Between XX and XY

Between XX and XY: Intersexuality and the Myth of Two Sexes by Gerald N. Callahan, Ph.D.
(Chicago Review Press)

Hi, all!

As some of you may have noticed, my flow of book reviews has slowed to a trickle over the past few months. It’s not because I don’t love what I do! I’m applying to graduate programs, you see, and I’ve been eaten up by applications and entrance requirements. As a result, it took me two whole months to make my way through a 160-page book, and I’ve done barely any non-personal-statement writing at all. Hopefully, though, I’ll be able to pick up the pace after the holidays.

The aforementioned 160-page book is Gerald N. Callahan’s Beyond XX and XY, which was sent to me right after the controversy over Caster Semenya’s gold medal erupted. The book, with a focus much more frank and progressive than most media out there, seems at first glance to be a good primer for non-intersex people who need a basic education about the range of human sexual development. “My purpose,” Callahan writes in the introduction, “is not to convince you that we need to imagine more sexes, because the concept of five sexes would be no closer to solving the problem than the idea of two sexes is.” Instead, he says, society needs to reexamine its very concept of sex, and ditch the binary system we’re dealing with now. He starts the book with a brief history of Western ideas of sex, highlighting Classical and Renaissance theories that male and female genitalia are identical, with only different positioning (males wear theirs on the outside and females on the inside), and explains early medical attitudes towards intersex conditions that mandated as little involvement from the parents or patient as possible. He stresses that bias and preconceptions influence science more than scientists care to admit – and doesn’t exclude modern medicine and research from his critique. He even censures bans against same-sex marriage (“Never mind that it is impossible to define exactly what a man or a woman is”) and acknowledges that Fallopian tubes probably weren’t first discovered by Gabriel Fallopius.

Unfortunately, although Callahan seems to have noble intentions, most of the book fails to really deviate from popular ideas about intersex conditions. First off, he doesn’t seem to consider the possibility that intersex or non-gender conforming people might read the book, and habitually refers to cisgendered non-intersex readers as “us” and the subjects of the book as “they.” Although “we” accept that gender is socially constructed, “sex remains inviolate to us – boy/girl, black/white.” Even if the intended audience is people new to intersex issues, would it hurt to be a little more inclusive? This tone reaches a nauseating climax at the end, when he begins to expound upon all the favors intersex people do for “us,” and explains that “we should be grateful” because “they have shown us that we can untie the knots that bind us to our own preconceptions and begin to live freer lives.” More disturbingly, in the middle of the book Callahan presents a string of stories about the trials and tribulations of intersex individuals, highlighting accounts of rape, assault, depression, and suicide. What was horrific and unjust in the real lives of his interviewees turns into lurid sensationalism on the page – and it’s hard to even see what point he’s trying to make about sex and gender. He follows up this chapter with a series of graphic descriptions of sexual reassignment surgery, making it seem as if a whole swath of the book was designed more to satisfy non-intersex readers’ morbid curiosity than to lead to a greater understanding of intersex.

Other chapters are more level-headed, although not very groundbreaking. Callahan discusses the development of sex in utero, various types of sexual activity in the animal world, and some cultures that are more welcoming to non-gender-conforming people than the West is. I suppose this is all information that would be useful to someone with no knowledge of intersex issues, but it doesn’t offer much more than, say, a trip to Wikipedia.

So is this book a useful introduction? On the one hand, any media that challenges harmful and nonsensical ideas about sex must be at least somewhat useful. On the other hand, I wonder if this book’s portrayal of intersex people and their bodies does more harm than good. It fails to make a convincing case for why people with non-conforming bodies don’t need to be “fixed,” but does make sure that non-intersex readers know all the steps that go into constructing a penis. I commend Callahan’s goal of educating readers about a widely misunderstood range of anatomies – but this book never quite gets there.

Coming up when I get my life back: food justice, Wal-Mart, and Merilyn French!

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8 comments for “Between XX and XY

  1. Brian
    December 1, 2009 at 6:24 pm

    Fancy that, I am also applying for grad school and have had little time to read, but this has been one of the books I have been able to finish.

    Anyways, I liked the book overall. I concede that there are major problems with inclusiveness as far as language goes. However, I’m more convinced that the author does make a case for why people with non-conforming bodies don’t need to be “fixed.” His book is basically split up with two questions: what is intersexed? and what, if anything, do we do about it? For the first, the descriptions of all the myriad of ways for humans (and then often other animals) to be intersexed is designed to slowly erode away a definition of intersexed. The effect of the biological discussions of the types of intersexed conditions slowly expand to ideas that all intersexed represents is a visible middle, but that there is so much more. It gets to his final point, that we are all intersexed. So the answer to the question what is intersexed is everything and nothing. It is everything because we all are to a certain degree involved with it but it is also nothing because it fails to really describe anything as it still relies on a sexual binary.

    As far as the question: “What do we do about it?”, he describes ways in which we have had thought of and currently do think of intersexed in the medical community, and what the medical community does to children in the name of gender conformity. Does he endorse them all? Of course not. In fact, the descriptions and techniques for surgery are often looked at and described as primitive and violent, especially with what superficial criteria they are decided upon. The surgery section is supposed to be graphic, it could not be anything else. He is discussing medical procedures and then evaluating them. There is not malice I saw, just a scientist. In the end I came away from the sections on surgery with a feeling of flabbergasted disgust. And I think that was the point.

    He is indeed refreshing when it comes to questioning neutrality of scientists and current medial research. When he cites medical research on the effectiveness of surgery, he does the same thing as he does with the question of what intersexed is. He starts with a narrow focus that appears to imply certainty, because of its simplicity, then steps back to reveal it is not clear at all. He looks at the largest study, that done by Johns Hopkins University, and just presents their conclusions. Then goes about slowly dismantling its certainty by adding more nuance. As a scientist he has to confront those studies. He confronts them head on and really de-legitimizes them on their own grounds of scientific reliability. May not have been the way I would have done it but he is a scientist after all, it’s kinda expected.

    The stories sometimes come off as sensational, I’ll definitely grant you that, though their emotional impact is still not something to shy away from. He certainly could have done a lot better if he wanted to include stories of the troubles intersexed people faced. But the interview snippets, I think, are done much more sensitively.

    So the book, I’ll agree, is by no means “perfect,” but I think it was a fantastic book for what it was, a book by a biologist trying to grapple with something society hardly talks about. Again I agree with you for the most part, but I seem to have enjoyed the book more then you, even with its glaring flaws, which any book like this is going to have. I probably just didn’t come into it with very high expectation so I was willing to overlook more.

    Anyways, great review.

  2. RD
    December 1, 2009 at 7:15 pm

    “In the end I came away from the sections on surgery with a feeling of flabbergasted disgust. And I think that was the point.”

    And this didn’t strike you as a problem at all? You don’t think the author could have made the point that the surgeries weren’t ok because they were non-consensual, rather than trying to make you feel disgust at genital surgery in general?

  3. Brian
    December 1, 2009 at 7:44 pm

    it was disgust at the non-consensual nature of them and of the indifference of the doctors, not to the surgery itself (though I am a bit squeemish, but thats beside the point). Should have made myself more clear, sorry. When I said primitive and violent, it was directed at the primitive way in which the doctors saw sex and gender and the violence was the reaction they had to non conformity. Both of which caused the flabbergasting disgust.

  4. jpe
    December 2, 2009 at 12:49 pm

    If we’re linguistic essentialists, then the existence of intermediate sexes does indeed pose a problem; for the pragmatist, though, it doesn’t a bit. The question is no longer “does our sex classification faithfully represent the world,” but “is our sex classification a useful way of dividing the world.” And the affirmation of the latter question is untouched by the existence of intersex individuals.

  5. FW
    December 2, 2009 at 2:07 pm

    I thought this was interesting, but have no clue if it’s “good science” in either practice or purpose (it doesn’t seem purposely exploitive though, to me):

    “Are we on the cusp of discovering what determines gender? The old mantra – all girls have XX chromosomes and all boys have XY – is no longer reliable. Scientists are now looking beyond chromosomes to “brain sex” and the role of newly discovered genes. By studying transsexuals and people on the gender extremes, they believe they can unlock the gender puzzle. This high-quality documentary looks at the new and challenging science of gender. ”

    and I also just found this:
    ” page describes how AIS and related conditions have been covered in printed matter “

  6. DG
    December 2, 2009 at 2:39 pm

    This is a very interesting review. It sounds like it approaches the issue with good intentions, but not from the most careful/inclusive angle? Still, a scientist who thinks this way is better than the “scientists” the book confronts, no?

    I’ll make an effort to pick a copy of this up, I think, and read it for myself.

  7. GC
    December 3, 2009 at 5:19 am

    I think that a more useful and thoughtful introduction could be John Colapinto’s excellent retelling of David Reimer’s harrowing story. The book’s name is As God made him. I truly recommend it, it makes you understand and see the whole picture (Colapinto really did a thorough research) . It’s very interesting and it explains in layman terms how we are born with our gender identity established. The last chapter talks about intersex people’s plight and has some words (kind of an epilogue) from David’s family, friends and David himself.

  8. Jadey
    December 6, 2009 at 1:17 pm

    I’d meant to read this a few months ago, and seeing the title of your review inspired me to get it from the library. I put off reading your review until I finished the book (about an hour ago now), because I wanted to come at it with no expectations. The outcome was pretty much the same, though. I skipped the chapter detailing the surgeries as soon as I realized what it was (seriously, the obsession with the bodies of marginalized people can stop anytime now — and I say that as somene who otherwise really enjoys learning about surgeries and dissections), and also found his finale with how grateful “we” should be with how much intersex people have taught “us” nauseating.

    I did really enjoy his thorough break-down of all of the types and ways that variance in human sex chromosomes occurs. I think that’s exactly the kind of information that people need to know, because usually our approach to DNA and genetic reproduction simplifies variance right out or reduces it to a “yes or no” option. Genetic diversity, regardless of its specific expression, is the key characteristic of a healthy species, and I wish anyone making any kind of “natural” and “normal” argument would figure that out. This kind of diversity is the rule, not the exception, and is therefore perfectly normal!

    Admittedly, I’m a huge fan of learning about the reproductive and sexual features and behaviours of human and non-human species (yeah, Discovery Channel dork here), so I appreciated those elements, but somewhere around the discussion of hermaphroditism in fish species, I realized two things: A) some of his “clever” descriptive prose was really awful and offensive (“from veiled damsel to bearded sheik” wtf??), and B) a lot of his presentation, like the persistant use of “we” and “us”, was already extremely othering to intersex *and* trans folk (he also didn’t do a good job of explaining how the latter can intersect with the former, and keeping the discussion of both separate), and the (non-human) animal comparisons were only making that worse. By the end of the book, it really did feel like he was treating intersex people as “subject matter” and not people.

    As well, for a book about physiological and genetic sex variance, he sure sucked at talking about gender identity and expression variance. Talk about erasing transgender, bigender, genderqueer, and agender people! Even when he was critiquing early sex assignment *surgery*, he didn’t question the need to always assign a sex to a child (and included, uncritically, a comment from another doctor who basically said that bigender, genderqueer, and agender people don’t have lives worth living). Assuming that every intersex child will fit in a *gender* binary isn’t much more helpful than assuming that they should fit in a sex binary.

    I can barely begin to discuss how offensive his discussion of “berdache [sic]” among indigenous nations was — this is the second time that I have been confronted by academic who has acknowledged that the term is incredibly offensive and inappropriate, only to go on to use it repeatedly because they can’t be arsed to try something different (the first was a soc prof and at least I got her to make a half-assed apology to the class). Not to mention his colonial assumptions that indigenous people and cultures are only interesting from a 200-year-old perspective.

    Finally, while I definitely agree that he made some very direct points about scientific bias early on when discussing pre-20th century science, I have a huge issue with how he presented the more recent reseach. Specifically, he failed to include important information about the studies up front that was seriously relevant to the integrity of the findings. He mentions vaguely in the first chapter that John Money’s tabula rasa theories had been mostly discredited, but didn’t describe *how* until chapters later, which was odd considering just how very wrong Money was. And the information about participant selection bias in the Johns Hopkins should have been presented immediately, not held back for dramatic effect, because it created a mixed message. The truth is that those studies are not terribly credible because of the serious flaws in their participant selection, but it’s hard to get that from the book because of the way he buries the rest of the details pages later. From the standpoint of the standards of scientific reporting (which requires one to state details of participant selection *before* describing the findings or even the methodology), it’s a totally irresponsible and inappropriate way to go about it.

    I started the book feeling much better about it than I did by the end. He gives in so frequently to the need for lurid and irrelevant details that I’d rather recommend people read certain chapters than the whole thing.

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