Sex is not “assigned” at birth

August 17, 2022 • 9:15 am

Even I have been guilty of saying that “male” and “female” are the two categories of “sexes assigned at birth”, while at the same time maintaining that there are two observed biological sexes in humans (and in nearly all mammals), and it’s that way because of evolution.  That, and empirical observation, shows that sex is almost completely binary. In contrast gender, a self-assigned adjective referring to one’s sexuality (or nonsexuality) is more of a continuum.

I’m not going to use the phrase “assignment at birth” any longer. It’s hypocritical to hold an empirical view of sex as a nearly complete binary and yet to also imply that somehow doctors slap on a newborn a label that’s more as a social construct than a biological fact. Make no mistake about it—”assigned” is meant not as simply “recorded”, but is now used to imply that sex is more or less arbitrary: an elusive social construct.

Sex is not “assigned” at birth, it’s determined at birth (or, to  be more accurate, at conception)—just as the number of limbs you have is determined at birth (or a ways into fetal development). Yes, there are exceptions to both normal limb number as well the apparatus for producing big or small gametes, but those exceptions are vanishingly rare. Individuals who deviate from the males-make-small-gametes and females-make-large-gametes binary constitute less than 0.02% of the population.

I realized this when I saw this article in the Associated Press about rugby champion Elia Green (born a female), who has decided to transition to the male gender. Since he’s retired from rugby, there’s no discussion about his participation in the sport (I believe men’s rugby banned transsexual males anyway), but that’s not the issue here. My point involves the implications of the article’s first paragraph:

BRISBANE, Australia (AP) — Ellia Green realized as a young child — long before becoming an Olympic champion — that a person’s identity and a gender assigned at birth can be very different things.

Two things are wrong here.  Neither sex nor gender are assigned at birth. Sex is determined at birth, usually based on phenotypic traits that are correlated with biological sex but don’t define biological sex (gamete size does that). Second, genders, being a person’s self-assigned role in the spectrum of sex, cannot possibly be “assigned at birth”. That must wait until the child is old enough to choose a gender or gender role—or is forced to adopt one by some authority.

66 thoughts on “Sex is not “assigned” at birth

  1. > Neither sex nor gender are assigned at birth.

    What terminology do you use for the act of labeling the 0.02% of humans who are actually intersex (roughly 1.5 million people) as male or female? Do you consider that to be ‘assigning’ or something else?

    1. “Intersex” covers a vast majority of diverse conditions. I would say “determined”, but it would probably take further research to find out what the condition was, and then you’d say, “The newborn was found to be X” or “determined to have condition X”.

    2. Request for information on intersex:
      1) are there any cases where the person produces both gametes?
      2) I learned from various medical websites that even if the person has body parts from both sexes, a determination can still be made that the person is one or the other sex. Is this correct?
      Thank you.

          1. … Which is buried behind a paywall, annoyingly.
            However the title of one of the “Recommended reading” column does raise some questions (” ‘True hermaphroditism—the importance of ultrasonic assessment’ by Pires et al in Ultrasound in Obstetrics & Gynecology). How many of these (rare) “true hermaphrodites” are chimeras of fraternal twins of opposite biological sex, which have developed the testes from the male fraternal twin and the ovaries of the female? (With random choice for where (from which zygote) the organs of the external genitalia originate.)

      1. 1- AFAIK not in mammals, I doubt there are male-female mosaics with functional gonads of both types, producing both gametes (true hermaphrodites).
        2 – Yes, that is correct in mammals, if there is an SRY gene (overwhelmingly -99+% of cases- found on a Y chromosome) the individual is male, if not, female.
        In cases of testosterone insensitivity (often only partial) you’d get a male pseudohermaphrodite (an ‘intersex’ person nowadays) with eg. female external genitalia, but no womb and internal testes. Indeed, it is more complex than that, there is a whole spectrum of sexual developmental anomalies, but as mentioned, all of them are pretty rare. And in about all of these rare cases a sex can still be determined.

        1. Androgen-insensitivity syndrome is special case that’s not so easy. Yes, these people have an XY karyotype and have testicular tissue internally, (which can’t descend into a non-existent scrotum.). So they are male. But without the ability to respond to testosterone, their bodies develop into girl fetuses and they grow up as girl children, with nothing suspected as an intersex condition until they don’t menstruate. By the time the diagnosis is usually made, they have been girls for 16 years. Not “raised as girls”, or “identified as girls”, or “surgically altered to look like girls”, but “have been girls”. Most will want to continue being women, with estrogens to produce a more adult feminine habitus, …or not, if that’s not important to her. But none want to “become men” just because they are XYs, even if this were biochemically or surgically possible. They have female bodies unmodified by testosterone and grew up as girls. In every way that could matter except fertility —and this may not matter to the individual—they are female, women, and there is no practical medical or social reason to assign them as male. Treatment should be focused on issues important to the individual.

          This is more profound than dysphoria over gender role. Her sex—female—was observed accurately at birth. But because of insensitivity to testosterone in utero and afterward, her gonads that can (potentially) produce only male gametes could not make male organs to match.

          From this, I’d argue that the definition of male sex is gonads that (can potentially) produce motile gametes plus the ability of the differentiating embryo to build the body parts that make gamete transfer possible.

          1. Androgen insensitivity syndrome is not always clear cut. Not all tissues are as insensitive as others. Caster Semenya being a case in point.
            However, if I’m not mistaken, their gonads do not become egg producing, they remain sterile.
            I would say that these ‘intersex’ people are of the female gender, but male sex, whether based on SRY or gonads.

            1. Caster Semenya did not have AIS. (His/her actual diagnosis was leaked and I won’t comment.). Had s/he had AIS, she would have been allowed to compete as a woman provided it was complete insensitivity, under the Differences in Sexual Development rules of international sport. It is the only condition under which a person with an XY karyotype can compete as female without objection about fairness. As you may know, some female athletes who achieve elite status while teenagers are flabbergasted to discover, upon required testing, that they have a Y chromosome. They had typically attributed their absence of menstrual periods to thinness and intensely focused training.

              You cannot refer to the sex of a person with XY-AIS as anything other than female. If you have been privileged to have met such a woman in a professional context, you will know what I mean.

              That’s why I propose that the binary male-female sex distinction ought to require, for maleness, the potential to make motile gametes plus the testosterone-mediated development of male external genitalia. This latter, after all, provides the basis for everyday ascertainment/observation of sex in the delivery room. Everyone else, including babies who will much later be found to have AIS, is female, as observed.

              This has nothing to do with gender, trans or otherwise.
              When we think of intersex conditions we are usually thinking about babies born with ambiguous external genitalia who can usually be sorted out with some degree of precision, at least sufficient to identify medical treatment necessary for health (e.g., undescended testes that may become malignant). The approach now, I understand, is to just let these kids grow up and be themselves and not mutilate them. Sometimes it won’t be clear until puberty. In the case of complete AIS, it rarely is, except in the unusual situation where a prepubescent girl needs a gynaecological examination. Even a regular ultrasound done for, say, suspected appendicitis, may not detect the absence of a uterus and ovaries in a child.

              Sorry to belabour the point. The division between large non-motile gametes and small motile ones has such a powerful scientific basis that the challenge posed by AIS deserves some thought. These individuals cannot make or disseminate motile gametes even though they have rudimentary testicular tissue and no ovarian tissue (which would normally contain oocytes at birth.). Since we learn in embryology that the default is female, I argue that you have to achieve all the developmental milestones to become male.
              Galileo’s Middle Finger. Heretics, Activists, and One Scholar’s Search for Justice, Alice Dreger, 2015. The episodes dealing with intersex conditions are written from more of what we would call a gender perspective and are not a compendium of the diagnostic breadth in the field. They are intensely human-focused and changed medical thinking.

              1. Leslie MacMillan I salute your ability to clarify the distinction. Let me repeat that phrase: to clarify the distinction. I freely admit I am suspicious of all who attempt to cloud, conflate, conceal, or obliterate the distinction of sex qua sex — I suspect they do so in order to allow gender to colonize sex.

                I hope — and believe so — that you realize that clarifying the distinction, along with your formulation “This has nothing to do with gender, trans or otherwise,” completely honors and respects humans born with intersex issues.

                Also, I have never heard the distinction clarified with focus on the motility or not of the gametes! Cool! I’m going to use that as a polite way to request voluntary ‘clarification’ during ‘discussions.’ …. “Are you willing to say if your gametes or motile or not?”

    3. There’s actually no such thing as ‘intersex’ every person born either has a Y chromosome or doesn’t. The correct definition of what you call “intersex’ is DSD – Disorder of Sex Development. No medic uses intersex. It’s not a condition.

  2. Good clarification.

    I’m wondering a bit about sex being “determined” at birth. It seems to me that sex is determined precisely at conception, as you point out (meaning that the biological sex of the child is established when sperm and egg fuse). At birth, I would say that the sex is “ascertained”—meaning that the folks attending the birth make observations that they use to name the sex as male or female. (Ascertainment can also take place in utero, with ultrasound for instance.) What are your thoughts about this further distinction?

    The idea is to recognize the step by which the sexy is the child is recognized, which I might call “ascertainment.”

        1. I’m good with “identified” or “observed” as well. The main point is to introduce the concept into our lexicon. Something happens whereby the parents and others (recognizing the anatomical correlates to biological sex) “note” or “observe” or “identify” or “recognize” or “ascertain” the sex of the child.

          On second thought, I might shy away from the word “identify” since that word is so closely tied to the politics of gender, which we are not addressing here.

      1. How is “assigned” political? It refers to assigning a value to a variable, in this case, sex, usually by a an attending medical professional on a birth certificate based on observation of external genitalia. The political question seems to be whether the variable should be assigned at all.

        1. “assigned” is an active verb. It assumes a subject who did the assigning, a person or supernatural agent who performed an act.

          I often use this against activists …. “Assigned at birth.” “Oh, you must believe in God then, since the baby did not assigned himself, only God remains as the assigner.” Woke activists do not like themselves to be seen as believing in God.

          1. Woke activists do not like themselves to be seen as believing in God? What nonsense. Many of the original Woke movement, which was specifically focused on black minority oppression in a white majority society (The US of A) tend to believe in God. As for modern day Woke Warriors, there must be a substantial amount who believe in a Higher Power of some kind. I, on the other hand, acknowledge Evolution as to the reason we, as a species, came into being, and spit on the concept of both there being an interventionist God and the idea a baby can be “assigned” a sex at birth. Especially as the amount of trans women and trans men way out number the percentage of intersex individuals. Hinting at some sort of psychogenic disorder that only has affected Western society, to the best of my knowledge. But, yeah, God… not involved in much, if anything at all. Almost like It didn’t exist.

            1. Again confusing the original woke movement with the current definition of the term. In the old days, sure. Today? Some do, some don’t, but it’s not an important part of wokeness.

        2. Assigned suggests a choice. None of us have a choice what sex we are. Sex is biologically determined. It can be shown with a blood test, regardless organ deformity as in DSD. Therefore ‘assigned’ is always wrong. You can’t assign a sex to someone. You can assign a gender because gender is a value statement not a fact.

      1. And a vote with JezGrove (somehow missed his post).
        “Observed” is actually what it is. If you see a vulva, chances are it is a girl, if you see a penis and scrotum the chances are pretty good it is a boy. That is indeed an ‘observation’. The best term of the lot. (IMMO).

  3. Other woke-ish terms that we should avoid are:

    (1) “Marginalised” applied to groups, when one means the more neutral term, “minority” groups. “Marginalised” is a done-to-them word, and implies that they are actively being oppressed by those (white, male, capitalists) in power.

    (2) “Community” when applied to what are actually large, disparate groups with a range of views and interests. Thus talk of the “black community” or “LGBTQ+ community” is intended to arouse warm-fuzzy feelings of one big happy family were it not for the (white, male, straight, capitalist) oppressors. No-one ever talks about the “white community” or the “straight community”.

    (3) Any other suggestions?

    1. Racialised. Passive aggressive verbs turned to adjectives are by design, as you stated above (implies that they are actively being oppressed by those (white, male, capitalists) in power).

        1. Agreed, j e, ‘problematic ‘ is really problematic. I could’t agree more. A nasty, insidious, guileful, sneaky, hypocritical, cowardly and hence vile term.
          It is a kind of red flag though, as soon as something or someone is called ‘problematic’, your default setting is: Hah, might there be something worthwhile there? In that sense it is a useful term.

    2. Re (1), I find “minoritised” to be “marginalised” on steroids. To actually make a group into a minority requires something extreme like ethnic cleansing (an atrocious euphemism) or “Great Replacement” immigration. 💢💢💢

  4. I suggest going even further, and refraining from using “biological sex.” Sex is sex. Period. With that as a floor, a fact of reality, then ‘gender’ might be rationally discussed. Otherwise, activists will keep trying to pull gender onto sex. (colonizing sex.)

  5. I don’t like “determined at birth” either because it is ambiguous. It could mean that the mid wife or doctor determines what the sex of the child is is but it could also mean that the sex was not actually chosen until the moment of birth. I prefer “observed at birth”.

    1. That used to be a laughable boilerplate line in crystallography. “The cell constants were determined to be …”

      1. “The cell constants were determined to be …
        It has been a long time since I tried reading a diffractogram.

  6. Yes, “assigned at birth” has become politicized, though I suspect it initially referred to nothing more than the sex recorded or “assigned” on one’s birth certificate. In that sense, it’s accurate enough.

    1. But recorded on a birth certificate is different from assigned. The latter implies that the person doing the assigning has some discretion and choice. Thus the term is quite deliberate, the woke want to be able to re-assign sex.

  7. Second, genders, being a person’s self-assigned role in the spectrum of sex, cannot possibly be “assigned at birth”. That must wait until the child is old enough to choose a gender or gender role—or is forced to adopt one by some authority.

    Since sex isn’t a spectrum, gender can’t be a role in the spectrum of sex. The way they use the term “gender” though is confusing. Sometimes they do seem to mean sex. But according to feminist doctrine, adopted by trans doctrine, “gender” is culturally-constructed norms, behaviors, and roles assigned to males and females. That would mean that trans people measure themselves against ideals about masculinity and femininity, see where they fall on the spectrum, and recognize that they’re not a man, not a woman, or neither one, depending. They’d be buying into and reinforcing sexist stereotypes. Trans people and their advocates hotly deny they’re doing anything of the sort while simultaneously saying and doing things which don’t seem to make sense unless yes, that’s what they’re doing.

    I’d say that gender, when defined as cultural stereotypes, is indeed assigned at birth when girl babies are given pink blankets and frilly lace booties and boy babies are given blue blankets and booties that look like basketball shoes. Children often grow up and reject that gendered nonsense — but that’s not because they’re a different gender. It’s because they’re themselves.

    1. In Brussels in the eighties, the files in St Pieter’s Hospital (Hôpital St Pierre, the largest hospital in Brussels at the time -and despite the name very secular) had pink files for boys and blue files for girls. I have Hawaiian shirts with pink flowers.
      I’m not sure where this association of pink with girls comes from. Weird. Does anybody know?

  8. The usages under discussion reveal the origin of this jargon: academic departments of X Studies or Critical X Theory, which followed the lead of post-modernism in substituting word salad for engagement with physical reality. We can thank academia for the half-educated battalions who suppose that sex is “assigned” not observed, that a numerical minority has been “minoritized”, that “LGBTQIA+” is a community, etc. etc.
    As for myself, I just take the jargon literally. I insist that characteristics of belonging to Homo sapiens rather than the Lemuroidea are “assigned”, that Genetics, the normal distribution, and the G-clef are devices of “white supremacy”, that my grandmother’s samovar puts me in the marginalized Russianx community, and so on.

    Incidentally, it was never necessary for every Podunk State College in the US to have departments of Critical X Theory. Academic institutions can actually exist without any such units. The number one ranked university in France is Paris-Saclay (, an outgrowth of the old Université Paris-Sud. It manages to get along without any of these mock
    disciplines in its catalogue.

  9. “That, and empirical observation, shows that sex is almost completely binary. ”

    I have been looking for good explanations of how “binary” can be the accurate language for a set of gametes, or secondary sex characteristics which are either one thing or another.

    “or”, “not”, and “and” are the words from Boolean algebra on sets.

    Is “binary” a sort of vernacular? Of “Boolean” too pedantic?
    Is “binary” used in the biological literature?

  10. Don’t know. Though “binary” apparently has a different meaning in the philosophical literature:

    A binary is a conceptual hierarchy which is formed by taking a term with a dominant positive value and creating a subordinate value by negating the privileged qualities of the dominant term. Masculine/Feminine is a binary. In fact, it is the ur-binary, to the extent that ALL of the binary pairs which structure Western thought (mind/body, reason/emotion, thought/sensation, universal/particular, one/many etc.) are gendered, and without exception, the ‘positive’ pole of the binary is masculine. Male and female is not a binary, it is a natural difference.

    — Jane Clare Jones

    If Genderists are applying this meaning of the term to Sex, it might explain why they think a sex binary reinforces sexism (but gender magically doesn’t.)

    1. That passage from Jane Clare Jones is misleading. The first Western philosophical study of opposition is in Parmenides [ahem, “the ur-binary”], and it is not couched in any ‘gendered’ context, but is remarkably, almost logically, general. Parmenides is concerned with distinctions between ‘what-is’ and ‘what-is-not’.

      1. I think she qualifies the term “ur-binary” by applying it only to “the binary pairs which structure Western thought.” But I’ve no expertise in Philosophy — or Feminist Philosophy.

    2. “Though “binary” apparently has a different meaning in the philosophical literature”

      [ the following is from Wikipedia ]

      Gottfried Liebniz invented the modern binary number system in 1689 in Explication de l’Arithmétique Binaire.

      Liebniz was probably aware of even older binary number systems dating back to ~ 6 BC, like the I Ching.

      … what I’d like to know is what came first – the natural sciences (or, as it probably was then, “natural philosophy”), or philosophers. Philosophers usurping technical language from productive fields and using the language unscrupulously would not be a surprise.

  11. I have to push back a little bit here. I totally agree that sex is determined during development – exactly when can be debated but certainly long before birth (except in truly rare cases). I would submit, however, that gender, at least as currently under discussion, is assigned at birth. Case in point – I have two sons (and one grandson), all of whom were obviously biologically male when borne, and because of that, I (and their mother and everyone else) assumed that their gender, when it developed would be male as well. Thus, we were in fact assigning a gender identity to them (they were obviously unable to do that themselves). In fact, although one is gay, our assignment turned out to be correct for both. So, in the context of current usage, I submit that sex is determined but gender is indeed assigned. And we have to be open to the possibility that that assignment is wrong.

    1. What if someone’s gender is “bigender” or “agender” or one of a hundred genders that people choose for themselves when they get older. Could you tell me how those genders would be assigned at birth?

      1. Assigning a “gender” (meaning not a social construct but a brain sexual identity determined by hormones in the womb) whose frequency is less than 1 percent is not a good idea, because it guarantees that you will be wrong more than 99 percent of the time.

        Instead, assigning either of the two cis genders is a very good idea, because more than 99 percent of the population is cis and therefore you have more than a 99 percent chance of getting it right.

    2. Could you list or describe some of the elements of the male “gender” — and how it is different than the female gender?

    1. but you can choose the latter.

      With the proviso that, for nationality, the group you are trying to be “assigned” to can refuse to accept you as a member.

    2. Errr. Most of us can’t choose our nationality actually. Even if you’re rich you can’t just go live somewhere and choose to be that nationality!! Not a good analogy. Gender is a fiction.

  12. The idea that there are diverse genders doesn’t make a lot of sense to me. I am male, but what is the male gender? I’m not into sports or fishing or cars, but that doesn’t make me less of a man.

    The idea of a “Gender spectrum” seems to imply there is a platonic idea of what a “male” or “female” is and that any deviancy from this a shift along said spectrum. But that platonic idea is cultural, and changes over time. Therefore there isn’t actually any objective complete set of attributes that we can actually say is “male” or “female”, only certain tendencies. There was a time when being foppish was fashionable, and where it was considered manly to publicly cry.

    The confusion goes away when one simply accepts that being a “tomboy’ doesn’t mean your less of a woman, or that not being into sports and perhaps taking up crochet doesn’t make you any less of a man. We could describe someone as “less typically male” but I find calling that person ACTUALLY less of a man because of that, quite, well, problamatic.

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