A woman spray-paints male and female figures on the ground. Photo: Getty
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Laurie Penny on gender: Society needs to get over its harmful obsession with labelling us all girls or boys

Germany has announced legislation to allow parents not to record the gender of their newborn - this is just a small step in the long march to equal rights and recognition for intersex, transsexual and transgender people in Europe.

When April Ashley, who in 1960 became one of the first Britons to have sex reassignment surgery, was asked by reporters if she was born a man or a woman, her answer was always the same: “I was born a baby.” For the full effect, imagine Ashley saying this with a little smile on her perfectly pencilled lips, dignified and demure in the face of the fusillade of stupid questions she has been fielding for more than 50 years. Sadly, Ashley’s point – that not all babies fit into the pink or blue box they were assigned at birth – is taking a long time to sink in.
 
Now, Germany has announced legislation to allow parents not to record the gender of their newborn if, as is surprisingly often the case, doctors cannot instantly determine what biological sex the wriggling, squalling bundle of growth hormones is.
 
There are many conditions that can cause a person to be biologically intersex. Stories about the “third gender”, about gods and humans who weren’t quite men or women, have been with us for millennia, but there has long been pressure on doctors and parents to “fix” any baby who isn’t obviously either a boy or a girl. This often entails intimate surgery that is performed when the child is too young to consent. Traumatic reports about the effect this sort of procedure can have on kids when they grow up appear routinely in the tabloids – but the question of why, precisely, it is considered so urgent that every child be forced to behave like a “normal” boy or girl is rarely discussed.
 
Germany’s law, which comes into force in November, is just a small step in the long march to equal rights and recognition for intersex, transsexual and transgender people in Europe, a trudge that is beset by bigots on one side and bureaucrats on the other.
 
The main detractors of the German law oppose the move not on moral grounds but because of the paperwork involved – and look at me not resorting to any national stereotypes about managerial dourness to finish this sentence . . . but what if the paperwork is the problem? What if you’re someone who is literally written out of every form and official document, every passport and bank account application, because society refuses to recognise there are more than two genders?
 
One in 2,000 babies, or 0.05 per cent of the world population, is estimated to be intersex. That’s about 31,400 people in the UK; 3.5 million people across the globe. That, in case you were wondering, is ten times the population of Iceland. And those 3.5 million are just those who are visibly intersex at birth: some estimates suggest that the correct proportion of human beings whose bodies differ in some way from “normal” male or female, either hormonally or genetically, could be as high as 1 per cent. Some of those people prefer to identify simply as men or as women, but many do not.
 
The German law will give the right to “leave the box blank” only to those born intersex – but gender identity is about more than biology. According to a 2012 Scottish trans mental health study, about a quarter of transsexual and transgender people do not identify as male or female, and prefer to present as nonbinary, gender-fluid or agendered.
 
So why aren’t we talking about this more? Why isn’t there a bigger public conversation about intersexuality and life outside the pinkand- blue binary? I don’t mean drooling “true stories” – I mean level-headed discussion that understands that intersex, transgender and androgynous people are “normal” humans, too, who spend as much time stuck on trains or waiting for trashy crime shows to download as they do considering the contents of their underpants. Why are these matters so rarely taught in schools? Why do so many children – including intersex and transgender kids – grow up believing you have to be a girl or a boy and that there are no other options?
 
Unfortunately, I know the answer. We don’t talk about it because questioning something as culturally fundamental as the gender binary is risky. It makes people confused and it makes them angry.
 
For some, the notion of large numbers of people not living as men or women doesn’t morally compute, objective fact and conservative morality never having been the most snuggly of bedfellows. These are often the same people who can be found quoting dubious evolutionary “studies” suggesting there are prehistoric reasons why “some girls just like pink”, possibly involving cavewomen and colourful fruit, even though the practice of dressing girls in pink is barely a century old.
 
The idea that there are only two possible genders and that those genders are rigid and fixed is an organising principle of life in most modern societies. It affects everything, from how we dress to whom we can marry and what work we get to do to whether or not we will be paid for that work. Discussion of conditions such as intersexuality threatens all that. It gives the lie to the gender binary, exposing it as not just flawed, but scientifically inaccurate. And so we carry on shoving intersex and transgender folk to one side and forcing everyone who isn’t “normal” to damn well act that way or face harassment, discrimination and violence, from the playground to the pulpit. Concerned parents of confused children are coerced into picking a sex and sticking to it – but is that for their own good, or for the good of a society wedded to a simple understanding of gender?
 
To anyone reading this who is intersex – and I know that there will be at least a few – I apologise for how basic this must sound. My sincere hope is that in ten years’ time articles such as this one will look outdated to the point of offence, rather like a column from the 1960s making the stunning observation that, gosh, some men fancy other men and might even like to marry them.
 
The journey from here to there will probably involve a lot of paperwork – but for millions of people across the world, it’ll be worth it.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.

This article first appeared in the 26 August 2013 issue of the New Statesman, How the dream died

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear