I have a DSD and am fed up.

@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).

OP, many thanks for this thread. I have learned a lot (including the concept of Schrodinger's genitals 😂) and suspect that I too may have been guilty of over-stressing the child-bearing, gynae issues side of being female. There are also obviously plenty of other elements, like being less strong than men, and more vulnerable to assault.

You have dealt admirably with one particular poster (the one with the 100 word sentences that can be hard to parse).

And yes, if you refer to something unusual there is a much higher chance of being outed. Like you, if I want to discuss potentially outing issues, then I NC. It's a totally sensible thing to do.

That's the point of an anonymous forum.

Yes, I'm sorry, I was mistaken. Unlike in females, meiosis doesn't occur until sperm formation.

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

@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.

Hi, OP.

Thanks for starting the thread.

I'm a few pages behind, but I wanted to say that CAIS is a genetic disorder linked to the X chromosome which both male and female embryos can carry but which only results in a DSD in male embryos. Typically the testes form and remain internal, producing testosterone in the male range but little to no sperm. When people talk about CAIS women they mean CAIS males with a DSD. Not having functional androgen receptors is just as abnormal in a female as in a male, but female sexual development doesn't need a high-testosterone environment to occur.

I agree with the OP that DSDs should be more widely explained and understood. 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. And genetic sex matters (at least IMO) for sport. Regarding CAIS, being many times more likely to feature in elite female sport than their incidence in the general population seems to indicate a significant advantage.

Aside from sport and perhaps needing specialist hospital bays/wards, a genetically male individual with a DSD which causes them to develop a female phenotype should be in female spaces. In practice, nobody is going to challenge them in communal facilities anyway, and not just because they look female, but also because they will have been socialised as female. If paperwork needs to be changed, so be it. This is an entirely separate situation to males with typical sex development claiming to be the opposite sex, or males with a DSD which permits masculinisation barging into female spaces on the basis of an erroneous birth certificate.

I think SRY translocation happens when sperm cells are being made by the subject’s father. Unlike eggs in girls/women, a boy isn’t born with sperm cells, he starts making them at puberty, so the grandmother wouldn’t be involved?

Just to add that in a minority of cases XX male syndrome can occur without SRY being translocated to X. In these SRY negative cases the phenotype can be more variable, but in some cases does appear typically male.

https://academic.oup.com/molehr/article-abstract/12/5/341/1005702?redirectedFrom=fulltext

Would that mean it has to be the one from the male gamete, or is it not possible to deduce that?

From the article, the translocation happens during the recombination stage of meiosis in the subject's father. So, it happened when PP's grandmother-in-law was in the early stages of pregnancy.

There's something almost awe-inspiring about the timescale.

Just to contribute re: the SRY gene really making the difference between male and female: my husband is XX but has the SRY gene erroneously. His DSD is literally called “XX Male” because his phenotype is completely male due to the SRY gene — “most typically have typical body and pubic hair, penis size, libido, and erectile function.[13] In all reported cases, individuals have been sterile, with azoospermia (no sperm in the ejaculate).[17][16][18] Due to its often-subtle presentation, many do not get diagnosed early until seeking treatment for infertility in adulthood; it's likely a significant proportion of cases remain undiagnosed.”

Thankfully these people are all legally biologically male despite their XX chromosomes as we clearly don’t want men capable of raping women in female spaces! That’s the whole point!

Thank you for this, ill-tempered, what a fantastic document to read.

I am full of admiration for the respondent. What a difficult life she lead.

And to hear of Dr Conway! He was an amazing hero to the women, girls and families I met at the support group and helped so many people affected with his kindness and attention. People would come from around the world to see him, first time many people found a really knowledgeable doctor.

I posted a dud link. This takes you to a pdf of the judgment:

https://fourteen.co.uk/wp-content/uploads/2017/08/MW-reported-case-2001-1-FLR-324.pdf

@DSDFury

I haven't RTFT but I've read your posts and I agree with every word: the rudeness towards you is shocking.

I've been looking for something that would clarify how the Supreme Court's understanding of 'biological sex' would apply to someone with a DSD that causes karyotype-genital incongruence, given that they mostly referred to case law (Corbett v Corbett) that was about a male transsexual who didnt have a DSD and was XY male at birth.

Corbett v Corbett based sex on a combination of karyotype, gonads, and internal and external anatomy, but not hormones or psychology.

I found this case - W v W:

https://vlex.co.uk/vid/w-v-w-nullity-804694637

The respondent, who probably had a form of PAIS, and had chosen to have feminising treatments, was found to be legally female on what can only be described as pragmatic grounds (it being impossible to apply the Corbett v Corbett test). This accords with my own view that people with DSDs that cause karyotype-genital incongruence should have the right to choose.

It seems clear that the SC would regard at least people with CAIS or Swyer Syndrome as biologically female for equality law purposes.

Karyotype is useful for the 99.982%, including things like XXY and XO. For the 0.018%, it isn't.

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.

Well it's a post on a forum not the OPs personal diary. Forums tend to invite responses whether they personally affect people or not, no? I responded because I had a different opinion to the OP saying those with DSDs weren't functioning as purpose, because I don't think our biological function described by science is a purpose. Then I responded that those with XY chromosomes aren't biologically female and I've asked OP to define what that even means if it's not genetically / chromosomal given OP agrees that a sexual binary is a fact. Then I've been all the more confused why OP is bemoaning the discussion of DSDs in relation to trans and gender given clearly there's a mess of opinions about it.

What's your opinion on what is the definition of biological female? Because you only seem to be posting to keep querying why I'm sharing my opinion on a public forum without sharing what's driving you to do the same.

@melonsandlemonsandpears
What is your personal involvement in this discussion? You've said that you don't have a DSD and you don't identify as trans, so that rules out direct personal involvement. You've also said that you don't know any trans identifying people and the only person in your family with a DSD is someone with Turner syndrome.

It seems odd that you seem to be so keen to have a heated discussion with the OP, who is personally affected by this issue, when it doesn't affect you any more than it does other people who are not trans identifying, don't have DSDs and don't have family members who are directly affected.

What is it about this issue which is making you so angry that others have a different opinion from you? Many of them also seem much better informed than you about DSDs and female anatomy.

Mammalian biology is binary.
Every mammal is male or female and had been for millions of years.
Humans are just another mammal.

Any alternative opinion is religion not reality.
Gender is most definitely a religion.

I've asked you and OP to otherwise define what biologically female means if we're including people with XY chromosomes into the category, I'm happy to be awakened of it's so simple, yet you haven't.
I have certainly tried but you don’t seem to listen or understand 😅
For example, I have literally said it’s not simple on a number of occasions now, so you are clearly not reading what I’m saying.

I'm fully in agreement chromosomes aren't everything for someone being defined a man or a woman.
Really? That contradicts what you said earlier.

Biologically reality isn't obnoxious. I'm fully in agreement chromosomes aren't everything for someone being defined a man or a woman. It's not an accepted scientific fact that DSDs that affect males make someone biologically female, so it's not obnoxious or obtuse to not hold that opinion and it's the reason you'll see science describe them as conditions that affect people who are either genetically male or genetically female. I've asked you and OP to otherwise define what biologically female means if we're including people with XY chromosomes into the category, I'm happy to be awakened of it's so simple, yet you haven't.

The doctors and medical experts are taking those things into account to determine the patients SOCIAL sex i.e. gender for their wellbeing and so they can establish what treatments are needed. They're not determining their biological sex, they already know what that is and it isn't determined by their opinions or the parents opinions!

For the 100th time I'm NOT saying OP has to be called he, a man or anything like that,I accept there are people with DSDs classed as women. I'm not going to be told I have to accept that I have to call those with XY chromosomes biological females though and I think the insistence on denying that fact is further muddying the waters.

You’re being obnoxious.

Also I think you should do some research regarding DSDs. You seem quite ignorant about them.

You've explained why you think some people with XY should be classed as biologically female but haven't explained then what is the definition of male and female sex and what separates them.

@melonsandlemonsandpears
You keep looking for simple explanations and definitions.
You seem fond of them. To you, having a Y chromosome means someone is irrevocably and ‘biologically’ male.

But DSDs are complex, not simple.
There is more to biology than chromosomes imo. Why should someone’s Y chromosome define them as male if it is not functioning to make a phenotypical male? The medical experts working in this area look at a range of biological functionalities when considering DSDs. They also consult with the person involved (or parents). What they don’t do is just consider chromosomes. Why do you think your opinion is more valid? Why are you so determined to tell a woman she’s really a male?

Chromosomes aren’t everything in the case of DSDs, the Y chromosome doesn’t always work to make a man.