The human body has 11 or 12 (depending on how you classify them) organ systems. An organ system is a collection of distinct body structures which all work together to support the same general function. Normal development of all but one of these organs systems results in the same basic anatomical configuration in all humans.
One of these organ systems, the reproductive system, is dimorphic – that is, normal development produces 2 structurally and functionally distinct forms of this organ system. These forms are designated male and female.
Our DNA provides a blueprint or set of instructions for development of all the structures in the human body, including the reproductive system. The reproductive system has several basic components which take on different forms in the male and female systems:
- Gonads – ovaries (female) vs testes (male). These are the organs that produce gametes or reproductive cells - ova (large, not self-mobile) in females, spermatozoa (small, self-mobile) in males
- Organs supporting gamete transport from gonads – Fallopian tubes or salpinges (female) vs epididymis and vas deferens (male)
- Organs making substances that support healthy gamete function – seminal vesicles and prostate making components of semen (male)
- Organs that support gamete delivery for fertilisation – vagina and cervix (female) vs penis (male)
- Organs that support gestation and delivery (females only) – uterus, cervix, vagina (plus ovaries for hormonal production and a temporary organ, the placenta, for vascular/nutritional support)
Normal execution of the complex developmental pathway that results in these distinct sets of internal reproductive system organs also produces 2 distinct configuration of external reproductive structures (external genitalia). Normal development of a male-pattern reproductive system is linked with a specific sequence of genetic material (the SRY gene) which is typically located on the Y chromosome.
Therefore, in the absence of disordered development of this pathway – i.e. in the overwhelming majority of humans – the configuration of the external genitalia is a reliable indicator of the configuration of the internal reproductive system, and the presence of absence of a Y chromosome in the karyotype (chromosome profile) is also a reliable indicator of the configuration of the reproductive system.
In disorders or differences of sexual development, this complex pathway doesn’t proceed in the way that would be expected from the simple criterion of the presence or absence of a Y chromosome. So there is a mismatch between genetic makeup and the configuration of the internal and/or external reproductive system structures. People with DSDs are still male or female; in fact many types of DSD are sex-specific and only occur in either males or females. There is no third sex and no third gamete.
The anatomical structures that develop in utero as the cardinal features of female and male reproductive systems are the primary sexual characteristics Secondary sexual characteristics are the changes in existing anatomical structures that occur as sexual maturity develops during puberty. A man is an sexually mature human whose natural reproductive system conforms most closely to a male phenotype, and a woman is a sexually mature human whose natural reproductive system configuration conforms most closely to a female phenotype.
In practice, everyone knows exactly – and in explicit biological terms - what a man is and what a woman is.
No parent takes a 16-year-old child with a penis and testicles to the GP to investigate why they haven’t started menstruating.
No-one planning a family in a heterosexual relationship thinks that both partners need an ultrasound to work out which of them will be the one to take maternity leave.
Just because we can’t easily a natural phenomenon according to a single black-and-white criterion doesn’t mean it doesn’t exist, or that we don’t apply our knowledge of it at a practical level on an everyday basis.
Physicists can’t agree on the fundamentals of whether light is a wave or a particle. Doesn’t stop us knowing that turning on an electric lamp will illuminate a dark room.