When Bodies Defy Boxes: Rethinking How We Categorize Sex

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Image by Kasezo

Waves and spark

Decades ago in college, I had a lively discussion with friends about the “Four Food Groups,” a food classification system we had all grown up with in the ‘70s and ‘80s. The so-called “Basic Four” (defined as meats, dairy, fruits/vegetables, and grains) was just one in a series of ever-evolving teaching tools created by the USDA to nudge Americans toward healthier eating habits.

One friend was earnestly critiquing the system. “The Basic Four reflects the outsized influence of the meat and dairy industries,” she said, going on about structures of power in government agencies. “The whole system is wrong,” she exclaimed. “When you look at food in nature, there are actually 12 food groups.”

Another friend sighed. “In nature,” she asserted, “there are no food groups.” Food groups are made-up categorization systems we apply to edible stuff because we find it useful. There are infinite ways we can create food groups (by color, flavor, growing region, plant/animal source, vitamin content, etc.). There could be four, 40, or 400 categories, depending on our goals.

In other words, food groups shouldn’t be mistaken for telling unwavering “truth” about food. They are just convenient systems we use to make meaning from our world. And it doesn’t hurt here to note that the way we choose to group anything usually reflects certain underlying values and assumptions.

Categorizing Sex

Now let’s consider the concept of “sex.” For our purposes, I’m not talking about “sex” as an activity we can enjoy. Rather, I am talking about “sex” as a system that we use to categorize bodies.

In most of our cultural and scientific language, when we refer to the “sex” of humans, we’re usually offered two options, female or male. When we’re taught about sexual anatomy and reproduction in our sex ed classes, we are presented with two sets of drawings to represent genitals and reproductive organs.

This binary female/male framework is reinforced in countless systems that we interact with daily, from “F” or “M” checkboxes on our birth certificates and government-issued IDs, to our health insurance paperwork, to organized sports, to name a few. It all appears so simple.

The trouble with this system is that the observed reality of natural variations in human bodies isn’t that simple. Yes, we most often observe people who fit common patterns of “male” and “female” in terms of their gonads, genitals, chromosomes, and hormonal levels. But intersex people, who make up about 1.7% of the population, have sex traits or reproductive anatomy that varies from those typical definitions of male or female.

There is no single way to be intersex; it is an umbrella term encompassing a variety of differences in genitalia, hormones, internal anatomy, or chromosomes. Some intersex characteristics can be seen at birth, while others become evident at puberty, when trying to conceive a child, or through genetic testing. There are over 40 known intersex variations, and we’re still learning. The science of sex has become more nuanced in recent decades. Human sexual development is a complex process that involves multiple stages and a cascade of biological processes. Is it really a surprise that folks in our communities reflect natural variations beyond two strict outcomes?

There is no doubt that the categories of female and male can at times be useful. But there are also times when insisting on the rigidity of those categories is limiting and damaging. Serious trouble creeps in when folks insist that female and male are the “only,” “true,” or “natural” options. Our politics is currently rife with such essentialist language, reinforcing the erasure, stigma, and harm that intersex folks are often subjected to in our society.

Unnecessary surgeries on intersex youth

One form of injustice that intersex people have faced for decades is the imposition of binary sex norms by the medical establishment in the form of “normalizing” surgeries. These are non-lifesaving procedures that aim to change natural variations in genital appearance based on ideas about what a “normal” body looks like. Most of these surgeries are done when a child is under 2 years old, denying people important choices about their own bodies—choices that can affect fertility, sexual function, and emotional well-being.

Across the U.S. (including Wisconsin), embedded within the text of 25 anti-transgender bills that would deny trans youth access to gender-affirming medical care, there is also specific language included that allows the continuation of surgical procedures on intersex kids—without their consent. You read that correctly: legislators who want to ban trans teens from getting medical procedures that they have consented to are perfectly okay with supporting non-consensual “normalizing” genital surgeries on intersex infants, despite intersex advocacy groups, human rights organizations, and three former U.S. Surgeons General recommending such surgeries be halted. Weaponizing a strict binary of sex appears to be more important to these legislators than the bodily autonomy and rights of trans and intersex youth.

We’re at an inflection point in our culture, one in which we can rethink whether a rigid binary system of sex is truly serving the diversity and dignity of all people in our communities. If it is not, what values are served by those who double down on this system? The science of sex is nuanced, as is the reality of human bodies and lived experience. Rhetoric and policies that insist on oversimplifying those complexities come at a high cost to real people. It is time we begin prioritizing the hospitality of nuance over the damages of exclusion.