What Does Gender Ambiguity Mean for Gay Marriage? (A Better Conversation Series)

Image Credit: Samir Luther

Image Credit: Samir Luther

 “Our piano player used to be a girl.”  

   The new pastor had just asked if there was anything special he should know about the church. The piano player had grown up in the church. He was born with both male and female sex organs. The parents consulted with their church leaders and prayed and cried and chose the female gender for their child.
   A few decades later, the grown child felt the parents had chosen incorrectly. So he changed it.  The church was OK with that choice. (It was a Nazarene church, by the way.)

   You might have heard the word hermaphrodite. 

That label has been around at least since Ovid’s mythical explanation of Hermaphroditus, the two-sexed child of Hermes and Aphrodite. Although the term is not quite PC now, it may be a good starting point for this discussion simply because most people have heard of it.

   A hermaphrodite has the most fundamental form of gender ambiguity - anatomical ambiguity.

   Some people are born with some or all sexual organs of both genders. Although rare, this has been a recognized phenomena since antiquity. In the 20th century, standard medical protocol was for the parents to choose a sex for the gender ambiguous child. Then, the doctors would perform the necessary surgeries to “normalize” the child’s genitalia.
   However, this often resulted in matured “hermaphrodites” feeling that their parents had chosen incorrectly. Hence, in recent years, many doctors are recommending allowing the child to reach puberty to see if one gender emerges as predominate with the pubescent influx of hormones. At that point, the individual may or may not choose to have surgery to altar the genitalia in the preferred direction.
   Adding to the complexity is the fact that some ambiguous anatomy is hidden until puberty or some other medical event reveals it. For example, a male may have a hidden uterus or ovaries.

   But medical scientists have discovered additional layers of gender complexity: ambiguous DNA or ambiguous hormones.

   Most females are born with XX chromosomes. Most males are born with XY chromosomes. This is what programs our bodies as male or female. However, some people are born with three chromosomes: XXY. Others have a partial chromosome, such as: XX(1/2 Y) or X(1/2 Y). This genetic ambiguity may or may not correlate to anatomical ambiguity or to felt gender ambiguity.
   Similarly, some people are born without the normal balance of sex hormones (testosterone or estrogen).  For example, in some remote villages in the Dominican Republic and Papua New Guinea, a significant minority of girls transform into boys at age 12 (or upon reaching puberty). Due to a genetic error, these babies are missing the enzyme necessary to produce normal levels of testosterone in utero.  Hence, their male sexual organs stay small and internal until the pubescent surge of testosterone enlarges them and pushes them outside the body.  
   Consider these frequency estimates from the Intersex Society of North America:

  • 1% of the population (1 out of 100) is born with bodies that differ somehow from the standard male or female types.
  • 0.1% to 0.2% of babies (1-2 out of 1,000) undergo surgery to “normalize” genital appearance.
  • 0.07% of the population (1 out of 1,500) currently qualify as “intersex," which is often the term preferred by people with significant gender ambiguity. (Other estimates suggest that as many as 1.7% of live births may qualify as intersex.)

   These first forms of gender ambiguity (anatomical, chromosomal, and hormonal) are not scientifically debatable. They are clear and confirmed, and no serious scientists argue their reality.

   Yet the complexity continues. Most mainstream scientists recognize a psychological condition known as gender dysphoria.

Simply put, a person feels significant discontent with the sex or gender they were assigned at birth. Often, the person feels that his/her outer anatomical gender does not match his/her inner felt gender. A boy feels that he has always been a girl on the inside, and vise versa. In terms of pop-culture, most of us are aware of transvestites and transexuals. Many of these individuals experience some form of gender dysphoria.
   Some studies suggest that genetic structure or physical brain structure may be causes of gender dysphoria.  However, the label itself is a debated scientific label. Some argue that the label is faulty and should not be used at all.
   But the appropriate cure is even more hotly debated. Some psychologists advocate resolving the felt gender ambiguity in favor the individual’s anatomical gender. Some encourage their patients to learn to live into the ambiguity by accepting a fluid definition of gender. Still other psychologists (serving patients with a glaring mismatch of their anatomical gender and felt gender) advocate for gender-altering surgeries. In fact, the American Medical Association considers sex reassignment surgeries one of the possible “medical necessities” in treating gender dysphoria.
   If you have any questions about the significance of this discussion, consider this glaring fact.  41% of people with gender dysphoria have attempted suicide, compared with a USA national average of only 1.6%.
   Estimates of the frequency of gender dysphoria vary widely from 0.05% to 1.7% of the population (from 1 out of 2,000 to 1 out of 59).

   The highest form of complexity and the deepest depths of debate are in the association of gender dysphoria and homosexuality.

Some psychologists consider homosexuality and bisexuality to be a form of gender dysphoria. Among those, some feel that these alternate sexualities should be “cured,” while others feel that they should be embraced. Still other psychologists consider sexual orientation and gender dysphoria to be separate issues only loosely related.
   Estimating the frequency of homosexuality and bisexuality is extremely difficult. First, due to social stigma, many who experience these orientations do not report them. Second, classifying sexual orientation is tricky. For example, if a person is in a long-term heterosexual relationship but experiences strong same-sex attraction, is that person “gay” or “bi”? What if they have a primary orientation with secondary experiences? It gets complicated fast.
   Estimates of the frequency of homosexuality and bisexuality range between 1% and 20% of the population (with that larger number representing people who have at least some crossover encounters). Based on the compilation of various studies, my best guess is that 5-10%  of all people are gay or bi.

   These various forms of sexuality may move along the same spectrum of ambiguity and clarity.

   Imagine anatomical ambiguity as the “clearest” form of ambiguity on the far left. One step to the right is genetic ambiguity - not physically obvious, but scientifically undebatable. One more step to the right would be gender dysphoria — people who feel they were born with the wrong gendered body. The next step to the right would be homosexuality — people who may or may not feel gender ambiguous but prefer sex with the same gender. The last and least ambiguous orientation on the far right would be heterosexual — people who feel only or primarily opposite sex attraction. In actual practice, social scientists say that many people find themselves between points along this spectrum.
   As far as I know, this spectrum of gender ambiguity is original to me. Several social scientists have suggested a human sexuality spectrum.  Here, I'm trying to link variance in gender identity with variance in sexual expression. Admittedly, this spectrum of gender identity is scientifically and socially debatable. Some LBGTQ people, for example, would chafe at anyone forcing them into a category of gender ambiguity. For me, though, this spectrum seems to make the most sense of the available evidence.

What does all of this mean for the Church and gay marriage?

   As an absolute minimum, the Church must have high levels of grace and flexibility for people with anatomical, genetic, and hormonal gender ambiguity.

    In the Chicago metropolitan area, where I live, our population of 10,000,000 means we have at least 7,000 physically gender ambiguous people (0.07%) living among us. (We probably have many more since divergent people tend to migrate toward urban centers.)
   The Church cannot be silent or blind to the real struggles of thousands of our neighbors. All of these people were born into a difficult life. They did not choose their gender ambiguity, and often others simply guessed at what gender they should be. As Christians, we should adopt an exceedingly compassionate approach to helping people with gender ambiguity learn how to navigate life in difficult and confusing circumstances.
   Like the church in the introduction, we should afford people with “clear” gender ambiguity the right to reset their presented gender - especially when others chose that gender without their consent and without a full understanding of the science and medicine involved. Because they have a “clear” ambiguity of gender, the only gracious and sane response is to allow significant leeway in learning how best to live out that complexity.
   Similarly, when Christians with "clear" gender ambiguity marry, it seems logical that they should be eligible for marriage with either gender. A person living as male but possessing female chromosomes as well should be able to choose a spouse from either gender. Logically, a partner of either gender could create a heterosexual union - or as close as is possible for that individual. They are a gender wild card, able to match with either gender.
   Our natural discomfort with gender ambiguity should take a backseat to the greater discomfort gender ambiguous people face in a world expecting gender clarity. The Church should lead society with grace here.

   Beyond this minimum lies a raging sea of debate.

  • Is the psychological condition of gender dysphoria an equal though less tangible variety of gender ambiguity?
  • Do people with gender dysphoria need the same kind of gracious leeway in terms of gender identity and marriage, or do they need guidance and healing to move toward gender clarity?
  • Is homosexuality also a variety of gender ambiguity, which should elicit the same kind of gracious response from the Church as people with ambiguous anatomy, mixed chromosomes, or atypical hormones?

   Honestly, I’m not sure of the answers to these questions. I find them incredibly challenging and thought provoking on the abstract level. Certainly, as we in the Church debate gay marriage, gender ambiguity must be part of the conversation.  However, on the personal level, when I meet individuals with some level of gender ambiguity, the only response I can muster is grace seeking understanding.

As we settle down for this long conversation on gay marriage, perhaps that’s the best we can hope for: grace seeking understanding.


This blog is part of a long series on how the Church can have a better conversation on homosexuality.  Read the rest of the articles here: