Assigned Sex: Understanding and Support Services

Introduction

Assigned sex is a term used to describe the sex that is assigned to an infant at birth based on the appearance of their external genitalia. This assignment is recorded on the infant‘s birth certificate and becomes a legal and social marker of their identity. However, assigned sex does not always align with an individual’s gender identity, which can lead to experiences of gender dysphoria and the need for support services. In this encyclopedia entry, we will explore the concept of assigned sex in detail, including its definition, the assignment process, and its implications for individuals and society.

Definition of Assigned Sex at Birth

Assigned sex at birth refers to the sex that is assigned to an infant based on the appearance of their external genitalia. This assignment is typically made by a healthcare provider, such as an obstetrician or pediatrician, and is recorded on the infant‘s birth certificate. Assigned sex is often conflated with gender identity, but they are distinct concepts. Gender identity refers to an individual’s inner sense of being male, female, or another gender, while assigned sex is based on physical characteristics observed at birth 1.

Terminology

There are several terms that are used to refer to assigned sex, including birth sex, natal sex, and biological sex. However, the term ” assigned sex at birth” is preferred by many in the LGBTQ community because it acknowledges that sex is assigned by others rather than being an inherent characteristic. Other terms, such as “biological sex,” can be seen as inaccurate or misleading because they suggest that sex is binary and immutable, when in reality it is complex and can change over time 2.

Sex Assignment Process

The sex assignment process typically occurs immediately after an infant is born. Healthcare providers examine the infant‘s external genitalia and assign a sex based on what they observe. In most cases, infants with a penis are assigned male, while infants with a vulva are assigned female. This assignment is then recorded on the infant‘s birth certificate and becomes a legal designation. However, the process of sex assignment is not always straightforward, particularly in cases where an infant‘s genitalia are ambiguous or do not clearly fit into binary categories of male or female 3.

Intersex Conditions

Intersex is an umbrella term used to describe a variety of conditions in which an individual’s reproductive or sexual anatomy does not fit typical definitions of male or female. Intersex individuals may have variations in their chromosomes, hormones, or genitalia that do not align with binary categories of sex. In cases where an infant is born with intersex traits, healthcare providers may assign a sex based on the infant‘s expected gender identity or the sex that is most likely to allow for functional genitalia. However, this practice is controversial and can have negative consequences for intersex individuals later in life 4.

Legal and Societal Implications

Assigned sex has significant legal and societal implications. Birth certificates, which include an individual’s assigned sex, are used as a form of identification and can impact access to certain spaces, services, and legal rights. For example, in some places, individuals may be required to use restrooms or locker rooms that correspond with their assigned sex rather than their gender identity. Assigned sex can also influence societal expectations and norms related to gender roles, expression, and behavior. These expectations can be limiting and harmful, particularly for individuals whose gender identity does not align with their assigned sex 5.

Gender Identity vs. Assigned Sex

Gender identity is distinct from assigned sex. Gender identity refers to an individual’s internal sense of being male, female, or another gender, while assigned sex is based on physical characteristics observed at birth. For many people, their gender identity aligns with their assigned sex, which is referred to as being cis gender. However, for trans gender and non-binary individuals, their gender identity differs from their assigned sex. This difference can cause distress and discomfort, known as gender dysphoria, and may lead individuals to seek gender-affirming medical treatments or legal recognition of their gender identity 6.

Historical and Cultural Perspectives

The concept of assigned sex has evolved over time and varies across cultures. In some cultures, there are recognized genders beyond the binary categories of male and female, such as the hijra in South Asia or the two-spirit in some Native American communities. However, the dominant Western medical model has historically relied on a binary understanding of sex and gender, which has been imposed on other cultures through colonialism and globalization. This imposition has led to the marginalization and erasure of traditional understandings of gender and has had negative impacts on individuals who do not fit within the binary model 7.

Medical and Ethical Concerns

The practice of assigning sex at birth raises several medical and ethical concerns. In cases where an infant‘s genitalia are ambiguous, healthcare providers may make decisions about sex assignment based on factors such as the infant‘s expected gender identity or the potential for functional genitalia. However, these decisions can have long-term consequences for the individual’s physical and mental health, particularly if their gender identity does not align with their assigned sex. Additionally, the practice of performing genital surgery on intersex infants to make their genitalia conform to binary categories of male or female is controversial and has been criticized as a violation of bodily autonomy and informed consent 8.

LGBTQ Perspectives

The term ” assigned sex at birth” is important in LGBTQ discussions because it acknowledges that sex is assigned by others rather than being an inherent characteristic. This understanding is crucial for trans gender and non-binary individuals whose gender identity differs from their assigned sex. The LGBTQ community has developed a glossary of related terms, such as cis gender, trans gender, and non-binary, to describe the diversity of gender identities and experiences. Personal stories from trans gender individuals highlight the significance of gender affirmation and the impact of assigned sex on their lives 9.

Controversies and Debates

There are several controversies and debates surrounding the concept of assigned sex. Some advocates argue for the use of the term “assigned gender at birth” rather than ” assigned sex at birth” to emphasize the social construction of gender. There are also debates about the ethics of current practices of sex assignment, particularly in cases of intersex infants. Some activists and scholars argue for a move away from binary categories of sex and gender altogether, while others advocate for changes in how sex and gender are recorded and understood at birth 10.

Current Trends and Future Directions

There are several emerging trends related to assigned sex and gender identity. Some jurisdictions are beginning to offer non-binary or gender-neutral options on birth certificates and other identity documents. There is also growing recognition of the need for more research on sex and gender, particularly in relation to health disparities and outcomes for trans gender and non-binary individuals. Activists and advocates continue to push for policy changes and greater recognition of the diversity of gender identities and experiences. As understanding of assigned sex and gender identity continues to evolve, it is likely that there will be further shifts in how these concepts are understood and represented in society 11.