Challenging the binary: Gender/sex and the bio‐logics of normalcy

Abstract

Background We are witnessing renewed debates regarding definitions and boundaries of human gender/sex, where lines of genetics, gonadal hormones, and secondary sex characteristics are drawn to defend strict binary categorizations, with attendant implications for the acceptability and limits of gender identity and diversity. Aims Many argue for the need to recognize the entanglement of gender/sex in humans and the myriad ways that gender experience becomes biology; translating this theory into practice in human biology research is essential. Biological anthropology is well poised to contribute to these societal conversations and debates. To do this effectively, a reconsideration of our own conceptions of gender/sex, gender identity, and sexuality is necessary. Methods In this article, we discuss biological variation associated with gender/sex and propose ways forward to ensure we are engaging with gender/sex diversity. We base our analysis in the concept of “biological normalcy,” which allows consideration of the relationships between statistical distributions and normative views. We address the problematic reliance on binary categories, the utilization of group means to represent typical biologies, and document ways in which binary norms reinforce stigma and inequality regarding gender/sex, gender identity, and sexuality. Discussion and Conclusions We conclude with guidelines and methodological suggestions for how to engage gender/sex and gender identity in research. Our goal is to contribute a framework that all human biologists can use, not just those who work with gender or sexually diverse populations. We hope that in bringing this perspective to bear in human biology, that novel ideas and applications will emerge from within our own discipline.

Why “sex as a biological variable” conflicts with precision medicine initiatives

“…In some cases, such as karyotype, sex may be well understood as a categorical variable, whereas in other contexts, such as measuring gonadal hormone levels, it may vary continuously. 14 Furthermore, some sex-associated traits, such as hormone levels, vary over the life of an individual, and are highly mutable, as for instance by exogenous supplementation, diet, and social roles. 14 Sex contextualism recognizes that male-female comparisons, in many cases, are insufficient or unnecessary to detect sex-related variation, and that findings of sex differences in one context may not be generalizable to another.…”

“… 14 Furthermore, some sex-associated traits, such as hormone levels, vary over the life of an individual, and are highly mutable, as for instance by exogenous supplementation, diet, and social roles. 14 Sex contextualism recognizes that male-female comparisons, in many cases, are insufficient or unnecessary to detect sex-related variation, and that findings of sex differences in one context may not be generalizable to another. On this view, sex-related variables are not omnirelevant, but emerge as relevant or not within the context of a research program or other pragmatic aim.…”

“…As biocultural anthropologist L. Zachary DuBois and evolutionary biologist Heather Shattuck-Heidorn write, “there are unnecessary and potentially inaccurate linkages made when binary categories of sex are exclusively drawn on to interpret sex-associated biology…. When used in this way, the categories themselves are interpreted as proxy for pathways and thus biological differences are concluded to be “sex-based,” as opposed to driven by some other mechanism.” 14 A contextualist approach avoids begging the question of the relationship between biological variables and “sex-associated” outcomes, which may actively mislead researchers in pursuit of sex-specific prevention and treatment interventions.…”

“…Taking seriously the social consequences of sex-based classification, such as the stigmatization of allegedly “abnormal” testosterone levels that depart from binarized expected values, also means that the “inclusion” of sex in biomedicine carries more ambivalent ethical weight than advocates allow. 14 As scientific journals begin to adopt publication guidelines informed by science funding mandates, a contextualist approach can help researchers evaluate both the pursuitworthiness and the epistemic merits of sex-based biology in ways that better capture the material, epistemological, and social complexities of rigorous scientific practice, and which vary appropriately across research contexts.…”

Re‐examining our roots: Queer history and anatomy

“…De‐gendering language is a valuable tool to create more inclusive spaces (Lazarus & Sanchez, 2021). For example, Dubois and Shattuck‐Heidorn (2021) discuss how the characterization of testosterone and estrogens as male or female hormones is misleading as these hormones have functions outside sexual function and development. They also posit that the separation of the hormones by sex is inaccurate since both are present in all humans and differences in levels can be better explained through other factors such as diet, activity levels, and even parenting (DuBois & Shattuck‐Heidorn, 2021; Gray et al, 2020).…”