The first says that boys and girls are born as such and, if there is a mistake in categorisation at birth, the truth will become apparent sooner or later. In other words, biology is destiny.
The second is that gender identity is flexible and can be modified through changing circumstances. In other words, people can re-label themselves, the conclusion drawn by Imperato-McGinley. (discussed elsewhere)
However, taking the third viewpoint first, Money and Erhardt assert that gender identity depends primarily on the sex of rearing. That is, given one or the other label, the child expects to grow according to that label, and others expect it to. In contrast to those who claim that biology is destiny, Money and Ehrhardt assert that in the first two-and-a-half to three years, a child sense of itself as male or female is flexible enough to allow its sexual label to be changed without undue disturbance.
A number of girls suffering from the adrenogenital syndrome (congenital adrenal hyperplasia), had been mistaken for boys and raised as such. Money and Ehrhardt found that, if they received surgery to reassign them as girls, before the age of about three, they adapted easily to the role of opposite sex. After the age of three they had quite severe problems. They were studied as they progressed into adulthood, with some difficulty, for the knowledge that they were 'different' could have affected them, and many dropped out of the programme. Bancroft suggests that those that were raised as boys were quite accepting of surgery to remove the uterus.
Money and Ehrhardt concluded that, regardless of all the biological and hormonal predictors, psychological sexuality or, more precisely, gender identity, is undifferentiated at birth, but becomes adjusted to the sex of rearing. Money suggested that it was rare for such people to request reassignment, even though, as girls, they might become virilised at puberty, or as boys, growing breasts and having difficulty with erections. Thus, they claimed that biological contributions to identity can be moulded or even reversed by social influences in early childhood. The people concerned may well, however, have felt themselves to be 'mannish' girls, or 'womanish' boys.
As a result, it has become standard practice in the more serious cases where male babies have ambiguous genitalia to reassign them as female, since it is possible nowadays to create a realistic pseudo-vagina, but not a penis.
In fact, in the last few years, there are numbers of such children who have rejected the assignment given them, and expressed a great deal of resentment about the surgery performed on them. In fact, it is now suggested that most CAH girls adopt the female role, even if originally brought up as boys. Moreover, it is clear that their experience cannot be generalised to all intersex children. We have hinted at this in the previous section, though, unfortunately, what information we have is anecdotal.
Given the confusion, can we really apply the conclusions to children who have no apparent abnormalities? The most that one can say, it seems to me, at this point, is that if people are unequivocally recognised as male or female, and recognise their bodies as such, then they generally see themselves as male or female. If their bodies are different in any way, then the seeds of doubt are sown, that absolute certainty is not there. Even so, there are a number of what might be termed cognitive transsexuals.
How is it that so many people have the unalterable certainty that they have been cast into the wrong role in life? We may list various factors, we can describe processes involved in developing certain behaviours. The complexity, however, of the biological and experiential paths taken by each individual, means that there is no one simple solution.
At this point we enter a morass of claims and counter-claims. This site aims to summarise what is written, interpreting it as dispassionately as possible. For our own personal speculations see"Questioning Assumptions"on our other site.
Bibliography and good reading.
Bland, J., (2001) About Gender: Discussion.
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Web page copyright 1999-2006
Derby TV/TS Group. Text copyright Jed Bland.
12.05.98 Amended 27.03.99, 01.04.01