I have a DSD and am fed up.

You are never answered why you define biological sex purely in terms of chromosomes when this is not standard in the medical/scientific community in the case of DSDs.

Doggedness = unwilling to bend facts. CAIS males are already perfectly accommodated for within womanhood, we don't need to redefine the term biological female away from it's scientific meaning to do that and although people are probably saying so to be kind, they're further muddying the waters of what biological sex means. A DSD is a medical condition that affects particular sexes or the sexes in different ways. There's absolutely no need to insist someone raised as a girl is biologically female. I'm not going to police my language for someone with a DSD anymore or less than a TiM. I'm happy to call OP a woman or she, but it's unreasonable to insist agreement that she is biologically female when her condition is defined as one that affects the male sex. Words have meanings.

Where there is discordance I don’t see XY DSDs being labelled male or XX DSDs being labelled female by the medical profession. Quite the contrary in fact.

There is no discordance in Turners and there are no males with Turners so it’s not at all a good example.

And the scientists / doctors understand DSDs to be medical conditions that affect either the male or female sex, it may be dogmatic but it's a fact you'll see upon googling any DSD. You won't find Turners affecting any males for example, ever, would you?

The crux of this conversation is that people with DSDs have a very specific medical situation. They will work out their treatment and their sex with medical assistance. They may need individual assessment for elite sport, but otherwise it’s their own personal business.
Their condition is not a choice, though they may have choices in treatment. It’s tiny numbers of people and it’s identifiable with testing.

I think Melon’s doggedness comes from a determination to identify a rule to keep trans identifying men separate from women. She wants a hard and fast rule to apply to trans people.

Personally I don’t think it’s necessary- the men who identify as women don’t have a DSD. The arrangements made to accommodate people with DSDs are totally irrelevant.

Far better to continue to emphasise the difference between DSDs and trans than to insist that they ‘rub up against’ each other.

You’ve been very patient, @DSDFury

I don't think the definition of biological female is a matter of opinion. I think the definition is better left to medical professionals and scientists who understand this much better than I do.

I started following this thread to better understand how trans ideology has affected those with DSDs.

Your dogmatic and argumentative attitude towards the OP is not helpful for people like me to understand how this affects people with DSDs. It just makes me realise how exhausting it must be for them to have to deal with people who insist on expounding their uninformed opinions about medical conditions of which they have little or no understanding.

Some parents of males with CAIS choose to register their children as males and some of the children themselves embrace maleness when they are older.

This might be true for PAIS, but CAIS is not usually detected until puberty in the UK.

Male gender identity in CAIS individuals is rare, the first being reported in 2011, and tricky, given the lack of T-response.

https://pubmed.ncbi.nlm.nih.gov/20358272/

I think your proposals are too complex, and unnecessary: DSDs and trans are mutually exclusive.

Some parents of males with CAIS choose to register their children as males and some of the children themselves embrace maleness when they are older. A poster on here some time ago said he has a DSD (I assumed CAIS) and as a gay male it meant that he had a much bigger potential pool of partners. I imagine that he knew about his condition early on. (I;m using male pronouns for clarity.)

An M on the birth certificate of a CAIS male would be correct and it would be useful in a medical and sporting context. It might be an idea to have ID that you can show at, say, a gym which carries a sex marker which is different to the one on your birth certificate (and the amendment would only be permitted in cases of DSD). As I said in my very first post, if paperwork can be amended in order to enable a person living with a male-specific DSD which leads to development of a female phenotype to live a better life I am fine with it as long as there is no detriment to women. There is a detriment in sport but I can't think of any other situation.
Accommodations can be made, but truth is truth. The reason I am calling males male in this context is that we have seen where trying to bend reality around people to spare their feelings leads.
Which brings us back to the point of the thread - the way that TA have co-opted, appropriated and bastardised the language of DSDs or the dilemmas of people living with DSDs and their loved ones.

Edited for clarity

I suppose that depends on what you think the sex marker on a birth certificate is actually for. Do you think that 46XY CAIS individuals should have an M on their birth certificate? Would that be useful?

I think the claimant would lose my hypothetical peerage case, for various reasons, but sadly I doubt we will ever get to find out.

The law is not itself biology. I'm not basing this on my personal beliefs - there are charts explaining the various DSDs and what sex the individual suffering from it is.

Whoever is scientifically classed as female is female, whoever is classed as male is male. That's my starting point. I have no expertise.

Yes, of course I would support a CAIS male who wanted to inherit over a youger brother with normal sexual development - they may be living as a woman (in the only true sense of that phrase) but they are male.

The only female space CAIS males should definitely be excluded from is women's sport.

Regarding this:
Your belief that people with Swyer Syndrome are female is just as pragmatic. Sure, they have only female structures, and menarche can be induced. But with no working SRY gene or second X, they have neither testes nor ovaries and are strictly speaking sexless. Shouldn't there be a blank on their birth certificate?
As I said, scientists class women with Swyer Syndrome as female. Maybe it is a pragmatic decision by them but at least it's sensible. What's the value of having a blank on the birth certificate?

Edited for clarity.

To the extent that the case law is developed (not very far, and there probably won't be a need to develop it further), CAIS women are biologically female, which is important for equality law.

The law isn't everything: but I'm intrigued by our differing perspectives, based on identical agreed facts.

To me, this is a very small group of people who have not developed according to karyotype (but have according to genome - I'm not aware of this ever being caused by environmental factors), and the decision about their sex can only be a pragmatic one. This is supported by the case law, which takes into account the preference of the individual and the treatment they choose.

Your belief that people with Swyer Syndrome are female is just as pragmatic. Sure, they have only female structures, and menarche can be induced. But with no working SRY gene or second X, they have neither testes nor ovaries and are strictly speaking sexless. Shouldn't there be a blank on their birth certificate?

Going back to the case law, if a 46XY CAIS woman sued her younger brother so that she could claim a peerage that passes only through the male line, would you support her?

I'm not being disingenuous. I think a lot of people genuinely don't know that females can have CAIS genetic mutation as well, but be unaffected by it. It's an easily comprehensible example of why we say DSDs are sex-specific.

ETA: A CAIS individual with a DSD is always male. A CAIS individual without a DSD is always female. So it's not right to talk about DSDs of CAIS females, was my original point.

I say this because they are biological males. The existence of CAIS females shows this.
I don't think you are correct - CAIS males can be registered and brought up as females for obvious reasons but the law does not say that they are automatically female as far as I am aware - IANAL.

Also, I only wish to exclude them from the female category in sport.

Yes I know how CAIS is inherited.
I think you’re being disingenuous when you suggest that people use the term CAIS males for this reason.

Thanks for the engagement - I'll think about it. The reason why I specified "male" is because the genetic disorder CAIS can be present in males or females. My point is that CAIS is not in itself the DSD, and females with CAIS do not develop a DSD at all. We could find a new way to describe males who have a DSD caused by CAIS - is that close to what you are saying? - but it's misleading to talk about CAIS individuals as females or women in a scientific sense because the babies affected are all male, none female.

So first you argue there are XX women with CAIS, and when I suggest there aren't you continue arguing with that premiss.

I'm outa here.

Btw, I've met many sisters of CAIS women and I never got the impression they considered themselves anything but mutual sisters.

CAIS women are biological females according to the law. Pre-same-sex marriage they could legally marry men. Under the Equality Act they can legally be included in women-only positive action, single-sex services and clubs and associations, and sue for sex-discrimination without resorting to the 'perceptive' label.

You and I agree about the medical facts. But, given that a CAIS woman experiences life much the same as any other (apart from infertility and a need for treatment), why is it so important to you to insist that she's really a man? What objective does it meet, that wasn't already addressed in my PP?

Thanks for the engagement - I'll think about it. The reason why I specified "male" is because the genetic disorder CAIS can be present in males or females. My point is that CAIS is not in itself the DSD, and females with CAIS do not develop a DSD at all. We could find a new way to describe males who have a DSD caused by CAIS - is that close to what you are saying? - but it's misleading to talk about CAIS individuals as females or women in a scientific sense because the babies affected are all male, none female.

I agree with PP that we can't always just say 'if it's XY, it must be a guy'.

So do I - there are rare cases of XY females, but it depends exactly what conditions we are talking about.

A male with CAIS is not biologically female - if they are female, then what are we to call their sisters who are unaffected by CAIS? Why do males with CAIS develop testes? CAIS female embryos develop ovaries. If not for the genetic disorder the male embryo would have undergone normal male sexual development. Their position is similar to males with 5-ARD but more extreme. It's incomplete male development. Ditto PAIS - although I believe that condition can be a result of several different factors and is of course a spectrum.
The acceptance of CAIS males in women's sport by some of the experts is not because they are female, but because they haven't undergone male puberty. (I think they should not be included.)

We do have to bring sex into sport categories because sex is the reason for the vast difference in athletic performance between males and females. If an athlete with a DSD is excluded from women's sport for safety and fairness, it is because they are male. The unfair advantages derive from being male.

If male and female are unmoored from sexual reproduction roles, we are lost.

I have no expertise in this area, but I understand that scientific consensus is that a woman with Swyer Syndrome is female. Male development never got started.

Have you seen any evidence of an XX woman with CAIS? it seems very, very unlikely to happen.

The Androgen receptor is on the X chromosome. It is likely to be recessive because XX individuals with one mis-coded AR are carriers - the mothers of CAIS XY women. For someone to have two defective ARs they would have had to inherit one from the mother and one from the father - but if the father had a completely defective AR on their one X chromosome then they would not be fertile, in fact they would be the one of the CAIS women we talk about here.

I guess more unusual situations could arise - there could be spontaneous errors in the AR in both X alleles, but this would look like carelessness, as someone said. Or they could have inherited one inactive AR from mother and the one other one would have the same mis-coded AR occurring randomly - unlikely. Another more far-fetched scenario might be the father being XXY with one normal and one mis-coded AR.

But, really?

@BellaAmorosa

I agree with PP that we can't always just say 'if it's XY, it must be a guy'.

Trans people and people with DSDs can readily be distinguished medically and legally. (Gender clinics used to test patients for DSDs, but rarely found them.)

People with DSDs can correct their original birth registration by way of a marginal annotation. Trans people are given an additional, altered, registration on a separate register from the main birth register.

Case law indicates that at least individuals with PAIS, CAIS and Swyer Syndrome are legally biologically female.

Medical accuracy is important - but it's not people with DSDs who've been causing medical confusion, and sometimes disaster, by concealing or lying about their birth sex.

And I believe it's possible to treat as female, gonadal males who've been registered female, without compromising the rights of others. They can be excluded from sports on the basis of safety and fairness, without bringing sex into it.

And if they've been through male puberty, and decided, for whatever reason, not to correct their birth registration, they can be excluded from women-only spaces under the derogation in the Equality Act from the ban on perceptive discrimination (the Supreme Court explains this in relation to transmen, but the principle is the same).

Thanks for the engagement - I'll think about it. The reason why I specified "male" is because the genetic disorder CAIS can be present in males or females. My point is that CAIS is not in itself the DSD, and females with CAIS do not develop a DSD at all. We could find a new way to describe males who have a DSD caused by CAIS - is that close to what you are saying? - but it's misleading to talk about CAIS individuals as females or women in a scientific sense because the babies affected are all male, none female.

@BellaAmorosa
I agree with much of what you say but not this bit
“When people talk about CAIS women they mean CAIS males with a DSD…I understand that it is painful to be described as being the opposite sex to how you see yourself, but it has to be like that in the context of discussing DSDs.”

I don’t think it has to be like that.

For example, in the journal abstract I linked just before your post you’ll see that the researchers spoke about a SRY-negative 46,XX male and said the frequency of the XX DSD in question was 1/20,000 males approx.

That’s usually how the conditions are termed scientifically/medically in my (limited) experience, eg as a 46,XY DSD rather than using terms such as male DSD or CAIS male. It seems where there is a DSD with discordance they don’t label XY male, or XX female.

Specialist charities say things like “for parents of XY girls…”

So, I don’t think it has to be as you say when discussing DSDs. A DSD can be explained without using terms like ‘CAIS males’. Being male or female depends on more than your chromosomes.

Gosh, I wasn't aware of this variation and had no idea the SRY gene could be found on an X chromosome. Would that mean it has to be the one from the male gamete, or is it not possible to deduce that?

If you don't mind me asking, did your husband discover it when you were trying to conceive? And how does he feel about having two X chromosomes?

Makes total sense to me that XX Males should be legally male.