Manager's Report

by Elizabeth Riley

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

Clearly the long struggle for rights is bearing riper and more succulent fruit. Over recent months there has been a range of interesting developments on the world stage that will have significant impact on the transgender, transsexual, intersex, gay, lesbian and bi-sexual communities.

Of great significance is the Brazilian Resolution. In brief this is a resolution to be tabled before the United Nations at their meeting in Geneva in March 2004, inviting discussion and argument as to whether sexual orientation and gender identity are human rights or not. The fifty-three nations represented will vote and publicly declare whether being Lesbian, Gay, Transgender, Transsexual, Bisexual, (or heterosexual for that matter), is a basic right of human beings.

Paralleling this is the speech made in Britain's House of Lords by Lord Winston on February 3, 2004. The following is an extract from that speech as recorded in the Lords Hansard.

'My Lords, I reluctantly join the debate at this stage of the Bill. I apologise for not being in the House at Second Reading and for hearing only part of the Committee stage. However, I feel so strongly about the amendment, as well as about Amendment No. 128, that it is important to put on record the medical facts.

As a practising obstetrician and gynaecologist who has been involved with reproductive medicine and the definition of sex in both animals and humans for the past thirty years in my research, I can only reiterate the comments of my noble friend Lord Turnberg.

The definition of sex is extremely complicated. It is not just a question of chromosomes. It is possible of course to have chromosomal sex and it is probable, though by no means certain, that all of us in this Chamber have chromosomes that are either XX or XY. However, even in the case of Turner's Syndrome, which my noble friend has just described, it is possible to have an XY mosaic, with some of the cells carrying a Y chromosome and some having a deleted X chromosome. The variations of that syndrome mean that people may have different degrees of masculinity or femininity.

Most practising doctors in the field would describe sex on six, totally separate, definitions. Those definitions can be chromosomal but, more importantly, they are genetic. It emerges that genes on the Y chromosome are not the only genes that define sex. Although the Y gene is by far the most common and important, there are genes on chromosome 17, chromosome 11, chromosome 10, chromosome 6 and chromosome 3 that can, in exceptional circumstances, determine sex of various kinds. Those people can carry on a completely normal life.

Genetic sex is therefore no less important than chromosomal sex, but that is not the end of the story. There is also hormonal sex. Some people will produce hormones that will tend to feminise them, while others will be masculinised. That can happen in utero. Good evidence has emerged from Professor Walters of Monash University in Australia - he is now long retired - that suggests that some people who become transsexuals later in life have been exposed to an abnormal surge of either male or female hormones during pregnancy. That has caused them to have a different psychological sex from their genital sex. Psychological sex of course depends on brain function. That also varies greatly and is probably genetically determined, but so much exploration of that subject is being conducted that is not fully understood.

Genetics is rapidly changing our understanding of where sex is determined. But to define it simply as genital, hormonal or, as the noble Lord, Lord Tebbit, seeks to do, as gonadal, is a travesty of what really happens.

Let me give one example. Janice was the most beautiful woman, who came to my unit some time ago. She was six feet tall, and had been brought up as a woman. She had very well developed breasts, a perfect physique, and was actually XY. She did not find that out until she was twenty. Some people with XY dysgenesis believe themselves to be female and relish being female. Others find that when they are actually male because of their chromosomes, they entirely change their view psychologically.

I should like to make the point made by Robert Jaffe, now retired, a very distinguished endocrinologist. He says in his chapter on reproductive medicine headed "Disorders of Sexual Development":

"It is crucial that the clinician who deals with patients with genital ambiguities be sensitive to the emotional as well as the physical needs of the patient. The patients frequently have a great deal of confusion and anxiety about their sexual roles.

Whereas genetic, gonadal, hormonal, and genital sex may be of prime importance to the physician, the gender identity (that is, how the patient views himself or herself) and the sex of rearing are paramount in determining the patient's sexual identity".

Robert Jaffe is effectively saying that there needs to be an understanding of the autonomy of the person concerned because, on the whole, they are the best people to judge how they feel about their sexuality. That is true of the 200 different mutations which could have affected Janice, my patient. There are so many different fluctuations in this broad spectrum of sexuality that I urge the House to be very cautious about defining it in terms of chromosomal, genital or any other simple definition. It simply is not medically just, and I am sure that it would produce bad law.'

Meanwhile, across the Atlantic, William O. Beeman, an anthropologist at Brown University delivered a not dissimilar argument in his commentary in the Pacific News Service on Feb 5, 2004, against current attempts by legislators in the U.S. to codify marriage as "between a man and a woman." In his commentary Beeman argues that such an attempt is doomed to failure since the "Laws Can't Define 'Man' or 'Woman'." He argues that there are at least three ways of codifying gender under law biologically, psychologically and culturally and on close examination all of them fail. By way of example he cites the many variations affecting those in the intersex community as proof of the unreliability of the biological argument. Though there is evidence to suggest that transsexuality is also biological in its origins, Beeman cites gender dysphoria as the prime example for the ineffectiveness of psychological attempts to codify gender. And in respect of cultural coding Beeman cites, out of many possibilities, the Zuni Indians of Arizona and the Hijra of India who culturally classified as neither male nor female. The thrust of his argument is, therefore, that: if the law cannot effectively define a 'man' or a 'woman' how can it seek to restrict marriage to people who are so defined.

For those of us in the affected communities there is nothing new in all of this. We've known from an early age and for many years now that sex and gender are far more complex and diverse than the predominant culture would have us believe. What is exciting is the ever increasing numbers of people outside our communities, many of them with a significant degree of influence, who are striding forth to champion our cause. Let's also acknowledge that this shifting recognition is not the result of some fortuitous accident, but a direct consequence of the committed efforts of the many activists in the transgender, transsexual, gay, lesbian, bisexual and intersex communities who have steadfastly refused to succumb to the oppression of a dominant culture over many, many years. Let's also remember that within that oppressive culture there are still a vast number of 'Lord Tebbits' who will cling to their crumbling view of reality no matter what the cost to others.

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.