Conservatives should think carefully about sex and gender. There is a formidable edifice of academic work on the topic, mostly being conducted in departments that conservatives (perhaps rightly) don’t take seriously and don’t care to touch. But like it or not, our culture has imbibed deeply of gender ideology. Conservatives can’t afford to be unfamiliar with the new language and its metaphysical presuppositions.

Therefore, I welcome Jennifer Gruenke’s recent essay in Public Discourse, wherein she describes the rare intersex condition “from a biological point of view” and argues that, given the scientific facts surrounding many of these cases, conservatives should take a more tempered approach toward transgenderism. As long as other possible explanations of gender dysphoria are ruled out, she argues, conservatives should give transgender people the benefit of the doubt and take their introspective reports at their word. Because there is a plausible genetic account of transgenderism, conservatives should assume that the transgender person’s professed divergence between bodily sex and reported gender is a result of some variety of intersex condition.

Unfortunately, I do not find Gruenke’s case convincing, for it relies on an unsupported assumption and does not succeed in answering a key objection.

Gruenke’s Account

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Gruenke’s account is as follows. All embryos start out, in a sense, as “female.” In males, the presence of certain hormones initiates or halts the default developmental pathways. If the right hormone is not produced, or if cells become unreceptive to it, then some or all of the pathways relevant to sexual phenotype may halt or fail to initiate at all. But since different pathways are regulated by different hormones, there is a possibility of phenotypic divergence: In a fetus with XY sex chromosomes, one part of the body might “masculinize,” in accordance with the “normal” pathway, while another part of the body does not.

This latter, unmasculinized part of the body might be the brain. In this case, Gruenke suggests, the person will grow up with a “female” brain. Therefore, it’s understandable that such a person would report being a female—having a female gender identity. But such a person would look just like a transgender person: an apparent male who reports being a female. Therefore it is plausible, Gruenke argues, to suppose that transgenderism can arise as a result of a straightforward mutation.

Gruenke does not deny that, as in some cases recently recounted at Public Discourse, divergence between bodily sex and introspective report might be the result of underlying psychological trauma. In those cases, she agrees, treatment should consist of therapy, not surgery. But, she claims, there is reason to believe that psychological trauma does not explain all cases of transgenderism. Transgenderism as a variety of the intersex condition should be our default assumption, where psychological trauma is not apparent, and gender-reassignment surgery might be an appropriate corrective.

Paradigm Cases

There is an assumption implicit in Gruenke’s argument. Her account relies on paradigm cases to determine what is constitutive of maleness and femaleness: which primary and secondary sex characteristics are male and which female, what a male or female gender identity is, etc.

Gruenke writes:

I will follow the convention of using the word “sex” to refer to the sexual characteristics of the body exclusive of the brain, and “gender” to refer to the subjective, internal experience of being a male or female. Sexual characteristics are either primary or secondary. Primary sexual characteristics develop prenatally and directly relate to reproduction (for example, having testes vs. ovaries). Secondary sexual characteristics develop at puberty, and may or may not relate to reproduction.

Suppose that transgenderism is possible, and one’s gender can diverge from one’s sex. It follows that, say, some females have male reproductive organs; some females have penises. But then what makes those reproductive organs male?

One cannot avoid appealing to paradigm cases, to what usually and typically happens, where “usually” and “typically” have both descriptive and normative force. We can see this in the truth of what some philosophers have called Aristotelian categoricals. A proposition like “Dogs are four-legged” does not claim (falsely) that all dogs have four legs; nor is it so trivial as to state that some particular dog has four legs. It rather states what is normal or typical for dogs.

In the passage quoted above, Gruenke is relying on such norms. Which sex characteristics are male depends on the role that they typically play in reproduction—or the fact (if they are not directly related to reproduction) that they occur alongside male primary sex characteristics. What counts as a mutation, or an inhibited/activated male or female developmental pathway, depends on what occurs normally.

This account of sex, then, has much in common with the account of sex identity that Christopher Tollefsen recently introduced at Public Discourse. Because human beings reproduce sexually, human beings are either male or female in the typical case, and their sex corresponds with the function that their reproductive organs can play in coitus. There is no other principled way for picking out the sexes.

As Tollefsen argues, sex being so defined, it is not even possible to change one’s sex, and attempts to do so will mutilate otherwise functional organs. So long as the practice of medicine is correctly understood as the practice of restoring human bodies to their proper functioning, gender-reassignment surgeries will fall outside the domain of medicine. The conservative can happily grant Gruenke’s biological account, for the sake of argument if not because it is true—there is a fair bit of disagreement over the science and how best to interpret it, after all. But Gruenke’s account, in what it presupposes, offers only reasons to accept Tollefsen’s argument, while offering nothing to resist his conclusion.

An Objection Unanswered

It is also worth looking at Gruenke’s response to the proposed analogy between transgenderism and psychological disorders such as anorexia. An anorexic person sees herself as being overweight, even though she is in fact underweight.

It would be silly to doubt the honesty of an anorexic person; though we think there is something wrong with her introspective report, we do not doubt that there is something behind it, that she makes it for some reason. The anorexic person might have brain chemistry similar to that of someone who is overweight. In fact, the chemical imbalance might be a result of some heritable mutation, shared by one’s identical twin. But an anorexic person’s introspective report is nevertheless incorrect.

Honesty, brain chemistry, and genetics are not sufficient to show that someone’s introspective report is correct. Nor are they sufficient to show that bodily change in accordance with the introspective report would be warranted.

Gruenke does not appreciate the force of this objection. She writes:

the analogy between people who are anorexic and those who are transgendered breaks down when we consider the respective goals of the two relevant parts of the brain. The part of the brain that regulates body weight exists so that a healthy weight can be maintained. There is a range for healthy body weight that is the norm; someone with anorexia wants to achieve a body weight that will lead to electrolyte imbalances that can be fatal.

But this first part of the response concedes the force of the objection and merely changes the subject. Again, the objection aims to show the insufficiency of honesty, brain chemistry, and genetics. To point now to some other difference (what perception of gender and perception of weight are supposed to regulate) between transgenderism and anorexia just changes the subject. It concedes that Gruenke’s biological account does not itself show that gender-reassignment surgery is an appropriate response to transgenderism; it concedes that something else is needed.

Moreover, this part of the response shares a flaw with many other responses to proposed analogies: It finds a difference between two things without arguing that it is the decisive or relevant one. Any two things that are analogous in some respect are also different in some other respect. That’s the point of an analogy.

Something else is needed—but what? The response cites a problem with anorexia: The brain is supposed to be regulating body weight. In anorexia, it does not succeed in doing so, and that is dangerous for the individual. Gruenke continues:

Thus in anorexia, subjective perception is clearly at odds with proper function of the human body. On the other hand, the part of the brain that contributes to the perception of gender doesn’t regulate anything, but exists just for psychological identity. One can survive, and even reproduce, without having any gender identity at all.

Note that the insufficiency of the mutation account is still tacitly granted. What’s needed is that, furthermore, the abnormal brain chemistry does not lead to bodily harm.

But this response begs the question against an account of sex and gender identity like Tollefsen’s. For what constitutes bodily harm? If a man’s female self-perception leads him to undergo surgery that renders him infertile, then bodily harm has occurred.

Moreover, we can apply Tollefsen’s account of gender identity too. For Gruenke claims that “the part of the brain that contributes to the perception of gender doesn’t regulate anything, but exists just for psychological identity.” In the paradigm case, sex identity and gender identity match up; this paradigm unity is not pointless. Gender does not merely serve “psychological identity,” then, but modulates how truths about our sexuality are conveyed publicly.

Ordinary Language and Gender

In debates about transgenderism, phrases like “feeling like a woman trapped in a man’s body” and “the subjective, internal experience of being a male or female” (Gruenke’s definition of “gender”) are common. But the meaning of these expressions is not immediately clear.

Do you have a feeling of being a man, or a feeling of being a woman? These feelings, if they exist, are not like the feeling of being pinched, the feeling of a hot stove, or the feeling of anxiety. Unless you are “genderfluid,” you have only ever felt like a man or felt like a woman: not both. You have no point of contrast. How do you know that this feeling is the feeling of being a man, as opposed to that of being a woman? Indeed, such a feeling would be an odd sort of feeling—for if a given person felt it persistently, throughout his life, with no point of contrast, then it would be pointless. It would not be a sort of signal, like our senses of pain and of taste are.

To use Thomas Nagel’s famous expression, there is something that it is like to be a bat, and there is something that it is like to be a human, but there is—as far as I can tell—nothing it is like to be male.

Perhaps these expressions are supposed to be elliptical for something, such as possessing a cluster of desires normally possessed by women. Someone inclined to say that he “feels like a woman” might variously desire to, say, wear dresses and high heels, to act like a woman and be treated like a woman. More specifically, the transgender person experiences these desires as frustrated. In that sense, he does not actually feel as most women feel, for even women who want to wear dresses and high heels generally experience those desires as fulfilled.

Now, I don’t want to deny that there is something, objectively speaking, to manhood and womanhood. To cite a few stereotypes, men might tend to be more competitive, women more nurturing. Boys might tend to prefer to play with cars, and girls with dolls. Men and women are sexually different, and (if Tollefsen is right) should develop a gender persona in accordance with their sexual identity. The point is not whether any of these things just listed is true, but that the denial that there is “something it is like” to be a man is not the same as saying there is nothing to manhood.

An Analogy with Marriage

This is why Tollefsen’s accounts of sex identity and gender identity are particularly attractive. What is fundamental is sex identity, which is defined in relation to procreative function. Gender is the social and psychological side of this; one adopts a gender persona in order to express truths about one’s sexuality, and this is essential to being part of a community where one’s sex identity is relevant.

There is a crucial difference between Tollefsen’s account of gender and Gruenke’s account. Adopting a gender persona is not given. It is something that is developed in response to one’s given sexual identity, which provides a sort of vocation—not a fully determinate life plan, but a structure nonetheless. Usually, as Tollefsen notes, society has a lot that is positive to contribute to development of a gender identity. There can sometimes be psychological factors at play that make it more difficult—sometimes extremely difficult—to develop one’s gender persona. Yet cultivating a gender persona remains, in a relevant sense, an active task.

Putting sexual identity in the driver’s seat has important advantages, especially where marriage is concerned. Our reproductive faculties are ordered to reproduction and the education—the rearing—of offspring. A man beset by salacious sexual fantasies, who desires to break apart his family in order to pursue them, ought to do otherwise because his sexual identity is ultimately ordered to his family’s good. His gender persona should be formed to the end to which his sexual identity “calls” him: responsible fatherhood.

Likewise, the orientation of the reproductive powers to reproduction provides a powerful argument that we should seek to conform our gender identity to our sexual identity—not the other way around.