Can Gender Be Separated from Biology?

“I am female,” Jackie Blankenship says. “That’s the only body I know.” That’s her declaration in an online article titled, “I’m intersex — 4 facts you don’t know about me.”[1] Despite the fact that in the title she identifies as “intersex,” meaning “between sex,” her strong affirmation is that she is a female.  Which is it? Is she a between sex or is she a female? In some ways she is both.

Because Jackie has Complete Androgen Insensitivity Syndrome (CAIS), her cells don’t respond to the masculinizing hormones that would normally cause an XY Chromosome baby like her to develop testes (the organs that produce sperm), a penis, and other male characteristics. She developed with a small vagina, albeit one that didn’t open into a cervix (a blind pouch, or more technically Müllerian agenesis or Müllerian aplasia), and an internal testis that doesn’t function to produce sperm, and when puberty came, no pubic or underarm hair. According to the President’s declaration[2] she is not a woman because she does not have the large reproductive cell (the ovum). Of course, she is not a man by his definition either, because she does not have the small reproductive cell either (the sperm).

When her parents explained her condition to her at age 9, she says,

I took it well, I think. I didn’t understand the impact it would have on me. I never really asked questions. But doctors told my parents we wouldn’t want to tell anyone. They really scared my mum and dad. There was a lot of fear and secrecy around it.

Later, when her friends started getting their menstrual periods and were stressing about it, she was relieved not to have to worry about that. She did, however, have surgery at age 15 to have her internal testes (the male gonad) removed because of the chances of them becoming cancerous. At age 18 she began therapy to have her vagina widened and lengthened in order to have intercourse, a therapy that she has to continue even now to prevent contraction. She says,

It was traumatic. I didn’t know what kind of sex I would be having. I didn’t know what I wanted in that department. I felt a lot of pressure to be ready.

When she got married, she and her husband wanted children, but she had no ova, so they got a donor ovum and fertilized it with her husband’s sperm, and her sister carried it in her womb to term.

Three things are important to learn from Jackie’s case about biological gender and gender identity:

1. The structure of one’s chromosomes (XX or XY) doesn’t in and of itself determine one’s biological gender. There are other factors at play that can affect the process of genderizing. Hormone sensitivity is critical, as are steroids and adrenal glands, and mutated genes.[3]
2. Conditions like Jackie’s lead to individuals with a mixture of the biological gender characteristics, both male and female characteristics, a kind of intersex or between sexes. But is it fair to call these variations a third, or fourth, etc., sex? If so, then every variation, and they are multitudinous, would constitute a different sex. The poles of biological gender still seem to gravitate around male and female.
3. Despite being intersex, Jackie has settled on a biological/social sex for herself, a female. She links this identification to her body, her phenotype or obvious female sex characteristics (“That’s the only body I know”). Is how she was raised by her parents, as a girl, also a factor in her sense of femininity? Is the lack of testosterone sensitivity, which virtually makes the testosterone in her system of no effect, also a factor in her feeling feminine? In either case, our gender identity can belie or oppose our biological reality. Jackie’s biological reality is “confused” about its gender, but she is not.

Could someone who doesn’t have a “confused” or “disordered” biology, someone apparently strictly male or female in terms of gonads and primary and secondary sex characteristics, legitimately have a sense that they are a gender opposite to their biology? Are there hidden biological factors that might influence this? Do there have to be?

 

[1] https://metro.co.uk/2025/08/27/im-intersex-woman-4-facts-probably-dont-know-24008637/

[2] https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/

[3] See The Past and Future of “Sex Genes” (https://pmc.ncbi.nlm.nih.gov/articles/PMC10842558/), whose authors discuss “the interactions of causal claims in science with cultural assumption about gender and outlines three influential strands of critical feminist philosophy of science: the critique of genetic determinism and genetic essentialism, of dualist assumptions, and of an androcentric bias in the conception of research strategies,” and argue that “systemic explanations preserve the causal importance of genes while avoiding genetic determinism and essentialism.”