Factors in Determining Sex and Gender in Cases of 5-alpha reductase deficiency
Which components of sex and gender are socially constructed as opposed biologically determined? This is a question that scientists have been trying to decipher for centuries, and society’s demand for neat little boxes has had detrimental effects on recognizing the complexity of these subjects. The dominant form of thought throughout the 1950’s was based on a study by Money and the Hampsons (1955) describing gender as fully determined by sex assigned at birth. This theory was opposed by a study in 1974 by Imperato-McGinley et al., which found that testosterone during development was the mediating factor in gender identity formed later in life, similar to a “true sex” model.
In the article Mistaken Gender: 5-Alpha Reductase Hermaphroditism and Biological Reductionism in Sexual Identity Reconsidered, cultural and clinical anthropologist Gilbert Hert analyzes sex and gender through the condition, 5-alpha reductase deficiency, in New Guinea and The Dominican Republic. This is a condition in which developing testes do not release enough testosterone in utero for the body to form a penis, and therefore these infants are born with genitalia presenting as female. However, at puberty, the influx of testosterone causes a change in genitalia where the undescended testes emerge and a penis develops.
In both New Guinea and The Dominican Republic, the condition is widely recognized, sometimes at birth but most often not until puberty. The individuals with this condition are considered members of a third sex, but must eventually fall into one of only two genders (masculine or feminine). Herdt argues that, even though these societies do not code for a three-gender system, since they do not inextricably link sex and gender they are more open than societies with a hard-set, two-sex system. In both countries, individuals with this condition are often raised unambiguously as girls throughout childhood, but once male genitalia starts to develop, usually switch to a masculine gender role as well. The Imperato-McGinley study used this information as evidence to support their hypothesis that gender was biologically determined, since the majority of the individuals chose to present as men in adulthood contrary to being raised as girls.
I raise an objection to this oversimplified understanding of sex and gender to argue that social factors related to the changed genitalia in relation to societal expectations may have influenced the individuals’ choices in choosing a gender in adulthood. Further evidence for this argument is that some of the affected individuals chose to continue living as women. A few of the women were married, but were promptly divorced once their genitalia were uncovered to their new husbands. After the divorce, the affected individuals began to present as the masculine gender, seemingly to better “fit” into society. As described in the article, the environment is not “laisser-faire”, and in fact, there are distinct advantages to belonging to the masculine gender in a patriarchal society. Therefore, Hert argues that since it is objectively better to be a man in these societies, the only reason individuals would continue to live as women is if there were some other internal factors being considered.
In his article, Hert raises the concern that rather than experiencing a switch from female to male post puberty, these individuals often experience a switch from female to a male-identified intersex person, who is often in the same social category as adult males. He goes on to critique the prescribed sex and gender system for forcing these individuals to choose to fit completely into the restrictive categories of male or female and man or woman once in adulthood.
