As you read the title, you may be overcome with indignation that this article is going to be a gender-essentialist rant. You’ll be relieved to know that it’s quite the opposite. My intent in writing this is to point out some serious misconceptions perpetuated in ‘trans 101’ and cisgender allyship resources, which end up doing much more harm than good for transgender people.

Anyone with an entry-level understanding of trans issues is probably familiar with the phrase “gender and sex are different things.”

While the idea of treating sex and gender as unrelated factors may result from an attempt to validate and support transgender identities, it actually perpetuates harmful cultural beliefs about the validity of sex assignment and the static nature of biological sex, which remove agency from trans and intersex people to define their own bodies and experiences. This way of thinking does nothing to combat (and in fact often co-signs) the pathologization, alienation, and exclusion of trans people, especially trans women, on the basis of their seemingly immutable “biological sex”.

Social Constructs, Social Constructs Everywhere…

The reality is that the concept of “biological sex” — along with gender, money, and traffic laws — is entirely socially constructed.

Now, your first reaction may be “Woah, woah, woah — penises and vaginas physically exist! Genitals obviously can’t be social constructs!”

This is at least partially true. The physical tissue and organs, to which the concept of sex is assigned, are not socially constructed; they exist through nature rather than human design.

However, words like “penis” and “vagina” are socially constructed. The study of medicine is socially constructed. The criteria that arbitrarily define “normal” and “abnormal” sex characteristics and create a dichotomy between “male” and “female” biology, is socially constructed. The expectations, functions and genders we assign to these organs and tissues? Definitely socially constructed.

While the intent of “gender and sex are different things” may be to illustrate that gender exists independently of (assigned) sex, the problem lies in the fact that sex cannot exist independently of gender.

There is a particularly problematic idea that words like “male” and “female” describe one’s unchanging physical sex (as ), and words like “man” and “woman” refer to an identity. This is untrue in any practical sense; for all social and legal purposes, words like “male/female” and “man/woman” are used interchangeably, with interchangeable social connotations.

The notion that one can validate a trans person’s “gender identity,” while still placing their bodies in the same category as cis people of the same sex assignment, is something that has been used to justify exclusion and violence against trans women, the alienation of trans people from gender-specific spaces, results in improper medical treatment, and is just another tool of transphobia and transmisogyny that allows people to turn around and say “I respect your ‘identity’, but you’re still basically a ______.”

Biological Sex as an Instrument of Transphobia

The concept of assigned sex as an unchanging objective fact has countless negative repercussions for trans people, from interpersonal relationships to accessing basic health care.

Cis people often employ the logic of biological sex to justify their experience of attraction or repulsion towards trans people, both of which can be rooted in transphobia. A lesbian attracted to a trans man can still consider herself to hold “gold star status” if she still considers her partner to be “biologically female”. A straight man believes he cannot act upon his attraction to a transgender woman since doing so might make him “gay”.

The concept biological sex reinforces the homophobia and pathologization that are integral to upholding institutional transphobia and transmisogyny.

I could write a whole separate piece on the horror show that results when we apply this logic within the penal system and sentencing transgender people on their assigned sex, but I think this fact sheet by Just Detention International can shine a light on that for me.

And don’t get me started about how this whole “sex = biology, gender = psychology” thing throws intersex people under the bus (considering a disproportionate amount of transgender people are intersex).

What does it even mean to have a “male body” or a “female body”? Are those categories inherently dyadic? Are they solely dependent on your birth assignment? Your hormones? Your genitals? Does a non-op trans woman who’s been on HRT for years still fit into the same “biological” category as a cisgender man? Is there a point at which, through medical intervention or legal recognition, a person ceases to be a member of one biological sex and assumes an officially designated and socially recognized new sex? Where do intersex people even fit into that? This entire concept is just a mess that quickly falls apart under the slightest inspection.

If someone identifies as male, then they are male and their body is male. If someone identifies as female, then they are female and their body is female. I identify as an androgyne, I am an androgyne, and my body and sex are (you guessed it) also androgynous — regardless of my medical decisions or transition status.

The purpose of trans inclusion is not to concede to the self-determined nature of gender while holding steadfast to the social construct of biological sex, and in fact these two things cannot exist in tandem. Trans people cannot truly have agency to self-determine their genders unless they also have agency to self-determine their bodies as being in alignment with that.

Trans inclusivity should redefine our understanding of gender and sex so that trans people are able to fit seamlessly within them (or better yet wouldn’t need to if the notions can be discarded entirely), not to have trans people straddle narrow, arbitrary classifications with certain parts of their personhood on one side of a line and certain parts on the other.

The Hard Facts

This is usually the point at which many scientifically-minded peers will take it upon themselves to point out the Hard Facts: “Male” and “Female” bodies have distinctive physical differences that result in different health care needs! You can’t change what chromosomes you have! A trans person’s health care will never be the same as that of a cis person of the same gender! We need to have these rigid physical criteria! For health! For science!

*sigh*

First of all, the things we currently know about the intrinsic differences in male and female physiology are basically just that we know a heck of a lot less than we thought we did. Recent findings have shown that there are no significant differences in male and female brain structure and that chromosomes do not determine sexual development, and many things we previously accepted as “hard facts” are turning out to be just antiquated speculation.

It’s almost as if the gender/sex binary was invented by people who then manufactured artificial qualifiers to reinforce it, which then became woven into our study of biology, medicine and psychology. Huh. Weird.

In reality, everyone’s medical needs are different. Yes, a trans man and a cis man will never have exactly the same medical needs, but also an able-bodied man will have different needs than a man with a disability, and there are even certain differences in medical treatment that exist between different ethnicities. Only a small portion of our medical treatment is actually affected by what’s between our legs, and when that becomes relevant to medical treatment, it needs to be discussed on an individual basis anyway.

The differences in health care needs between a transgender person and a cisgender person of similar health are largely negligible. They become even more negligible if the trans person in question is undergoing hormone therapy, since there are more general medical concerns influenced by your present hormones (such as bone and muscle density, risk of heart disease, cholesterol, pattern baldness, and PMS) than there are directly influenced by the genitals you were born with.

The idea that gender exists independently from sex and that transgender people should be lumped into their coercively assigned sex category for medical purposes only results in the gross mistreatment of transgender patients, as well as general confusion for their health care team.

The more we dissect the logic supporting the idea of biological sex and gender identity as independent and unrelated factors, the more apparent it becomes that this concept is more of a useful device for cisgender people to seem inclusive while still being transphobic, rather than something that actually benefits trans people. While educating others about trans inclusion and allyship, it is more important that the concepts we are reinforcing are helpful, rather than be easily integrated into other false preconceptions.