The Social Construction of Sex and Me

I keep running into smart people who seem to think I believe that sex “isn’t real” because it is all “socially constructed.” Allow me to correct this erroneous social construction of me by summarizing here what I think about sex and gender. I’m tempted to say “what I know about sex and gender” because there are few things I feel as sure about as this.

Testes are real. Ovaries are equally real. They sometimes make real gametes. (I don’t mean to imply they sometimes make fantasy gametes—just that they sometimes don’t make gametes.) Chromosomes and genes are also real. As anyone who’s every forgotten to wear a pad on the right day knows, menstrual blood is real. To the delight of this straight woman, penile erections are real. So are clitoral erections. I’m equally delighted about those.

When I say these are “real,” what I mean is that these things have a material existence independent of our ability as humans to notice, study, deny, politicize, or categorize them. I can’t believe I even have to assert this claim, but some academics have gone over the deep end and disagree. (I don’t hang out with such people unless there I have some form of pain killer at the ready.)

So why would I write a book with the phrase medical invention of sex in the title?

Is a Small Penis in the Hand Worth Three in the Bush?

OK, that title may be too cheeky. But it got your attention. Here’s what I’m thinking about….

The internationally-syndicated sex-advice columnist Dan Savage recently asked me to help out with a reader who thought he had a small penis and was considering “enhancement” surgery or pills. As a consequence, I’ve gotten a bunch of mail from guys with penis size questions or comments. A man I’ll call Bob wrote to say this:

“I am one of the people with extreme small [penis] size but am proof it doesn’t cause problems if you learn to work with it. I have 3 grown children now and am happily married. We are all given many differences in life and how we deal with them is what makes the difference. Keep sending the messages…your work is important.”

When I wrote Bob to thank him for his mail and to ask him if I could quote him, he followed-up:

What to Wear?

Before Powerpoint became ubiquitously doable, I traveled with slides. (You remember 35 mm slides?) And I had a little ritual that centered on slides: The night before I had to leave on a speaking trip, I would drive my mate crazy by rushing all around the house demanding, “Have you seen my slides? Where are my slides?!”

Once I moved all my slides to my computer and started doing it all in Powerpoint, I couldn’t do that ritual, so I developed another to drive my mate crazy. Now the night before I leave on a speaking trip, I rush around the house pleading, “What should I wear? Help me figure out what to wear!”

It’s actually a serious problem for me, and not because I’m indecisive about clothes...although I am indecisive about clothes.

Choosing Children's Sexual Orientation

In a just-published New York Magazine piece, “The Science of Gaydar,” writer David France looks at the growing scientific evidence for innate differences between gay and straight people. France ends by gazing towards the future, and asks the question, “What if prenatal tests were able to show a predisposition to gayness?” Well, France reports, “[Northwestern University psychological professor] Michael Bailey, for one, isn’t troubled by the moral implications any more than he would oppose fetal screens for potential birth defects, though he quickly adds his personal belief that homosexuality is ‘a good’ on par with heterosexuality.”

Bailey espouses a definite Seinfeldian “not that there’s anything wrong with that” attitude toward homosexuality. In a paper he published on the subject with lawyer Aaron Greenberg in 2001, he wrote: “Because homosexuality causes no direct harm to others (other than those who take offense at it on irrational and/or inhumane grounds) and because homosexual behavior is crucial to the ability of homosexual people to enjoy their lives (as heterosexual behavior is to heterosexuals), homosexuality should not be morally condemned or proscribed.” But, Greenberg and Bailey say, it’s wrong to tell parents they can’t select for (or against) a heterosexual or homosexual predisposition in their children.

Products of Conception

Deborah Costandine and I met in June of 2004, but she didn’t send me the autopsy report of her baby for another year and a half. So I didn’t start looking for more information about what had happened to her until January of 2006. That’s when Deb wrote to say she was wanted some help, so that’s when I went into the basement of my medical school’s library and started looking for her conjoined twin.

Really Changing Sex

What would it take to get the government to worry less about our genders?

On Tuesday, the New York Times reported that New York City “is moving forward with a plan to let people alter the sex on their birth certificates even if they have not had sex-change surgery.” Under the new plan “being considered by the city’s Board of Health… people born in the city would be able to change the documented sex on their birth certificates by providing affidavits from a doctor and a mental health professional laying out why their patients should be considered members of the opposite sex, and asserting that their proposed change would be permanent.” No more need to get surgery or even hormone treatments to get the legal gender you feel is right for you.

Quite a progressive move, this. And nicely in keeping with the long history of liberal democracy, wherein social and political identities have been increasingly decoupled from anatomy. Think about it: your social identity and legal rights depend a lot less on your body type now than they did fifty years ago, and much less than they did a hundred or five hundred years ago. Most of the major civil rights movements have been about just this: arguing against body-based discrimination, whether it be race-based, sex-based, or ability-based.

Why should a person have to go through expensive and dangerous transsexual surgeries – many of which she might not want or be able to afford – to get people to recognize her as the gender she says she is?

But even for a gender progressive, the New York city approach raises a host of questions.

The Federal Marriage Amendment and the New 'One Drop of Blood' Rule

Intersex messes with the opponents of gay marriage.

As anti-miscegenation laws took hold in an effort to stop blacks and whites from marrying, by necessity courts had to start deciding who counted as white or black. The standard that ultimately emerged – namely the “one drop of blood” rule of blackness – dictated that any trace of black heritage, no matter how remote or invisible, made you black.

Although a legal necessity, the rule amounted to a biological and social absurdity, one that thrust upon many people an identity that made no sense in terms of their bodily appearances and their lives. For example, Susie Phipps grew up, lived, and married twice as a white woman, but was informed in 1983 by the Louisiana courts (in response to a passport application dispute) that she was really “colored” because she had had one black ancestor six generations back.

As conservatives continue to push the Federal Marriage Amendment and similar state-level same-sex marriage prohibitions, there are signs that a new one drop of blood rule is about to emerge – but this time it will be about sex instead of race. Soon, the way this sort of legislation is going, against their will some men will legally become women, and vice versa. It’s already happening in Texas.

Let me back up a bit.