At the halfway point of your mother’s uterine life, she had all the eggs nestling and jostling about in her little ovaries that she would ever have. At twenty weeks she had 6 to 7 million proud eggs within her, fresh heirlooms of genetic brilliance all. A woman’s egg, her offering in the formation of a new human soul, is yet another example of nature’s lavish abundance. For “the millions of eggs that we women begin with are cleanly destroyed through an innate cell program called apoptosis. The eggs do not simply die— they commit suicide. Their membranes ruffle up like petticoats whipped by the wind and they break into pieces, thence to be absorbed bit by bit into the hearts of neighboring cells. By graciously if melodramatically getting out of the way, the sacrificial eggs leave their sisters plenty of hatching room.” (1) The eggs that survived the sweeping rejection of apoptosis now await their chance to slide down the fallopian tube to the uterus. Here, many years later, the egg that formed you was one of the few who were surprised to be eagerly met by thousands of sperm whipping and racing towards it. One sperm penetrated the luminous egg and formed you— a statistical miracle.
Though you were either genetically male (XY) or female (XX) at fertilization, your sex was otherwise indistinguishable for the next several weeks. The male and female gonads plod along without committing to either sex into the sixth week of gestation before converting into either ovaries or testes. Little boys immediately go about egging on their prized gonads, whose job is to pump out the testosterone that affects the remainder of their development. Girls are a bit shyer; they set about primping their müllerian duct into the appropriate internal organs a few weeks later. By birth, you came into the world a fully female baby with your chromosomes, reproductive organs, hormone levels, and brain processing all intricately synchronized like a master Russian ballet.
“Except when you don’t. Because, sometimes, you won’t. I'm sorry to say so but, sadly it's true that bang-ups and hang-ups can happen to you.”(2) This timeless wisdom from Dr Seuss aids me in warning that at every step of the sexual differentiation, something can, and often does go wrong. The four defining sex characteristics include a person’s chromosomes, reproductive organs, hormone levels, and brain processing and a discrepancy between these puts someone into the category of being an intersexed person; that is, not fully male or female. Milton Diamond commented on intersexed development saying it is “biologically understandable while statistically uncommon” (3). “Ironically since the advancements in surgery have made it possible for intersex conditions to be concealed, many people are not aware of how frequently intersex conditions arise in human beings or that they occur at all” (4). How commonly is a person born who can’t be clearly defined as ‘male’ or ‘female’? A study that surveyed medical literature from 1955 to the present found that as many as 2% of live births do not conform to the ideal male or female (5).
The list of possible deviations is long. Some people have ambiguous genetic material with some XY cells and others XX. A common condition called Androgen Insensitivity Syndrome occurs when chromosomal ‘males’ are androgen insensitive resulting in the body developing female genitals and hormone levels. Distinctively feminine to the eye and often in their gendered identity, AIS women often do not discover their condition until puberty or when they seek infertility treatments and a doctor informs them they are infertile due to the fact that they are— partially men. Likewise, genetic females can be prenatally overdosed with androgens resulting in partial male development. Any mis-measure of the hormonal cocktail produces a person whose sex cannot be confirmed by a quick diaper change. Not only is the amount of necessary uterine hormones precise, the timing is as well. The timing of hormonal exposure can result, for example, in a person who is a fully functional male on the outside, but partially female on the inside with most of the piping for female reproduction. “Sometimes a person isn’t found to have intersex anatomy until she or he reaches the age of puberty, or finds himself an infertile adult, or dies of old age and is autopsied. Some people live and die with intersex anatomy without anyone (including themselves) ever knowing” (6).
Unfortunately this is a reality that most people are unaware of, and of which I myself didn’t even stumble upon until three years into the research of this book when I had a hard time finding an answer to the basic question: ‘what does it mean to be female?’ Surprisingly, the common notion that females have XX chromosomes and boys the XY, is not even close to being true. The
To be Continued...
- Angier, Natalie. Women: An Intimate Geography.
; Peter Davison Publishing with Houghton Mifflin Company. 1999 P 3 New York
- Diamond, Milton, H. Keith Sigmundson. “Management of Intersexuality: Guidelines for Dealing with Individuals with Ambiguous Genitalia.” Archives of Pediatrics and Adolescent Medicine. (1997)
- Dr. Seuss. Oh The Places You’ll Go.
- Domurat Dreger, Alice. “‘Ambiguous Sex’ –Or Ambivalent Medicine?” The
Report May/Jun 1998, Volume 28, Issue 3 P24-35. Hastings Center
- Blackless, Melanie, Anthony Charuvastra, Amanda Derryck, Anne Fausto-Sterling, Karl Lauzanne, Ellen Lee. How sexually dimorphic are we? Review and Synthesis. American Journal of Human Biology Volume 12 Issue 2, P 151 – 166
- Intersex Society of
North America. “Does Having a Y Chromosome Make Someone A Man?” May 2006.
. “What If It's (Sort of) a Boy and (Sort of) a Girl?” The New York Times. September 24, 2006 Elizabeth