Oct 29 2013

Gender – It’s Complicated

A new study by gender researcher, Laurel Westbrook, explores attitudes toward gender determination in various contexts. The issue of gender is interesting partly because it is one of those topics that at first seems fairly straightforward when in fact it is quite complex, not only biologically, but ethically.

By now many people are familiar with the distinction between sex and gender, sex referring to biological characteristic relative to male and female, and gender being a social construct relative to masculine and feminine. In both cases the first thing we must realize is to avoid the false dichotomy as sex and gender occur along a spectrum, and are not binary.


Biological sex in humans is determined by several factors. Developmentally there are two main factors, genetics and hormonal environment. The system is binary in that there appears to be a female developmental pathway and a male developmental pathway, and most individuals do end up unambiguously toward one end or the other of this axis.

However, this developmental scheme can be altered in every conceivable way. The XX (female) and XY (male) chromosomal makeups are not the only possibilities. There are individuals with XXX, X, XXY and other permutations.

Even with typical XX and XY chromosomes, sexual development is highly dependent on the relative concentrations of masculinizing (such as testosterone) and feminizing (estrogen) hormones in the womb and in the body as development occurs. There are not only genetic, but epigenetic, and maternal factors that can affect this. There are also specific conditions, such as adrenal hyperplasia, that can result in an increase in masculinizing hormones, resulting in ambiguous genitalia.

Biologically there are three aspects of sex – primary sexual characteristics (genitalia and reproductive organs) secondary sexual characteristics (distribution of hair and body fat), and sexual orientation. While these properties tend to segregate together, they also occur in every possible permutation.

Sexual orientation is a bit socially controversial, but there is not much scientific debate about the fact that biological factors on the brain have a strong influence on sexual orientation. People, in other words, do not just choose to be heterosexual, homosexual, or somewhere in between, they appear to be born with their orientation. This is not to say that culture and society do not affect behavior, but the evidence suggests that basic sexual desires are hardwired into our brains, and can even be considered a secondary sexual characteristic.

The notion that biological sex is complicated should not come as a surprise to anyone familiar with biology, and would not be controversial were it not for the social implications of these facts.

One last point on sex – given that diversity is ubiquitous in nature, it does seem reasonable to consider the various spectrums of sexual characteristics in terms of typical with variations rather than the loaded concepts of normal and abnormal.


As complicated as the biology of sex can be, gender is even more complex, in my opinion, because we are dealing with more abstract constructs rather than measurable biological properties.  Gender refers to the purely social construct of feminine and masculine. How to dress, behave, adorn oneself, and one’s role in the family and in society are all socially determined, with tremendous variations across different societies and over historical time.

Essentially most people self-identify as either a man or a woman, and tend to follow the social norms for that gender. As with sex, however, this is a false dichotomy in that there are transgender individuals who do not adhere to this simple scheme.

One thing I find interesting is that different societies tend to tolerate different degrees of bending gender roles. In Western society, at least in the last generation or so, we tend to be more progressive in our attitudes toward gender and gender roles. Men can be “metrosexual” and women can wear business suits and take on traditional male roles in society.

However, if you bend these traditional roles too far, then people start to become uncomfortable.

Societal attitudes toward transgender individuals is the subject of Westbrook’s study. She finds that attitude depend greatly on context. I think this reflects genuine ethical dilemmas.

In progressive societies, we tend to value individual freedom. In this context there is increasing comfort with the notion that everyone should be free to self identify where along the gender spectrum they feel comfortable. Everyone can decide for themselves what their own gender is, and that should be respected. If you value progressive ideals, it’s hard to argue with that.

However, there are certain spaces in our society in which the sexes are segregated – public bathrooms and competitive sports, for example. When you ask people about gender freedom in these contexts, suddenly their progressive ideals become challenged and they become more parochial.

Westbrook explains:

“In our analysis, we find that these moments, which we term ‘gender panics,’ are the result of a clash between two competing cultural ideas about gender identity: a belief that gender is determined by biology versus a belief that a person’s self-identity in terms of gender should be validated. These gender panics frequently result in a reshaping of the language of such policies so that they require extensive bodily changes before transgender individuals have access to particular rights.”

In general people are OK with gender self-identity, but when we talk about public bathrooms and sports, suddenly they want biological determinism. They want women to have woman parts, and men to have man parts.

I don’t think there is any objective resolution to this ethical dilemma. Some would argue for an absolute validation of gender self-identity, and I understand the reasoning here, but it is dismissive of other concerns.

For example, should a person who is, by every biological measure, male but who self-identifies as gender female be allowed to compete in athletic competitions as a woman? I think this is a sticking point for a lot of people. We don’t want to challenge someone’s gender self-identity, but sports segregation is more about sex than gender, and so it doesn’t seem fair.

Westbrook points out that gender panics occur more in the context of men invading female spaces than the other way around. With regard to sports, this makes sense. One might argue that the point of women’s sports is to provide a space where women can compete against each other without the unfair advantages that testosterone provides to men. If a woman can compete in a male sport, then good for her. But if a man competes against women and a woman’s sport, that seems unfair.

Ethical dilemmas are created when a situation puts us at cross-purposes. We cannot simultaneously fulfill all of our ethical goals, and so we have to prioritize and choose. Different people will have different priorities and will therefore make different choices. Somewhere in the middle is a reasonable compromise (identified by a choice that makes everyone equally unhappy).

36 responses so far

36 Responses to “Gender – It’s Complicated”

  1. fergl100on 29 Oct 2013 at 9:02 am

    Hi Dr Novella

    Love the blog.

    Don’t think you get YY sex chromosome though, too many genes on the X are required.


  2. Steven Novellaon 29 Oct 2013 at 9:53 am

    fergl – you’re right. I made the correction. Thanks.

  3. Cow_Cookieon 29 Oct 2013 at 10:00 am

    I wonder if you couldn’t use branding and marketing to shape public acceptance of gender variation in sports. Instead of calling it men’s and women’s, the two categories would be referred to by the mechanics — sort of like how grand prix motorcycle racing has a 250 cc class and a 1,000 cc class.

    Mixed martial arts recently faced this dilemma with fighter Fallon Fox, a transgender fighter who had gender reassignment surgery. Despite doctors testifying to the contrary, other fighters complained that she had greater bone density and muscle mass than other fighters in the women’s division.

    Fox would likely generate some amount of controversy anyway, but naming the classes after the mechanics could counter some of the public perceptions that a fighter has an advantage. Instead of having men’s MMA and women’s MMA, licensing bodies would have a low-D/low-T class and a high-D/high-T class. If a fighter’s anatomy comes in below certain parameters, he or she would be eligible for the low-D (densisty)/low-T (testosterone) class, period. Sex, gender, whatever wouldn’t matter because the competitors would all be on the same playing field.

    From a marketing standpoint, a post-op fighter competing in the low-D/low-T division would no longer be a man competing in the women’s division. It would merely be a fighter competing in the class most suited for her body. And the same would be true for transgender males who don’t go through gender reassignment surgery. They wouldn’t be competing in the men’s division. They’d just be competing in the division suited for their body. Combat sports already have weight classes. This wouldn’t be much different.

  4. Steven Novellaon 29 Oct 2013 at 10:32 am

    That’s a good point. For some sports we may need to reconceptualize competitive categories that are operationally defined and more fair and practical, and divorced from the social construct of gender. Weight class for fighters is a good example.

    Sports are adopting these rules in any case, as they are forced to operationally define man and woman for the purpose of competitive segregation. The problem is, as I outlined above, any such system will be imperfect and have exceptions. No matter what parameter you choose, there will be other parameters that may not cluster typically with the measured criterion.

    But I do like the idea of not labeling in a way that makes it sound like gender. This way, it does not matter how someone self-identifies in terms of gender, if the categories are based on testosterone level.

  5. Ori Vandewalleon 29 Oct 2013 at 11:57 am

    I’ve witnessed otherwise socially progressive individuals get very caught up by the issue of pronouns. To them, someone who wants to use a pronoun that differs from their biological sex is delusional, because their biological sex is an obvious fact. This belief that anyone transgender is obviously delusional informs anything else that person has to say about the subject.

    What seems to trip people up is the idea that they should have to change what they do/say/see because another person chooses to self-identify in a non-traditional way. It’s perfectly okay for you to be transgendered… just so long as that doesn’t affect me in any way. I’m not sure how to combat that attitude.

    My personal preference is that we abandon the concept of gender altogether, because it doesn’t seem to serve any vital function in society. I often wonder if transgendered individuals wouldn’t feel such internal conflict if, externally, the concept of a specific gender role just didn’t exist. But I know my personal preference is a little out there, and I know that I’m biologically male and that I conform rather neatly (but not perfectly) to traditional masculine behaviors, so it’s hard for me to understand what a transgendered individual truly feels.

  6. rezistnzisfutlon 29 Oct 2013 at 12:14 pm

    I’m not sure how we can tease out gender from sex as they seem intertwined. Perhaps we can mitigate it in a lot of ways, and I think it’s good to have healthy discussion in deciding what is merely arbitrary from what is legitimate, but gender has evolved as a social construct directly from sexual dimorphism, I’m not sure how we can escape that entirely.

  7. Ori Vandewalleon 29 Oct 2013 at 12:41 pm

    I think humans have evolved plenty of traits that we’ve escaped with little difficulty. Take long-distance running, for example. Humans have pretty incredible endurance, and there are some of us that can run marathons as a result. But most of us make no use of this trait whatsoever, despite it being one of the defining traits of our hunting success (and thus survival) in our evolutionary past.

    You could make the argument that our problems with obesity are a result of our lack of exercise, but you can also point to changes in diet. The point is, people are able to live long, productive, healthy, and happy lives without ever having to chase a prey animal for half an hour.

    Concordantly, I’m not sure there’s any reason why we can’t live long, productive, healthy, and happy lives without being steeped in gender roles.

  8. rezistnzisfutlon 29 Oct 2013 at 1:13 pm

    No doubt that it’s possible for a few people to live that way – there will always be exceptions. I’m dubious as to whether gender will ever be completely eliminated because sexual dimorphism exists and the fact that humans are highly social animals that tend to form groups. Gender roles may change, but gender will be borne at least initially on sex.

  9. ConspicuousCarlon 29 Oct 2013 at 1:28 pm

    I find it interesting that social movements vary between wanting to avoid labels and demanding them.

  10. Ori Vandewalleon 29 Oct 2013 at 1:54 pm

    rezistnzisfutl: Yeah, what I’m suggesting isn’t easy or practical, but I think it would be better for equality in the long run. Some counter this argument by saying I want all people to be the same (i.e. like me). But that’s not what I imagine. I just want people to be different based on traits that actually matter. *shrug*

  11. Steven Novellaon 29 Oct 2013 at 5:07 pm

    I think what we want is a society in which people can be whatever they want without judgement. How to achieve that is tricky, but it starts with getting rid of old simplistic notions.

    The factor with gender that may be relevant also is that there is a dominant mode that most people fall into – traditional binary male/female identification. I do think this will tend to be dominant, but the manifestations will differ. The lines and roles are increasingly blurred (metrosexuals and tom boys). Dress, jewelry, makeup, sports, professions – many traditional barriers being broken or redefined. This is good in that everyone can decide for themselves what they feel comfortable with, and there won’t be narrow societal roles they have to fit into.

    But perhaps because of the fact that most people tend to cluster toward one end or the other of human sexual dimorphism, there may be some traits having to do with feminine and masculine that will also tend to cluster. This is OK as long as we don’t mistake clustering for “normal” and turn that into judgementalism or condemnation of those who fall outside of the typical clusters.

    It also seems that gender roles are dominantly cultural, but we tend to mistake the gender roles of our own culture as “natural” and biologically determined when they are not.

  12. pseudonymoniaeon 29 Oct 2013 at 5:49 pm

    “…there is not much scientific debate about the fact that biological factors on the brain have a strong influence on sexual orientation. People, in other words… appear to be born with their orientation”

    The former statement is not equivalent to the latter. Yes, biological factors influence brain development and undoubtedly have a strong influence on sexual orientation (although, to my knowledge this claim is largely inferred due to a lack of contrary evidence, rather than drawing upon direct empirical support).

    But, taking this position as our starting assumption, what exactly implies that people are “born” with a specific sexual orientation? Infants do not display orientation-specific responses to stimuli (and, let’s be honest, it’s implausible that a contemporary paper reporting such a result would have any predictive validity) and given the frequency at which adults “come out” as a different orientation from that assumed by society, I imagine that even tests applied during adolescence would have imperfect validity. With this in mind, I don’t see how we could possibly have empirical evidence to support this statement.

    Of course, the flawed idea that a person can be “trained” to be heterosexual or homosexual obviously lacks empirical evidence, but this doesn’t imply that the developmental process that mediates sexual orientation reaches completion or life-long permanence at birth.

  13. steve12on 29 Oct 2013 at 6:42 pm

    “what exactly implies that people are “born” with a specific sexual orientation?”

    There’s convergent evidence that’s suggestive of something happening via hormones gesationally, or some complex interplay b/t genes and hormones:


  14. elmer mccurdyon 29 Oct 2013 at 7:23 pm

    When I spent a couple months hopping around the Philippines, I found it really interesting how common and seemingly accepted transvestites were there.

  15. banyanon 29 Oct 2013 at 8:05 pm

    Disruptions in the gender binary have some crazy results when the law assumes that everyone is all-male or all-female. In Texas, for example, courts have held that if you were considered male at birth, then you are male for the purpose of their same-sex marriage laws. Consequently, transgendered women who were considered male at birth are only allowed to marry other women.

  16. rezistnzisfutlon 29 Oct 2013 at 8:26 pm

    I do want to be clear that I, too, feel that a greater degree of education and tolerance is attainable and should be a goal. People should be able to identify how they wish, for no other reason that they just want to be, without repercussion. I also think that obviously unhealthy aspects of gender should be addressed, those aspects that harm oneself or others.

    Dr. Novella, wouldn’t it be the case that whenever any group of “similars” forms, there is always going to be some sort of “normal”? Perhaps it’s in how this “normal” is regarded is the key issue. As with gender, I’m not sure if we’ll ever grow out of there being some sort of prejudice and discrimination, even if those things are minor. Don’t get me wrong, I’m not excusing those things, it just seems like, as with gender, most likely they’ll always exist to some degree and we’ll always have issues to deal with in some form or another.

  17. denisexon 30 Oct 2013 at 1:42 am

    If sex is biological and gender is a social construct, then I’m having a hard time comprehending transgender. We don’t believe gender identity is strictly or even primarily about social roles, do we?

    “Biologically there are three aspects of sex – primary sexual characteristics (genitalia and reproductive organs) secondary sexual characteristics (distribution of hair and body fat), and sexual orientation.”

    Isn’t gender identification likely to be grounded in biology as well? I understand that it is thought to be possibly influenced by prenatal hormonal events. It seems to me that when a boy has personality traits and preferences considered feminine we are talking about social roles, but when he feels that he IS a girl we may be talking about something biological; in that case is gender really the right word to describe this?

  18. Will Nitschkeon 30 Oct 2013 at 2:37 am

    “In progressive societies, we tend to value individual freedom…”

    Not really. Progressives have been notoriously active in restricting free speech and individual rights in the interests of ‘fairness’. For example, making the holding of certain opinions on identify illegal. This has certainly become true of Australian, Canadian and UK society, where upsetting someone in a minority group of some type, is potentially against the law.

  19. Steven Novellaon 30 Oct 2013 at 9:25 am

    By “born with sexual orientation” I did not mean to imply that infants have a sexual orientation, but that their ultimate orientation is determined by the time they are born by the development of their brain.

    The evidence for this is that people tend to have their sexual orientation as far back into their childhood as they can remember. And it is notoriously difficult to change one’s orientation, which is typical of characteristics determined by development rather than later socialization or other environmental factors.

  20. ccbowerson 30 Oct 2013 at 12:15 pm

    “The evidence for this is that people tend to have their sexual orientation as far back into their childhood as they can remember. And it is notoriously difficult to change one’s orientation, which is typical of characteristics determined by development rather than later socialization or other environmental factors.”

    I tend to agree with your stance on sexual orientation, but the latter argument is more convincing than the former. Of course you know how easily new information can be reincorporated into the past in order to make complete a narrative. I’m not saying those memories are wrong, but I wouldn’t use them as evidence.

    Ultimately, I don’t think it matters much whether we assumed that sexual orientation is completely determined at birth, prior to birth, or a little after birth, because it should not change how we think about the topic for adolescents and adults. Clearly orientation is not significantly alterable at the point at which it becomes important for an individual, and the vast majority of people recognize this (the Bachmanns of the world aside).

  21. steve12on 30 Oct 2013 at 4:15 pm

    “what exactly implies that people are “born” with a specific sexual orientation?”

    There’s convergent evidence that’s suggestive of something happening via hormones gesationally, or some complex interplay b/t genes and hormones:


  22. steve12on 30 Oct 2013 at 4:16 pm

    A few more links to go with my comment directly above (any more puts me in ‘waiting for moderation’ jail):


  23. neuromanon 30 Oct 2013 at 4:49 pm

    Do you think gender is 100% socially constructed? No room for nature and nurture? If you concede that all human behavior is the result of brain activity, then you must agree that neural network wiring and synaptic connections are constrained by both genes and environment. Thus, gender would be the outcome of a complex interplay of genes, environment on the behaviors of neural systems. Am I preaching to the choir?

  24. Bill Openthalton 31 Oct 2013 at 3:53 am

    It really is totally, utterly unimportant how a person’s sexual orientation is arrived at. It is no less valid if it is a subconscious choice based on social circumstances, or a conscious decision. The belief that homosexuality is acceptable if it is genetically determined is a throwback to the religious (and thus social) classification of all sexual behaviour as justified only if it leads to reproduction, and the equally religiously-inspired idea that if not inborn, it is a conscious — and thus immoral — choice.

  25. BillyJoe7on 31 Oct 2013 at 7:53 am

    In some circles, being bisexual has become the “in thing” to try out, much like it has become fashionable to share, and therefore promote cutting experiences online.
    The other neglected subject is what might be called gender neutrality – the complete absence of libido from birth.
    Perhaps they are not very interesting subjects.

  26. Bill Openthalton 31 Oct 2013 at 8:28 am

    BillyJoe7, now that you bring bisexuality into the picture, it has always struck me as odd that people use the fact they are attracted to both sexes to (morally) justify sleeping with someone else than their spouse. What’s the difference between being attracted to many women, and being attracted to many men and women when one has promised to be true to one’s spouse?

    Neuroman, some aspects of our behaviour are conditioned by our genes, some are learned. It would be amazing if having a different sex, with the concomitant statistical differences in body shape, gait, strength and even brain structure would not lead to statistical differences in basic behaviour. So yes, gender is not a purely social construct, but societies can either minimise or maximise the differences.

  27. Steven Novellaon 31 Oct 2013 at 9:33 am

    I agree that there are biological factors regarding gender identity and behavior. There is lots of evidence for differences in behavior between boys and girls from as early as it can be measured. I do not buy the argument by those who reject this data that infants are already socialized into a gender, to the point that it affects their toy choice or other behaviors.

    One way to separate inborn vs socialized behavior is to look at cultural differences. The big picture is that there seems to be some common themes of feminine and masculine, but the details vary widely among cultures. That is what I mean by socially constructed – the details of what behavior is appropriate for each gender.

    Clothing, jewelry, hair length, and makeup tend to have gender implications, but the details seem to vary without limit among cultures. A guy with earrings, eyeliner, and long hair would have been thought effeminate in the 1950s, and today is just stylish.

    It’s similar to food choice. That you like fat and salt is genetically determined, but you have to grow up with vegemite to like it. (Yes, you can acquire a taste later in life, but culture pretty much determines what foods you find palatable.)

  28. pseudonymoniaeon 31 Oct 2013 at 4:11 pm

    @Dr. Novella: I think you misunderstand my point, which is that given the absence of any measurable orientation at birth, we require some other metric to demonstrate whether or not sexual orientation has been determined at this point. The relative stability of orientation from “as far back into… childhood as they can remember” suggests that sexual orientation has developed by early childhood (assuming no retrospective fallacy), but doesn’t necessarily imply that individuals are “born with” their sexual orientation already determined. It seems equally plausible that the biological processes guiding the development of sexual orientation play out probabilistically in early life (though, this doesn’t need to imply that “life experiences” play a role).

    Steve12 argues that hormones present during gestation may be key determinants, which may well be true. Though, the evidence that he cites (e.g. cross-correlations between finger ratios, androgen exposure and adult sexual orientation as well as heritability studies) doesn’t tell us whether orientation has been indelibly determined by birth, per se. Post-gestational hormonal factors aren’t exactly non-existent, and may (or may not) have an influence on the development of sexual orientation.

    I definitely agree with ccbowers that the timing over which developmentally-programmed orientation plays out should be largely irrelevant to the broader social debate, however, I think we can all agree that it is important from a scientific perspective to be clear on exactly what the evidence says. And from what I can tell, it doesn’t indicate at what stage of development hormonal (or other factors) stop having an influence on the development of sexual orientation.

  29. Steven Novellaon 01 Nov 2013 at 7:14 am

    You are correct. The evidence does not prove that orientation is determined entirely by birth. It does, however, suggest it, and that is the most parsimonious interpretation of the evidence. it is possible that later development might still go in different directions (this is more likely to be the case with disorders that affect the typical concentration of various hormones).

    In any case, this is a distinction without a consequential difference. Personality traits, including sexual orientation, seem to be largely biologically determined (again, not without interaction with environment), and seem to be present as early as we can test for them. At what developmental point they are actually locked in and determined is hard to say beyond that.

    I also agree this all has zero bearing on the ethics of how to treat sexual orientation. Respecting peoples choices with regard to gender and sex is independent of the question of how much are those choices biologically determined.

  30. ghulseon 01 Nov 2013 at 3:32 pm

    Good article. Too often we’re inclined to take mental shortcuts, see the world in oversimplified terms, labeling and compartmentalizing along discrete categories. As Novella says here, human sexuality is much more complex than gay or straight or male or female.

    I’ve always found Kinsey’s quote here to be very useful:

    “Males do not represent two discrete populations, heterosexual and homosexual. The world is not to be divided into sheep and goats. Not all things are black nor all things white. It is a fundamental of taxonomy that nature rarely deals with discrete categories. Only the human mind invents categories and tries to force facts into separated pigeon-holes. The living world is a continuum in each and every one of its aspects. The sooner we learn this concerning human sexual behavior, the sooner we shall reach a sound understanding of the realities of sex.”

    -Alfred Kinsey

  31. daedalus2uon 01 Nov 2013 at 4:51 pm

    There is a case of MZ twins where one of them voluntarily underwent a MtF gender change and the other did not.

    “Determined at birth” is not the same as “determined genetically”. Humans grow from a single cell to ~10^12 cells at birth. There are many details that cannot be determined genetically but which still matter.

  32. lofgrenon 02 Nov 2013 at 9:02 pm

    While I do not share the view, it seems entirely reasonable to me that some people would be comfortable with penis-havers identifying as women but still not being allowed to use the women’s bathroom. Segregated bathrooms are a matter of comfort, and it definitely makes some women uncomfortable to share a bathroom with somebody who they perceive as male and vice-versa for men. In fact the only reason I really disagree is that it seems to me the discomfort of having to reveal that you are transgender by using the “wrong” bathroom probably far exceeds that of somebody having to use a stall next to a person with different parts.

  33. BillyJoe7on 02 Nov 2013 at 9:27 pm

    I would have assumed that, before reassignment surgery, anatomical males and females would use male and female toilets respectively. Am I wrong in that assumption?

  34. lofgrenon 02 Nov 2013 at 10:20 pm


  35. ccbowerson 02 Nov 2013 at 11:12 pm

    “Am I wrong in that assumption?”

    I would think that it has more to do with gender identity than anatomy. If a person identifies with (and dresses and lives their life as) a gender that conflicts with their biological sex, I would think that they would utilize the private spaces of the gender with which they identify when possible. In certain circumstances, such as a changing room that didn’t have privacy within it, this would be problematic, but it would be problematic either way.

  36. aecoleman1on 14 Nov 2013 at 5:03 pm

    Dr. Novella,

    As a transgender FTM, I really appreciate posts like this. It’s considerate and well spoken without sacrificing the facts to the politics. That’s more valuable to the trans community than any well meant hyperbole or flag waving. Thank you very much for this post. I’m going to share it with other members of the community; it has to be one of the most concise, clearly put “intro level” articles I’ve ever seen. It would make an excellent reference material for the never-ending intro level conversations that trans people end up in. The only thing I would have added to the article regarded gender identity and behavior, but I see that it’s been covered in the comments.

    Wonderful stuff!


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