Let’s start with some context and definitions. Sex and its cultural cousin, gender, are complex constructs. Sex usually refers to the biological differences between males and females: penis and vagina; XY (male) and XX (female) chromosomes; male hormones (e.g., testosterone) and female hormones (e.g., estrogens); and so forth. So, sex refers to male and female anatomy and their biological processes. Gender usually pertains to the expectations that a culture places on males and females to behave in a specific way; in other words, what are the typical masculine and feminine roles in society? Gender also often relates to one’s psychological feelings or states as a male or a female. So, for example, people who perceive themselves as a man have a male gender identity.
You may be thinking, This is easy enough, so why are they such complex concepts? Well, let’s deconstruct these concepts a bit. First, are there just two sexes? Another one of my dumb questions, you ask? (For more dumb questions, see chapter 5 on masturbation.) Well, actually, despite what most people believe, some experts suggest that two sexes are too limiting and that perhaps as many as five different sexes exist in human beings. Anne Fausto-Sterling, a biologist at Brown University, advocated this position, albeit one that she later admitted was argued tongue-in-cheek and to prove a broader point (1993; 2000). That broader point was that the rigid binary system of two sexes is not complex enough to understand the variation that exists in biological sex. John Money, the famous psychologist and sexologist, also pointed out the ambiguity in biological sex by noting that whether we call someone a male or female can depend on a variety of biological variables, not all of which are necessarily aligned or consistent (Money, Hampson, & Hampson, 1957). So, one can define sex by XY (male) or XX (female) chromosomes, but what if the gonads—testes or ovaries—do not match up with a standard XY or XX chromosomal profile in a given person? In other words, what if someone has XY chromosomes but also has ovaries? What if someone has the internal reproductive organs normally reserved for women (e.g., fallopian tubes and uterus) but has external male genitalia? This kind of sexual ambiguity, sometimes called intersexuality, is surprisingly prevalent (i.e., about 1–2 percent of births) (Fausto-Sterling, 2000), and it illustrates the need, when speaking about biological sex, for language and concepts capable of handling complexity.
There is also ambiguity when we refer to male and female hormones. The so-called female hormones, the estrogens that are produced by the ovaries in women (e.g., estradiol), also exist in men; in fact, testosterone, a so-called male hormone, is converted to estradiol in men under the influence of the enzyme aromatase. Women also produce testosterone, so this hormone is also not fully sex specific—that is, it is not limited to men.