‘Nature’ actually produces a variation of combinations of female and male sex characteristics (Fausto-Sterling, 2002a; Hird, 2004; Oudshoorn, 1994). Some individuals have a genetic sex that is different from their hormonal and/or anatomical sex. For example a child might be genetically female (have two X chromosomes and no Y), but have male genitalia. Accurate estimates are difficult but anything from 1 in 2000 babies, to 17 in 1000 infants are born with some form of ‘intersex’ condition (Fausto-Sterling, 2002b: 20; Hird, 2004: 15) and this has prompted the slightly tongue in cheek suggestion that five sex categories would more accurately describe what occurs ‘in nature’ (Fausto-Sterling, 2002a; 2002b). Just because individuals whose genetic, hormonal and anatomical sex match are more common than the many other combinations does not mean those other combinations are not ‘natural’. They are genetic variations and variations are important in maintaining the biodiversity which promotes life (Hird, 2004). However, society is organized around the idea that female or male are the only options, and it is
very difficult for those whose sex is unclear to do anything within such a society or for others to know how to deal with them. From everyday matters such as which public toilets to use or ticking either ‘female’ or ‘male’ boxes on official forms, to major decisions about who goes into the frontline of battles, the assumption is that men are men and women are women.
The way that intersex individuals are dealt with shows that the decision about what sex to label a child is a social decision (see Kessler and McKenna, 1978). Any development of sex within an individual that does not fit into the categories ‘male’ or ‘female’ is seen as a ‘wrong turning’, they are supposedly sexual abnormalities that have to be ‘fixed’. For example, where a child has a very small penis, even if genetically male, it is recommended they should have surgery and be raised as a girl. Fausto-Sterling (2004: 344) argues that this shows that having a sizeable penis is seen as crucial to being masculine. Complicated ‘corrective’ surgery is performed on people who are healthy, although anatomically sexually ambiguous (Hird, 2004:131—42). Such people do not make sense in terms of one of the most basic ways in which society is organized.
The problems of being uncertain of one’s sex are noted by Melissa, who has an intersex condition. She was born with XX chromosomes (female) and internally a womb and ovaries, but had ambiguous genitalia that were identified as either an enlarged clitoris or a small penis. She did not know about her condition until she was 18 years old, only being aware that something was wrong ‘down there’. Her mother told her to ‘always use a cubicle to change at school’ and that only doctors should ever touch her (Toomey, 2001: 37). Melissa and others like her have been routinely subjected to operations to try and ‘normalize’ their ambiguous sexual anatomy. They are very seldom told the real reason for these operations and are often unaware of their condition. The outcome of surgery is frequently unsatisfactory for the individual, but the medical establishment are profoundly caught up in the belief that social and individual confusion will result if the distinction between male and female is questioned. Therefore where a newborn human’s sex is unclear a medical team will meet to decide, as soon as possible after the birth, what sex to make the baby (Toomey, 2001: 40, emphasis mine).This illustrates that sex is primarily a social category, although initially sociologists of gender (for example, Oakley, 1972) tended to bracket sex off as a biological and fixed fact onto which the social meanings constituting gender were imposed. Discussions about the advantages and limitations of such a move occur in Chapter 3, but here I want to focus on how intersex people challenge ideas of women and men as absolutely physically different.
Intersexuality puts the categories ‘male’ and ‘female’ into question and shows how for granted we take it that females will become feminine and males masculine, and all will perform the social tasks expected.
Intersexual people show that bodies are important in forming gender identity and that having an ambiguous body makes forming a gender identity complex, but only because of entrenched common sense ideas that if you have a female body you must become feminine and if you have a male body you should become masculine. The assumption is that gender identity simply emerges from sex. For those whose bodies do not clearly fit either sex category, gender identity is a problem. In fact, even those whose bodies can be clearly ‘sexed’ sometimes do not feel like their gender identity corresponds to their sex. For example, some men with penises feel like women trapped in men’s bodies. Their gender identity is not connected to their biological sex. Conventional wisdom indicates that ‘male’ or ‘female’ are adequate labels and that any bodies which do not ‘fit’just need to be ‘correctly’ assigned to one or the other, and maybe reassigned later if ‘wrong’. These are essentialist arguments that assume we all have a ‘true’ or ‘natural’ identity which is either feminine or masculine. If we are born female we will become ‘feminine’ as long as nothing goes ‘wrong’. If this is such a ‘natural’ thing then how do people whose sex and gender differ emerge, why do all women not behave in the same way, and how and why do ways of being feminine and masculine change? If femininity just ‘naturally’ develops from having a female body, what happens if someone has a body that cannot clearly be defined as either female or male? Intersex people illustrate how hard it is for all of us to think of‘people’ without thinking of them as gendered. The construction of gender (femininity and masculinity) is based on an early decision about sex (Kessler and McKenna, 1978).
Biological variations in sex are commonly reduced into just two categories — male and female — because for someone to be of in-between or ambiguous sex threatens a social order based on there being only two sexes. There is a whole series of decisions about what we can and cannot do and be which is organized around knowing whether someone is a man or a woman. Sociologists focus on the argument that once the decision about which sex we are is made, it has significant effects on how we live our lives. Much early sociological attention to gender gave particular importance to deciding just how different women and men are and to what extent these differences were due to social and cultural practices rather than a ‘natural’ product of biology.