Biology's Impact on Gender Role

The topic of gender identity is a controversial topic when studying individuals who deviate from the norms. Individuals who are transgender have a gender identity which does not match their biological sex. Much controversy surrounds the basis of gender identity, with some attributing gender to social factors and others assuming a biological explanation. One model, shown below (figure 1), highlights the importance of hormones, while others focus on genetics or environment.

 Recent research has focused on the biological conditions which are correlated with a high rate of gender role change. In a review of the literature, Peggy T. Cohen-Kettins examined studies of individuals with 5α-reductase-2-defficiency (5α-RD 2) or 17β-hydroxysteroid dehydrogenase-3 deficiency (17β-HSD-3).

What are 5α-RD 2 and 17β-HSD-3? 5α-RD 2 and 17β-HSD-3 are enzyme deficiencies which result in the outer genitals being incompletely masculinized. At birth, the individual may be labeled as female due to lack of external genital features; however, the individual has XY chromosomes, internal male genital structures, and will develop male secondary sex characteristics(Cohen et al., 2005). Frequently the disorder emerges around age 12 when individuals begin to develop the male secondary sex characteristics. Recent research has found that the majority of individuals originally raised as female change their gender identity to male, matching their biological sex. These conditions are both rare, caused by autosomal recessive genes (figure 1), 5α-RD 2 affecting 1 in 5,5005-Alpha-Reductase Deficiency and17β-HSD-3 affecting 1 in 127,00017-beta hydroxysteroid deficiency. Figure 2. Diagram of unaffected parents and the possible genes for their children Wikipedia.

Cohen-Kettins found that 56-63% of individuals with 5α-RD 2 and 39-64% of individuals with 17β-HSD-3 assigned a female role at birth later changed their gender to male. This research has serious implications on the ways in which we treat individuals with genital ambiguity. As a result of ambiguous genitalia, parents and doctors often feel forced to pick a gender for their child. Many parents choose to have their child’s external genitalia surgically altered to match the gender they select. However, based on this study, approximately half of individuals assigned as female will change their gender identity to male. Therefore, we should not perform genital surgery at a young age as the chosen gender identity may change as a child enters adulthood. As such, “the utmost care should be taken not to assign a gender to the child before evaluation and consultation with an experienced, multidisciplinary team. The first words spoken to the parents are likely to be remembered and should focus on the overall health of the infant”  New Internationalist Magazine.

Ethically, making a decision for a young child can be a very difficult decision. Having a child undergo genital reconstruction surgery will lead to large and irreversible changes in the child’s life. While perhaps more of an ethical dilemma than a scientific one, science can help us determine what factors impact an adult’s gender role and better predict outcomes. This is not a universal problem; however, as some societies have adapted to this abnormality. Some areas of the world have an exceptionally high incidence rate and therefore have special names (such as guevedoche) for these disorders. In these areas, in which the incidence can be as high as one in 150, a separate gender category is created. This leads me to wonder if the current two sex categories are inaccurate. Perhaps these individuals fit into neither of these categories and exist in a category that we fail to recognize.

If we take a standpoint that focused exclusively on the role of neonatal androgen levels in the brain, then we would expect to see all individuals assigned as female seek a change in gender identity due to the high neonatal testosterone levels. The lack of consensus on gender identity suggests that there are several other factors, besides genetics, that affect the gender role of an individual. These factors include the severity of the mutation, cultural and environmental pressures, a patient’s psychological reaction, and the reaction of the social environment.

The main problem with this research is that researchers are unable to directly manipulate the variables and have a randomized, double-blind procedure. Given the ethics involved in human research, we cannot manipulate the environment that individuals grow up in and therefore we must gather information from the experiences of individuals affected by these disorders. Studying disorders like these provides insight onto different variables and their effect on an individual’s gender identity; however, this is just the first step in better identifying the factors that affect an individual’s gender identity.