Published February 15, 2023
Every newborn child is either a boy or a girl, just as every human adult is either a man or a woman. This is a biological reality. Boy and girl, man and woman, are just the age-specific terms for human males and females. Sex for human beings, like all other mammalian species, is binary. And stable. Sex does not exist along a spectrum, nor is it fluid. That’s why activists use different words—gender, and gender identity—to make those claims.
But stick with sex for a moment. The reason we can confidently say that sex in humans (like other mammals) is binary and stable is because there are two ways of being organized for sexual reproduction. What do I mean by that? Organisms are organized. Human beings, like other organisms, are composed of parts—organs—that work together as an integrated unit (a whole or complete entity). The various organs perform various functions, but not in a haphazard or disorganized way. They are, rather, organized. All of us humans—male and female alike—are organized the same way when it comes to our respiratory system and the function of breathing, and our circulatory system and the function of pumping blood. But we are organized differently in one key respect—sexual reproduction. So when we say there are male and female human organisms—people—we are talking about two ways of being organized sexually—that is, in respect of sexual reproduction and the reproductive system.
Sex is not “assigned at birth,” nor at a twenty-week ultrasound. It is identified, that is, recognized, based on the organization of the organism. Sex—in terms of male and female—is determined by the organization of the organism for sexually reproductive functioning. So sex as a status—male and female—is a recognition of the organization of a body to reproduce in a certain way. More than simply being identified on the basis of such organization, sex is a coherent concept based—and based only—on that organization. The fundamental conceptual distinction between a male and a female is the organism’s organization for sexual reproduction.
Why say it’s binary and stable? It’s binary because there are only two types of sexual organization, and their component parts. There are two gametes, two genitals, two sets of reproductive organs, and two reproductive systems. That is, there is sperm and egg, penis and vagina, testicles and ovaries. There is no third genital, no third gonad, no third gamete, no third reproductive organ, no third reproductive system. That’s the binary. It’s stable—rather than fluid—because unlike some other species, the human being does not—indeed cannot—change sexes, morphing from male to female and vice versa. Nor do truly “intersex” people or “hermaphrodites” exist. Yes, there are disorders of sexual development, where someone may develop without a complete reproductive system and perhaps even with vestigial aspects of the other reproductive system, but these people truly are—and they know themselves to be—male or female—that is, their bodies are fundamentally organized for either the male or female role in procreation. Not both, not neither, and not somewhere in between. (For more on this, see Chapter 4 of When Harry Became Sally.)
“Gender Identity” is Gender Ideology
Of course disorders of sexual development are not what is driving modern transgender ideology. When you see someone appeal to so-called “intersex” conditions, it is a red-herring. What’s taking place today is not the question of how to identify sex in cases where it’s not fully formed and thus hard (at least early on) to classify. No, instead a new ideological framework is being imposed, one where sex is said to be merely “assigned at birth” and then something called “gender identity”—one’s inner sense of something called “gender”—determines one’s sex. On such a theory, there is no intrinsic meaning or importance to the sexed body. Instead, subjective feelings determine reality, so that all of us must adopt a “gender identity.” The end result is that identifying as a boy or a girl, or a man or a woman—or both, or neither, or somewhere in between—is what makes you a boy or a girl, a man or a woman—or both, neither, or somewhere in between. That’s the new dogma, rather than boys being immature human males, and men being mature human males; and girls being immature human females, and women being mature human females. We’ve moved from an objective recognition of reality to a subjective assertion of identity—and to ruthless demands that everyone affirms these identities.
But what could determine this so-called “gender identity” as an inner sense of “gender” distinct from sexual identity and bodily sex? The answer is simple: Social and cultural assumptions based on stereotypes. Stereotypes about how boys and girls, men and women, are supposed to behave, what they’re supposed to be interested in, how they’re supposed to look. Some claim that with “gender identity” there’s an inner truth that is “discovered” (and then asserted) while others say “gender” is a self-created “performance.” What is discovered or performed, however, will be the result of cultural assumptions. In this sense, “gender identity” is a social construct. And today, many new “gender identities” are an explicit rejection of the stable sex binary itself: hence the rise of non-binary identities. Indeed, increasingly it appears that many young women are just opting out—rejecting—their femaleness without any real sense of what it is they’re embracing.
Historically it was primarily little boys and middle-aged men who identified as “transsexual” or “transgender”—or, more accurately, who experienced a form of identity distress that subsequently was classified as gender identity disorder, and has now been reclassified as gender dysphoria. Such individuals experienced a deep sense of alienation from their own bodily sex, and a “transgender” identity was thought to be a possible escape, or coping mechanism, or solution and resolution to that dysphoria. Today something radically different is taking place, where all of us are supposedly men or women based upon how we “identify”—hence the concepts of “cisgender” and “transgender.” Indeed, to even suggest one is “cisgender” implies that “sex” and “gender identity” are only contingently related. (But the options are no longer literally trans-gender, as non-binary and fluid identities are no less valid according to reigning ideology.)
The end result is that we’ve seen an explosion in the number of young people, particularly young women, who are identifying as something other than the male or the female that they are in reality. And it is happening as part of a social contagion, where self-created or self-discovered gender identities sweep through schools and friend-groups as the latest fad. But it’s a fad that can lead to “irreversible damage,” in the memorable phrase of Abigail Shrier’s outstanding book.
Speaking the Truth Is Love
How should we respond when someone adopts an identity at odds with reality, and then asks us to “affirm” that identity, especially if they seek technical interventions in the forms of hormonal or surgical alterations to their bodies? How should we respond when it’s a child or teenager caught up in this craze?
First, it is neither loving nor compassionate to affirm someone in a mistaken identity. Whether it be a new name or new pronouns, hormones or surgery, if the intention behind the intervention is to endorse the new identity, we’re failing in our duties to love—to will the authentic good of another. It is not good to attempt to live detached from reality. Consider medical technologies that could be used to “affirm” a false identity. The purpose of medicine is to bring about human health and wholeness, human flourishing in the physical and psychological domains. Here health is understood not as the subjective satisfaction of desires but as the objective well-functioning of the mind and body, where our various bodily systems achieve their ends—the circulatory system to circulate blood, the digestive system to digest nutrients, the respiratory system to absorb oxygen—and where our thoughts and feelings achieve their ends of bringing us into, and keeping us in, contact with reality. The use of hormones or surgery to redesign a body according to beliefs at odds with reality profoundly violates this norm.
Second, it is never loving to mutilate bodies at the service of affirming false identities. When it comes to medical interventions—so-called “medical transition” or “gender-affirming ‘care’”—physicians are deploying bad means (mutilation) in the service of bad ends (affirming falsehoods). Administering high doses of estrogen to a man who rejects his male reality for some alternative identity (whether as a woman, non-binary, gender-ambidextrous, etc.), or administering high doses of testosterone to a woman who rejects her female reality for some alternative identity (whether as a man, non-binary, etc.), or removing reproductive organs and using plastic surgery to create orifices or appendages that resemble those of the other sex (or neither, or both), mutilates the body in an effort to reinforce beliefs at odds with reality. This is a misdirection of the medical profession, a violation of sound medical ethics—and thus a failure of love on our part if we support it. (It is also worth mentioning, at least in passing, that “sex-reassignment” is literally impossible, and that the best evidence, as I document in When Harry Became Sally and subsequently, continues to show that “gender-affirmation” procedures do not bring about psychological wholeness.)
Third, things get worse with children, especially when it comes to puberty blocking drugs. It is a profound failure of love—indeed a profound injustice—for an adult to interfere with the natural development of a child’s body to alter its appearance based on gender ideology. To intervene in a child’s physical development, to block the child from going through normal puberty—all in an attempt to “affirm” a “gender identity” that rejects bodily reality—is profoundly unethical. Likewise, to tell a child (or anyone, for that matter) that he or she is the opposite sex (or both, or neither), or to encourage a child’s mistaken belief that he is something other than a boy, or she something other than a girl, is deeply unjust to that child.
Children who feel deep discomfort with their bodily sex should be treated with kindness, respect, compassion, and love. They need to be protected from bullying, teasing, and any form of mistreatment. But they deserve to know the truth and to be guided to embrace the truth with whatever assistance we can give to help them feel comfortable with their bodies.
This includes providing counseling for any underlying trauma or for social dynamics at home or school that may play a role in the dysphoria. And it includes helping them to break down misguided sex stereotypes or cultural expectations that may underlie their dysphoria. But it must also entail a resolute refusal to go along with ideologies that reinforce sex stereotypes. Preferring the color pink or playing with dolls does not make someone a girl. Rather than teaching children to understand themselves based on how well they fit prevailing cultural expectations on sex, we should be teaching them that the truth of their sexual identity is based on their bodies—sexual identity is received, not self-determined—and that sometimes cultural associations attached to the sexes are in fact misguided or simply too narrow. (On this last point, see Chapter 7 of When Harry Became Sally.) Girls can like football and hunting without being “boys” or “nonbinary.” There is a wonderfully rich array of ways of expressing one’s embodiment as female.
The Truth is Visible to All
Nothing that I have said in this essay is unique to Christianity. Everything here is a matter of reality knowable without the aid of revelation from God’s Word. Christian revelation confirms these truths, deepens our appreciation for and knowledge of these truths, and places temporal reality into a larger creational and eschatological framework. But it does not fundamentally change the underlying nature of our embodiment as male or female, or the moral norms that govern it.
Knowing that God the Father created my body, God the Son has redeemed it, and God the Holy Spirit is sanctifying it profoundly deepens my appreciation for embodiment. And that’s good news indeed. And we should share that good news. But it’s not as if the truths about the human person argued for above are only for Christians. Or that it would be “imposing” our religion or our morality on others to see to it that our laws respected these truths. To authentically love our neighbors requires us to embrace and advance these truths for everyone, everywhere.
Ryan T. Anderson, Ph.D., is the President of the Ethics and Public Policy Center.