Facts for You

A blog about health, economics & politics

Gender identity is in the news yet again, but all is not smooth sailing. On 15 June 2020, the US Supreme Court invoked Title VII of the Civil Rights Act 1964, which prohibits sex discrimination in employment. In a 6-to-3 ruling, the learned judges reiterated that transgender people could not be discriminated against in the workplace. However, on 1 July, the US Housing and Urban Development went on to announce a new rule whereby, irrespective of their gender identity, homeless people would be rehoused according to their birth-assigned sex. This ruling directly contradicts the Equal Access Rule of 2016, which prevents federally-funded homeless shelters from discriminating against transgender people.

Around the same time, a controversy is continuing this side of the Atlantic. It was triggered by a tweet from celebrity author J.K. Rowling on 19 December 2019. In this tweet, Rowling declared her support for Maya Forstater, a tax expert and visiting fellow at the Center for Global Development, a non-profit international policy think tank based in London and Washington DC. In a series of tweets, deemed to be “transphobic”, Forstater had stated that biological sex is immutable, and had voiced particular concerns about biologically male people, who had declared themselves as transgender women, being allowed into women-only public spaces. Forstater lost her contract for consultancy services with the think tank after a judge at the Central London Employment Tribunal ruled against her philosophical belief that sex is solely determined by biology. As Rowling got drawn into the controversy, some of her erstwhile colleagues and collaborators publicly distanced themselves from her statements. Rowling then issued a 3,600-word blog to further explain her views. In this blog she claimed that her views were based on personal experiences of misogyny, domestic violence and sexism, and were guided by her extensive researches into transgender issues. As a result, she has even been led believe that not all people with confused gender identities need to actually transition between the sexes.

Gender identity has become an increasingly complex matter. The conventional view of gender as a binary characteristic, making you either male or female, is gradually being replaced by an alternative opinion that gender is a continuum, representing a spectrum of both gender identity and sexual orientation. Most people are “cisgender” and their gender identity matches the sex they were assigned at birth. Societal acceptance has, however, encouraged increasing numbers of people to come out and identify themselves as “transgender”, with a gender identity that does not match the gender they were assigned at birth. The process by which a cisgender person becomes transgender is referred to as transitioning, while a reversal involves “re-transitioning”.

Any discussion of gender identity has to be preceded by a look at biological sex, or gender assignment at birth. Biological sex is typically defined by the appearance of the external genitalia at birth, and in later life also by secondary sex characteristics, such as body shape, breast size, body hair distribution and voice pitch.

Biological sex usually corresponds with chromosomal sex. Human cells normally contain 23 pairs of chromosomes, including a pair of sex chromosomes (X and Y). This can be represented as 46 XX for females and 46 XY in males. But then, males can also have 47 XXY and 47 XYY chromosomal patterns, while females can be either 45 XO or 47 XXX. When it comes to their external genitals, some infants can display so-called “ambiguous external genitalia”, in which the appearance of the external genitals does not correspond to their chromosomal sex. In such “intersex” states, also referred to as hermaphroditism, babies with female chromosomes may display male external genitals (masculinizing syndromes),while those with male chromosomes may present with female external genitals. These conditions are caused by imbalances in sex hormone production, and are treated medically in the first instance, well before sexual orientation is an issue.

The deliberate transition between male to female gender identity, or vice versa, may take one of two basic forms. Social transitioning is a covert process, whereby a trans identity is temporarily achieved by cross-dressing, mostly in private (transvestism). Medical transitioning (transsexualism), on the other hand, is an overt and more permanent process of change in gender identity, involving long-term hormone therapy and sometimes even gender reassignment, or sex change, surgery. Starting in the 20th century, there have been many high-profile examples of gender reassignment surgery, often performed by highly reputable surgeons. Early and prominent examples of successful surgical gender reassignment surgery in the UK include those of April Ashley and Roberta Cowell.

In passing, it is important to recognise that gender identity is not the same as sexual orientation. Sexuality can vary from person to person, irrespective of gender identity. Both cis- or transgender people can be sexually and/or romantically attracted in many different ways- either heterosexual, homosexual (gay or lesbian), bisexual, pansexual, or even asexual.

Transgender people can face many problems in their daily lives. Apart from possible rejection by close family members, they may not be accepted by society at large. Discrimination may lead to difficulties when it comes to finding employment, securing housing, and accessing public facilities. Transgender people often have to deal with the effects of poverty, violence, mental health issues (depression, eating disorders, self-harm), substance abuse, and other health problems. To add to this, healthcare professionals may be unaware of specific transgender health issues, which they frequently do not learn about while at medical school.

In the UK, the Gender Recognition Act 2004 provides the basis for the designation of gender on birth certificates. Details of gender certification at birth cannot be changed retrospectively, but one’s current gender identity can be confirmed by a Gender Recognition Certificate (GRC). A GRC can be issued to trans people who have been diagnosed with gender dysphoria. They must have lived in their new gender for at least two years and then convinced a panel of doctors and lawyers of their intentions. In England and Wales, they also need spousal consent if they have been previously married.

When it comes to gender, most of us seem happily reconciled to our assigned sex. Others, however, never come to terms with their designated gender, feeling trapped in bodies they no longer identify with. Such transgender people have been around for centuries, throughout the world, and transgender identity is an inescapable fact of life.

Individual attitudes to transgender people vary widely, depending on personal moral codes and religious beliefs, societal norms, and a commitment to equality and human rights. There are many different points of view, including one that underpins the controversy referred to above. Most recently, some so-called “trans-exclusionary radical feminists” (TERFs) have expressed concerns about the specific risks of allowing male-to-female trans people into single-sex, women-only, public spaces. In their view, trans-women just cannot be treated in the same way the same as other women, who they believe are most easily recognised by their ability to menstruate.

Ultimately, what is eventually permitted is down to government action, backed by appropriate legislation. Nevertheless, in the meantime, mutual understanding and tolerance can only but foster a climate of peaceful coexistence, in which the various issues are debated and then acted upon.

Ashis Banerjee