[Genuine Realist]

The irony here is that the terms “cis” and “trans” mean “on the same side” and “across from” respectively.  In order to be across from something, there has to be a something to be across from. You can try to state that this is gender at birth, but hormone treatment and gender affirming surgery is not there to wash out the legacy of being assigned a gender at birth; they exist because absent such interventions there is a disconnect between the someone’s gender and an appearance that was shaped by hormones.

I am very sympathetic to the issue of intersex individuals brought up in the threads. My older daughter, who is 46 XX, met one of the mild conditions described: what at first seemed to just be a case of being a “late bloomer”, endocrinologically wound up being a case of her ovaries never turning on, a condition called primary ovarian failure; absent exogenous estrogen therapy, she would have never developed secondary female sexual characteristics, and, unfortunately, is incapable of ovulating, and thus becoming pregnant without reproductive assistance. That would put her on the intersex spectrum, although pretty close on the axis to what we label as female.

However, mental models are useful and necessary for understanding the world around us.  There may be cases, such as in the researcher’s lab, where doing away with dichotomous labels to understand the effect of hormone disrupters on rats is necessary. Likewise, when thinking about intersex persons, it may be more  useful to view sex as a continuum.  But even the prefix “Inter-“ starts with the presupposition that there are two anchors to be “between”.  Again, let us not get so caught up in making sure that we are inclusive that we throw out useful descriptors of the world around us even if they are imperfect.

Getting back to my daughter, if we didn’t have a conception of normal female development to anchor our expectations of where she should be developmentally, we would have never known that she wasn’t just a “late bloomer” and wouldn’t have taken her to an endocrinologist, who measured her estrogen and FSH levels, which most closely matched those of a post-menopausal woman (again, without the idea of sex, we wouldn’t know what “normal” levels of these hormones are for what was then a 12-year-old girl).  Because some potential serious conditions can lead to primary ovarian failure, including chromosomal abnormalities and autoimmune conditions, she was worked up for them, which is why I know her karyotype. Thankfully, there doesn’t appear to be anything else wrong, and treatment is as simple as putting on an estrogen patch every few days and occasional progesterone pills. This has allowed her to resume the development of secondary sexual characteristics, and made her appearance more closely match her gender. It has also allowed her to put on bone mineral density and other necessary changes in puberty that otherwise wouldn’t occur normally but are necessary for adult health. But, because her own ovaries don’t work, she won’t be able to conceive her own children under current reproductive technology, though if she wanted to, she should be able to become pregnant with an implanted embryo, should she choose.

BC

That's an interesting story. 

I am curious whether you sought psychological counseling for her at that time. Girls of that age are extraordinarily worried about their bodies and the onset of purity. So I imagine this was a situation in which counseling might have been useful.

Also, did she ever wonder about her gender?

[Genuine Realist]

The irony here is that the terms “cis” and “trans” mean “on the same side” and “across from” respectively.  In order to be across from something, there has to be a something to be across from. You can try to state that this is gender at birth, but hormone treatment and gender affirming surgery is not there to wash out the legacy of being assigned a gender at birth; they exist because absent such interventions there is a disconnect between the someone’s gender and an appearance that was shaped by hormones.

I am very sympathetic to the issue of intersex individuals brought up in the threads. My older daughter, who is 46 XX, met one of the mild conditions described: what at first seemed to just be a case of being a “late bloomer”, endocrinologically wound up being a case of her ovaries never turning on, a condition called primary ovarian failure; absent exogenous estrogen therapy, she would have never developed secondary female sexual characteristics, and, unfortunately, is incapable of ovulating, and thus becoming pregnant without reproductive assistance. That would put her on the intersex spectrum, although pretty close on the axis to what we label as female.

However, mental models are useful and necessary for understanding the world around us.  There may be cases, such as in the researcher’s lab, where doing away with dichotomous labels to understand the effect of hormone disrupters on rats is necessary. Likewise, when thinking about intersex persons, it may be more  useful to view sex as a continuum.  But even the prefix “Inter-“ starts with the presupposition that there are two anchors to be “between”.  Again, let us not get so caught up in making sure that we are inclusive that we throw out useful descriptors of the world around us even if they are imperfect.

Getting back to my daughter, if we didn’t have a conception of normal female development to anchor our expectations of where she should be developmentally, we would have never known that she wasn’t just a “late bloomer” and wouldn’t have taken her to an endocrinologist, who measured her estrogen and FSH levels, which most closely matched those of a post-menopausal woman (again, without the idea of sex, we wouldn’t know what “normal” levels of these hormones are for what was then a 12-year-old girl).  Because some potential serious conditions can lead to primary ovarian failure, including chromosomal abnormalities and autoimmune conditions, she was worked up for them, which is why I know her karyotype. Thankfully, there doesn’t appear to be anything else wrong, and treatment is as simple as putting on an estrogen patch every few days and occasional progesterone pills. This has allowed her to resume the development of secondary sexual characteristics, and made her appearance more closely match her gender. It has also allowed her to put on bone mineral density and other necessary changes in puberty that otherwise wouldn’t occur normally but are necessary for adult health. But, because her own ovaries don’t work, she won’t be able to conceive her own children under current reproductive technology, though if she wanted to, she should be able to become pregnant with an implanted embryo, should she choose.

BC

That's an interesting story. 

I am curious whether you sought psychological counseling for her at that time. Girls of that age are extraordinarily worried about their bodies and the onset of purity. So I imagine this was a situation in which counseling might have been useful.

Also, did she ever wonder about her gender?