Why Can't We Go on as Three?

Abstract

Common sense is watchword of a good clinician. And common sense tells us that world of human beings is divided into male and female, boys and girls, men and women. Or does it? Wittgenstein once wrote, If you believe that our concepts are right ones, ones suited to intelligent human beings, that anyone with different ones would not realize something that we realize, then imagine certain general facts of nature different from way they are, and conceptual structures different from our own will appear natural to you.[1] To see something of what Wittgenstein is getting at here, consider following story. In 1970s Juliane Imperato-McGinley and colleagues published studies identifying a rare deficiency of testosterone metabolism, 5-alpha-reductase deficiency syndrome.[2] Children with this condition are genetically XY, but are born sexually ambiguous. In rural Dominican Republic where studies were conducted, these children are often raised as girls. Until puberty, that is. Because when children reach puberty they undergo striking changes. Their voices deepen; their muscles develop; their testes descend; and what was thought to be a clitoris enlarges to become more like a penis. The child who was thought to be a girl, or sexually ambiguous, gradually becomes a boy. Dominican Republic villagers call these children guevedoce, or penis at twelve. How you see this case (as with any case) will depend on where you are standing. For U.S. researchers who published study, it looks like a case of mistaken sexual identity: genetic boys who were raised as girls, and whose true sexual identity emerges only at puberty. Imperato-McGinley and colleagues point to influence of normal levels of testosterone on brains of these children in utero, neonatally, and at puberty. Once these children began to appear male rather than female during puberty, they were able to change from being female to being male with relative ease. They gradually began to feel less like girls and more like boys; eventually, they came to see themselves as men. Of eighteen children followed in study who were raised as girls, seventeen changed to a male gender identity during puberty. Sixteen changed to a male gender role, working as farmers and doing other traditionally male work, and fifteen of them went on to marry women. For those of us whose world is divided into men and women, like these U.S. researchers, relative ease of this female-to-male transformation looks like evidence that (contrary to theories of Money and others) in matters of sexual identity, biology outweighs socialization. In end, testosterone prevailed. But this is not only way to see this case. Gilbert Herdt has argued that what we see here is not so much a case of mistaken sex as a culture with a sex; that transition from female to male was unproblematic not because of male biology and a laissez faire attitude toward sexual identity, as U.S researchers assumed, but because local Dominican Republic culture into which these children were born recognizes a third-sex category: guevedoce.[3] Not all cultures for two sexes way Western cultures do, and in areas of Dominican Republic where 5-alpha-reductase deficiency is common, the villagers have more than a simple word for hermaphrodite; they have a triadic sexual code (p. 428). Thus sexually ambiguous child is born not into a world divided up into male and female, but into a world divided into male, female, and guevedoce. Different concepts, different facts of nature. In fact, we don't even need to postulate different facts of nature, only (as Wittgenstein would say) different forms of life. History and anthropology have shown us many societies whose conceptions of sex and gender are vastly different from our own. One of best known examples of a third sex/third gender are berdaches of traditional North American societies. …