Definition of "woman" / implications for people with DSDs

[proximalhumerous]

Two points, but I didn't want to start two threads as there are already several.

Am I being stupid / obtuse / disingenuous / unreasonable to wonder how the recent judgment could possibly have gone any other way in a sane society? I mean how can the definition of "x" be something that started off as "y" and changed artificially (as opposed to organically) to become "x"? That would be totally illogical, surely?

Additionally, can anyone point me towards any credible sources to explain how this ruling is likely to affect people with DSDs? Understandably, a lot of self-described* intersex people believe that sex is a spectrum, but given the SC disagrees with this, what are the implications?

*When I say self-described I mean that they use this term rather than "DSD" to describe themselves, not that they merely identify as intersex without any medical diagnosis.

people with DSDs are either male with dsd or female with dsd.
The idea that gets pushed about people who are neither or its genuinely ambiguous, is a fabrication

This ruling has no effect on people with DSDs. They already know what sex they are.

This is what I believe, but not what a significant number of people with a DSD believe.

You seem to be speaking with authority - are there definitely no DSDs which are ambiguous?

Most people with DSD want nothing to do with the debate.

Many DSD are apparently sex specific I.e. they only affect one sex for example XO, XXY and XXXY. Others are more complex but ultimately with testing they can identify if a person is male or female. This is what is recorded on their birth certificate.

There is historically an issue for people with DSD where doctors played god/experimented. Thankfully this should no longer happen.

There have been other cases in other areas of law that have had to define whether partiuclar people with DSDs are male or female. Here is the most famous one (was a marriage valid at a time when any same sex marriage was void). Presumably a similar approach would be used to any relevant Equality Act case. Of course is a person with a DSD was treated differently on the assumption that they were female, but on this test would have been seen as male, they would be able to claim for perception based discrimination anyway. http://www.pfc.org.uk/caselaw/W%20v%20W.pdf

Thanks @Mia85 - I'll have a look at that.

There are a few DSDs which, at birth, may appear ambiguous, eg 5-ARD & CAIS.

The ambiguity is resolved at puberty at the latest.

It’s usually resolves a whole lot sooner, as medical professionals are more aware that a tiny minority of babies have somewhat ambiguous genitals.

What do you mean by "resolved"? Naturally, with hormones, or surgically?

Resolved as in identified as being actually male or female i would have thought.

the starting point is obviously that anyone with a y chromosome (including xxy people but nearly always of course xy) is male and anyone without (including x0 but nearly always of course xx) is female.

this is a great starting point, far better than eg assuming a coin will land H or T rather than on its side. the arguable exceptions to it are real but easily rare enough to be dealt with on a case by case basis.

I mean “resolved” as in the early ambiguity later becomes unambiguous, @proximalhumerous

It’s the usual verb for such a situation.

In the case of ambiguity in the appearance of newborns, it resolves all by itself, which is why I phrased it in an active rather than a passive voice.

In 5-ARD (known in Spanish as “testicles at 12”) it is resolved by natural puberty, when the male genitals masculinise.

In CAIS it is resolved when the natural puberty that appeared likely does not occur: an apparently female body does not undergo menarche.

This usually (depending on access to medical facilities) will be confirmed by testing.

No actual medical intervention is required at all, though with 5-ARD it’s as well to keep an eye on undescended testicles, as they’re more prone to cancer.

I mean “resolved” as in the early ambiguity later becomes unambiguous. It’s the usual verb for such a situation.

In the case of ambiguity in the appearance of newborns, it resolves all by itself, which is why I phrased it in an active rather than a passive voice.

@Sazzasez Thank you for the explanation. You actually wrote, "It's usually resolves..." which obviously contains a typo, so I didn't know whether you meant to write, "It usually resolves" which suggests it happens completely naturally, or "It's usually resolved..." which is passive voice and could suggest there might be some medical intervention. Sorry to be picky, but I was genuinely unsure which you meant.

Of course that's the starting point, as it should be, but I was asking specifically about the exceptions. Swyer's Syndrome, for example, has an XY genotype but a female phenotype (if my terminology is correct).

OP why are you so concerned with the sex of people with DSDs?

What specific part of the ruling do you think might affect them?

Genetic testing at birth can identify the sex of all those with DSDs. XY is part of a karyotype (just looks at chromosomes) not genotype which would be the genes. We can now look at the whole genotype of newborns routinely.

I would also be very wary of taking the word of transactivists who claim to be intersex. May claim impossible conditions, or different incompatible conditions depending on what they have recently read. I remember one claiming that doctors didn’t know what sex she was even though she was pregnant. Others give the game away by declaring their GP diagnosed them that afternoon with a condition that would require genetic testing.

Yup everyone with a dsd in the UK knows what sex they are. Most are completely obvious. Eg Turner syndrome female. Kleinfelter male. Anything not obvious would be tested. In countries without access to health care people may accidentally in very few cases be perceived to be the incorrect sex.

Ah right, that makes sense, thanks. So if there was genital ambiguity presumably a genetic test would be carried out for clarification? And what would that show that's relevant to the sex/gender debate besides chromosomes?

Not an expert but IAUI it's the SRY gene (part of the Y chromosome) which causes male characteristics to develop. World Athletics have recently approved a test to determine whether an athlete is biologically female which tests for this SRY gene specifically, rather than just XX / XY

Swyer's syndrome is XY but without the SRY gene, so male characteristics don't develop and female (albeit infertile) ones do. Seems like it's vanishingly rare though.

I have been surprised by how many intersex people are transactivists, so perhaps they are not all being entirely honest.

Reading with interest as I would like to be able to discuss this with some authority: is anyone able to point me to a scientific/medical source that sets this out clearly please? I am from a scientific background but no longer work in the field so am out of touch with the most helpful sources. Thank you 🙏

Because I have one myself. I don't think the ruling will make any difference to those of us who aren't also trans, but the majority of people I know with DSDs seem very upset by the ruling so I'm trying to work out whether I'm missing something.

Are you on X? Emma Hilton @fondofbeetlesposted loads about DSDs, with more clarity and patience than she had to during the whole Imane Khelif furore. Loads of good info if you do a search for DSD on her timeline

Good luck, as this is what I've been trying to achieve since starting the thread!!

Not entirely sure what you're getting at, but for example a genetic test would identify the extremely rare cases where someone has a functioning SRY gene that has been moved away from a Y chromosome, whereas karyotyping wouldn't. Tbh I don't really see how any of this is relevant to "the sex/gender debate". TRAs like to say that sex is awfully complicated because of the existence of DSDs but this is just a stupid argument. Sex is only complicated in the same way that everything in developmental biology is complicated - everything that can go wrong will, very occasionally, go wrong. I suppose it's just a warning to be careful with precisely what you say. I doubt anyone would actually want someone with CAIS (XY chromosomes, SRY gene, but a complete inability to react to the testosterone so phenotypically female as in really do, involuntarily, pass) to have to use the men's toilets because of that Y chromosome - but it's a non argument: there aren't people with CAIS being thrown out of the ladies' because nobody would know who they are and we aren't doing karyotyping at the door.