"I think most people think of it in binary terms -- that is, you're either one or the other," male or female, said Myron Genel, a professor emeritus of pediatrics at Yale University. "In reality, it's more of a continuum."
-- From "Which side are you on?" by David A. Fahrenthold, The Washington Post 10/20/09
"There's not one sign or unique parameter or marker . . . that clearly defines sex -- as in clearly separates, unequivocally, males from females," said Eric Vilain, a professor of human genetics at UCLA.
The signposts of a person's sex include the chromosomes, X and Y and others, that are the blueprints for sexual development. Hormones such as testosterone and estrogen are the chemical messages. There is sexual anatomy, built on those chemical orders.
And there is a psychological sense of identity -- which some scientists refer to as "gender," as opposed to "sex," which is everything physical.
But the signs don't always point in the same direction.
. . . conditions can set women's hormones and genetics at odds in the opposite way, making them appear unusually masculine despite their female XX chromosomes. And still others can create confusing markers of sex in men, leaving them with male anatomy and hormone levels but two or more X chromosomes.
In other cases, the cause of the disagreement is a sex-change procedure; in these circumstances, anatomy and chromosomes would no longer agree. The National Center for Transgender Equality estimates that 0.25 percent to 1 percent of the U.S. population has changed gender, or intends to in the future.
Together, cases such as these have led some researchers to believe it's impossible to find a universal boundary between male and female.
At the same time, courts and government agencies in the United States have been engaged in a parallel struggle to define gender, mostly driven by cases where people have changed their sex and want the government to recognize it.
In the D.C. suburbs, for instance, many authorities have decided on a simple test: Surgery makes the gender. In Maryland and Virginia, for instance, officials will alter the sex on a driver's license if presented with proof of sex-reassignment surgery. The District, by contrast, doesn't inquire about surgery: It requires that a medical provider or social worker attest that a person has a new "gender identity."
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