Alice Dreger’s Middle Finger: Sex, Gender and Unhelpful Hair-Splitting

Is there a more controversial issue in the western upper middle class right now than the intersection of gender and sex? But partial conflation between what sex is and what gender is only part of the reason that so much people are talking past one another on these issues. Perhaps there are only two sexes—but there is more than one definition of sex.

Alice Dreger’s Middle Finger

What has prompted me to write this is a series of Twitter storms over Alice Dreger having the gall to say:

People. There are more than two sexes. There are more than two genders. This is not a political statement. It's just reality.

— Alice Dreger (@AliceDreger) November 18, 2018

Dreger has spent the majority of her career protecting the rights of intersex individuals. Her early work as a scientist-activist helped turn the tide on the policy of sex reassignment at birth through corrective surgery (which she opposed, arguing that the later complications resulting from such reassignment are far worse than leaving a person as is). The medical community has since converged on her position. Lately, Dreger has stirred up further controversy through her research on Ray Blanchard’s transsexualism typology, which classifies two types of male-to-female transsexuals: homosexual transsexuals, who alter their appearance to attract men, and autogynephilic transsexuals, who alter their appearance because the thought of being a woman turns them on.

Dreger’s book Galileo’s Middle Finger covers all the background to this and to her career in general. I recommend anyone who isn’t aware of these issues to check it out. Alice is fair-handed in her discussion, and—unlike most people who oppose her—she has a proven track record of putting her career on the line for the rights of people who are being abused in the name of faulty science. If you are wondering how a scientist could become both hated and loved by people on both sides of a debate, take a look at her career trajectory.

Alice’s tweet was presumably prompted by ongoing discussions about whether the US Department of Health and Human Services can determine a person’s sex based on the genitals that person is born with. This is a rather straightforward issue if sex is binary, but intersex individuals, whose outward appearance does not fall within the traditional binary, really can’t be classified by their genitals. People born intersex can have a male penis but produce eggs; they can also have a vagina but have gonads which produce sperm. How do you classify these people by sex?

Enter the Categorical Fatalists

Since the Health and Human Services proposal came out, a number of popular articles in publications from Slate to the New York Times have seemingly come out against the notion of binary sex entirely. These pieces, highlighting the lives and biology of intersex people, claim that sex as a binary is not a biological principle. They are right, in that biological sex is difficult to determine in humans, but wrong, in denying sex as a binary biological principle. The lack of nuance in some of these thought pieces displays either a complete ignorance of the biological literature or a purposeful obfuscation of what sex is.

What Is Sex?

Unless you are a unicellular organism, sex is binary. You are either a male, a female or a pseudo-hermaphrodite with both male and female sex cells (true hermaphroditism, which involves two sets of functioning gonads, has never been observed in humans).

Sex is determined by which gametes an individual produces. The principle of anisogamy dictates that nearly all sexually reproducing organisms produce one of two types of sex cells: large gametes or small ones. There are multiple theories as to why this binary exists, but its universal presence amid all multicellular organisms (save some species of algae) suggests a strong selection for this principle among sexually reproducing organisms.

But this is not what Dreger is talking about.

Everyone has been quick to jump on Dreger because she has further stated that defining sex by any single term is both political and impractical. Such incredulousness has been expressed at this statement that Dreger has been exiled from the pantheon of heterodox, reality-acknowledging scientists (she recently won Heterodox Academy’s first Open Mind Award) and lumped in with the postmodernists.

This is just postmodern category scepticism. Defining sex in terms of our best biological theories is as practical as it gets. I choose a truth respecting politics. https://t.co/cYYPF4DxFP

— Gary Edwards🍶 (@GEdwardsTwit) November 19, 2018

To think that Dreger was denying the principle of anisogamy is a misunderstanding. Furthermore, to call her a categorical skeptic is nonsense. She is talking about things which are inherently political because they are the objects of policy decisions. In order to make a policy decision about sex, you have to determine which type of sex you’re talking about.

Sex and Gender and Sex Again

Dreger’s argument is not based on categorical skepticism, but full-blown scientific processualism. Processual thinkers use categories in a strictly pragmatic way, while categorical fatalists are far less processual than they make themselves out to be. People either tend to think in categories or they do not. In the programming world this is expressed through the analogy of mappers and packers. Mappers are able to use new information to update their conceptual frameworks, in order to map the overall layout of the structure of information. Packers, on the other hand, fear information loss and attempt to reinforce, rather than restructure, their conceptual frameworks.

This divide can be seen in the science of human population differences as they manifest through race. Race operates as a rather inconsequential, but useful, conceptual scaffold for processual folks like David Reich (who studies gene flow) and Jerry Coyne (who studies speciation processes), while a vast number of non-processual anthropologists pontificate in their ANTH 101 courses on the myth of race without ever acknowledging what it is that concepts of race really stand for (inconsequential conceptual scaffolds reflecting nested human population differences). We anthropologists don’t tend to be quantitatively minded: this is why we think categorically. In an attempt to be more processual, we become categorical fatalists—not realizing that we usually lack a processual framework to describe what’s really going on. But it’s not only anthropologists who think like this.

This type of thinking is present to a large extent in Debra Soh’s critique of gender concepts. Soh, who is by definition a categorical fatalist because she wishes to collapse gender into sex, believes that there are only two genders. I am not going to try and claim that this is a simple conceptual misunderstanding between sex and gender on her part because her argument—published in Playboy—was that our conceptualization of gender is a purposeful obfuscation of sex. This is where Soh’s lack of processualism is obvious because gender is not and was never meant to be a biological fact. Like the concept of an occupation, gender is one of Durkheim’s classic social facts, which “cannot be confused with organic phenomena, nor with physical phenomena, which have no existence save in and through the individual consciousness.”

As a social fact, gender is an attempt to account for at least four overall factors in human classification:

1. Sex
2. Sexual orientation
3. Genital variation
4. Outward behavior

Since cultural shortcuts lead to common classifications of observable things (these classifications are by definition pragmatic), societies around the world use gender in various ways, to explain variation around these typically bi-modal, biologically coded phenomena. In most cultures, gender is a tool for understanding variation that is difficult to fit into the innate bimodal variation of natural sex. I might agree with Soh that such conceptualization is rather unnecessary if we universally acknowledge variation in the top four factors (in which case we can just rely on a trimodal sex classification). This does not mean that non-binary gender is not real.

Gender is often used as a conceptual shortcut. For example, in many societies, gender is used as a proxy in order to remove homosexuality as a concept because, to those societies, homosexuality is abhorrent, intersex people are born wrong and sissy boys don’t get to be seen as men. According to this view, homosexuals do not exist in Iran because they automatically receive gender reassignment surgery. The kathoey or ladyboy phenomenon in Thailand is likewise a result of perceptions about homosexuals: the Thai terms for gay and transsexual are the same. As in Blanchard’s typology, this definition means that homosexual males in Thailand find it easier to live in society by presenting as women to their families.

There is nothing intrinsically freeing about gender fluidity, because it is often itself a constraint imposed by a culture in order to put people into its own categorical boxes. But gender is a social fact—and not always an oppressive one. We need a term to describe the variation around this social fact, which differs across cultures.

In the debate about which sex terms to use, I would class Dreger as a processualist—and those who claim that she is a categorical fatalist as the true categoricalists. Dreger is not referring to anisogamic sex. She is also not referring to gender. She is referring to the outward appearance of a person’s genitalia, the mismatch between these outward appearances and inner gonads, and the undeniable variation which exists around these things. What is the term we use for this rather different thing? It’s also sex.

This conceptualization of sex is totally different from a discussion of gametes and homosexual transsexuals. Dreger’s statement is valid. To have to choose between definitions is political, and to pick based on anisogamy is impractical. This is not a case of categorical skepticism. There is a higher order non-scientific issue at stake here: which concept of sex do we use if two different things are both sex?

You can believe that the principle of anisogamy dictates that there are only two biological sexes, you can have a rather fluid concept of the gender spectrum, and you can also believe that there are more than two sexes. To fail to acknowledge this is to split hairs, which is not helpful.