Sax (2002) +

"How Common is Intersex? A Response to Anne Fausto-Sterling" by Leonard Sax (2002)

Critical Reading Questions

Does Sax (2002) consider “sex” to be dichotomous or continuous? Explain why he thinks this way. Does Fausto-Sterling (2000) consider “sex” to be dichotomous or continuous? Explain why she thinks this way. Based on the evidence, who would you conclude is correct?

  • Sax (2002) considers "sex" to be primarily dichotomous, meaning it typically falls into two distinct categories: male or female. He holds this view because he focuses on the specific biological criteria for defining sex, (objective, like chromosomal sex and distinct genitalia)

  • Fausto-Sterling (2000) leans towards considering "sex" as more of a continuum rather than strictly dichotomous. her broader definition of intersexuality allows her to incorporate various conditions that blur the boundaries between typical male and female categories (make it look more like.a spectrum)

Why does Sax (2002) consider the following true examples of intersexuality: androgen insensitivity syndrome and congenital adrenal hyperplasia?

  • considers Androgen Insensitivity Syndrome (AIS) and Congenital Adrenal Hyperplasia (CAH) as true examples of intersexuality

  • these conditions involve a significant discrepancy or ambiguity between an individual's chromosomal sex (genotype) and their physical appearance (phenotype).

  • there's a clear mismatch or ambiguity between an individual's genetic sex and their physical traits, reflecting the essential criterion of intersexuality according to Sax's definition

Why does Sax (2002) not consider the following true examples of intersexuality: Late-onset congenital adrenal hyperplasia, sex chromosome aneuploidies and vaginal agenesis?

  • does not consider Late-Onset Congenital Adrenal Hyperplasia (LOCAH), sex chromosome aneuploidies (like XXY, XXX), and vaginal agenesis as true examples of intersexuality

  • these conditions typically do not involve a significant discrepancy or ambiguity between an individual's chromosomal sex (genotype) and their observable physical appearance (phenotype).

  1. Late-Onset Congenital Adrenal Hyperplasia (LOCAH):

    • adrenal glands produce too many male hormones (androgens), symptoms become noticeable later in life. lead to symptoms like excessive hair growth or irregular menstrual cycles.

  2. Sex Chromosome Aneuploidies:

    • abnormal number of chromosomes, leading to physical and developmental differences.

  3. Vaginal Agenesis:

    • condition where the vagina doesn't develop or is underdeveloped. result in challenges related to menstruation and sexual activity.

Fausto-Sterling argues that late-onset congenital adrenal hyperplasia can cause significant clitoral growth and this can result in surgical intervention (to reduce the size of the elongated clitoris). However, the only reference to this claim that she gives pertains to someone with androgen insensitivity syndrome, not late-onset congenital adrenal hyperplasia. Why would she do this?

  • the reference she provides pertains to someone with Androgen Insensitivity Syndrome (AIS), not specifically LOCAH.

  • This discrepancy in her reference might be due to a lack of specific evidence or cases directly linking to her claims

  • referencing AIS might have been used to illustrate the broader point regarding the impact of hormonal imbalances on genital development rather than solely focusing on LOCAH

According to Sax (2002) is intersexuality natural? Is it normal? What’s the difference?

  • intersexuality is a natural variation in human biology

  • acknowledges intersexuality as a natural occurrence in which individuals have variations in their biological sex characteristics that differ from the typical male or female categories

  • Sax distinguishes between something being natural and something being considered normal. While intersexuality is a natural variation, the term "normal" usually implies conforming to the majority or the typical standard.

  • Sax might argue that although intersexuality is a naturally occurring variation, it may not be considered "normal" (its very rare)

  • while intersexuality is a naturally occurring part of human biological diversity, it may not conform to the conventional societal understanding of what is considered normal

Definitions of Intersex

Fausto-Sterling's Definition

  • Her definition encompassed conditions that most clinicians wouldn't recognize as intersex.

  • Intersex = "any deviation from the Platonic ideal" (encompasses individuals who are phenotypically indistinguishable from normal)

  • Fausto-Sterling's Believed Common Intersex Conditions: (not intersex)

    • The five most common conditions listed are not intersex conditions (show no meaningful clinical sense to call it intersex)

      1. Late-Onset Congenital Adrenal Hyperplasia LOCAH

      2. Klinefelter Syndrome

      3. Turner Syndrome

      4. Vaginal Agenesis

  • Frequency Estimations: Fausto-Sterling's assertion of 1.7% intersex births.

  • Sexuality as a Continuum: Suggests a continuum of human sexuality beyond the binary notion. Fausto-Sterling's argument rests on her claim that intersex births are a fairly common phenomenon

  • Modern surgery: help maintain the two-sex system. Today children who are born "either/or-neither/both"—a fairly common phenomenon —usually disappear from view because doctors "correct" them right away with surgery

Sax's Definition

  • instances where chromosomal sex conflicts with phenotypic sex or where the phenotype isn't classifiable as either male or female

  • a more clinical useful definition of intersex

  • Sax argues for a more precise definition of intersexuality.

Classic intersex conditions

  1. congenital adrenal hyperplasia (CAH)

    • individuals with XX chromosomes (typically female), this excess of androgens can cause the external genitalia to be more masculine or ambiguous.

  2. complete androgen insensitivity syndrome (CAIS)

    • individuals have XY chromosomes (typically male. The external genitalia may appear typically female or ambiguous. This is due to the body's inability to utilize male hormones effectively.

Human Sexuality as Dichotomy: Humans are either male or female. (99.98% of humans are either male or female)

Necessity of Precise Definition: Argues for a more restricted definition of intersex to maintain clinical clarity