Sex as a Dichotomy
The word “dichotomy” means treating two things as opposite or entirely different. Sex has typically been viewed as having only two distinct categories, male and female, which are mutually exclusive. Think about the cartoon at the beginning of the module and about the meaning behind the phrase “the opposite sex.”
While this is a common way of thinking about sex, it does not adequately capture the range and variety of human biology and self-perception. While the majority of people can be readily identified as female or male, the distinction may not always be clear or fixed. For example, individuals can have an extra X or Y chromosome (XXX, XXY, XYY), yet appear to be either typically male or female with respect to their external genitals and overall appearance. In other instances, sex chromosomes can be missing or have irregularities. For example, females with Turner’s Syndrome have ovaries but are often unable to reproduce. There are also individuals whose sex chromosomes and genitalia are not clearly or exclusively female or male. The term “intersex” is often used to refer to people whose anatomy does not conform to the two standard biological categories.
Similarly, secondary sex characteristics tend to be associated with one sex or the other, but these associations are not absolute. For example, men tend to be taller than women owing to differences in bone size and muscle mass, but you probably know tall women and short men. Similarly, women typically have wider hips than men, to accommodate gestation and childbirth, but you can probably think of women who have very small hips as well as men whose hips are wider than their shoulders. Few – if any – of us have only “male” or “female” physical characteristics, or match an ideal form of male or female.
Sex as a Continuum
A more accurate model for sex is a continuum. The word continuum refers to the idea that many small and subtle differences can exist between two distinct extremes. In a sex continuum, biological and physiological characteristics may be associated more with females or males, but individuals may combine these characteristics to various degrees. To illustrate this point, we can go back to the examples of height and body type. Males and females come in all different shapes and sizes, despite having sex chromosomes that identify them as male or female. Thinking about sex as a continuum allows us to recognize and acknowledge this range in characteristics and to avoid categorizing individuals as only female or male.
Variations in chromosomal make-up and secondary sex characteristics challenge the use of only two categories of analysis when we talk about sex, encouraging us to have a more fluid and flexible understanding. This way of thinking about ”sex” is beneficial because it more accurately represents human experience, including the needs and challenges facing individuals who do not identify with the categories of female and male. It also encourages us to learn more about just how sex matters when it comes to health and other aspects of human existence.