You may recall that I recently criticized one of Harriet Hall’s posts claiming that gender differences don’t matter. It appeared to me based on reading that article that Hall did not really understand current research and theories of sex, gender, and sexuality. Her post was full of essentialism and unfounded biases.
Well, Harriet Hall is at it again. This time, Hall is here to tell us that gender is complicated.
Really? You don’t say!
Hall’s post does contain some factually accurate information, and I agree with her premise that sex, gender, and sexuality are complicated subjects. I have two major problems with Hall’s approach to gender: (1) If gender is complicated, then why the hell does she keep trying to boil it all down to short, simple blog posts on the topic? And (2) if gender differences don’t matter as she asserted in her previous post, why the hell is she writing a whole post about how many gender differences there are? It seems contradictory—either gender differences matter enough to warrant discussion and for people to build identities around or they don’t. You cannot have it both ways, Dr. Hall.
But I digress. Let me tackle some of the glaring problems with this latest post in particular. I must warn you, this post is rather lengthy because it takes a lot more words to correct errors than it does to make the errors in the first place.
Concerning the meaning of “gender,” Hall correctly notes that the word is often conflated with “sex” (as she herself does both in the previous post and in this one—even after noting how this can muddy the waters!). Let me address some of her specific claims:
The words are often used interchangeably, although the preferred usage is to use sex to refer to biological differences and gender to refer to social roles. (Which becomes problematic when you’re not sure if a given trait is determined by biology or culture.)
Of course it’s problematic when you work from the assumption that either culture or biology determines sex/gender traits. As I noted in my last post, though, current thinking on sex/gender is moving away from the nature/culture dichotomy towards a biocultural approach which takes into consideration how both culture and biology (nature) work together to co-produce sex/gender. Still, it is best for clarity’s sake to use “sex” to refer to bodies and “gender” to refer to identities and social roles.
The modern academic sense of gender was popularized by the feminist movement.
This is superficially correct, but I think that this statement obfuscates how radical of a shift in thinking the sex/gender split was. Before Gayle Rubin’s 1974 “The Traffic in Women” pushed the paradigm shift in the social sciences, sex and gender were conflated into both being biological/innate. The sex/gender split was not simply an analytical split—it was also a political necessity. This is what allowed feminists to begin to argue that a person’s biological characteristics (sex) does not determine the kinds of labor they should do (gender). For anyone who is even remotely aware of feminism, it is clear how important this split was in the 60s and 70s. It allowed for feminists to argue that they are not bound by their nature to fulfill the roles forced on them by a patriarchal society.
As a result, scientists have sometimes chosen to extend the use of the word to biological differences in an attempt to show their sympathy with feminist goals.
I give this a big citation needed. I am highly skeptical that the reason scientists (specifically medical scientists) use the word gender to refer to biological sex is an act of feminist solidarity.
Some have even argued that “sex” is a just another social construct.
Yes, many people have argued that sex is a social construction. One of my favorite social theorists Judith Butler argues just such a point. Very convincingly, I might add. Butler argues that sex comes already wrapped up in our understandings of gender (something that biologist Anne Fausto-Sterling agrees with). In this way, the category of “sex” is a construction—it is a way that we make meanings out of bodies. This does not mean that sex is not real (an argument I often hear from people who do not understand what it means that something is “socially constructed”) and does not refer to real differences among bodies. But the ways that we construct this category (in our society, as a binary opposition) is cultural. Biological bodily traits exist—how we make sense of them (i.e., “sex”) is what’s constructed.
After this brief terminological introduction, Hall proceeds to give a list of factors that demonstrate the complexity of sex and gender. While many of the points in this list are factually true, there are some major problems with the list (problems that make it clear that she’s done a very small amount of reading, probably in older literature from the early 2000s and earlier).
Let me address some of the points on her list, starting with chromosomal sex.
Males are XY, females are XX. But there are individuals who are XXY (Klinefelter syndrome), XYY, a mosaic of XX and XY cells, XXX, XO (Turner’s syndrome), and various other accidents of cell division gone awry. How are these anomalies to be categorized? How do they affect behavior and gender role?
This is a very good example of why the language used to discuss this topic is important. “Males are XY, females are XX” is an oversimplification despite her best efforts at pointing out how it’s not simple. If I had written this, I would have worded it: “Male-bodied people typically have XY chromosomes, and female-bodied people typically have XX chromosomes.” But a person with AIS can have XY chromosomes (and no extra chromosomes) and be female-bodied.
So how are these “anomalies” (keeping in mind that, depending on how its measured, this refers to as many as 1 in 100 people to 1 in 2000 people—not exactly super rare) to be categorized? Well, that has changed over time (thus the cultural construction of sex). Today, we consider people with these traits to be intersex. How do chromosomes affect behavior and gender role? That’s a complicated and as far as I know not entirely understood topic. But one way that they affect gender roles that is pretty clear is that we assign meanings to what it means to be XY or XX and then determine what those kinds of bodies should be doing. That is, of course, a cultural constructionist approach to the question.
Intrauterine hormonal effects – Her descriptions of these traits are factually sort of accurate, but I feel that the language used still leaves something to be desired. So, someone with AIS is not a “male fetus”—it is a female-bodied person with XY chromosomes whose body does not recognize androgens. The way that Hall’s paragraph on hormonal traits reads is that the determining factor in sex is chromosomes. It’s not that someone with AIS is “born looking like a girl”—it’s that their body has developed into a female body and continues to develop as a female body unless there is some medical intervention.
The sex of rearing – Once again, conflating sex/gender into a single category. Nonetheless, the David Reimer case is certainly one example of how altering a person’s body does not necessarily bring it in line with their internal sense of gender. That being said, there were many of John Money’s other cases that had no such issues when they grew up—in fact, Money argued that Reimer was an anomaly. I’m certainly not arguing in favor of John Money’s research program—I think it was extremely unethical and problematic. But to point at this one case and declare socialization irrelevant (which is what it appears to me as if Hall is doing, though I could be wrong) is throwing the baby out with the bathwater. (PS, for an interesting discussion of Money’s research and how it has affected and been perceived by intersex people, I highly recommend Katrina Karkazis’s book Fixing Sex).
Sexual Desire – I have a big fucking problem with how this is worded. In one fell swoop, Hall lumps together queer people with pedophila and beastiality. The thing is, queer and non-queer people’s orientation is about more than desire and behavior. It’s also about identity, which is both individual/personal and social. Sexuality, then, is more than just what people desire and how they pleasure their bodies. To pretend that desire and acting on desire is the sum total of sexuality is a claim that is so completely out of touch with the literature on sexuality and sexual orientation that it would be laughable were it not eerily familiar to the arguments I hear from Right-wing asshats.
Social gender – as opposed to what, biological gender? Gender is always already social, so this feels a bit redundant. Regardless, Hall’s questions are so absurdly essentialist that I must quote them in full for those who have not clicked over to read her post.
Does the individual play the role expected of a male or female in society? All the time, or part of the time? Does he/she sometimes dress in clothes of the opposite sex, publicly or in secret? Do friends and associates perceive the individual as male or female?
“The role”? There is no one single role, even in a system based on a gender binary. Further, those roles are not static, but fluid and always changing and shifting. None of us is ever always doing or being the ideal man or woman. Because no such thing exists. Yet our ideas of what makes someone a man or a woman are based on idealized visions of what those things mean. This is the foundational problem of a strict gender binary opposition: no one fits. Norms are always changing. I also find it weird that after attempting to deconstruct the notion of a binary that Hall’s entire post is written with the language of a sex/gender/sexuality binary opposition (e.g., “clothes of the opposite sex,” as if there’s only two!).
Gender Dysphoria – No. No no no no no no no no no no. Though, on an interesting note, the way Hall wrote this reads as if she buys into sex as a cultural construction. If sex is “assigned,” (which I agree, it is! I’m just not sure Hall agrees), then it is not an inherent trait. But my main problem with this is that it buys into the old GID rhetoric of being “born in the wrong body.” Gender dysphoria, at least in the new DSM-V, is really more about an incongruence between the gender a person is assigned (usually before/at birth) and the gender they experience or identify with. It does not necessarily have to involve feeling like a person is the “wrong” sex.
Surgically-altered external genitalia – These questions feel like they’re coming from someone who has never read a word of trans* literature in their lives. So let me help:
What do we call someone who has undergone sex change surgery?
First, “sex change surgery” feels outdated and my understanding is that some trans* folks find that phrase problematic. It’s probably better to use the phrase “sex reassignment surgery.” So what do we call someone who has undergone SRS? Transsexual.
What do we call someone who wants the surgery and is waiting for it?
Transgender or Transsexual, depending on if they have begun to transition in other ways, such as social transitioning and/or hormone treatment.
At what point in the long sex-change process can the sex be assumed to actually have changed?
How about when the person says it has or feels like their transition is complete?
Hall begins her conclusion with a perplexing paragraph that reads as if an undergraduate in a gender studies course who has just been introduced to these concepts wrote it. Which is fine—people gotta start somewhere. However, she’s posting this on Science-Based Medicine, once again using that forum as a platform to muddy the waters of sex, gender, and sexuality research. Perhaps if she wishes to continue speaking out on this topic, she should spend some time reading the literature in more depth.
Finally, I have to address her final two paragraphs because I feel that they are full of fallacious thinking and biological reductionism (despite her claiming in the third-to-last paragraph that culture and biology work in tandem!).
So what are we to do? Reject the very ideas of sex and gender and stop trying to classify people? Reject the dichotomy? Of course not! The binary classification is sufficient for most practical purposes and is very useful. In medicine, the knowledge that a patient is male or female helps to guide diagnosis and treatment. We know that men and women have different responses to medications and different incidences of various diseases.
It is enough to remember that male/female categories are arbitrary and not absolute. Science is not simple. We try to categorize, but nature is infinitely inventive.
So after all of that, Hall concludes with “but the binary is still a necessary evil.” Right. This brings everything in line with her assertion that minority identities are irrelevant and unimportant.
To answer the question of what do we do: Of course we reject the binary! If we are interested in the truth—as someone who writes for a blog called Science-Based Medicine should be—then we should reject those concepts that are clearly not in line with our best information. Just because the binary classification makes life easier for certain segments of the population does not mean it is the way things are. In medicine, the knowledge that a person is queer also helps guide diagnosis and treatment. The knowledge that a person is transgender also helps guide diagnosis and treatment. The thing is, working from the assumption that the binary is useful has the effect of making invisible people who do not fit the binary. I’m not just talking about social invisibility—let me put it in a context that this medico-reductivist thinking will better understand.
If a person comes into an emergency room and is for whatever reason unable to give intake information (assuming they do not try to hide any information because of stigmatization), if the physicians make assumptions about the person’s sex/gender based solely on appearance, this can have negative consequences because, as Hall admits, a person’s sex/gender can affect diagnosis and responses to treatment. In the interest of improving health outcomes, the idea of sex/gender as a binary opposition should be jettisoned as quickly as possible, as should the idea of a binary sexual orientation. If I seem a annoyed by this point, that’s because I am. This is an area I have done research in and am currently working to produce curricular recommendations to alter medical school curriculum to better address the needs of queer people.
So no, Dr. Hall. It is not enough to remember that the sex/gender binary is arbitrary and not absolute. That is enough for people who have the privilege of fitting into normative understandings of sex, gender, and sexuality. But it’s never enough for those of us who experience a constant barrage of stigma, prejudice, and discrimination because of who we are. And I’d appreciate it if you’d stop trying to convince us that our identities are unimportant and meaningless.
(H/T to audpicc for alerting me to Hall’s latest post.)
ETA (2/19/2013 @ 11:50 a.m. Eastern Time): Hall has responded to both of my posts here. As I am currently operating on very little sleep and have obligations today, I will not be able to address her concerns in any detail until later this afternoon. I’m not sure if I will do so in a post or in the comments on her post.