Elizabeth Veronica Weaver: Biological reasons for gender dysphoria

With all the misinformation spread about “trans” people and about “only two sexes,” the scientific evidence for individuals born with both male and female characteristics has not been part of the national conversation. These individuals, currently referred to as “intersex,” are those who, due to genetic variations, have both male and female characteristics, including genitalia.

Variations are genetic changes that differ between individuals (e.g., an extra pair of ribs). These are notable, but don’t affect life span or function. Malformations are severe changes (e.g., limb abnormalities caused by thalidomide). While some malformations are so severe that they prove lethal, others, such as the thalidomide example, do not cause death but leave the affected individual with severe physical or mental disabilities.

However, intersex variations are in a class of their own since, in a rational society, they have no effect on a long, meaningful life. In our current political environment, these individuals are being used as political pawns by religious groups and politicians who deny their very existence. There are also mental health consequences.

There are at least five major genetic conditions that can cause these conditions. One involves the fusion of two eggs prior to birth, resulting in a fetus with two X and one Y chromosome (XXY) and the expression of both male and female genitalia at birth, though the expression of the symptoms varies in affected individuals. It may not be overtly apparent until puberty.

Another type are individuals who are completely male (Klinefelter syndrome) but cell receptors for the male hormone are resistant to the androgen (male sex hormone), similar to insulin resistance. These young men have undeveloped testes and a penis, but since the male hormones can’t be expressed, without treatment, they present as female: tall, broad shoulders, small breasts, no menstruation ever occurring, resulting in infertility. This condition is sometimes diagnosed during puberty; otherwise, unless another medical condition requiring detailed testing occurs, it may never come to light. Currently, no reliable information exists on the number of affected individuals, but estimates indicate population percentages between 0.5% and 1.7%.

Most of these people do not consider themselves part of the LGBTQ community. In past centuries, no treatments, hormonal or surgical, allowed individuals to decide to transition to one sex or the other. Imagine a teen going through puberty and finding out that they had this condition. How do you explain this situation to peers and other people you come in contact with? If they want to compete in sports, where do they fit in, especially if they are younger and haven’t made a final decision?

In all cases, affected individuals will need to decide their gender identity eventually. Depending on the extent of the condition, hormones and/or surgery may be appropriate interventions. If they were born with both types of genitalia, then God did indeed create a “trans” person who should be accepted and loved just like anyone else.

With advances in modern medicine, affected individuals now have choices. When to make them is controversial. Ethically, is it up to the doctors or parents, or should children be allowed to reach an age when they can make decisions? All treatments involve hormone treatments, the same treatments being banned in many states today.

With all the culture wars being hyped for political purposes, this is one group (of many) that is falling through the cracks. For all our talk of being “Christian” and “pro-life,” we Americans, as a group, are not particularly caring, compassionate or tolerant of anyone “different.”

These individuals should be able to lead productive, normal lives and make decisions they need to concerning their gender “identity.” Denying what they have to go through, and not allowing them the medical treatment they need if and when they make a decision, is cruel and unusual punishment. Lawmakers playing “God” and “Doctor” with no medical degree need to stop their discrimination and their attacks on the medical profession.

Elizabeth Veronica Weaver of Hempfield was a toxicologist for over 40 years and a certified toxicologist from 1997-22, with expertise in reproductive toxicology and teratology, the study of variations and malformations.