I have a DSD and am fed up.

[DSDFury]

A DSD (Disorder/Difference of Sexual Development) is a congenital medical condition, usually resulting in sterility, as it does in my case. Broadly, it means there is chromosomal or other genetic anomaly which has resulted in the foetus not developing along typical lines for a male or female. Not all the resulting abnormalities are external, and we are certainly not hermaphrodites.

I am sick to death of DSDs being co-opted by the trans movement as "proof" that sex isn't binary. I am not some weird third sex, I am not part of a spectrum, and I don't feel the need to tell everyone about my condition.

I am sick to death of DSDs being misrepresented as an identity (looking at you, Fife NHS). It comes with some shitty elements such as infertility, but that is just one of many, many things that makes me who I am. I am a very ordinary middle-aged woman who shops in M&S and doesn't have blue hair.

I don't want to be in the sodding rainbow, I don't want to be on a flag and I absolutely don't want to be seen as synonymous with trans (looking at you, Women's Institute).

To (possibly) coin a phrase, I have "gender euphoria". I have never doubted for a second that I am female and I was delighted to finally go through puberty once I had been diagnosed. I don't believe that my spirit has been fortuitously put in the correct body or any such nonsense; I am female because I embody a body which has a womb and a vagina rather than a penis and testicles. I look, and sound, entirely female in every respect.

I do want our existence to be acknowledged, as in certain situations (mainly medical, but some legal) it is important to recognise this group of conditions. However I think conflating us with trans hinders this far, far more than helps, as it obfuscates the issue.

I am not particularly concerned about the implications of the Supreme Court ruling, certainly don't regard it as genocide (ridiculous hyperbole) and think it would have been insane for it to go any other way, although I fervently hope that anyone in charge of policy has sufficient knowledge of these conditions to be aware that there will be people whose chromosomes do not match their phenotype/appearance because of a medical condition rather than because they are trans.

People on the Feminism board seem to be extremely knowledgeable, but I bet a sizeable sector of the general population would be surprised by more than one thing I have written,

Thank you for reading.

@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.

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.

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.

@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 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

Thank you for your thoughts and for the link. I will take a look.

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 really miss Dr Conway - he was fantastic; so careful to find the best levels and combination of hormones, etc. None of the consultants I've seen since have quite lived up to him, unfortunately.

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!

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.

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.

That is indeed awe-inspiring!

@girljulian - apologies, I somehow failed to notice you'd attached a link which probably answers at least some of my questions.

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

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.

@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.

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

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

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.

@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).

He actually found out when he was a student because he was trying to make a quick buck donating sperm! It was a bit of a shock, obviously, but he just sees it as he’s an infertile man. Lots of men are infertile for various reasons.

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.

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?

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.

First of all, isn't that the point? The vast,vast majority of females have two X chromosomes and deficiencies on one can be masked by the other. Eg haemophilia.
You are talking about the DSD caused by CAIS, not the genetic mutation. If a female is affected, she still develops normally although menarche is sometimes delayed. Both males and females need some testosterone. Both can have CAIS, but it only causes a DSD in males because male sexual development is dependent on being able to utilise the high levels of testosterone which testes produce.

How likely it is that a female has delayed menarche is not really important. The point is that CAIS affects males and females differently - it causes a DSD in males alone.