Are We Prepared to Abandon the Idea of Sex Binarism? A Biomedical Perspective

Rey, Rodolfo

doi:10.1159/000522409

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Gender expression and gender role describe preferences regarding clothing choices, preferred activities, and occupations. Sexual orientation signifies romantic and erotic preferences [5]. Usually, the appearance of the external genitalia, chromosomal constitution, hormone concentrations, gonadal histology, and gender identity are congruent.…”

Section: Sex Versus Gendermentioning

confidence: 99%

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

et al. 2022

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Testes were associated with maleness from antiquity, and ancient societies had fanciful myths about the origins of the sexes and about fetal sexual development. 17th century anatomists developed the concept that mammals developed from eggs and discovered sperm in semen; in 1878, Hertwig observed sperm entering eggs (of sea urchins), establishing the cellular basis of sex development. Individuals with atypical genitalia were known clinically in the 17th century, with much debate about their origins, but by the late 19th century it was generally accepted that gonads determined sex, and that sex determined gender role. Testosterone was isolated in 1935, and Alfred Jost showed that both circulating testosterone and diffusible anti-Mullerian hormone were needed for male development. Patients with apparent androgen insensitivity were reported in 1937 and shown to be unresponsive to exogenous androgen by Lawson Wilkins in 1957; androgen receptor mutations were reported in 1989. Steroidogenic errors were associated with differences in sex development (DSDs) starting in the 1940s, and finding mutations in the responsible enzymes explained many forms of hyper- and hypo-androgenism in both sexes. Sex chromosomes were identified in the early 20th century; Y was associated with maleness, and the responsible <i>SRY</i> gene was identified in 1991. Early efforts to manage patients with DSDs were confounded by philosophical perspectives on the relative roles of prenatal biology versus postnatal environment. Approaches to natal sex assignment evolved in the later 20th century and now emphasize a team approach based on data, not guessing, parental involvement, cultural considerations, and the acknowledgement of uncertainty.

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Section: Sex Versus Gendermentioning

confidence: 99%

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

et al. 2022

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Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development: Common Ground and Opportunities for Improvement

Cools,

Cheng,

Hall

et al. 2024

Horm Res Paediatr

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Background: In the last 15 years, the care provided for individuals born with differences of sex development (DSD) has evolved, with a strong emphasis on interdisciplinary approaches. However, these developments have not convinced some stakeholders to embrace the current model of care. This care model has also paid insufficient attention to socio-cultural differences and global inequalities. Summary: This article is an opinion statement, resulting from in-depth discussions and reflection among clinicians, patients, and family support organizations based in the US and Europe, where we seek areas of common ground and try to identify opportunities to further develop resources. The product of these conversations is summarized in 10 panels. The corresponding sections provide additional discussion on some of the panel items. Key messages: Participants identified areas of agreement and gained a deeper understanding of the reasons behind disagreements on certain matters and identified the necessary steps to foster future consensus. We offer preliminary recommendations for guiding clinical management and resource allocation. By promoting a broader consensus, we aim to enhance the quality of care and well-being for individuals of all ages who have a DSD.

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Are We Prepared to Abandon the Idea of Sex Binarism? A Biomedical Perspective

Cited by 2 publications

References 24 publications

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development: Common Ground and Opportunities for Improvement

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