When I say “gender” I am referring to what a person identifies as. I use the terms boy/man and girl/woman, and also cis-gender or transgender woman/girl or man/boy.  “Cis” refers to “same” and indicates someone feels the same as what they were assigned at birth and “trans” refer to “different” and indicates someone feels different from what they were assigned. But gender is a social construct that also includes people who identify as gender non-binary, gender non-conforming, or gender fluid for example. I have also recently adopted ‘epi-gender’, to indicate my freedom from gender or being beyond gender. How someone feels is that person’s right and I believe that we should respect someone’s chosen identity just the same as we honour someone who identifies with their race, religion, or citizenship, as other examples. All of these are social constructs, some more obviously beyond by geography and genetics but social constructs nonetheless. Humans have created ideas of what it means to be human and all the variations of humanness and that includes what it means to be man or woman. As a result of that construction, we also constructed the idea of being more than the binary and therefore now include genders in between or beyond. The gender spectrum to me, is intuitive. But what I want to share with you below is both the idea that biological sex is also non-binary and that gender might have a biological bases. The latter point isn’t meant to change how a person identifies, but rather, to lend some biological support for a feeling that some people have known in their hearts for their entire existence, which for some people feels like they were “born that way”. Quite possibly, a good part of our gender identity is born with us, albeit subject to influence from society. This is the nature-nurture debate that will not be resolved here, except to suggest both nature and nurture are at play but the debate that is outstanding is to what degree are either. 

When I was born, the doctors would have announced to my mom that she has a baby girl! I know my dad wasn’t in the room so he would have found out later. And I know this would have been a surprise to my parents because my mom was not pregnant during a time of routine ultrasounds, and as a result, gender-reveal parties. I will express my disdain for those parties now and explain why later. I think gender reveal parties are actually just one of many unfortunate ways babies are predetermined to a life of a particular gender, along with boy-verus-girl clothing, hairstyles, names, toys, jobs, etc. All of this poses many problems. The practice of announcing the sex of the baby is pretty routine here in North America. 

Being assigned a girl on November 5th, 1975 changed my life forever. The year I was born was one year after single women were granted the right to have a credit card in the USA, without a man’s co-signature. Housing discrimination on the basis of sex was legal until 1974 when it was outlawed by US Congress. Not until 3 years later, was the Pregnancy Discrimination Act in the USA put in place to ban employment discrimination against pregnant women. Many groups at this time were still allowed to legally exclude women from becoming members including the Kiwanis and Rotary Clubs. In Canada the birth control was removed from the criminal code only 6 years before I was born, in 1969. In the 70s, indigenous women (then known as Native women) lost their Indian status if they “married out” (i.e., married a white man) but Indigenous men did not lose their status if they married out. It didn’t became illegal for a man to rape his wife until 1983. You can read more here: https://www.thecanadianencyclopedia.ca/en/article/womens-movements-in-canada-196085. A positive was that The United Nations declared 1975 International Women’s Year!

What that year of birth meant for me personally (0ver and above all of those lack of opportunities) was that I was growing up in a time where I was limited on what I could do because I was assigned a girl at birth. I didn’t play hockey because girls didn’t play hockey. Luckily, girls were allowed to play sports by then, just not hockey. I played ringette instead, which was great and wonderful and I was very competitive at it, but it was a default sport. Despite being a girl with limited options, I did go on to play lots of wonderful sports most of which were done competitive, including soccer, basketball, volleyball, and ultimate frisbee. Eventually, I even got to play hockey. It was in 1992, my graduating year of high school. The year before it had been announced that women’s hockey would be in the 1996 Olympics. THAT was the point when I decided to play hockey because all of a sudden the message changed: girls COULD play hockey. So I started, and although I never got to go to the Olympics, I did get to play varsity for the Dalhousie Women’s Hockey Team, which was the greatest accomplishment I could have hoped for. Could I have gone farther? Likely. I was/am athletic enough to have succeeded in enough sports despite the challenges. Imagine what I and other girls and women could accomplished in later time. 

Getting the assignment of a girl was a prescription for many things. My school yearbook that my mom started when I began kindergarten was most telling. Each year, there was a list of career options that I got to pick from for what I wanted to be when I grew up. There is a boy’s section and a girl’s section. I could be a teacher but not a scientist. Boys could be though. 




INSERT PHOTO FROM MY ALBUM




The Problem with Categories

Most (if not all) of biology does not easily reduce itself to a true binary or into categories. Humans, like scientists, create the categories so that we (and our brains) can easily make sense of our world. It’s an effective cognitive strategy to process large amounts of information. Rather than remembering every individual, my brain just has to remember the entire category. Like when you see a dog, it’s easier to remember what it looked like if you know the category (i.e., species) from which it comes. But categorizing organisms is not black and white. The lines are blurred. There are countless examples of animals that we cannot easily classify and different scientists can debate the categories within their fields. For a thought piece on this issue read this Discover Magazine: https://www.discovermagazine.com/planet-earth/when-animals-attack-our-attempts-to-categorize-them. The situation with sex is similar in that there is also a blurring of the lines. Although the majority of people can be placed into a tidy category of either boy/man or girl/woman, many can’t and those who can’t deserve to be included in our understand of sex and gender. Sex and gender as a binary is a construction of our mind. We need to acknowledge that categories don’t paint an accurate picture of what exists in nature. That being said, we still assign babies typically to one of two categories: Male or Female. Luckily, people are starting to appreciate the value of offering at least the middle option — intersex — to those who are “ambiguous”, for lack of a better term. This starting point gives rise to the unfortunate situation where some people grew up thinking they are either supposed to be like what was is in the category they were given and don’t fit into it. This is uncomfortable and it’s not fair to restrict and limit ourselves this way. 




Assigning Sex

Most people know that females (those who are biologically female, regardless of their gender) start menstruating during puberty. Because of this, their bodies and brains start a monthly cycle whereby they fluctuate through this window of fertilization opportunity and end with menstruating if no fertilization takes place. Males start a little later generally speaking and have hormones that trigger a similar but different puberty process. Their bodies and brains start to mature into adults just like typical females but they don’t have a monthly cycle like females do. Their sperm can fertilize an egg essentially at any point during the month, providing they generally have a high enough sperm count. Lots of sperms end up in the semen that gets ejaculated, but only one sperm will be the one that penetrates the wall of the egg and becomes the biological sperm donor to the new zygote, as the fertilized egg would then be called. 

Sperms and eggs separately carry half of the genetic material (i.e., 23 chromosomes each from the donor) the baby needs to develop. When the join to make the eventual baby, the offspring gets a full set of chromosomes and therefore all its DNA material, which gives rise to our genetics. The egg always carries an X, so everyone should have an X and as far as I know, babies are not viable without at least one X. The sperm carries either an X or a Y. If the sperm that joins with the egg is carrying a Y, then the offspring is genetically XY and genetically considered a male. If the sperm that joins with the egg is carrying a X, then the offspring is genetically XX and genetically considered a female. If all goes according to that genetic plan, the babies will be male and female, respectively. But… genetics is only one thing and gender is another. We will explore gender later. But there is still lots to dig into about genetics of sex!

Eventually that little zygote I referred to before, with whatever genes it has, turns into a fetus and then typically incubates in a uterus for about 9-10 months until they are born. Around the 6 weeks after conception (i.e., fertilization) the babies differentiate into males and females based on the code given by the XX or XY genetics. Genes on the Y chromosome instruct the development of all the male reproductive organs (i.e., testes inside the scrotum and the penis system). Interestingly, the cells (and tissue) that is targeted to turn into the penis and the testes come from that same tissue that would have turned into female organs without the presence of that Y chromosome. Watch this video to learn more:

TWEET IT - http://clicktotweet.com/36Jk0 Dear Gentlemen, science has a confession. You were once...a female - which helps to explain where your nipples came ...

When babies are born, they are typically assigned a sex (and by extension a gender) based on the external anatomy seen at birth, which is most often the two ends of the spectrum: male or female. Both sexes of babies have gonads, which turn into testes (i.e., testicles) for males and ovaries for females. The gonads come from the same structures and develop into their respect parts based on whether the body responds to testosterone, as directed by the Y chromosome. By 20 weeks in utero we can clearly see the external genitalia of male fetuses. Males and females have tissue that will develop into the penis in males or the clitoris in females. Surround that is the tissue that develops into the scrotum in males and holds the testes or the labia in females that surrounds the vaginal opening, called the vulva. Whereas the tissue stays separate and open in females, it fuses in males.

Babies are not genetically tested to determine if they are XX or XY, or… a variety of other combinations which we will come back to later (e.g., XXY, XO, XYY). They are assigned by how their external genitalia look, just like in this photo:

Quigley Scale, similar to the Prader scale.

Quigley Scale, similar to the Prader scale.


Although this photo shows a variation that indicates a non-binary distinction, it still offers the people assigning the sex with one of two options, males or females based on where along the split the baby’s genitalia fit.

Intersex

The reality is that some babies don’t fit into this binary and have external genitalia that do not appear like one of the two ends of the continuum. Under the influence of testosterone in the womb, the clitoris can become enlarged resulting in a baby being born with a very large clitoris, which looks ambiguously like a small penis. Babies who cannot be assigned a sex based on the binary are currently referred to as “intersex” (formerly they were referred to as what is now considered a derogatory term “hermaphrodite”). A common practice for babies born as intersex used to be to assign them a sex that best matched or if they truly were ambiguous, it could be up to the parents to decide. That practice is known now to come with many negative consequences.

Intersex is “a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. For example, a person might be born appearing to be female on the outside, but having mostly male-typical anatomy on the inside. Or a person may be born with genitals that seem to be in-between the usual male and female types—for example, a girl may be born with a noticeably large clitoris, or lacking a vaginal opening, or a boy may be born with a notably small penis, or with a scrotum that is divided so that it has formed more like labia. Or a person may be born with mosaic genetics, so that some of her cells have XX chromosomes and some of them have XY.” From Interact: Advocates for Intersex Youth: https://isna.org/.

Intersex is one clear example of how the binary of sex breaks down. It’s also a very wonderful example of how people who are intersex are now feeling able to claim a space for themselves where they feel included as who they are, rather than having to be arbitrarily and often mistakenly assigned to one of only 2 categories.

Oprah some good interviews with people who are intersex: https://www.youtube.com/watch?v=I9a1rXOpIuc&itct=CBEQpDAYBiITCNr_zfWW2csCFUYMTgod_lgHBDIHcmVsYXRlZEin7euqttLc_sYB&app=desktop

Androgen Insensitivity Syndrome

Another example of not fitting into the binary is with people who are born XY but have a condition in which they fail to respond to the Y chromosome’s instructions to develop as a male. They are androgen insensitive. This means that they are genetically male (XY) but do NOT respond to androgens during development. As a result, despite being genetically male, they are born looking like a female with all of their external genitalia appearing to be female (e.g.,vulva, labia, no scrotum or penis). No one knows that this baby is actually genetically a males until sometime into puberty when the child who was most always raised as a girl does not have a menstrual cycle. These individuals (who would also be classified as “intersex”) still have testes that never descended and those testes release a hormone called mullein-inhibiting hormone (MIH) which prevents their internal reproductive organs from developing like typical females either. Although they don’t develop into a male at puberty, they also don’t start to menstruate. At that point, it might be discovered that the now teen is genetically a male. But then this begs the question, Is this person still a girl/woman?  They were raised as one and they generally identify as one (as science has shown). They tend to report being happily a girl/woman and without any desire to be identified as a boy or man. So should that sex be stripped of them just because they are genetically a male? Certainly not. Genetics is but one way to define sex.

XO - Turner’s Syndrome

Another example of conflicting chromosomes and bodily appearance/function is Turner’s Syndrome, characterized by XO genotype, with “O” indicating the lack of a second sex chromosome. A female genotype would be XX and males would be XY, so is a person with only X a male or a female? In fact, they present as a female but their female characteristics are typically underdeveloped and they are often infertile. Without the presence of the Y chromosome, the male organs would not develop either and instead, female organs would develop but are underdeveloped. These individuals would also fall under the category of “intersex”.

Intersex is a general umbrella term for any condition does not fit the binary. Beyond just explaining the biology of non-binary conditions, the intersex identity is also giving some intersex people an identity that feels more aligned with what they feel (i.e., not within the binary). This is an important part of breaking down the binary world of gender and my guess is that it will continue to grow as a movement for accepting the many ways in which humans are born. For a list of some of the conditions that give rise to intersex and other conditions that make sex assignment unclear, see this page: https://isna.org/faq/conditions/.

Puberty

Puberty comes with a whole host of events, which we all learned about in grade 5 or 6, right? At least in some regions there is good sex education. Here in Ontario, we did have good sex education that was put in place by the Wynne government in 2015 (updated finally since the 90s) but then in 2018 the Ford government destroyed it. I’m hoping that by the time this is published we have re-instated a proper sex education. But I digress. Much of what we have learned about puberty was through having gone through it ourselves. For most cis-gender kids, puberty means that females go from girls to women and males go from boys to men, if all goes as typically prescribed. Personally, I went from a pre-pubescent girl into a menstruating teen at the age of 12. This time is known as the activation period of hormonal responses, compared to peri-natal development, which is more organizational in nature. That means that the hormones set the baby’s reproductive systems to be organized in a particular way, for example as male or female, or the variations in between. But the reproductive organs don’t become active until puberty, during a time when those organs respond to a surge of hormones (including testosterone and estrogen), the activation period. The activation is based on an organization laid down much earlier. As has been discussed, several things have to fall into place for a boy to turn into a man and a girl to turn into a woman. 

An extreme example of when this turns out differently than expected is seen within a group of people in the Dominican Republic, in the town of Salinas and surrounding areas. Here, there is a genetic variation in which girls — babies assigned the sex of female at birth because their genitals appeared as such — turn into boys at puberty. The kids are referred to as Guevedoces, meaning “penis at 12”. This happens because of a genetic mutation that results in a disruption of a hormone called dihydrotestosterone (DHT), which normally transforms the internal tubing of all babies into a male’s reproductive system, including a penis. The enzyme that converts testosterone into DHT is called 5-alpha-reductase. Without that enzyme the structure that would have come the penis becomes the clitoris… So you end up with a baby who is genetically XY but is assigned female at birth because everything appears to be a normal female. The puberty hits and the children get a surge of testosterone, which they DO respond to, and then you have a girl turning into a boy going through puberty to become a man. YES, you read this right: A girl goes through puberty and becomes a man. This is a natural genetic variation, not a surgery or anything done medically. I love this example because I think it’s one of the best examples of how the non-binary does not hold up. It’s also an amazing example of how sex assignment at birth can be misleading. For more on this you can read this article: https://www.bbc.com/news/magazine-34290981. 

As mentioned, the condition of girls turning into boys is an extreme example against the binary concept, indeed. In textbooks, this condition is presented as an anomaly against the norm of what puberty typically entails. But collectively, there are many examples of the non-binary including the Guevedoce children, any of the intersex conditions mentioned above and more, and androgen insensitivity syndrome, all of which have been discussed. Others conditions that may be of interest to anyone who wants further evidence of the non-binary can refer to congenital adrenal hyperplasia, turner’s syndrome, or XYY (Jacob’s Syndrome), for example. These are all biological conditions with known biological underpinnings that lend significant support to the non-binary nature of sex. Hopefully, you have been convinced that sex can be considered as more of a spectrum or continuum rather than a dichotomy. But what about gender? If there evidence that it too is non-binary? Indeed,  there is and furthermore, there is evidence that gender as a psychological experience has a biological component. Neuroscience has taught us a lot about the biology of behaviour, thoughts, and emotions. Gender is simply another such experience. 

By now, it should be obvious that to reduce sex to a binary is not sufficient to actually capture the true nature of human sex assignment. Although most individuals can and do fit neatly into the binary model when all things line up (e.g., chromosomes, response to androgens, development of internal and external genitalia, what happens at puberty). But the fact that there are enough people who do NOT fit into the binary speaks to the need to expand how we think of sex. It simply is not a binary from a biological perspective. There is no denying that. 

Sex Differences in the Brain

I began my career as a scientist as a “sex differences researcher”. My honour’s thesis project was looking at the differences between male and female rats as they aged and as it related to a very specific male-dominated trait of spatial performance. I raised rats from babies. Half of the female rats were given two testosterone injections right after birth. We removed the gonads in half of the male rats that were born, to reduce their overall testosterone levels, which would be secreted by the gonads. Then we compared these 4 groups of animals as they aged: Normal Males, Normal Females, High-Testosterone Females, and Low-Testosterone Males. What we found was that the Normal Males performed as expected in a maze that required spatial learning and memory. The Normal Females performed the worst, also as expected. There was substantial science to suggest that males typically outperform females on spatial tasks and problems, even in humans. Alternatively, females tend to outperform males on verbal tasks. In my study, we also found that the Low-Testosterone Males didn’t do so well, but they still did better than the Normal Females. In fact, they did about the same as the High-Testosterone Females, which did better than their Normal Female counterparts. The conclusion that I drew from these results was that testosterone was contributing to this spatial behaviour, because when you reduced it in males (i.e., removed their gonads) and increased it in the females, it made males perform worse and females perform better, respectively. I also found differences in the hippocampus (it was thicker in males), an area of the brain related to spatial memory. Imagine having to remember a new route (without google maps) to get somewhere? The hippocampus helps with that and that’s essentially what we were asking our rats to do. So do areas of the parietal cortex, which tend to be bigger in males; whereas areas in the temporal lobe that have to do with language, then to be bigger in females. 

There are many brain differences related to this behaviour and to the verbal behaviour I also mentioned. Sex differences have been studied for the past 3-4 decades and was really the start of an important part of science: female inclusion! Female participants (including both laboratory animals and girls and women) have been left out of much of science for a very long time. In fact, this became a recognized problem in science many years ago when US National Institutes of Health (NIH) established the Office of Research on Women's Health (ORWH) in the mid 90s. But most researchers continued to neglect sex differences choosing males over females and at times claiming that their cycling hormones made data collection more problematic. This is true actually. As I continued throughout my science training into my PhD I always included females in my studies and compared the results between males and females. I also took vaginal swabs of my females every day (sometimes for 6 weeks of one study!) and looked to see where in their 4-day cycle they were. To account for varying hormone levels that cycle over 4 days, ideally I would have had 4 times as many females in my studies. I didn’t. Often I could barely argue to double my number of rats or mice by including females. It’s expensive to include females and it use more animal lives. It’s inconvenient. But this inconvenience has come at a severe cost to girls and women, who are more likely to experience side effects from drugs and who have different heart attack symptoms, to cite 2 examples of the way in which science discriminates against females. When the basic science neglects females, those data trickle upwards and cause bias in all the data and studies. In 2014 the NIH agreed to push this policy and monitor the inclusion of females in studies (https://www.nature.com/news/policy-nih-to-balance-sex-in-cell-and-animal-studies-1.15195). But today, this still has not been rectified (https://www.insidehighered.com/news/2020/06/15/study-says-biological-research-still-treats-female-subjects-afterthought). This SHOULD concern us women.  For more on this check out these scientific articles:

Bias in science is HUGE. There have also been many efforts to include minorities in the samples, because they too are often ignored. Also related to this topic of gender though, is the fact that anyone who deviates from the ascribed norm would be excluded, literally, from a study. So intersex people and anyone who did not identify with their sex (if they even felt comfortable sharing that) would have been excluded. And so would anyone who was not heteronormative. 

As sex differences researcher, we fought for females, women, and girls to be included in  science. We did not fight for other genders, or at least I didn’t, yet. So the practice in science of looking at sex differences did contribute to the binary way of seeing sex in many ways because it was always a male-versus-female comparison. But I have to remind myself that the role of sex differences was still important. Before sex differences, there were only “men”. Only men’s experiences and brains were considered so fighting to look at one other gender or sex (i.e., female) was a needed accomplishment. I admit that I have personally had to switch my language around include sex and gender as variables in my science away from simply including females/women to also a variety of gender options. I guess all this was a long-winded way of defending my past actions with context. 

I will continue to talk about sex differences because that’s largely the knowledge we have and it’s not a bad place to start because genetic females who develop in a typical fashion would be expected have menstrual cycles, which includes humans and non-human animals. This poses an inherent differences in female’s brains because they are exposed to more estrogen and less testosterone and have more estrogen receptors. The fact that females have a menstrual cycle (be it ~28 days in humans or 4-5 days in rats, for example) has allowed us to study how behaviours and experiences of females change over a typical month, consistent with varying hormone levels. To get into all of those differences would take a whole other book. For a review, check out these scientific papers: 

The hypothalamus is brain area that has been studied the most and the first because it is known to regulate the hormones that differ between men and women. Indeed, males have a particularly larger nucleus in the hypothalamus, one of the key regions involved in sex steroid hormone regulation. This part of the hypothalamus (the medial preoptic area) that shows the sex difference has been named the “Sexually Dimorphic Nucleus” or SDN for short. Another area known as the INAH3 (aka the third interstitial nucleus of the anterior hypothalamus) is also bigger in males. A third area of the hypothalamus is bigger in females than in males: The anterior ventral paraventricular hypothalamus (AVPv) in females is larger compared to males. Why these areas become different is hard to say but most evidence points to hormonal influences.


For an overview of hormones and behaviour (not brain specifically) visit: https://nobaproject.com/modules/hormones-behavior#abstract.


What I have done here is simply discuss at a very broad level sex differences in the brain. Going deeper is challenging for one chapter. But remember earlier when I talked about history of sex differences research? Well, embedded in that discussion was the idea that we do need to expand beyond the binary there. This idea is well articulated by Anna Grabowski in a recent paper on: Sex on the brain: Are gender‐dependent structural and functional differences associated with behavior? https://onlinelibrary.wiley.com/doi/full/10.1002/jnr.23953. This is a good read (or skim) for anyone wanting to think beyond the binary of sex differences and start to better consider the variations that exist between (or even beyond) the binary. One of the problems with sex differences is that it implies that all members of one sex are one way and the other sex is the other way. This causes the false idea that all males are better at spatial tasks, for example. That’s not true. And same with verbal skills. Not all females are better. This is where our own neuropsychoidiology comes in to help figure out where our brain is. But I think I will end here with this to avoid writing another book. What I think is a great topic to go into now, is gender, because there is some examples of the neurobiology of gender that I think are worth getting into, with the idea that gender is more than just a social construct, it is also a deeply felt sense of identity that some people feel they are born with whether or not it aligns with the sex they were assigned at birth.

Gender

Gender is an identity. It is what a person feels they are, which can include girl/woman or boy/man when we consider the binary. But we (many of us at least) now accept that gender can be beyond the simplicity of a binary and can include gender fluid people (i.e., people who flow between one and the other gender), gender non-binary (i.e., people who are neither man or woman and might refer to themselves as “they”), gender non-conforming (i.e., people who’s gender does not conform to the gender norms that society dictates), transgender people (i.e., a person who gender does not match with the sex they were assigned at birth), cis-gender people (i.e., a person who’s gender matches with the sex they were assigned at birth), people of transgender experience (i.e., people who have undergone a transition to another gender than the one they were assigned and were at one point transgender but no longer identify with trans and refer to themselves simply as they gender they have transitioned into without the ‘trans’ attached), and my new preference, epi-gender (people who feel that they are free from gender norms or wish to be). There are also two-spirited people, which is a term that is given to indigenous people who identify as both male and female genders at once and it is largely a celebrated experience, from what I have learned. The constant evolution of gender terms is for some people confusing but to others (like me) the evolution is a beautiful example of how our human experience cannot be reduced to a binary. Nature is a continuum of experiences and so is gender and sex.

Neurobiology of Gender

There is biological evidence that “gender” is something distinct from the sex we were assigned or the sex our genetics code for. In 1995, a study was published showing that the brain region known as the bed nucleus of the stria terminalis, which is consistently bigger in males compared to females, was small like a woman’s in some people who identified as a woman but were assigned and raised as ‘male’ (i.e., who we would now call a transgender women). This was rather remarkable because it really was the first piece of evidence that the brain was sex typed in a way that was consistent with a gender identity that people felt not what their anatomy suggested. I.e., this little area of the brain was consistent with this individuals felt gender identity NOT their assigned sex at birth! Although super interesting, this study has many flaws, largely because this field of research was virtually impossible at the time. Anyone reading this who was alive and conscious during the mid 90s would probably remember that transgender was not what it is today in the year 2020. Transgender was hardly even called transgender. It was a disorder in the Diagnostic and Statistical Manual of Mental Disorders of either transexual or transvestite. 

Then, in 2008, another study lended some support to the neurobiology of gender by showing that another part of the hypothalamus (the uncinate nucleus) of several transgender women (i.e., women who were born as male) looked like that of cis-gender women not like that of cis-gender men, again suggesting that these areas of the brain represent gender identity, not sex assignment at birth. All of this can be considered quite amazing because it suggests, in some small way, that a person’s brain might reflect how they actually feel to be despite the sex they were assigned at birth and the sex they were forced to live with for at least some time. This represents a possibility that our gender identity has a biological basis. 

Hormones are another consideration in sex assignment and gender identity. For example, a person can have more male-like hormone status (i.e., great testosterone/androgens levels) or female-like hormone status (less testosterone, more estrogen, and eventually cycling hormones once puberty starts), or all sorts of variations in between. Consider South African Olympic sprinter, Caster Semenya, who is as an example of a person who has been at the centre of the debate of what constitutes a man or a woman in sport according. She was assigned the sex of a girl as a baby, was raised as a female, and identifies as a woman. In 2009 after a rapid progression in her sport, she was forced into a sex verification test. The results were never officially released but leaks suggested that the results were that she was genetically XY. What is known is that she has elevated level of testosterone, which are beyond normal levels for a female. She has a condition known as ‘hyperandrogen’, which more specifically means higher androgen levels consistent with the male sex. Hyper means more or heightened and androgen refers to the classification of hormones that are typically more prevalent in males. Specifically, she has a deficiency in 5alpha-reductase, a genetic condition that results in more female-like genitalia, which is also an intersex condition. As a result, the Association of Athletics Federation (IAAF) ruled that Caster would have to artificially lower her testosterone to be more consistent with typical females to continue to compete as a woman, in April 2018. She appealed and lost. I believe she appealed again and then recently lost another appeal (Sept 2020). To read more about this continued human rights issue, head to this CBC article: https://www.cbc.ca/sports/iaaf-caster-semenya-human-rights-1.5115453. 

The problem for Semenya Caster is that she is caught in the non-binary truth of sex and gender. Sport is almost always categorized in the binary with men competing against men and women competing against women. But as the move to expand gender identifies and further understand what lies along the continuum, the gender binary rules are challenges. This is a very obvious problem in binary thinking. Personally, as someone who grew up as a female athlete and continues to recognize the disadvantages we experience in sport, I am not yet ready to give up the binary. I still want to see the advancement of women in sport. But, as someone who critiques the binary, I have to admit that we need a new model that will continue to allow women to advance in a male-dominated industry while also acknowledging that the binary does not serve gender segregation as a whole. This is a complicated problem and it needs some deep thinking. I pose this conundrum to my university students when I blow their mind with a lecture on this topic. We have yet to resolve it. 

Another example of hormone disruptions in relation to gender identity is Congenital Adrenal Hyperplasia, a genetic mutation that knocks out one of the enzymes involved in the manufacture of corticosteroid hormones. The by-product is that adrenal glands secrete more androgens. In boys, there is little effect. But in girls, there is partially masculinized genitals. Girls with CAH also tend to be more active and aggressive, show similar toy preference to boys, and have better visuospatial tasks consistent with a male-type behavioural profile. Females with CAH and low Prader grades have the potential for a normal sexual and reproductive life. Those with greater degrees of prenatal androgen exposure (Prader grades IV and V) raised as females also tend to identify themselves as girls/women but experience more male-like behavior in childhood, have a greater rate of homosexuality (which sometimes is argued as displaying more male-like behaviour in that attractions are directed at females), and have greater difficulty with vaginal penetration and maintaining pregnancies. Related, is the disorder referred to above, Androgen Insensitivity Syndrome, where genetic males are assigned female at birth because their genitals have been feminized due to an insensitivity to androgens (i.e., male dominant hormones). People with Complete AIS typically identify as Female and rarely change genders. However, people with partial AIS mostly identify as males (8:10, male:female) and 9.1% have been reported to change genders.

For more information: https://www.frontiersin.org/articles/10.3389/fped.2016.00048/full and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040068/. 

The science itself on the neurobiology of gender identity is worthy of critique for several reasons but mostly because more studies are required to better understand this. The difficulty before has been that transgender voices and experiences are only now being recognized, acknowledged, and studied so acquiring data, and good data, has been challenging. Despite that, my neurobiological hunch about gender is that somewhere, in our brain, is evidence for why we feel to be a certain gender. This would be consistent with the idea that many transgender people express, that they have always felt different from the sex they were assigned and the gender they were raised with. That being said, I don’t particularly think gender identity is as simple as being reduced to one or a few areas of the brain, but rather that a collection of areas of the brain that together give rise to a feeling of a particular gender. Furthermore, how our brain evolves over time in our body and in a society that tells us what gender we are to be is not insignificant. Society IS a huge influence on how we feel, how we live and express our genders, and how our brain develops.

Wait, What is Gender?

I love the idea that we can have a gender identity, a felt sense of the gender we are and a potential biological component to that. I like biology because for me, it takes the burden off of me for being a certain way. Rather than having to defend a choice, I feel like I can chalk it up to biology. Maybe that’s a cop out. Or maybe that just makes sense because so many things don’t feel like a choice and the discomfort often comes when something that feels wrong is forced upon us. 

But I still don't know what I am. Actually, I still don’t know what a man versus a woman is. Genetics is one factor. Genitals and reproductive organs are another. Responsiveness to hormones is another. Brain organization is another. Felt identity is yet another. There seems to be many factors that give rise to sex and gender. The genderbread visualization is a great tool to help understand how these align (or don’t): https://www.genderbread.org/. But what exactly is a man or a woman beyond the stereotypes that exist? And more personally, what am I? 

I am genetically XX (female), which I can deduce because I got pregnant without intervention. Aligned with that, I was assigned the sex of a female because my genitals were indicative of being a “girl”.  Hormonally, I don’t actually know my baseline testosterone levels but I know that my circulating menstruating hormones are normal, at least when they have been checked. But my testosterone, I am going to guess, is on the higher side of the spectrum of females. Not that of Caster Semenya, but higher than some other females, I think. I think this because I am decently muscular and I am athletic. I feel more aggressive than the average female, which may be because of hormones but may be because of my dad encouraging me in sports and I developed unusual female confidence for my time. 

Identifying as a woman has been hard though, possibly because of the patriarchy’s oppression of women and a societal pressure to not rightfully claim womanhood or be an empowered woman. Owning my space as a woman has been hard and also, admittedly, giving other women their right to being a “woman” has also been hard. I struggle to call my female friends “women”. That’s wrong of me and makes me a bad feminist. I’m sorry about that and I am still trying to change, yes. But teasing out whether my inability to own my title of woman is because of systemic sexism or because I don’t identify as a woman is unintelligible at present. I simply don’t know. And I don’t know how I will know. I might never know because I was born in 1975 and my fate was determined, to a large extent. I didn’t grow up feeling like I wasn’t a girl… but I didn’t really grow up thinking I was a girl. I’ll have to dig deep and I’m still not sure that I can be conclusive. 

I did say at the start that I use the pronouns she/her. That’s true. I do. But in recent years and particularly so since becoming a parent, I have preferred “person” and if I wasn’t exhausted by fighting for gender equality I would force the gender-neutral “ze” on people. I just don’t have the energy to argue with people the same way that I did when I was young and childless. I don’t like the gender stereotypes and so part of me tries to resist it by not using she/her. I want to live free of gender, hence the use of epi-gender, my new preference. But whereas I struggle to release associations and stereotypes from gender, many transgender people have been exhausting themselves fighting to claim a gender identity with the use of their preferred pronouns and claim a gender stereotype they deserve. Their fight is valid.

In the end, I don’t know what gender is and I don’t know what gender I am. I am a feminist but that doesn’t mean I have to be a woman. Men can (and should) be a feminist too! It feels more like gender is evolving and is in its awkward teenage years of puberty where no one really looks like girls or boys any more but they don’t yet like men and women either. We are somewhere in between. That’s what gender is for me: Awkward and indiscernible. I hate the stereotypes and worse, I hate having to be forced into them, for myself or my young kiddo, but I also appreciate that these stereotypes evolved out of somewhere, like biology and sociology. I think the problem was that for a long time we thought the only biology that mattered was the genitals we were born with when actually, we are learning that genitals are part of it but largely because they are a product of genetics that dictate a starting place… but then many things will influence where a person goes from there, including where they gonads go, where their clitoris goes, what their hormones do, how the body responds to hormones, how the brain changes, and internal sense of self.