At the end of last month, a report surfaced that the Health and Human Services Department pushed for a definition of gender that focused on biological characteristics — a move that would change how the government handled sex-discrimination complaints in education.
Activists and some medical groups responded with vehement criticism, signaling that the administration somehow erased or invalidated people’s experiences.
In a letter sent on Monday, a long list of health groups told HHS and Education Department Secretary Betsy DeVos to reverse the decision which, they said, ran “counter to decades of medical science and legal jurisprudence.”
“Gender identity and assigned sex at birth can be different one from the other, and that difference needs to be recognized in order to effectively guarantee access to care for transgender people,” the letter reads.
The dozens of signatories included associations like the American Psychological Association, the American Psychiatric Association, and the American Academy of Pediatrics.
The letter also warned about the legal implications of defining gender that way and suggested that gender identity may have a biological component:
“This definition would effectively erase federal recognition of transgender people, whose gender identity differs from the sex that they were assigned at birth, and runs contrary to medical science. Professional medical and health organizations—such as the American Medical Association5 and the American Psychiatric Association6—have for years confirmed that there is a complex medical spectrum of sex that includes genetic markers, internal and external anatomy, and gender identity, which may itself have a biological component.”
While many medical associations supported the letter, some medical professionals dissented. In statements to IJR, both Dr. Michelle Cretella, who leads the American College of Pediatricians, and Dr. Paul McHugh, who previously served as chief of psychiatry at John’s Hopkins, challenged the letter’s arguments.
“The letter presumes to challenge the standard biological observation that human sex like all animal – and some plant – sex is binary,” he said, “formed at conception and immutable but it does so not with new bio-scientific observations and arguments but with social justice arguments and some therapeutic presumptions.”
Dr. Cretella similarly pointed to a biological basis for sex:
“The Institute of Medicine recognized the singular importance of sex to health and the field of medicine nearly two decades ago. Every single cell of our body contains sex chromosomes which impart innate differences between men and women in literally every cell of our bodies.There are over 6500 genetic differences between human males and females. These differences impact our brains, every other organ system, our propensity for developing certain diseases, differential responses to drugs, different responses to pain, differential cognitive and emotional processes, behavior and more. In reality, people who “identify” as transgender remain either a biological male or female. Doctors unconstrained by transgender politics know full well that were they to treat patients in accordance with their “discordant” gender identity instead of their sex the results could be deadly. An identity contrary to reality – “gender identity” or otherwise – has no place being acknowledged in either medicine or law. Doctors and scientists, of all people, should know this. That the leaders of these 35 organizations would sacrifice both science and common sense on the altar of political correctness is a testament to how low the once noble profession of medicine has sank.”
As Dr. McHugh noted, the letter also claimed that the administration’s definition excluded intersex individuals.
“The reported memo’s narrow definition of sex also ignores the existence of intersex people, who are born with sex characteristics, such as anatomy or chromosomes, that do not fit the typical male/female binary definition set forth in the reported memo,” the letter read.
“Transgender and intersex people have existed throughout time and have unique health needs and lived experiences.”
But, according to Dr. McHugh, intersex individuals didn’t negate a “binary conception of human sex”:
“The one biological fact noted is the existence of ‘intersex’ births and the issues these patients have in later development but this fact cannot serve as an argument against a binary conception of human sex in that all the intersex patients are subjects of errors in embryogenesis or fetal formation in the same way as Down Syndrome and the like are developmental afflictions They, like intersex individuals, do not provoke an assumption of some distinct human kind or species but rather a way development can go awry . We are all in favor of social justice and have therapeutic concerns and proposals for these subjects but I do not see any reason for believing that denying the biological truth about sex will bring better justice to them or others or more successful therapies – more likely the opposite.”
As IJR previously noted, the administration’s definition also gathered praise from individuals who described themselves as “ex-transgender.”
While it’s unclear how the administration will proceed on this issue, it appeared to have legal backing as HHS noted that a previous court ruling indicated former President Barack Obama’s administration set too broad of a standard for Title IX.
“That court found that the Obama administration regulation was overbroad and inconsistent with the text of the 1972 Title IX law prohibiting discrimination on the basis of sex,” HHS spokesperson Caitlin Oakley said in a statement provided to IJR.