Signed, scientists

As scientists, we are compelled to write to you, our elected representatives, about the current administration’s proposal to legally define gender as a binary condition determined at birth, based on genitalia, and with plans to clarify disputes using “genetic testing”.1 This proposal is fundamentally inconsistent not only with science, but also with ethical practices, human rights, and basic dignity.2

The proposal is in no way “grounded in science” as the administration claims. The relationship between sex chromosomes, genitalia, and gender identity is complex, and not fully understood. There are no genetic tests that can unambiguously determine gender, or even sex. Furthermore, even if such tests existed, it would be unconscionable to use the pretext of science to enact policies that overrule the lived experience of people’s own gender identities.

The proposed policy seeks to erase the identities of millions of Americans who identify as transgender (individuals whose gender identification differs from their assigned sex at birth) or have intersex bodies (individuals with biologically atypical patterns of male and female traits). In transgender individuals, the existence and validity of a distinct gender identity is supported by a number of neuroanatomical studies.3 Though scientists are just beginning to understand the biological basis of gender identity, it is clear that many factors, known and unknown, mediate the complex links between identity, genes, and anatomy.4

In intersex people, their genitalia, as well as their various secondary sexual characteristics, can differ from what clinicians would predict from their sex chromosomes. In fact, some people will live their entire lives without ever knowing that they are intersex.5 The proposed policy will force many intersex people to be legally classified in ways that erase their intersex status and identity, as well as lead to more medically unnecessary and risky surgeries at birth. Such non-consensual gender assignment and surgeries result in increased health risks in adulthood6, 7 and violate intersex people’s right to self-determination.

Millions of Americans identify as transgender or gender non-conforming, or have intersex bodies, and are at increased risk of physical and mental health disorders resulting from discrimination, fear for personal safety, and family and societal rejection. Multiple standards of health care for transgender and intersex people emphasize that recognizing an individual’s self-identified gender, not their external genitalia or chromosomes, is the best practice for providing evidence-based, effective, and lifesaving care.8, 9 Our best available evidence shows that affirmation of gender identity is paramount to the survival, health, and livelihood of transgender and intersex people.10

Given its scientific and ethical failings, we call upon the administration to withdraw this proposed policy. We also ask our elected representatives to oppose its implementation, as it would cause grave harm to transgender and intersex Americans and weaken the constitutional rights of all Americans. Transgender and intersex people deserve equal access to the rights, livelihoods, liberties, and dignity to which we are all entitled on the basis of our shared humanity.

View References 1. Reuters. Trump Administration Trying to Define Transgender Out of Existence: NY Times. The New York Times [Internet]. 2018 Oct 21. 2. OHCHR | Embrace diversity and protect trans and gender diverse children and adolescents [Internet]. 3. Kreukels BPC, Guillamon A. Neuroimaging studies in people with gender incongruence. International Review of Psychiatry. 2016 Jan 2;28(1):120–8. 4. Bramble MS, Lipson A, Vashist N, Vilain E. Effects of chromosomal sex and hormonal influences on shaping sex differences in brain and behavior: Lessons from cases of disorders of sex development. Journal of Neuroscience Research. 2017 Jan 2;95(1–2):65–74. 5. Dumic M, Lin-Su K, Leibel NI, Ciglar S, Vinci G, Lasan R, Nimkarn S, Wilson JD, McElreavey K, New MI. Report of Fertility in a Woman with a Predominantly 46,XY Karyotype in a Family with Multiple Disorders of Sexual Development. J Clin Endocrinol Metab. 2008 Jan 1;93(1):182–9. 6. How Intersex People Identify – Intersex Campaign for Equality [Internet]. 7. Minto CL, Creighton S, Mrcog M, Woodhouse C. Long term sexual function in intersex conditions with ambiguous genitalia. Journal of Pediatric and Adolescent Gynecology. 2001 Aug 1;14(3):141–2. 8. The World Professiona Association for Transgender Health. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, 7th Version [Internet]. 9. Luk Gijs PhD, Anne Brewaeys PhD. Surgical Treatment of Gender Dysphoria in Adults and Adolescents: Recent Developments, Effectiveness, and Challenges. Annual Review of Sex Research. 2007 Mar 1;18(1):178–224. 10. National Center for Transgender Equality. The Report of the 2015 U.S. Transgender Survey, Executive Summary [Internet]. 2016 Dec.

Signed,

Biologists, Geneticists, Psychologists, Anthropologists, Physicians, Neuroscientists, Social Scientists, Biochemists, Mental Health Service Providers,

and other scientists in Solidarity

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