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Two Sexes Are Not Enough

  • By Dr. Anne Fausto-Sterling
  • Posted 10.30.01
  • NOVA

In this excerpt from her recent book Sexing the Body: Gender Politics and the Construction of Sexuality, Brown University biologist and historian Anne Fausto-Sterling argues for a redefinition of our two-sex-only world. She also offers new guidelines on how doctors should handle intersex babies.

Intersexuals, formerly called hermaphrodites, have been around as long as humans have, though until recently few felt comfortable enough to "come out" about their conditions. Enlarge Photo credit: Antique photograph of circus performer from Freaks, Geeks and Strange Girls by Randy Johnson

a deep-rooted dichotomy

In 1843 Levi Suydam, a 23-year-old resident of Salisbury, Connecticut, asked the town's board of selectmen to allow him to vote as a Whig in a hotly contested local election. The request raised a flurry of objections from the opposition party, for a reason that must be rare in the annals of American democracy: It was said that Suydam was "more female than male," and thus (since only men had the right to vote) should not be allowed to cast a ballot. The selectmen brought in a physician, one Dr. William Barry, to examine Suydam and settle the matter. Presumably, upon encountering a phallus and testicles, the good doctor declared the prospective voter male. With Suydam safely in their column, the Whigs won the election by a majority of one.

A few days later, however, Barry discovered that Suydam menstruated regularly and had a vaginal opening. Suydam had the narrow shoulders and broad hips characteristic of a female build, but occasionally "he" felt physical attractions to the "opposite" sex (by which "he" meant women). Furthermore, "his feminine propensities, such as fondness for gay colors, for pieces of calico, comparing and placing them together, and an aversion for bodily labor and an inability to perform the same, were remarked by many." (Note that this 19th-century doctor did not distinguish between "sex" and "gender." Thus he considered a fondness for piecing together swatches of calico just as telling as anatomy and physiology.) No one has yet discovered whether Suydam lost the right to vote. Whatever the outcome, the story conveys both the political weight our culture places on ascertaining a person's correct "sex" and the deep confusion that arises when it can't be easily determined.

Some find the changes under way deeply disturbing; others find them liberating.

European and American culture is deeply devoted to the idea that there are only two sexes. Even our language refuses other possibilities; thus to write about Levi Suydam I have had to invent conventions—s/he and h/er to denote individuals who are clearly neither/both male and female or who are, perhaps, both at once. Nor is the linguistic convenience an idle fancy. Whether one falls into the category of man or woman matters in concrete ways. For Suydam—and still today for women in some parts of the world—it meant the right to vote. It might mean being subject to the military draft and to various laws concerning the family and marriage. In many parts of the United States, for example, two individuals legally registered as men cannot have sexual relations without breaking antisodomy laws.

Male and female form the extremes of a biological continuum that features many types of intersex conditions. Enlarge Photo credit: Antique photograph fromFreaks, Geeks and Strange Girls by Randy Johnson

But if the state and legal system has an interest in maintaining only two sexes, our collective biological bodies do not. While male and female stand on the extreme ends of a biological continuum, there are many other bodies, bodies such as Suydam's, that evidently mix together anatomical components conventionally attributed to both males and females. The implications of my argument for a sexual continuum are profound. If nature really offers us more than two sexes, then it follows that our current notions of masculinity and femininity are cultural conceits. Reconceptualizing the category of "sex" challenges cherished aspects of European and American social organization.

Indeed, we have begun to insist on the male-female dichotomy at increasingly early stages, making the two-sex system more deeply a part of how we imagine human life and giving it the appearance of being both inborn and natural. Nowadays, months before the child leaves the comfort of the womb, amniocentesis and ultrasound identify a fetus's sex. Parents can decorate the baby's room in gender-appropriate style, sports wallpaper—in blue—for the little boy, flowered designs—in pink—for the little girl. Researchers have nearly completed development of technology that can choose the sex of a child at the moment of fertilization. Moreover, modern surgical techniques help maintain the two-sex system. Today children who are born "either/or—neither/both"—a fairly common phenomenon—usually disappear from view because doctors "correct" them right away with surgery. In the past, however, intersexuals (or hermaphrodites, as they were called until recently), were culturally acknowledged.

Within 24 hours of the birth of an intersex baby, doctors typically operate to assign the newborn a gender. Enlarge Photo credit: WGBH/NOVA

Hermaphroditic heresies

In 1993 I published a modest proposal suggesting that we replace our two-sex system with a five-sex one. In addition to males and females, I argued, we should also accept the categories herms (named after "true" hermaphrodites), merms (named after male "pseudohermaphrodites"), and ferms (named after female "pseudohermaphrodites").

Editor's note: A "true" hermaphrodite bears an ovary and a testis, or a combined gonad called an ovo-testis. A "pseudohermaphrodite" has either an ovary or a testis, along with genitals from the "opposite" sex.

I'd intended to be provocative, but I had also been writing tongue in cheek and so was surprised by the extent of the controversy the article unleashed. Right-wing Christians somehow connected my idea of five sexes to the United Nations-sponsored Fourth World Conference on Women, to be held in Beijing two years later, apparently seeing some sort of global conspiracy at work. "It is maddening," says the text of a New York Times advertisement paid for by the Catholic League for Religious and Civil Rights, "to listen to discussions of 'five genders' when every sane person knows there are but two sexes, both of which are rooted in nature."

[Sexologist] John Money was also horrified by my article, although for different reasons. In a new edition of his guide for those who counsel intersexual children and their families, he wrote: "In the 1970's nurturists ... became ... 'social constructionists.' They align themselves against biology and medicine ... They consider all sex differences as artifacts of social construction. In cases of birth defects of the sex organs, they attack all medical and surgical interventions as unjustified meddling designed to force babies into fixed social molds of male and female ... One writer has gone even to the extreme of proposing that there are five sexes ... (Fausto-Sterling)."

Sexologist John Money, who features largely in the NOVA program "Sex: Unknown," was "horrified" at Fausto-Sterling's proposal that there be five sexes. Enlarge Photo credit: WGBH/NOVA

Meanwhile, those battling against the constraints of our sex/gender system were delighted by the article. The science fiction writer Melissa Scott wrote a novel entitled Shadow Man, which includes nine types of sexual preference and several genders, including fems (people with testes, XY chromosomes, and some aspects of female genitalia), herms (people with ovaries and testes), and mems (people with XX chromosomes and some aspects of male genitalia). Others used the idea of five sexes as a starting point for their own multi-gendered theories.

Clearly I had struck a nerve. The fact that so many people could get riled up by my proposal to revamp our sex/gender system suggested that change (and resistance to it) might be in the offing. Indeed, a lot has changed since 1993, and I like to think that my article was one important stimulus. Intersexuals have materialized before our very eyes, like beings beamed up onto the Starship Enterprise. They have become political organizers lobbying physicians and politicians to change treatment practices. More generally, the debate over our cultural conceptions of gender has escalated, and the boundaries separating masculine and feminine seem harder than ever to define. Some find the changes under way deeply disturbing; others find them liberating.

However well-intentioned, the methods for managing intersexuality, so entrenched since the 1950s, have done serious harm.

I, of course, am committed to challenging ideas about the male/female divide. In chorus with a growing organization of adult intersexuals, a small group of scholars, and a small but growing cadre of medical practitioners, I argue that medical management of intersexual births needs to change. First, let there be no unnecessary infant surgery (by necessary I mean to save the infant's life or significantly improve h/er physical well-being). Second, let physicians assign a provisional sex (male or female) to the infant (based on existing knowledge of the probability of a particular gender identity formation—penis size be damned!). Third, let the medical care team provide full information and long-term counseling to the parents and to the child. However well-intentioned, the methods for managing intersexuality, so entrenched since the 1950s, have done serious harm.

This feature originally appeared on the site for the NOVA program SEX: Unknown.

Dr. Anne Fausto-Sterling is a biologist and historian at Brown University. The passages above were excerpted from her book Sexing the Body: Gender Politics and the Construction of Sexuality. ©1999 by Anne Fausto-Sterling. Reprinted by permission of Basic Books. All rights reserved.

Related Links

  • The Intersex Spectrum

    Physical gender is not always just a matter of XX or XY, girl or boy. Learn about a range of intersex conditions.

  • My Life as an Intersexual

    Max Beck, a man who was raised as a woman, talks about his experience as an individual of ambiguous gender.

  • How Is Sex Determined?

    See how a human embryo develops the key characteristics that make it male or female.