As a transgender woman that teaches and writes about the philosophy of gender, I find it frustrating that certain arguments persist concerning transgender people. One of these is that gender is determined entirely by biology and that the biology is simple: you are born a male or female, exclusively and exhaustively. According to this perspective, the transgender community ignores biology, believing wrongly that gender is independent of biology. The latter is often called “gender ideology”, as if all trans persons have the same perspective about the nature of gender.
As an expert in this field (both personally and academically), I can confidently say that this argument is flawed in several ways. To begin, people in the transgender community disagree about the nature of gender and what it means to be transgender. Some argue that being trans is reducible to having a mental health condition called “gender dysphoria” (as described in the DSM-5) and that this is caused by the sexual differentiation that happens in the brain. There are studies that suggest that a part of the brain near the hypothalamus called the “bed nucleus of the stria terminalis” (abbreviated “BSTc”) in transgender women matches non-transgender women and similarly for transgender men. So, for these folks, gender is determined by biology of the brain, but not by karyotype or genital appearance. This view about being transgender is shared by a significant number of the scientific experts. This is sometimes called “transmedicalism”. Clearly, this view does not ignore the biology.
Others in the transgender community disagree with the equation of being trans with gender dysphoria and downplay or dismiss the importance of the above studies. And to be sure, some trans individuals do not have significant gender dysphoria. Many transgender individuals believe that gender is merely a social construct. This is an idea that goes back to mid 20th century feminism, when Simone de Beauvoir proclaimed that “one is not born a woman” in her groundbreaking book The Second Sex. The idea that gender is a social construct has been defended by the majority of feminist writers.
The debate between the so-called transmedicalists and the social constructivists continues to this day. My view that is that they are both partially correct. Gender is a social construct to some degree. Certainly there is nothing about biology that entails that women wear high heels and men do not. We have many expectations about gender that obviously have nothing to do with biology. But I also believe that the biology is relevant and cannot be ignored if we are to understand being transgender and, indeed, gender itself. Gender dysphoria (GD) involves an intense discomfort regarding the sexual characteristics of one’s body. For the trans individuals that suffer from GD, it does not subside through therapeutic efforts to make them comfortable with their bodies as they are. By contrast, hormone replacement therapy combined with affirmative therapy is quite successful. The studies mentioned above suggest an explanation for this.
We all know that sex hormones change our bodies in various ways. But most don’t understand how complex this sexual differentiation is. Everyone has androgens and estrogens but they have these hormones in varying degrees. On average, men have rather more testosterone and less estrogen than women and vice versa for estrogen. But it’s all a matter of degree. And how these affect the body varies significantly. In fact, sexual differentiation happens at various times during fetal development and through someone’s life, including in one’s later years (for example, in menopause). This process of sexual differentiation affects one’s genitals, body hair, fat distribution, breast development, skin thickness, muscle development, bone structure, overall growth rates, and even the development of the brain. Some believe––as I do––that hormones even affects how one responds emotionally.
However, the really surprising fact is that many of these processes don’t go in the same direction on the masculinizing to feminizing scale. So, for example, some women will have genitalia that are identified as female and yet also have very narrow hips that are tilted more like a typical male. Many female runners manifest this ambiguity. Even one’s karyotypes (i.e., XX and XY) don’t always determine how sexual differentiation will proceed. Moreover, XX and XY aren’t even the only possible karyotypes. For example, some men have XXY and have an ovum as well as a testicle. They often don’t find out about this until trying to have children later in life. Furthermore, some women (as assigned by birth) actually have an XY karyotype but due to a condition called androgen insensitivity syndrome their bodies do not respond to androgens. They usually discover this around the time of puberty (since they do not menstruate) but the majority of them continue to identify as women. And, of course, many infants are born with ambiguous genitalia which are not easily identified as either female or male. More surprisingly, there are even some that are born with female genitalia that turn into male genitalia at puberty. We call these conditions intersex and it is as common as having red hair. So, the biology of sexual differentiation is rather complex. As feminist philosopher of science, Cordelia Fine, has put it in her book Delusions of Gender, sexual differentiation is not binary but rather like a mosaic.
Given this, it is no surprise that in some people the sexual characteristics of their bodies do not end up matching the sexual differentiation of the BSTc. And this would explain gender dysphoria. If the BSTc has something to do with how one’s consciousness of one’s sex/gender then if it doesn’t match the body, we would expect feelings of discomfort. In suggesting this explanation (which is accepted by many scientists), I don’t mean to erase trans individuals that do not experience this kind of gender dysphoria. I’m not a transmedicalist. But I do believe that we must take biology into account when we are thinking about the nature of gender. There are biological differences between men and women and these account for why we take our social constructs of these ideas to be natural. But as humans are wont to do, we oversimplify and recoil in disgust when we are presented with something that undermines our simplistic view of the world. This is the case with anti-trans podcasters such as Matt Walsh and journalists such as Jennifer Graham. To be frank, they are right to think that biology matters, but wrong to think that they understand biology. Their ignorance is the real reason that they recoil from the growing acceptance of transgender people. It’s time to really pay attention to the biology and when we do we will find that transgender and intersex individuals are just part of the remarkable diversity that nature has produced.
Kelli D. Potter is an American philosopher and associate professor of philosophy at Utah Valley University. Her areas of expertise include: philosophy of religion, Mormon studies, philosophy of gender, and philosophy of logic. Potter was a foundig board member of the Society for Mormon Philosophy and Theology, serving from 2000-2002. She also served on the editorial board of Dialogue: A Journal of Mormon Thought from 1999-2003. As a trans woman, Potter has addressed injustices and theology related to the transgender community and the Church of Jesus Christ of Latter-day Saints in her writing.
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