by Sylvia Sensiper
Current research suggests that our self-identification as either a man or a
woman may have as much to do with biology as it does to the way that we are
treated as infants and nurtured in our formative years.
How do you define your gender? Do you consider yourself feminine, masculine, or
somewhere in the middle? How do you think others see you? What are your earliest
memories of being aware that you were a boy or a girl? What if you found out
that you were living a life opposite from that for which you were biologically
A recent article in the journal Pediatrics (July 1998) presents the case of a
Canadian boy who was "re-assigned" a new gender and raised as a girl after a
circumcision accident. An operation at seven months removed the testicles and
the remainder of the penis, and the patient was also given female hormones to
develop breasts and other female traits. To this day, the subject continues to
live as a woman and describes herself as bisexual.
But other cases have not had such "happy endings." In a (much) earlier case
remarkably similar to the first one, a boy was reassigned as a girl at 17 months
of age. She, however, rejected her female identity at age 14 and began living
life as a male. Dr. William Reiner of Johns Hopkins Hospital commented about
this case, "Despite everyone telling him constantly that he was a girl, and
despite his being treated with female hormones, his brain knew he was a male. It
refused to take on what it was being told."
What happened in each of these cases? Why was one girl comfortable with her
assigned role and the other one not?
Formation of gender identity
The answer may lie in the way that gender identity is formed. Many experts
believe that gender identity is pliable. Some think that before the age of
approximately 18 months, babies do not self-identify as either boys or girls.
Others think that gender identity remains flexible until puberty.
These experts all claim that the biological differentiation that occurs during
these highly formative periods is not what shapes the behavioral characteristics
that our society thinks of as primarily female or male.
For example, the aggressive and rough physical play deemed typical of boys is
not a natural behavior, but a learned behavior. So too, the nurturing and
interpersonal play attributed to girls is something that they learn through
external and environmental cues, however subtle.
Within the debate about gender differences, theories of gender identity
formation appear to lie along a continuum. At one end are writers and
researchers who insist that gender identity emerges naturally as a part of
biological development. A mid-point view claims that gender identity is an
interaction between biological and cultural factors. At the other end of the
spectrum are those researchers who argue that the formation of a gender identity
is a cultural process of imitation and improvisation.
It is commonly believed that biological sex is determined at conception. The
sex chromosome in women is an "X", whereas the male can carry either an "X" or a
"Y." The combination of an "X" and a "Y" normally produces a male, and a
combination of two "X" chromosomes normally produces a female. But embryonic
sexual development is more than Xs and Ys. It is a complex process that begins
from a similar starting point and involves both physical and hormonal changes.
Until the sixth week of development, both XX and XY embryos are anatomically
identical. Both embryos have an 'indifferent gonad,' with the potential to
develop either male or female internal organs. After the sixth week, hormonal
influences induce the development of either male or female organs.
At puberty, the release of growth hormone in the pituitary gland creates complex
and very visible hormonal and physical sexual differentiation between males and
females. Males develop facial and body hair, deeper voices, and the enlargement
of the penis and scrotum. Females begin to develop breasts, body hair,
broadening hips, and the onset of menstruation.
These are the 'normal' parameters of biological sexual development. These are
the biological milestones that lead us to consciously and unconsciously
understand ourselves as male or female.
But it is the unusual situations-ones in which development has gone awry--that
have given researchers the richest data on gender identity formation. For
example, an infant with the genetically inherited disease called andrenogenital
syndrome (AGS) exhibits what appears to be normal male genitalia, but has two X
chromosomes, ovaries and oviducts. In another abnormal situation, an XY baby is
born with ambiguous female genitalia as well as internal male organs that
develop further at puberty. These abnormal cases are estimated to occur in
1/1000 live births.
Researchers that have followed these and other children with atypical sexual
development through life have developed theories to account for these anomalies
and show how elastic the process of gender differentiation really is.
The interaction of biology and culture
John Money, a medical psychologist and professor of pediatrics at Johns
Hopkins University, has developed a theory that takes into account both genetics
and the environment. According to Money, any given embryo has a "genetic
program" based on the set of chromosomes it carries, either XX or XY. However,
this program can be affected hormonally during the prenatal stage by any one of
a variety of factors - a loss or gain of a chromosome, an excess or deficiency
of maternal hormone, or a nutrition deficiency. After birth, he feels gender
development occurs more through cues and behaviors in the environment, offered
predominantly through the infant's primary caregivers, and less through
Money developed his theory through his extensive work with hermaphrodites, who
have both ovarian and testicular tissue. Their complex personal histories often
include a re-assignment of sex from that which was assumed at birth. For this
reason, Money and his team have encouraged the parents of children with
ambiguous genitalia (intersex children) to have the child undergo sexual
remodeling and to raise the child accordingly.
Money hypothesizes that sexual identity is like language -- easily acquired, but
only in a critical "window" during early childhood. He has modeled his surgical
procedures on that theory. His research indicates that gender re-assignments, in
which physical features are changed with the help of surgery and parental
rearing practices, can occur with some ease until age three. It is difficult
after that age, because by that time children have come to think of themselves
as either permanently male or permanently female.
Another view on the matter, however, has been developed by Dr. Julianne
Imperato-McGinley and her colleagues.
Their research focused on female children in three rural villages in Santo
Domingo, all of which seem to produce an unusual number of intersex children.
Although raised as girls, the children developed typical male characteristics at
puberty. Their voices deepened and they developed adult-sized penises and
scrotum. Sixteen out of the eighteen children studied then assumed a male gender
role, married, and fathered children. Imperato-McGinley feels that in the
absence of sociocultural factors that could interrupt the natural sequence of
events, the effect of testosterone predominates the selection of gender
identity, overriding the effect of being reared as girls.
Imperato-McGuinley disputes Money's theory. She claims that gender identity "is
not unalterably fixed in childhood, but rather is continually evolving."
Gender as performative
On the far end of the spectrum is Judith Butler. She believes that the
formation of gender identity is a combination of historic, psychoanalytic, and
anthropologic concepts. She claims that gender identity is performative--a kind
of improvisational theater where identities can be adopted and explored. Her
theory takes the physical body into account, but is not constrained by it. Her
theories are a way of opening up our traditional categories of female and male
to multiple possibilities of human being.
Many popular ideas have been built around the idea of gender difference. The
opposite sex is categorized as "alien" or from another planet. But as Anne
Fausto-Sterling points out in her book "Myths of Gender," an account of female
and male development "might just as easily highlight their similarities, their
identical starting points, and minor divergences."
Origins of gender identity and its formation is a complex and highly charged
subject. The debate is ongoing, because it touches on some of our most powerful
human emotions and experiences. But it is unfair to present the debate without
asking one more, very difficult question: when it is in question, do kids have
the right to make their own decisions about their very own sexual identity?