Non-Binary Visibility
This week is Non-Binary Visibility Week and it culminates in International Non-Binary People’s Day on July 14th. We are proud to be owned and operated by Anna Baxter, a non-binary (genderfluid) person and have two other non-binary folks on our team (Jace and Auggie). It’s important to have clinicians with lived experience as a non-binary person living in a very binary world on your team if your practice offers gender therapy because being non-binary is very different from being a more binary transgender person. Non-binary people experience the pressure to fit into gender boxes, in their expression, in their identity, even in their language like pronouns to be accepted and therefore safe in our society. Things like jewelry, body and facial hair, dresses, shoes and other accessories are signals of gender to someone without the understanding of non-binary genders and to have a mixture of these features can sometimes inspire strangers to judge, comment, or even act in violence.
According to a 2021 study by the Williams Institute an estimated 1.2 million adults in America aged 18-60 identify as non-binary, making 11% of the LGBTQ adults in that age bracket (source). Overall, LGBT adults are 5.5% of the American population, according to the Williams Institute (source). So we are a small, but not insignificant number of people in America.
To understand non-binary genders, it’s helpful to understand intersex biological experiences and the last two centuries worth of history related to biological sex and gender identities.
History of Binary Sex (Gender) - From https://isna.org/faq/history/
Pre-19th century: any variations in genital appearance at birth went unnoticed and largely undiscussed, sex (and gender) was assigned at birth by midwives, grandmothers, and other local elders.
In the late 1800s the medical community began to realize “abnormal” sex anatomies were actually quite common, each doctor reporting dozens of cases per year of “hermaphroditism” (a term no longer used). “Because most medical experts were politically conservative and wanted to keep sex borders clearly defined to combat open homosexuality and the rise of feminism, intersex caused them notable stress.” So these physicians devised a system that would label every child born “truly male” or “truly female”. Any person born with non-standard genitalia but with ovaries was labeled female pseudo-hermaphrodite. Every person born with non-standard genitalia with testes was labeled male pseudo-hermaphrodite. If a person had both ovarian and testes they were labeled a true hermaphrodite. Technical limitations meant they could only be determined by dissection posthumously; they didn’t regularly perform surgeries on babies yet. Genital surgeries were performed for cosmetic reasons on adults at their request.
Once labeled “truly male” or “truly female” they were told to act socially and sexually normative to their assigned gender. For some people, that didn’t make sense (In the 1910s as today, women with androgen insensitivity couldn’t practically be labeled men just because they had testes. There was no simple social category for those diagnosed with “true hermaphroditism.”
Most people with intersex presentation were socially healthy without surgery; they did not disproportionately live as hermits or attempt suicide. Psychologist John Money studied adults with intersex and found—before the era of standard cosmetic surgical intervention for intersex presentations—that they enjoyed a lower rate of psychopathology than the general population.
1920s
Experts treating intersex developed a notion of binary gender (social role) separated from biological sex. Physicians began to more actively offer surgical “corrections” to bring the biological sex into line with the assigned gender.
1950s
In the 1950’s intersex was viewed primarily as a psychosocial problem that mixed sex categories in socially uncomfortable ways, biologically an intersex person didn’t match the social construct of gender. Johns Hopkins University developed the first multi-disciplinary approach to treating intersex presentation - the “optimum gender of rearing” model which sought to eliminate intersex in early childhood. Each child’s potential for a “normal” (i.e., binary) gender identity should be maximized by making each child’s body, upbringing, and mind align as much as possible. Because of the belief that it was harder to surgically engineer a boy than a girl, most children with intersex were made as feminine as possible, utilizing surgery, endocrinology, and psychology. A “successful” patient was one judged to be stable and “normal” (i.e., heterosexual) in the assigned gender. What actually happened was doctors made the surgical decisions for the patients with deception, little investment in informed consent, minimal psychological support and little to no studying outcomes in a systematic way.
Why was this ok!?
Psychologist John Money argued that gender identity was largely mutable early in life, that nurture was more important than nature. “John/Joan” was an identical twin male, whose penis was burned off during circumcision and his family decided to raise him as a girl. Dr. Money used this evidence to prove a successful case of establishing and maintaining a stable and “normal” gender identity into adulthood. When John/Joan’s parents informed him of what happened, he immediately re-assumed the gender role of a man.
Surgeons and psychologists liked the theory because it signified that they were providing necessary, good care to “abnormal” children.
Feminists liked the theory because they preferred the idea that gender – and therefore gender norms – were socially constructed and malleable.
1993
Feminist biologist Anne Fausto-Sterling published articles in The Sciences and The New York Times exposing the basic fact that intersex exists. In response, Cheryl Chase wrote a letter to The Sciences announcing the founding of the Intersex Society of North America (ISNA) (support group turned advocacy group).
Even today in the 2020s, the goal of many leading teams treating intersex conditions is still to make intersex disappear and support the person in living in a stable binary gender identity.
All of the intersex presentations are based on observable differences in external genitalia, internal reproductive organs, chromosomes, and hormones. The prevalence of intersex conditions according to ISNA is approximately 1 in 100 births or 1% of babies born, as common as a child being born a redhead.
Studies in brain dimorphism have shown that gender is also variable based on shapes and functions of 11 particular areas in the brain, with binary transgender people’s brains matching that of their identity rather than their sex assigned at birth based on their biological sex characteristics. The brain is infinitely more complex than the rest of the body, we still don’t quite understand how it all works. In a given person, some of these areas can be structured or function similarly or differently to the binary gender identity or biological sex characteristics. A more recent study (2021, source) shows that brains are far more “intersex” than we previously understood, suggesting a mosaic approach to understanding gender in the human brain.
Considering all of these facets of biological sex and gender identity and gender presentation - how likely is it that the entirety of people born are 100% purely male or female based on all possible gender characteristics (biological, neurological, psychological)? Very slim. We don’t have firm statistics yet, but according to a 2021 study by the Williams Institute an estimated 1.2 million adults in America aged 18-60 identify as non-binary, making 11% of the LGBTQ adults in that age bracket (source). Overall, LGBT adults are 5.5% of the American population, according to the Williams Institute (source). So we are a small, but not insignificant number of people in America. Our biological characteristics and gender expression can vary wildly and our gender identity can be different from each others’. Some nonbinary people are transgender (seek medical intervention to align body with gender identity) but many are not.
So during Non-Binary Visibility Week, we challenge you to consider your assumptions about someone else’s gender identity according to their gender expression and available sex characteristics. How accurate or inaccurate might they be? Ask a non-binary person if they’re willing to share with you their understanding of themselves: biologically, psychologically, and culturally. And check out some of the awesome non-binary persons strutting their stuff on the internet, using their privileges to be loud, proud and educate about their nonbinary identity so that more quiet nonbinary people feel safer to Live and Love themselves authentically.
