On Sunday, the New York Times reported that the Trump administration has been mulling over a strategy to redefine sex. Counter to medical and judicial consensus, a draft memo originating in the Department of Health and Human Services (whose civil rights office is headed up by known bigot Roger Severino) outlined a plan to decide “a person’s status as male or female based on immutable biological traits identifiable by or before birth,” as dictated by genitalia, original birth certificates, and genetic testing.
This isn’t the first time Severino has characterized LGBTQ identities as going “against your biology,” and the move would roll back the Obama-era protections for trans Americans he once deemed a manifestation of “radical gender ideology.” As it turns out, that’s one of Severino’s favorite phrases—and the evangelical right’s. But acceptance and affirmation of trans people isn’t an extremist act—erasure of anyone whose identity doesn’t fit your understanding of sex is. And it’s hard to overstate just how reductive and rudimentary that understanding seems to be: Where the HHS memo claims to be putting forward a definition that is “grounded in science,” it willfully elides the biological realities that would make such rigid classifications impossible.
It’s tempting to reach for the rarest, most dramatic cases to demonstrate the sheer diversity of human bodies: the man who discovered he had a womb at 70! The woman whose cells were partly genetically male! But we don’t have to go that far to find the people this definition would harm. Sex is complicated, and it can be classed three ways: chromosomal, gonadal, and anatomical. For as many as 1 in 100 people, not all of those elements match up.
In most cases, it’s true that a pair of X chromosomes denote “female,” while an X and a Y indicate “male.” But you can also be born with fewer than two sex chromosomes (a single X or Y, known as a monosomy) or more (XXX, XYY, XXY, and XXXY are among the polysomal possibilities). And even if you have the standard number, your anatomy may not match the expected outcome for the set: DNA fragments can be passed between them and recombined, and certain configurations will mean that your body doesn’t respond to the hormones whose production is encoded by your genes. Under such circumstances, you can appear female, and indeed be assigned female at birth, while still carrying XY chromosomes—something you may not even be aware of yourself. But HHS doesn’t have a plan for cases like this one, in which a person’s original birth certificate and genetic testing would lead to opposing conclusions.
Nor would basing legal sex on “the genitals that a person is born with” be as straightforward as the agency seems to believe. According to the American Psychological Association, up to “1 in every 1,500 babies is born with genitals that cannot easily be classified as male or female.” Sex assigned at birth is, for many intersex people, something improvised by doctors, who often prescribe invasive operations intended to “correct” ambiguous genitalia. A Human Rights Watch report characterized these often traumatic, medically unnecessary surgeries as “guesswork,” with the risk of incorrect assignment as high as 40 percent. The Trump administration’s approach would encourage such hasty designations and then deny these individuals any recourse when they reject the arbitrary decisions made in their infancy, as many ultimately do. (Some end up identifying as trans themselves.)
This policy marks the logical endpoint of an obsession with genitalia as infallible indicators of immutable sex—a narrative that has harmed trans and intersex individuals for generations. And while the discrepancies might be more readily apparent for those with chromosomal, gonadal, or anatomical abnormalities, invalidating trans identities likewise flies in the face of medical consensus. Gender incongruence is no longer classed as a mental health disorder by the World Health Organization. The American Psychological Association recognizes and affirms trans identities. And leading medical journal the Lancet has described legal recognition as “crucial for transgender people to achieve … healthy lives and gender equality.”
We’ve known for some time that Trump has a tenuous relationship with facts. He may enjoy the trappings of science and the veneer of objectivity it affords (as when he demands DNA tests from his political rivals and brags about his late uncle, a professor at MIT), but he’s all too happy to ignore the evidence when it doesn’t align with his views—which is often. On climate change, decades’ worth of data were apparently inferior to his “natural instinct for science.” On trans and intersex identities, the careful conclusions of the medical community and the lived experiences of countless people are now being swept aside in the same way.
High-ranking members of the current administration may regard trans people and their supporters as willfully deluded radicals—but they’re the ones forcing individuals into one of two boxes irrespective of their identity and, yes, their biology. It’s a policy of characteristic carelessness and cruelty that seeks to write one marginalized group out of existence and manages to do the same to millions more people in the process. But no government can legislate away facts or human beings they find inconvenient. Both deserve and demand to be recognized.