Sex and Gender

Question 1

Define sex. How many sexes are there ?

Answer 1

“Sex” refers to the biological status of a person as male or female in their physical development. Sex is judged on a) the genital appearance at birth but also b) internal reproductive organs, skeletal characteristics and musculature (which are also sex differentiated).

Traditionally, only two:

• Male
• Female

Question 2

How many sexes should there be according to feminist biologist Fausto-Sterling ?

Answer 2

• Replace our two-sex system with five sexes 1. Males

2. Females
3. Herms (“true”hermaphrodites), have testes and ovary
4. Merms male“pseudohermaphrodites”), have testes and some aspect female genitalia but no ovaries
5. Ferms (female“pseudohermaphrodites”), have ovaries and some aspect of male genitalia but no testes

Question 3

How is someone’s legal sex determined ? Give an example in which this is different from their biological sex. How does gender relate to this ?

Answer 3

A person’s “legal sex” is determined by their birth certificate, sex which medical authorities assign a person.

Someone can be given legal sex of female but for this to have been achieved through a surgical procedure, so biologically male, and this may result in dysphoria with sex which they have been assigned.

Assumption is made that the gender status (boy, girl), aligns with legal sex.

Question 4

Define gender.

Answer 4

Gender refers to the cultural rather than biological differences between men and women.

• Three related aspects:
1. a society’s constructed gender roles, norms and
behaviours, e.g. masculinity and femininity
2. gender identity, a person’s internal perception or self-
conception of their gender
3. gender presentation/expression, the way a person lives in society and interacts with others, e.g. clothing, enactment

Question 5

How many “genders” are there?

Answer 5

A lot

Question 6

Define Masculinity and femininity.

Answer 6

Social identities constructed by cultures to organize social environments; classify and control human behavior, define men and women as acceptable social beings

Concepts vary between cultures but serve the same function:
• Define
• Understand
• Evaluate men and women

BUT gender does not necessarily represent a simple binary choice

Question 7

The term masculine and feminine refer to a person’s ?

Answer 7

Gender

Question 8

Give an example of a gender stereotype.

Answer 8

Women tend to be overly emotional, while men tend to be level-headed.

Question 9

Define socio-biology.

Answer 9

The genetic basis of social behaviour

Question 10

Describe the socio-biological view on gender.

Answer 10

Rather than gender roles, norms and behaviours being constructed by society, socio-biology maintains that gender is fixed by biological reproduction:

1. Men driven by psychological and physiological urges ingrained in the “caveman” era
2. Women’s domestic labour, nurturing behaviors, attention to beauty genetically predetermined

• Sociobiological theories of gender “now exist in popular culture as an insidious common sense subtext”

Question 11

Describe any views opposing the socio-biological view that gender is fixed by biological reproduction.

Answer 11

View that gender is as much the product of socialization as biology:
“Maternal bonding”, “maternal instinct”: produced and enabled by the expectation of infant/child survival; deferred in many cultures
• “Sex drive”: cross-country variations in extent of male-female differences in “sex drive”: evidence of biology, or of common cross- cultural threads in constructions of femininity and masculinity? Cross-country variations in “socio-sexuality” closely correspond with indices of gender equality and development (which hints that these differences are not biological)

Question 12

Give an example of a phenomenon in which gender plays an important role.

Answer 12

Pregnancy and birth, as social and cultural (there, the gender roles is not so much biological as it is social),

• Couvade (couvade refers to a practice wherein birthing woman is in the main part of hut whilst her partner is lying in rafters. She’s pulling on ropes attached to his testicles so that every time she hurts she pulls and he hurts too, co-gendering of giving birth)
• Neo-couvade (in Western world, idea that there is a larger emphasis on co-gendering of giving birth since the dad is expected to attend, support the wife etc.)
• Dad cutting the cord (new ritual involvement of male in birthing process)

Once again, cross-country variations suggests it is social and cultural more than biological.

Question 13

Give specific examples of instances in life which support the theory that gender identify is socially produced.

Answer 13

• Gendered parenting begins at ultrasound
• Colour-coded clothing
• Nursery décor
• Toys
• Games
• Styles of walking
• Expression of emotions

Question 14

Define transgender. What are the main kinds of transgender?

Answer 14

• Transgender: umbrella term for people whose gender identity and gender expression differs from the sex assigned at birth. Includes:

1. Transmen: assigned female at birth but identifies as a woman (or towards the feminine end of the gender spectrum)
2. Transwomen: assigned male at birth but identifies as a man (or towards the masculine end of the gender spectrum)
3. Non-binary people

Question 15

Define gender non-binary. Identify examples.

Answer 15

• Non-binary refers to a person who has a gender identity which is in between or beyond the two categories ‘man’ and ‘woman’; fluctuates between ‘man’ and ‘woman’; or who has no gender; either permanently or some of the time. For example:

1. Genderfluid: have gender identities that fluctuate
2. Bigender/pangender: they may identify as having more than one gender depending on the context
3. A-gender/non-gendered: feel that they have no gender
4. Third gender/genderqueer: they may identify gender differently

Question 16

Describe any legal campaigns about gender.

Answer 16

• Growing campaign from transgender groups in the UK for a third sex option in birth certificates and passports, as in Australia, New Zealand, Denmark, Germany, India, Nepal, Pakistan and Bangladesh,
• Responds to hijra campaigning (India), trans and non-specific gender

Question 17

Is transsexualism psychiatric, or somatic ?

Answer 17

• Von Krafft-Ebing’s (1894) The Psychopathia Sexualis described ‘contrary inverted sexual feelings’ and ‘gynandry’
• Stoller (1968, 1975) first distinguished ‘transsexualism’ from homosexuality and transvestism; proposed ‘transsexualism’ to be the product of ‘unconscious’ rearing of the child in the opposite sex: ‘too much mother made possible by too little father’
• Subsequently, most authorities consider aaetiology to consist of parental ‘deviations’ from ‘normal’ femininity and masculinity
• ‘Transsexualism’ now recognized as ‘gender dysphoria’ or ‘gender identity disorder’ – a psychiatric condition

Medical model of psychiatric aetiology is controversial – perceived by some to be outdated and discriminatory and equivalent to a ‘diagnosing’ homosexuality or medical models of disability
INDEED, ALTHOUGH medical framework premised on seeing ‘gender dysphoria’ as mental illness, some research suggests possible somatic/’biological’ underpinnings e.g. transmen having female patterns in a normally sexually dimorphic part of the brain.

Question 18

Define gender dysphoria.

Answer 18

‘Gender dysphoria’, ‘gender identity disorder’

1. A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex)
2. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex
3. The disturbance is not concurrent with a physical intersex condition
4. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Question 19

Define transitioning.

Answer 19

process of changing from one gender to another, with or without medical intervention

Question 20

Define gender/sex reassignment.

Answer 20

Process undertaken under medical supervision to change one’s physical sexual characteristics. Includes:
• Telling family, friends, colleagues
• Changing one’s name and/or sex on legal documents
• Hormone therapy
• Hair removal
• Voice therapy and possibly (although not always)
• Chest and/or genital surgery

Question 21

Which of sex or gender reassignment is more suitable ?

Answer 21

Gender is what you identify as

Reassignment is bringing you in line, with what you identified with all the time, so sex being reassigned (biological aspects and legal sex brought in line).

Question 22

Describe the medico-legal process of reassignment.

Answer 22

• Visit to GP, referral to psychiatrist
• Detailed psychiatric inquiry into gender development in childhood
and puberty; current life circumstances and stability
• Diagnosis of gender dysphoria allows referral to gender identity clinic for consideration of alternatives to gender/sex reassignment, range of options and their implications
• Real-life experience/test: period of living out the gender with which identify before start hormone therapy or surgery (3m according to international medical standards, 1 year for genital surgery)

Question 23

Define acquired gender.

Answer 23

The new gender of a person who has transitioned and had their gender reassigned and/or legally recognised

Question 24

What is the end point of transitioning ?

Answer 24

• Gender Recognition Certificate: issued under the Gender Recognition Act 2004 by the gender recognition panel. The holder of a full GRC is legally recognised in his or her acquired gender for all purposes, legal and social. Issued provided that the applicant can prove they:
• Have, or have had, gender dysphoria
• Have lived in their acquired gender for two years prior to the application, and
• Intends to live permanently in their acquired gender

Question 25

Define gender essentialism.

Answer 25

Gender essentialism is the widely discredited idea that men and women act differently and have different options in life because of intrinsic or essential differences between them. In other words, it is the idea that men and women are fundamentally different for reasons that are unchangeable.

Question 26

Identify real life examples which go against gender essentialism.

Answer 26

• Oregon in US, 2014: world’s first transman gives birth to baby
• UK, 2018: baby could become first baby without a legal mother

Question 27

Identify GMC outcomes associated with gender.

Answer 27

• Sociology, social epidemiology, public health: sex and gender as social determinants of health; gendered health inequalities and inequities
• Diversity, equalities and inclusion: respect for all patients; recognise the rights and the equal value of all people and how opportunities for some people may be restricted by others’ perceptions