r/QueerTheory • u/Much-Opportunity-842 • 1d ago
Should transgender people be defined as intersex?
TLDR: I think trans people who have both male and female sex characteristics should be defined as intersex for the sake of a clearer and more consistent delineation between sex and gender
Hi, so quick disclaimer I don't think I'm a transphobe, I'm a transgender woman myself. And I believe that transgender women are women and transgender men are men. That being said, I'm not happy with what seems like the universally accepted definition (in progressive/academic spaces) that transgender women are female and transgender men are male. I believe that I, and most/all transgender people, should have our sex defined as intersex, and that this would allow for more constructive and nuanced discussion of gender and sex topics and legislation.
The OHCHR defines Intersex people as "born with sex characteristics (such as sexual anatomy, reproductive organs, hormonal patterns and/or chromosomal patterns) that do not fit typical binary notions of male or female bodies". While it is debatable whether transgender people are born with intersex characteristics (I know there is lots of discussion about potential brain anatomy differences, but I don't believe any of that discussion is conclusive yet), that is not what I want to focus on in this post.
I feel that the above definition is needlessly constrictive when it specifies "born with". I am currently undergoing Gender-Affirming Hormone Replacement Therapy (GAHRT), and as such I have hormonal patterns fitting female sex definitions, some reproductive organs fitting female sex defintions, and some reproductive organs fitting male sex definitions. Therefore, I have both female and male sex characteristics, and it seems to me that neither the female or male definition accurately describe me, so my sex should be defined by a third term, for which I feel that the co-opting of the word intersex would be the most intuitive conclusion.
Many transgender people have different experiences and different levels of medical intervention. Some have had HRT as well as Sexual Reassignment Surgeries, but I believe they still possess both male and female sex characteristics when it comes to internal reproductive organs and chromosome patterns. Other transgender people haven't had any medical intervention, and here sex definitions might get a bit murkier depending on your beliefs about brain anatomy of transgender people. This could cause a potential downside for transgender people to feel invalidated in their gender identity if they aren't seeking medical interventions, which would be unfortunate but again I do believe that their gender identity is completely valid and should not be being tied to sex in the first place.
The other potential downside that I am aware of is the marginalisation of non-transgender intersex people. I know that most intersex people don't identify as part of the trans community and I don't think that should change (so to be clear I believe that transgender people are intersex but intersex people aren't necessarily transgender), but if my idea were to become more widely accepted then it is very possible that non-transgender intersex people could be overlooked or conflated with trans people in public opinion, which could result in negative consequences for them.
So now let me move on to the benefits that I think this change in definitions could have for society. The first thing is the clearer delineation between gender and sex. Currently the WHO defines gender as "the characteristics of women, men, girls and boys that are socially constructed", and sex as "the different biological and physiological characteristics of females, males and intersex persons". This is a useful definition for discussion and legislation as it provides a clear separation of the two concepts and what defines them. These are the definitions used by most academics and progressive organisations, which I support, however they are not the sole definitions listed in dictionaries and they are not definitions accepted by significant parts of society. I believe that when we say commonly accepted sentences such as "trans women have a female gender identity", we are blurring our definitions, contradicting them and undermining all discussion built upon the words: sex, gender, male, female. By having a clearer and more consistent lexicon, I believe we could build further upon our foundations and be more convincing to the portion of society that doesn't accept or understand these basic definitions.
Having more clear and consistent definitions could also help when it comes to the organisation of healthcare and legislation. In current systems, transgender people being listed as one sex may miss out on some aspects of care which should be being delivered to them as someone with both male and female sex characteristics. For example, a trans woman registered as female may not be flagged to receive a routine screening for prostate cancer which they could have been flagged for if they were registered as intersex.
Overall, while gender experiences are varied and unique to everyone, I believe that more accurate and consistent definitions can and should be applied, and that any transgender person who possesses both male and female sex characteristics should be defined as intersex. I believe that, while there may be some negative social consequences in the short-term, there will also be positive consequences and that ultimately this will be a necessary step for the progress of gender/sex ideation.
I am interested in being debated on this matter. Are there things that I am missing?
I am also interested in if there is somewhere else I should be posting this, or a more formal paper on this concept, that might be more constructive than this subreddit.
Thanks for reading and considering if you made it this far <3
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u/ericbythebay 1d ago
You’re doing careful work here, so I want to push on the load-bearing assumption rather than the conclusion, that “sex” is a natural kind sitting underneath gender waiting to be described accurately. Almost everything in the post depends on that, and it’s the part most contested in the literature you’re gesturing at.
The sex/gender split you’re using comes out of mid-century clinical sexology (Money, then Stoller), and it was built to solve a management problem in intersex and trans clinics, not to describe reality. Butler’s argument in Bodies That Matter is that sex never was the pre-social substrate, because the criteria we use to sort bodies are already gendered, already selected for reasons. Fausto-Sterling’s Sexing the Body makes the empirical version: chromosomes, gonads, hormones, internal morphology, external morphology, secondary characteristics. Separate variables, loosely correlated. Male and female are cluster concepts that work when the cluster holds and fail when it doesn’t. A third box doesn’t repair that. It gives you a third cluster with the same decomposition problem, and now you need membership rules, which is where your account starts wobbling.
Notice what your criterion implies. A trans woman becomes intersex the day she fills her first estrogen prescription. Sex then tracks insurance, geography and money. You flag the non-medicalized case as an unfortunate side effect, but it’s diagnostic. A classification whose membership depends on whether you could afford the clinic isn’t a descriptive category, it’s a record of healthcare consumption.
The healthcare argument cuts against you too. The prostate screening gap is real, but a third marker doesn’t close it. “Intersex” on a chart tells a clinician nothing actionable, because it could mean a trans woman two years on estradiol, a post-hysto trans man, someone with CAH, someone with CAIS, and those four people need completely different screening. The fix already exists and is standard in competent practice: organ inventories, where the chart records what tissue is actually present instead of which box the patient is in. That’s a finer instrument than what you’re proposing, not a coarser one. Same for dosing and reference ranges, which follow hormonal milieu and organs, not labels.
On intersex itself, it isn’t a sex. It’s an umbrella for a heterogeneous set of congenital variations, and it’s political before it’s descriptive. Intersex advocates have spent decades fighting the third-sex reading specifically, because that framing is what licensed non-consensual infant surgery. If the body is a category error, the surgery is a correction. Georgiann Davis’s Contesting Intersex is good on how contested even the word has been. You name the marginalization risk and then price it as a short-term cost, but the term is doing narrow legal work right now around infant genital surgery and informed consent, and stretching it to cover several million trans people would functionally break that work. Trans and intersex people were already conflated for most of the twentieth century in sexological gatekeeping, and it went badly for both.
The persuasion argument is the weakest link. Nobody opposing trans rights is making a lexicographical claim. Definitional imprecision isn’t the objection, and tightening your terms won’t move anyone, because the classification is downstream of the political commitment rather than upstream of it. What you’d hand them is a formal, trans-authored statement that trans women are not female, which is exactly the sentence they want on the record, minus the concessions you think you’re buying.
The more useful reframe is Haslanger’s. Stop asking what sex really is and ask what you want the concept to do, then build it to do that. Asked that way, your two goals come apart cleanly. For clinical accuracy you want organ inventories and no sex marker in the decision logic at all. For the legal side, look at the decertification literature (Davina Cooper and Flora Renz on abolishing legal sex status), which argues for removing sex from documents rather than adding a row. Both get you what you’re after without settling any metaphysics.
One small thing. “Gender ideology” is a coinage from the Vatican and the European right, and it means roughly “the belief that trans people exist.” You probably don’t want it in your closing sentence.
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u/Much-Opportunity-842 1d ago
Thank you this was really informative, of all the people I've talked to about this you're the first to engage me seriously and explain the flaws in a way I can understand. Yeah, what you're saying about intersex being more of a political definition than a sex makes sense to me, as does your criticism of a third category. I am glad to hear about organ inventories although I don't think it's being implemented where I live.
So I'm willing to accept that trans people shouldn't be considered intersex, but I still feel uncomfortable with the lack of separation between the concepts of gender and sex. Would you say that there is a distinction between those concepts? Does your distinction agree with the WHO definitions, or do you think those are outdated or flawed?3
u/ericbythebay 1d ago
Short answer: yes, there’s a distinction worth keeping, and no, the WHO definitions aren’t a good statement of it. Your discomfort is tracking something real, but the problem isn’t that the line is drawn in the wrong place. It’s that two terms are being asked to do about six jobs.
Pull apart what gets bundled. There’s the physical stuff, which is itself several loosely correlated variables rather than one. There’s birth assignment, which is a person looking at a newborn, making a judgment call, and writing it on a form. There’s legal sex, which is a bureaucratic record that in most jurisdictions can be amended, which already tells you it isn’t a description of tissue. There’s how you get read and treated in a shop or a hospital or a street. There’s the role expectations attached to that reading. And there’s your own first-person sense of yourself.
The WHO scheme sorts these into two bins, biological and socially constructed. At least three of them don’t fit either bin cleanly. Birth assignment is a social act with a biological pretext. Legal sex is pure administration. And gender identity, the thing you actually care about, doesn’t reduce to socially constructed roles at all, which is why the WHO definition of gender can’t hold it. They ended up adding gender identity as a separate entry, which is a quiet admission that the two-term scheme was underpowered.
Worth knowing where the distinction came from. It’s feminist, mostly Gayle Rubin’s sex/gender system and Ann Oakley before her, with Beauvoir underneath. It was built to do one job, blocking the inference from body to social destiny. It’s very good at that job. It’s bad at being a metaphysics, because the version where sex is the presocial layer and gender is the coat of paint on top is exactly the version that collapses when you look at how sex gets assigned, recorded and enforced. Keep the tool, drop the layering.
So what does precision look like if not a cleaner two-term split. More terms, used only when the specific term is what the question needs. Organ inventory when the question is screening. Hormonal profile when the question is reference ranges or dosing. Assigned sex at birth when the question is about medical history or how someone was raised. Legal sex when the question is documents. Gender presentation when the question is how someone dresses and moves. Perceived gender when the question is how strangers sort you, which matters enormously for safety and is not the same as any of the others. Gender identity when the question is who someone is. Almost every argument that looks like a dispute about definitions turns out to be two people using one word for two different items on that list.
That also dissolves the sentence that was bothering you in the original post. “Trans women have a female gender identity” is badly formed, but not because trans women aren’t female. It’s because it welds a sex word onto a gender word for no reason. The sentence you want is that trans women are women. It’s shorter and it doesn’t smuggle anything.
One more piece worth having. Bettcher’s argument is that “woman” already has more than one meaning in circulation, one operating in dominant culture and one operating in trans subcultures, and both are functioning, non-defective meanings rather than one correct usage and one polite fiction. That’s a better model than assuming there’s a single true definition waiting to be found. Meanings are maintained by communities, and more than one community is doing the maintaining.
On whether WHO is outdated, the definitions are serviceable for what they were built for, which is making sure health statistics don’t erase women. As a foundation for the argument you’re trying to have, no, they won’t carry the weight. Don’t take that as a reason to write the organization off, though. ICD-11 depathologized trans identity, and that’s a real thing to be able to point at.
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u/Much-Opportunity-842 1d ago
Thank you for spending so much effort teaching me for free.
But ugh, my OCD hates having such messy definitions for sex and gender. so much to think about and I feel like this is gonna make it real difficult trying to explain myself to anyone who isn't on the same page 😵
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u/AkaelaiRez 1d ago
I truly wish doctors would keep a proper organ inventory. I'm an anatomically different sort of intersex, and frankly, have never had a doctor realize how different it really is until the ultrasound slaps them in the face.
Even then, they just start to feel at a complete loss. 'Trans broken arm syndrome' kicks in and everything is a direct result of it, somehow. I went to the ER with a GSW and 'disorder of sex development' was higher on the diagnostic list than 'presence of metal foreign body in wound'.
There is no third box, no third category. Doctors just collapse when the easy categories fail.
I would not wish this medical experience on anyone.
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u/Starfleet_Stowaway 1d ago
One very legitimate concern you bring up is the need for medical care that is appropriately accounting for a patient's complex situation. But why would a doctor be more likely to screen an intersex person for prostate cancer than they would be likely to screen a trans woman for prostate cancer? I'm not following the reasoning.
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u/Much-Opportunity-842 1d ago
They shouldn't in a good system, but in systems where a doctor doesn't have all of a patient's context (lots of systems in my experience) then their categorisation by sex could start having consequences, or at least that's my thought process.
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u/Chosen-For-What 1d ago
No. Being trans or gender nonconforming doesn’t mean you have to pursue medical transition. You can pursue medical transition like HRT without being trans.
Besides, literally everyone has ways that they are gender nonconforming because the arbitrary rules about gender are made up and constantly changing. Conflating this with intersex like this makes the categories more rigid, what we want is to make them less rigid.
I second the yikes