Challenging the binary: Gender/sex and the bio-logics of normalcy

Challenging the binary: Gender/sex and the bio-logics of normalcy. L. Zachary DuBois, Heather Shattuck-Heidorn. American Journal of Human Biology, June 6 2021. https://doi.org/10.1002/ajhb.23623

Abstract

Background: We are witnessing renewed debates regarding definitions and boundaries of human gender/sex, where lines of genetics, gonadal hormones, and secondary sex characteristics are drawn to defend strict binary categorizations, with attendant implications for the acceptability and limits of gender identity and diversity.

Aims: Many argue for the need to recognize the entanglement of gender/sex in humans and the myriad ways that gender experience becomes biology; translating this theory into practice in human biology research is essential. Biological anthropology is well poised to contribute to these societal conversations and debates. To do this effectively, a reconsideration of our own conceptions of gender/sex, gender identity, and sexuality is necessary.

Methods: In this article, we discuss biological variation associated with gender/sex and propose ways forward to ensure we are engaging with gender/sex diversity. We base our analysis in the concept of “biological normalcy,” which allows consideration of the relationships between statistical distributions and normative views. We address the problematic reliance on binary categories, the utilization of group means to represent typical biologies, and document ways in which binary norms reinforce stigma and inequality regarding gender/sex, gender identity, and sexuality.

Discussion and Conclusions: We conclude with guidelines and methodological suggestions for how to engage gender/sex and gender identity in research. Our goal is to contribute a framework that all human biologists can use, not just those who work with gender or sexually diverse populations. We hope that in bringing this perspective to bear in human biology, that novel ideas and applications will emerge from within our own discipline.

1 | INTRODUCTION

Biological anthropologists are experts at teasing apart the complexities of biocultural interactions that inform what it is to be human, examining how broad-ranging factors such as market acculturation (Godoy et al., 2005; Liebert et al., 2013), parenting strategies (McKenna et al., 2007; Nelson, 2016), or socially constructed categories of race (Dressler & Bindon, 2000; Gravlee, 2009) relate to physiology including growth and development, immune function, and endocrinology. Yet we have not fully engaged with cutting-edge understandings of variation in gender, sex, and sexuality. This is a critical gap, especially given renewed debates regarding the boundaries of human sex, where lines of genetics, “sex hormones,” and secondary sex characteristics are drawn to defend a strict biologically based sex binary, with attendant implications for the acceptability and limits of gender identity and expression for all people. Whether regulating testosterone levels and bodies of women and girls in sports, legislating the use of gender-specific bathrooms, or enacting broadsweeping federal definitions of sex, bodily “norms” are being weaponized as a means to discriminate (Karkazis et al., 2012; Nondiscrimination in Health and Health Education or Activities, 2020). Biological anthropology is well poised to contribute to these societal conversations, but first, we need to more deeply consider our own conceptions of sex, gender, and sexuality, and how we implement such understandings in our research. In this article, we discuss biological variation associated with sex and gender and possible ways forward for conceptualizing and operationalizing these constructs within biological anthropology. We base our analysis in the concept of “biological normalcy,” which allows consideration of the relationships between “statistical distributions of biological traits and normative views about what bodies ‘should’ be like or what constitutes a ‘normal’ body” (Wiley & Cullin, 2020: p. 1; Wiley, 2021). A classic example of how bionormalcy enables critical interrogation of norms is seen in the case of dietary recommendations normalizing milk consumption culturally as “healthy” and even necessary, despite the statistical norm of lactase nonpersistence (Wiley, 2021). This can be seen as normalizing and even moralizing a biological trait present only in some individuals in some populations (Wiley & Allen, 2017; Wiley & Cullin, 2020). This example aptly demonstrates the fact that many of the statistical distributions that end up being “normalized” are based on samples drawn from predominantly white, “Western” populations (Clancy & Davis, 2019; Henrich et al., 2010), with the psychological, behavioral, and biological traits of these populations referenced as the standard from which other populations deviate (e.g., body size and growth, Thompson et al., 2014). The model of biological normalcy (Figure 1) is circular. Cultural norms and assumptions inform the development of research questions, methods of data collection, and analyses as well as interpretations of data. Statistical norms are also leveraged (albeit sometimes unconsciously) to create, reinforce, or otherwise inform those very cultural norms and assumptions. However, normalcy has not always been conceptualized in this way. The word “normal” as reflective of something to be desired in reference to an “abnormal” state arose only in the mid to late 19th century (Cryle & Stephens, 2017; Hacking, 1990). Initially, the term “normal” did not represent statistical distributions nor did it carry the morality it is imbued with today. Instead, norms provided a way to reference something “in its own right” and not necessarily through comparison to an ideal. In this way, even anomalies could be understood within a framework of “normal.” With the emergence of statistics in the late 19th century, the concept of the normal became hitched to statistical distributions and to the racist and eugenicist ideas imposed on population traits (Cryle & Stephens, 2017). And with this shift, the concept of the normal intertwines with the history of biological anthropology, as eugenic and white supremacist concepts of human traits and the categorical position of white men as both unmarked and ideal are the very foundation of much of our field (Blakey, 2020; Caspari, 2018; Marks, 2012). Racism and colonialism are equally culpable in the development of value-laden categories of sex and gender and the behavioral norms to which they are often tied. For example, conceptualizations of femininity and masculinity themselves were initially intertwined with racialized categories in an effort to hierarchically demarcate rank, reflecting a colonialist project with the “white ideal” as most differentiated between the sexes (Markowitz, 2001). As a field, biological anthropology continues to suffer from how our history influences who practices biological anthropology (e.g., Bolnick et al., 2019). As biocultural anthropologists, in this article, we aim to broaden the way that human biology engages with categorical thinking about gender and sex and to push for greater recognition of variation in these domains. We are inspired by the decades of strong work into race as a social construct with biological outcomes (Armelagos & Goodman, 1998; Dressler et al., 2005; Graves Jr, 2003; Graves Jr, 2015; Gravlee, 2009; Williams & Mohammed, 2013), and by recent work contextualizing how concepts such as violence are gendered and raced (e.g., Nelson, 2021; Smith, 2021). In our own work, we have grappled with how to better conceptualize and operationalize sex and gender, whether examining energetics and immune function in pubertal girls (ShattuckHeidorn, Reiches, & Richardson, 2020), sexual decision making among queer adolescent cis men (DuBoiset al., 2015), or immune marker and environmental conditions for (cis) men and women (Shattuck-Heidorn, Eick, et al., 2020). In some of our prior work, the category “cis” was unmarked, and at times, in our analytical strategies, we have statistically compared cis men to cis women without a clear justification as to why the sample should be divided by sex as opposed to some other trait(s). Much of our recent scholarship integrates theoretical insights from gender and feminist theory and presents challenges to simple gender/sex binaries through our research questions, study designs, and hypotheses. This is reflected for example, in work expanding understandings of stigma and embodied inequalities among trans and gender diverse people (DuBois, 2012; DuBois et al., 2017), furthering our methodological and theoretical approaches to better encompass gender/sex and sexual diversity (DuBois et al., 2021; Shattuck-Heidorn & Richardson, 2019), and interrogations into the basis for disparities in COVID-19 outcomes (Gibb et al., 2020; Rushovich et al., 2021; Shattuck-Heidorn, Reiches, & Richardson, 2020). Such interdisciplinary merging has enabled us to better conceptualize human gender/sex and enhanced our understanding of variation in embodiment and health. In this article, we address the following critical areas: (1) the problematic reliance on binary sex categories used as a priori biological categories across traits; (2) the attendant focus on group means to represent typical “male” and “female” behaviors and biology and accompanying fixation on “difference;” (3) the ways in which binary sex norms reinforce stigma and inequality regarding sex, gender, gender identity, and sexuality; (4) the need for “best practices” to effectively engage sex and gender in research; and (5) methodological suggestions to address the lack of inclusive data collection needed to enhance our understanding of gender and sex and sexual variation. Our goal is to contribute to a framework that all human biology researchers, not just those who work with gender or sexually diverse populations, can use to inform their thinking as well as decisions about best practices for whether and how to implement sex and gender analyses within their research, both theoretically and methodologically.

6 | CONCLUSIONS

As human biologists, gender/sex is central to how we understand and organize our thinking about human evolution as well as health in contemporary and historic contexts. The entwinement of gender and sex is complex, as is much of the science exploring this variation and how it develops. It is increasingly necessary for human biologists to engage novel methodologies to ensure we are capturing and engaging with gender/sex diversity. As detailed above, research in human biology and other disciplines challenges the understanding and the use of binary sex as a meaningful category explaining human biological variation across contexts. The work reviewed here is a small part of a large field of research that pushes us to continue to consider the ways in which human bodies and identities resist static categorization. Hormones vary and function in complex ecological and social environments, brains and bodies develop over time in response to varied experiences and inputs, and societal structures of gender norms, race and racism, and sexuality influence and mediate human biology. As the common-sense notion of binary categories for human gender/sex are destabilized, our discipline is well-positioned to meaningfully explore the complexity of gender/sex in terms of human variation and to understand that variation within a sociocultural context, including race, sexuality, and gender diversity. Our field has contributed substantially to an understanding of human biology in a socioecological context. We look forward to a generation of work from biological anthropologists who are incorporating intersectional analyses of gender/sex and gender identity into our understandings of human diversity.