Assigned at Birth?

In 2022, when I signed up for a COVID-19 booster at CVS, I encountered a strange question on the online form: I was asked what sex I was assigned at birth. There was a question mark icon I could select to learn more. Clicking on it, I found the following verbiage:

How do we use sex assigned at birth information? The Centers for Disease Control and Prevention (CDC) requires us to collect this demographic information for COVID-19 vaccinations. Our pharmacy team uses this to provide information about your medications and vaccines such as potential side effects that relate specifically to your sex assigned at birth.

No one assigned my sex at my birth in 1983. If they had, it would have no connection to potential side effects, because such side effects are primarily related to biological realities. Male and female immune systems respond differently to vaccinations because sexual differentiation is real, not because it is assigned. 

If sex is assigned the way that names are assigned, then why not ask about side effects related to my name assigned at birth? Whoever wrote this questionnaire for CVS knows that historically, no one thought of sex assignment in 1983; linguistically, no one actually says they are assigning a sex at birth; and biologically, culturally assigned designations do not have side effects in the way that biological features do.

There is a troubling unreality to the discourse around “assigning” that corrodes our ability to publicly deliberate about sexual difference, feminism, and issues related to trans identity. When we say that we “assign” sex, we employ language to describe a biological reality that simply does not exist. 

Philosophers since Socrates have worked hard to pay attention to how we speak. For Aristotle, paying attention to endoxa—what is commonly said—is a necessary step toward accessing and understanding reality. In what follows, I want to call out the deep untruth of the “assigning” discourse, then explain the merits, and wisdom, of “finding out.” 

Finding Out the Sex of Your Child

Ultrasounds have become an important moment of preparation for the birth of a child. You watch, patiently and nervously, as the ultrasound technician scans along, looking for the baby, when suddenly a foot, hand, or face appears. With our third child, the technician was scanning along and suddenly said, “Whoops! I forgot to ask you if you are finding out the baby’s sex.” Of course, the “whoops” was motivated by having shown some tell-tale signs. A boy, I found out before the technicians let us know. Beyond the unexpected reveal, the language of the moment is pretty set: “Do you want to find out the sex?” and then, “You are having a boy (or a girl).” What no one says in the process is: “What sex are you assigning the baby?”

Ultrasounds first reveal our children to us, a revelation that includes their sex. With my son, the sex was disclosed beyond any of our intentions. The technician did not mean to show, and we had not yet asked. But there he was. We unintentionally perceived beyond and before any possible “assigning” could have taken place.

And it is a discovery, one over which we have no real say. When we discover something, we uncover a reality that is already there. It is a datum: a given, a reality. There is a certain passivity to discovery; you cannot decide something will be there. It is there or it is not, and so it manifests itself to you. In contrast, assigning puts you in charge. To assign is to determine for another what will be the case. 

Granted, in finding out the sex, one does get some say about the timing: will you find out at the anatomy scan, through an early blood test, or at birth? Regardless of when you find out, the sex of the child is the first thing you discover about him or her, long before you know his or her personality, temperament, or preferences. Before anything else, the child is differentiated from half of his or her fellow humans by revealing an identity as a “he” or a “she.” 

Having two daughters and a son, I have seen that this excitement is not limited to parents. With my first two children, I told friends we are having a girl. The response: “That’s wonderful!” With our youngest I told them we are having a boy. The response: “That’s wonderful!” What is so delightful about the identical responses to differing information is that it is in fact wonderful. This first gift of particularity, the gift that allows you to say “he” or “she,” is wonderful either way. Wonder is in response to a revelation. We can tell this revelatory character by the fact that no one has said to me “It is wonderful that you made that choice” or “Good work assigning ‘male.’”

The excitement at this moment is the first of a lifetime of discoveries that shape the way you raise the child. Because of this discovery, parents can begin raising the child by assigning a name. Here, again, we encounter an important linguistic difference. People ask you if you are going to find out the sex; but about the name, they ask if you have chosen one. When the child reveals his or her sex to the parent, the parent must assign the name.

The difference between these two scenarios is clear and emblematic of the complicated dynamics of parenting. The child is his or her own person. As Hannah Arendt describes in her theory of natality, each person is a new beginning. They are agents able to initiate themselves into the world in their unique way. Parenting takes a lot of “finding out” about the child that we do not manufacture. And yet they are also formed by parents and society because humans are traditional beings, shaped by the rich norms and practices of a given culture. It can be hard to tell the difference between what arises from this new person and what is given to him or her. Parenting is a mix of discovering and assigning and learning to tell the difference. 

The Fiction of “Assigning” Sex

Just because something is commonly said does not mean it is true; but such falsehoods still must be taken seriously. What is commonly said about the sex of a child is that people are finding out, discovering, and delighting in the revelation of a particular sex (including over-the-top gender reveal parties). Few ever say that they are “assigning” their child’s gender, even if they buy into the cultural ethos that suggests such assignment is possible in the first place.

Consider this as a way of thinking about it. My family will be buying a three-bedroom rowhouse. When I was talking with a friend about possibly having a fourth child, I said that I hoped it would be a boy. Why? Because the two boys sharing a room, and two girls sharing a room, is a better arrangement than three girls in one room and one boy in another. And of course, people respond, “Well, you don’t have any control over that.” And they are right. 

But I could have responded differently. I could have said that considering our housing situation, I am going to assign my next child as male. I would have a legitimate reason to do so. If it is all a matter of assignment, why not? How do you envision people responding? Beyond perplexity, people would be troubled by this distortion of reality and by its resulting absurdity. But they would also be troubled by its domineering approach to the child.

Imagine at the ultrasound I am told, “It’s a girl!” I respond, “No, I am assigning the child to be a boy!” Or I say that there is no need to check at all since I have already decided. The idea of “assigning,” of course, runs up against reality in a way that “finding out” does not. Having found out, I am faced with reasonable questions. Having “assigned,” I cannot engage in the discourse that arises from the reality of having a girl (like, for instance, that there is no need for a circumcision to be performed after birth).

To claim such a power over my child would be tyrannical. It would deny the complicated dialectic of what arises from the child and what is offered by the parent. Think how disturbed one would be by a parent, or worse, a pediatrician or ultrasound technician, who spoke and acted this way. Imagine asking if the doctor is assigning the sex at the ultrasound or birth. Imagine handing that power to the medical establishment. Our revulsion at the realities that would flow from accepting this discourse speaks to the deeper truth and realism not of assigning, but of finding out.

Recovering the Gift

Discarding the language of assigning does not fully resolve the complexity of sexual identity and the task of raising a child. First, we can overdetermine what sexual identity means for a child as evidenced in the blue or pink extravaganzas of gender reveal parties. Further, there are children born with a range of intersex conditions, though these rare circumstances (.002–.005 percent of births) are notable because they create a challenge of finding out the child’s sex. Finally, evaluating the realism of describing sex as discovered or assigned does not itself resolve the many complexities of public debates about transgender issues.

Nevertheless, it’s vital to recognize that the language of “assigned at birth” is a distortion of reality. Recognizing it as a distortion helps us in our public debates because it clarifies meaning and sets contours to how we can discuss biological realities. It rejects a way of speaking about sex that treats it as an artifice rather than a reality—as something we can define and shape and make, not a mystery to be discovered and enjoyed. Most importantly, remembering how we actually speak of children reminds us that children are not a product but a gift. A world where sex is assigned is a world of false power and dominion, not of gift, discovery, or revelation. 

To assign is to flail and thrash about as we try to exert control over the uncontrollable. But to wait in the ultrasound office or in the delivery room to find out, to then share with others in this first discovery of our child’s identity, to delight equally in male and female, is to recover our fundamental vulnerability to the gifts given to us. Our vulnerability to the gift is the source of our delight at the news that unto us a son or daughter is given.

Image by Rattanachat and licensed via Adobe Stock.