Between+XX+and+XY:+Intersexuality+and+the+myth+of+two+sexes

Usually each of us has a total of forty six

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Unformatted text preview: s of sex disposed of them as quickly and as easily as it had blinded other human eyes. Sex in the Genes By the twentieth century, geneticists stepped forward to offer their help. It seemed to many that here, at last, was the answer—a candle to crack A Brief History of Sex 29 the dark. Karyotyping is an assessment of all of a person’s chromosomes, a measure of each of the wormy curls that wrap themselves inside the nucleus of every one of our cells. A karyotype requires only a few cells and the force to drive these cells into a state called “metaphase,” where all the chromosomes become visible. A simple black and white photograph records everything for analysis. After that, all that is needed is a pair of sharp scissors and a person of great patience to cut out each of the little squiggles from the chromosomal picture and match them up with one another. Usually, each of us has a total of forty-six chromosomes: twentytwo matched pairs, and two sex chromosomes that may or may not be matched. According to karyotypers, boys are 46,XY and girls are 46,XX—meaning “normal” girls have forty-six chromosomes including two X chromosomes, and “normal” boys have forty-six chromosomes including one X and one Y chromosome. At first karyotyping seemed to have finally laid all ambiguity to rest. But pretty quickly we discovered that whole classes of people have more or fewer than forty-six chromosomes, often including unusual numbers of sex chromosomes. Even the geneticists had to admit that their central dogma, at least in its simplest form, had flaws. At the very least, though, it still seemed the basic tenet was true. It might be that a few folks had abnormal numbers of chromosomes, but if you had the requisite number plus an X and a Y you grew up to be a man. And if you had a set of forty-six that included two X chromosomes, you grew up to be a woman. But even as karyotyping took hold in the late 1950s, both old and new studies came to light that cast some doubt on the absolutism of the genetics of sex. The first of these was a rediscovered study from 1945 that examined the lives of eighty-four hermaphrodites. These researchers concluded that “the hermaphrodite assumes a heterosexual libido and sex role that accords primarily with his or her masculine or physical upbringing,” not his or her chromosomes.21 A slight tremor rippled the ground beneath the geneticists’ feet. The second was a study of intersex patients conducted in 1955 at Johns Hopkins Hospital in Baltimore, Maryland.22 This classic study 30 Between XX and XY further supported the earlier findings that “the gender assignment in infancy will be the one the patient stays with into adulthood, regardless of the standard biological indicators of sex.” This meant that, to these researchers, it appeared that people tended to end up being what other people told them to be, not what their chromosomes predicted they should be. That fractured a lot of paradigms about childhood development. The group at Johns Hopkins, as well as many others, dropped the “true sex” policy (such as XX or XY) and adopted the “optimal gender” policy for assigning sex to sexually ambiguous children.23 According to this policy, proposed by Dr. John Money and his colleagues at Johns Hopkins, “the assignment or reassignment of gender should be based on the expected optimal outcome in terms of psychosexual, reproductive, and overall psychologic/psychiatric functioning.”24 Translated, that meant that it was up to the pediatricians, endocrinologists, plastic surgeons, and parents—not chromosomes, gonads, or the vagaries of biology—to determine the sex of the child. Furthermore, this protocol suggested surgery as early as possible to quickly unify physical appearance and the gender expectations of all involved. Though many of these ideas have since been discredited, they took hold like grappling hooks in the medical community of the time. If a baby’s sex wasn’t obvious, as soon as possible those involved told the parents (if they wished to involve the parents at all) what sex would be best for their child. Then all moved quickly to create a physical reality for the child that is consistent with the chosen gender. The nature of sex had lost its prominence; in its place, the “optimal gender” policy raised up the force of nurture—the reality of sex by reason and design, sex by environment. To this point, no one had considered the child’s nervous system to be of any consequence in human sexual development. In infants especially, the mind and brain were thought to be of no consequence, but that perception was about to change. At the time, most people thought that at birth, and for the first few years afterward, the child was a blank slate. Masculine or feminine characteristics and perceptions could be pushed in either direction simply by manipulating the social, biologi- A Brief History of Sex 31 cal, and psychological fabric of a child’s life. Like a neuter ball of clay, the...
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