Trouble with Gender: A Review

The controversies surrounding ‘gender’, ‘gender identity’ and ‘transgender’ often depend on differences of opinion of what these concepts might mean. This in turn influences how they may be used in such areas as law and medicine. Since conceptual analysis is a part of philosophy, it seems reasonable to have philosophers weigh in. The book “Trouble with Gender: Sex Facts, Gender Fictions” (Polity Press 2024), by Alex Byrne, is such a work of philosophy. It is written for the general reader, with the goal of elucidating concepts relating to gender in a serious but entertaining way. While the book does not aim to settle social or political issues, it may be relevant to some of them.

There is one particular situation where the reviewer feels that conceptual analysis could have an impact on an important practical issue. The use of the phrase ‘transgender child’ as a noun seems to indicate that there is such a thing as a child of one sex who is in some peculiar sense of the other sex. In effect, it endorses a theory that will be referred to below as ‘innate gender identity’. The simple fact that this noun is used without qualification in legal and medical contexts has a huge influence on current discourse.

This review may seem more academic than the book itself since it attempts to maintain precision by giving a number of direct quotations. The aim is to highlight some of the main concepts in Byrne’s book and to give brief explanations of his conclusions. In other words, the review attempts to describe more than to evaluate. The reader should turn to the book itself for the details of the supporting arguments, which lead in all sorts of fascinating directions.

Gender

In this area, conceptual confusion begins with the word gender. Byrne describes some ways the word is used:

• Gender as sex (female/male);
• Gender as femininity/masculinity;
• Gender as sex-typed social roles;
• Gender as gender identity;
• Gender as woman/man.

For the final item to make sense the woman/man distinction must differ from the female/male distinction. In fact, it is sometimes claimed that the woman/man categories should be supplemented by others such as ‘pangender’ or ‘genderqueer’.

Gender is a particularly dangerous word, since it is easy to use it in a context where one meaning is confused for another. Byrne suggests avoiding the word altogether, except possibly when it is clear the meaning is sex. Maybe even then one should specify it explicitly as gender (male/female). As Byrne says,

This is not a trivial grammatical issue, such as ‘which’ versus ‘that’ or whether sentences can be ended with prepositions. ‘Gender’ is everywhere, from the law to medicine, and misunderstandings can have serious consequences. Muddleheaded ways of using the word can usually be traced to academics, who have managed to confuse themselves even more than they have confused the rest of us.

Sex

Sex is a mechanism of reproduction; an important chapter in the science of evolution. The most familiar version of sex is that found in mammals. A male produces sperm that fertilizes the female’s egg; the resulting embryo develops in the body of the female. Is it thus evident that sex is binary? Byrne gives two senses in which the answer seems to be affirmative:

• 2-Sexes: There are exactly two sexes, female and male.
• Binary-Sex: Everyone (or very nearly everyone) is either one of the other and not both.

It is hard to argue against the 2-Sexes claim without pointing to a third sex. But is it true that a mammal must be either female or male and not both? Biological mechanisms are not perfect, and in the case of sex, there are DSDs. These are disorders of sexual development, sometimes called (misleadingly) intersex traits which can lead to decreased fertility or even sterility.

In the vast majority of DSD conditions, there is no ambiguity about whether the individual is female or male. There are extraordinarily rare situations where there is a genuine puzzle. Byrne writes:

Combining Hull’s and Sax’s criticisms, the estimate of the frequency of intersex conditions – as originally understood by Fausto-Sterling – becomes 0.015 per cent, more than 100 times lower than her initial figure. Since most people in this 0.015 per cent are clearly exactly one of the two sexes (like those with CAH), the dispute about Binary-Sex is left with a minute proportion of cases to haggle over, perhaps 1 in 20,000 births or even fewer. Academic – or sometimes intensely personal – interest aside, nothing of importance remains.

Though Byrne does not mention it, there is another sense in which sex is binary. Consider the life history of an individual mammal from the viewpoint of the present. One can look either forward or backwards in time. Looking backwards in time leads to an event in which one female and one male contribute to the birth of this individual. This is a truly binary process. Looking forward in time gives a different picture. All sorts of things can go wrong and inhibit reproduction. There are many examples: the individual may die of a disease, in an accident or of starvation. Or the individual may be sterile, or simply not interested in reproducing. Or it may be impossible to find a mate. Among these difficulties, DSDs are among the least common. Conclusion: To see the sex binary most clearly, look backwards in time.

Man/Woman

A man is an adult human male, while a woman is an adult human female. Or so we thought. But Byrne notes, “Putting all this evidence together, the view that women are adult human females looks solid. And yet, no one in the mainstream of feminist philosophy or gender studies believes it.”
There must then be other proposals for the appropriate definition of, say, ‘woman.’ Here is one, quoting Byrne:

As Judith Butler puts it (less clearly than Harrop), ‘by “women” I mean all those who identify in that way.’ This is circular, in the sense that, if you don’t understand the word ‘woman’ to begin with, you will not be able to understand the explanation, which uses the word ‘woman’. It is thus not a definition as ordinarily understood. But that doesn’t mean that it’s not true.

Various philosophers have pointed out a difficulty with this definition. Byrne continues:

However, the circular claim about women is clearly false. We’ll turn to what ‘identifying as so-and-so’ might come to in chapter 8, but whatever it means, presumably some sort of psychological competence is required to ‘identify as a woman’. Some elderly females with dementia will fail the competence requirement, and thus will not be women, which is absurd. And the parallel account for girl (which should also be true if the one for woman is) is even more clearly false. Newborn girls do not identify as anything.

The attempt to change the definition of “woman” from the traditional definition can lead to intricate tangles. Byrne’s clearest discussion of this is in a note. Here is an excerpt from this note. For clarity, it has been divided into paragraphs.

‘Trans women are women, of course they are, because “women” is a social and historical category that gets expanded with time’ (Butler and Jones 2021: 28:58). There are two instructive mistakes here.

The first is that the category woman has changed. Consider this example: the word ‘meat’ used to mean solid food. Subsequently the word changed its meaning, becoming more exclusive: it now applies only to the flesh of animals (but not fish). The category meat did not change; rather, the word ‘meat’ once picked out the category solid food and now it picks out another category, animal flesh. When we speak of the category meat in contemporary English, we are speaking of this second category. What Butler should have said, then, is that the word ‘woman’ has changed its meaning, like the word ‘meat;’ Unlike the word ‘meat’ ‘woman’ has become more inclusive, applying to more people than it did before. In particular, although it used not to apply to trans women, now it does. Surely Butler thinks the same is true of ‘man’. That has also become more inclusive, now applying to more people than it did before. (If trans women are women, then trans men are men.)

Butler’s second mistake is to think that this alleged change makes the ‘right’ sentences come out true, for instance ‘Trans women are women’ and ‘Trans women are not men.’ If the alleged change is a real change, the first sentence is true, but the second sentence is false. If ‘woman’ and ‘man’ have become more inclusive, they still apply to the people they used to apply to. Presumably, back in the regressive past, ‘man’ applied to trans women (perhaps because it once meant adult human male). But then ‘man’ in the new sense also applies to trans women.

As Byrne points out, “the substantial issues can (and should) be stated and debated without taking a stand on whether trans women are women. That settles nothing.”

Gender Identity

Gender identity is an elusive concept. A presumably authoritative definition is given in the latest WPATH Standards of Care (SOC8): gender identity is “a person’s deeply felt, internal, intrinsic sense of their own gender.” Neglecting for the moment the ambiguity in the word gender, it is clearly meant to be something important, even “intrinsic.” This is a common thread throughout discussions of this topic. Thus, for instance, the LGBTQ advocacy group GLAAD claims that “gender identity is an innate trait that cannot be changed.”

Byrne calls this description of gender identity the orthodox view. It might have been clearer to call it innate gender identity. In any case, he summarizes the desired picture as follows:

Wanted: some psychological entity that has (at least) two settings, F and M. Everyone has one of these things; in natal females, the setting is almost always F, and in natal males, it is almost always M. The settings are innate and very hard to alter. In the unusual case where a natal male’s setting is F, he will suffer gender dysphoria – distress at his sexed body – which may be alleviated by altering the body in the female direction; conversely for a natal female whose setting is M.

The question is whether there is such a thing as innate gender identity. One problem is that there is no apparent mechanism for it. Furthermore, the evidence for its existence is questionable. One source of evidence might be people who report that they have a particular innate gender identity. This, however, has the same status as a report of a conversation with God. It may be telling something important, but it may not be clear exactly what.

Another source of evidence might be the existence of gender dysphoria, that is, distress with one’s sexed body. According to WPATH, gender dysphoria “is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth.” Thus, the theory of innate gender identity purports to explain gender dysphoria. Here the problem is that there could well be other reasonable explanations of gender dysphoria.

‘Innate gender identity’ should be distinguished from other versions of ‘gender identity’. Thus, Byrne describes something called ‘core gender identity’. Core gender identity is the conviction (right or wrong) of one’s sex. Older children and adults generally have a core gender identity, in most cases the one corresponding to the reality of their sex. However, this is not the same as innate gender identity. A male who has just become convinced of having an innate gender identity that is female will still know from the evidence of his body and from previous upbringing that he is male. In the reviewer’s opinion core gender identity is not a particularly helpful term, since all it means is knowing one’s sex.

The problem remains of understanding the definition of gender identity in the WPATH Standards of Care. The problem is with the word gender. Byrne writes:

Again, in order to understand this definition, we need to understand the word ‘gender’, and SOC8 does little to explain it, beyond saying that ‘man and woman’ are genders, and clearly implying that there are more. The previous Standards of Care (SOC7) is more forthcoming and includes this list: ‘male (a boy or a man), female (a girl or woman) . . . boygirl, girlboy, trans-gender, genderqueer, eunuch …’ SOC7 does a better job than the Yogyakarta Principles at explaining ‘gender’, trying to convey its meaning by giving many examples in the hope that the reader will catch on.

The list itself needs explaining, though, because it uses special terms such as ‘genderqueer’. What does ‘genderqueer’ mean? Here’s the SOC7 definition: ‘Identity label that may be used by individuals whose gender identity and/or role does not conform to a binary understanding of gender as limited to the categories of man or woman, male or female.’ Being genderqueer seems very different from being a eunuch, another WPATH example of a gender. A eunuch is simply a castrated male.

One begins to suspect that circular definitions are the rule. Indeed, as Byrne writes:

What’s worse, we are now going round in a circle. ‘Gender identity’ is defined using ‘genderqueer’, and ‘genderqueer’ is defined using ‘gender identity’. Note also that transgender is also one of WPATH’s genders. This is another example of circularity, because SOC7 defines ‘transgender’ using ‘gender identity’: The gender identity of transgender people differs to varying degrees from the sex they were assigned at birth. At no point do we get an explanation of gender identity that doesn’t itself rely on the very notion to be explained.

There is also a problem with the purported explanation of gender dysphoria. Suppose that it were due to the mismatch between innate gender identity and sex. Then since transition changes neither innate gender identity nor sex, it should not reduce gender dysphoria.

In SOC7 WPATH gives a more detailed description of gender dysphoria that goes some way to confronting this problem:

Gender dysphoria: Distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics).

Byrne restates the WPATH description in a more precise way:

Gender dysphoria: Distress that is caused by a discrepancy between a person’s gender identity and that person’s gender role and/or bodily sex characteristics.

The empirical definition of gender dysphoria is distress with one’s sexed body. So it is misleading to take the WPATH version or the variant proposed by Byrne as a definition; it is instead a theory of how gender dysphoria comes about.

The theory of innate gender identity in combination with the above theory on the origin of gender dysphoria indicates that gender dysphoria should arise precisely when there is a discrepancy between a person’s (presumably self-reported) gender identity and that person’s gender role and/or bodily sex characteristics. The combined theories are cast in doubt by examples of discrepancy without gender dysphoria. They are also undermined by examples of gender dysphoria not accompanied by discrepancy. Byrne considers both kinds of examples.

It seems to the reviewer that Byrne’s arguments support the assertion that gender dysphoria need not be explained by a mysterious ‘innate gender identity’. Distress with one’s sexed body could well have biological, psychological, or social origins. If this is to be called gender identity, then perhaps it would be clearer to call it ‘acquired gender identity’ in recognition that it has a cause that can be investigated by usual scientific or diagnostic means.

Identity

After two chapters dealing with sex differences in humans, a final chapter returns to the subject of identity. This is a much more prosaic and general sense of the word ‘identity’. Nevertheless, there are distinctions to be made. Here are things that an individual can do with respect to a group. The notion of ‘group’ is quite wide; it could be a nationality, a profession or many other things.

• be in the group;
• believe that they are in the group;
• identify as being in the group (social: encouraging others to classify them as in the group);
• identify with the group (personal: feeling a sympathy or kinship with members of the group).

All this applies when the group is a particular sex, female, or male. According to Byrne:

Transitioning from one sex to the other involves identifying as the target sex. It also – at least in many cases – involves identifying with the target sex, a kind of tribal identity.

The target sex is the new “sex of living.” In this way of thinking, no one is born transgender, and transgender can be a transitory state.
This more elastic description gives the possibility of understanding what it could mean to be non-binary. Byrne suggests that it be taken to mean identifying with those who defy gender stereotypes.
The non-binary category has given rise to the fashion of using neopronouns. The simplest and perhaps most popular choice is they/them. Byrne writes:

So-called singular ‘they’ as in, ‘If a celebrity comes to the party, they will have a good time’ and ‘England expects everyone to do their duty’, has been around since the fourteenth century. What is new is non-binary ‘they’, as in ‘They are a singer’ (pointing at Sam Smith), and ‘If Sam comes to the party, they will have good time.’

This does not mean that the use of ‘they’ in this context is completely harmless. The usual pronouns he and she can be used neutrally, giving a clue to sex with no obligation to indicate gender stereotypes. Neopronouns, starting with ‘they’, are defined in a context of gender stereotypes, and this could spill over to ‘he’ and ‘she’. This is no improvement. Sometimes sex is all we need.

The centrality of sex

The book “Trouble With Gender: Sex Facts, Gender Fictions” reviewed here is not the only book by a philosopher touching critically on gender topics. There is also the now classic “Material Girls: Why Reality Matters for Feminism” by Kathleen Stock, which includes philosophy with a dose of feminism. Byrne’s book, by contrast, generally avoids taking a position on issues outside of philosophy. Still, there is an overall theme: maintaining that sex is the key. Without sex, there would be no gender. Again Byrne:

Setting the afterlife aside, the significance of sex will always be with us. Humans are exceptional animals in many ways, but not in this one. It’s not simply that we come in two sexes, but that we come in two sexed forms – humans are sexually dimorphic. If human females and males were practically indistinguishable, there would be no trouble with gender and no need for this book. It is not all trouble, though: without sexual dimorphism, much of value in our society, art and culture would be absent. Underneath the – surely transient – contemporary social currents discussed in this book is the human condition.