Monday, 22 October 2018

Anatomy Does Not Determine Gender

Determine Gender

Anatomy Does Not Determine Gender, Experts Say

Defining gender as a condition determined strictly by a person’s genitals are predicated on the notion that doctors and scientists abandoned way back as oversimplified and sometimes medically meaningless.

Researchers who have studied gender issues and provided health care to people that do not fit the standard M/F pigeonholes said that the Trump administration’s latest decision to define gender goes beyond the bounds of the knowledge domain.

“The concept a person’s sex is decided by their anatomy at birth isn't true, and we’ve known that it’s not true for many years,” said Dr. Joshua D. Safer, an endocrinologist, and executive of the middle for Transgender Medicine and Surgery at Mount Sinai Health System in New York.

He is also president of the us Professional Association of Transgender Health.

But exactly what does determine identity — a person’s powerful, core knowledge of who they're — isn't so clear.

“We know that there's a big, durable biological underpinning to identity,” Dr. Safer said.

“What we don’t know are all of the biological factors at play that specify gender identity.

As far as we within the mainstream biological-medical community understand it in 2018, it's hard-wired, it's biological, it's not entirely hormonal, and we do not have identified genes, so we cannot specifically say it's genetic.”

Are genes a factor?

Genetics does play a role, though. In studies of twins, if one is transgender, the opposite is far more likely to even be transgender if they're identical, instead of fraternal twins.

Identical twins are near matches, genetically; fraternal ones aren't. The findings are similar for twins who have Type 1 diabetes, which is understood to possess a robust genetic component.

The Trump administration’s proposal, outlined during a memo by the Health and Human Services Department would establish a legal definition of sex under Title IX, the federal civil rights law that bans gender discrimination in education schemes that receive government financial assistance.

The change would eliminate protections afforded transgender people under the Obama administration.

The agency’s proposed definition would be determined by the genitals that an individual is born with, consistent with a draft reviewed by The NY Times.

Whatever is on the birth certificate defines gender, “unless rebutted by reliable genetic evidence,” consistent with the memo.

But what would constitute reliable evidence? It may be hard to find.

“We don’t know genes for everything that we’ve identified medically,” Dr. Safer said.

“We just don’t have such a sophisticated understanding of the many medical processes, not even
about sex.

” How to define identity Researchers say identity comes from the brain, not the body.

Some put it more bluntly: It originates between your ears, not between your legs.

But the forces that acted on the brain to shape that identity aren't understood, and physical or chemical differences within the brain that may relate to gender haven't been well defined.

No one knows needless to say why body and mind sometimes don't match. But being transgender is not a matter of choice, Dr. Safer said. It is not a fad or a whim.

For transgender people, it's generally an awesome sense that their gender isn't the one on their birth certificate.

And gender isn't about whom they’re interested in — it’s about who they are.

Distress over the mind-body mismatch can become especially intense around puberty and the risk of suicide shoots up for children during this situation.

Mainstream medicine has begun to acknowledge how serious a problem it is: Last month, the American Academy of Pediatrics issued its first-ever policy statement regarding look after transgender children and adolescents, and people who are “gender-diverse,” or non-binary, meaning they're neither clearly male nor female.

The pediatric statement urged a “gender-affirming approach,” which translates as respecting and supporting children, even young ones, in “their self-expressed identity.”

The society also noted that transgender children “have high rates of depression, anxiety, eating disorders, substance use, self-harm and suicide.”

Last year, the Endocrine Society — the professional group for experts within the glands and organs that produce hormones — issued guidelines for treating transgender people.

They said identity was biologically based and urged federal and personal insurers to cover medical needs associated with it for transgender people.

It’s not as simple as X and Y Apart from transgender issues, other conditions make it clear that defining male and female is not so simple.

For instance, there are people with XY chromosomes — which makes them genetically male — who look, act and desire women because their bodies cannot react to male hormones.

In other cases, some women with a condition that exposed they too high levels of testosterone before birth identify as male — but more with an equivalent condition do not.

Some of the foremost compelling evidence for the thought of identity is hard-wired into the brain comes from medical reports on people that were born within the 1950s and The 1960s with birth defects involving their genitals.

Doctors thought the humane solution, to spare such children from being ostracized were to perform surgery to form one sex or the other.

Since it's easier for surgeons to form a vagina than a penis, most of those babies were made female.

Their parents were advised to boost them as girls and never to inform them about their condition at birth. The general belief was that their upbringing — a triumph of nurture over nature — would make them truly female.

The idea was a failure. As they matured, many had a transparent sense that they were male.

According to a study of 16 of them, quite half aroused identifying as male.

“Considering the fact that you can brainwash some people about just about anything, failing with so many is catastrophic,” Dr. Safer said in an email.

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