The Sweetest Poisons: Preston Sprinkle's "Embodied" Chapter 2A Definitions. A Review

 This is the third installment in my series reviewing Preston Sprinkle's book Embodied: Transgender Identities, the Church, & What the Bible has to Say. Click HERE for the Intro to this series where I discuss my thematic concerns with the book and for an index for the full series.

In Chapter 2 of Embodied Preston Sprinkle defines his terms. Or, at least, he defines some of them. He opens with a reasonable caveat that there are lots of terms and he recommends "the internet" for the ones he doesn't include in this chapter. To that end, here is a link to GLAAD's media reference guide for trans related terms, and here is a link to the HRC's glossary. He also makes it clear that these are going to be substantial definitions  and that the terms sex and gender will take up a half of the chapter. Chapter 2 is really both definitions and Sprinkle's initial reflection on those terms and their definitions. 

Before I launch into an analysis of Sprinkle's take on these terms, I want to recognized that many
debates and arguments are won or lost on the basis of definitions. An argument or position built on a definition of key terms will often fall or stand depending on the careful definition of those terms and, for that reason, in a good faith discussion it is important to agree with your interlocutor up front about what the key terms mean and how you will be using them. A small difference in the definition of a few key terms may be minor at the outset but as the lines of argument built on them extend, the distance between what is said and what is heard can grow significantly. Thus it is important to be clear about terms as we dive into the book.

For those reasons, this installment is only going to respond to the first half of Chapter 2. Sprinkle's definitions and statements are...let's say problematic... and it is going to require a good deal of space to respond.

Most of the Terms

As I hope will be clear by the end of this section, Preston Sprinkle is either sloppy in his research or a disturbingly motivated reporter throughout the text and no less in this chapter. Sprinkle provides a total of 5 footnotes to the first half of this chapter and only one (for "transgender" where he cites Mark Yarhouse) cites or uses a definitional source for the terms he uses. Instead Sprinkle provides his own definitions. The effect of this is to allow Sprinkle to present himself in this chapter as a teacher, helping the reader familiarize themselves with the technical jargon of this subject. But that mode of writing disguises (and Sprinkle only alludes to this when he absolutely has to) the extremely contested nature of a lot of these terms. Specifically because arguments and then positions are built on the definition of words, trans people are extremely careful in our usages of relevant vocabulary. Every single one of the terms Sprinkle lists and reflects on is presented in a way that differs from the definition and/or explication of it that you would encounter reading a text by a transgender person. 

And that leads me to my second top level observation of this chapter, one that will resurface again and again as we work through the book: Sprinkle uses "debated-ness" in an almost entirely one sided way. When he encounters scholarship or terminology that he doesn't like he is quick to highlight any debates or contention about it before stating his position. He will sometimes provide a citation for the debate but even when he does his sources is nearly always wildly unbalanced in favor of his position. In contrast whenever possible he seems to have avoided mentioning debates or contentions that would tend to challenge his position or the usage of his terms. His bias for a particular set of conclusions is hidden by his tone and the unbalanced nature of his citations which has the alarming potential of leading the reader to misapprehend the state of the discussion by and about trans people. 

Transgender

Sprinkle actually chooses to defer any in-depth discussion of this term for Chapter 3. For the purposes of this chapter he provides Mark Yarhouse's definition: An umbrella term for the many ways in which people might experience and/or present and express (or live out) their gender identities differently from people whose sense of gender identity is congruent with their biological sex. Beyond that he really wants to stress the "umbrella" nature of this term. And on one level, that's fair—"transgender" is indeed importantly an umbrella term—but on another level, he is setting up to engage in the sort of slippery rhetoric that I identified in my introduction to this series and which I will have a good deal more to discuss as he explains some of his thinking when we get to Chapter 3.

Nonbinary

Here again, Sprinkle highlights that the terms is an umbrella term and provides a fully adequate explanation of what binary entails and that nonbinary designates trans identities which are not binary. He then rather dismissively lists genderqueer, genderfluid, and pangender as sub-categories of non-binary identities. He doesn't offer any clarity into the difference between those three identities.

And then he digresses: 

To be clear, all non-intersex(1) persons (and most intersex persons, as we'll see) are biologically male or female, regardless of how they identify.

He goes on to say that the various non-binary identities designate something about the person's relationship to the categories "masculinity and femininity" or it indicates "that they experience some level of incongruence between their bodies and their minds". He then suggests that all of this well be less confusing when he unpacks sex and gender. But I have a little more to say at this point.

What Sprinkle is doing, with a light touch here, is setting up a critique he will be leveling at trans folk later on. It is a critique based primarily in TERF allegations against trans women (though it is used against trans men and non-binary people as well) and boils down to the idea that we reinforce harmful gender stereotypes. This is a wildly off base accusation based, usually, in not having interacted with more than a handful of trans people. I will respond to it when he finally makes the accusation but for the time being let us just note his decision to highlight the "don't fit into strict categories of masculinity and femininity" bit. Here he seems to be widening the umbrella a little farther than trans people actually do. I don't know that I have ever encountered a trans person who rejected the possibility of a tomboy or a feminine guy as fully cisgender identities, but by Sprinkle's definition here those folk (who may be more or less varied in the expression of their gender identities based in cultural gender assumptions) would seem to be categorized as non-binary and therefore trans.

Trans*

Sprinkle's justification for using trans* with the * is brief:

Since so many gender identity terms can overlap with each other, some people put an asterisk after the word trans, styling it as trans*, when they want to us it as a broad umbrella term to include a whole range of identities that aren't strictly transgender, such as nonbinary, genderqueer, and the like. I'll do the same in this book. [emphasis original]

I don't know who these people are (and Sprinkle declines to cite the claim so I have no way of knowing whom he has in mind here). In my experience, and as I discussed in the intro to this series, people who want to use trans as an umbrella term just do, they don't add an *. More strange to me was Sprinkle's suggestion that non-binary and gender queer folk aren't strictly transgender. I am of the impression that there is some variation in which people with those identities choose to identify, or not, as trans but simple declaring them not "strictly transgender" isn't anything I have seen in mainstream trans discourse. As one non-binary friend of mine responded, "Sprinkle would have done far better to have simply observed that some non-binary people identify as trans while other don't"

Gender dysphoria

Sprinkle's definition of this term is great:

Gender dysphoria is a psychological term for the distress some people feel when their internal sense of self doesn't match their biological sex.

For sure, he doesn't cite that definition from any particular source but it is fairly standard. And after this paragraph Sprinkle proceeds to give us three heart wrenching descriptions, all first hand accounts, of the experience of gender dysphoria. Again this is perfectly reasonable in a text of this sort. 

Unfortunately between the definition and the examples, Sprinkle sneaks in this little false claim which I will have to respond to:

As a diagnosis, Gender Dysphoria used to be called Gender Identity Disorder, but the name was changed to Gender Dysphoria in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th edition) in 2013.

This is a common enough misconception but it is decidedly wrong and a text on the subject of transgender people absolutely ought to know better. With even a little bit of research, Dr. Sprinkle would have found that

With the publication of DSM-5 in 2013, "gender identity disorder" was eliminated and replaced with "gender dysphoria." This change further focused the diagnosis on the gender identity-related distress that some transgender people experience (and for which they may seek psychiatric, medical, and surgical treatments) rather than on transgender individuals or identities themselves. [emphasis mine]

That is from the American Psychiatric Assocaition's Guide for Working With Transgender and Gender Nonconforming Patients it took me all of 2 minutes to google. The difference between reality and Sprinkle's claim should be clear but in case it isn't, the shift from Gender Identity Disorder to Gender Dysphoria as the "core" diagnosis for trans people who seek therapy designates a shift from seeing the identity or the person as the problem in need of treatment to the distress generated by the experience of gender incongruence. With the old diagnosis the person or their identity was the problem; with the update, it is the distress that is the problem. That is not at all insignificant. 

Transition

Sprinkle opens this section by saying that transition "is the term most trans*[sic] people prefer for what is sometimes called "sex change." In fact transition is a larger category (and Sprinkle is about to acknowledge the range of the the term) than "sex change" ever was. Again it isn't a huge thing but I want us to notice that by locating the distinction between the two terms in what trans people prefer rather than in a technical difference, Sprinkle is adding one more little bit to his argument (intentional or not) that trans people and trans identities are all about feelings and that we are not making defensible truth claims. 

Sprinkle then goes on to accurately identify social transition, hormonal transition, and surgical transition as three categories of transitioning. It is more common in my experience to see these categorized as social transition and medical transition but I see no need to quibble. 

• Social Transition Sprinkle describes as typically dressing and acting as the sex with which a trans person identifies. This is a little weird as he is about to set himself against the idea that there are forms of dress and behavior of a given sex, but overall it is not egregious. He also mentions new names and pronouns as included in this form of transition

• Hormonal Transition in Sprinkle's view "means taking high levels of hormones typically produced by the opposite [sic] biological sex: those transitioning to male take testosterone, and those transitioning to female take estrogen(2). I don't really know why Sprinkle insisted on "high levels of hormones" other than to make Hormone Replacement Therapy (HRT) seem more dangerous than it is. The general goal for binary trans people who are on HRT is to have hormone levels that mirror those of their cis counterparts. If I were to find that my estrogen levels were significantly higher than the standard range for cisgender women I would be alarmed. 

Sprinkle then goes on to say that this intervention "is called 'cross-sex hormone therapy' (CHT) or 'hormone replacement therapy' (HRT or  HT). I don't know a single trans person who calls it CHT or HT, we pretty much universally (to my knowledge and in my experience) refer to it as HRT. And yet Sprinkle will refer to it as CHT for the rest of the book and I can't help noticing that this serves to emphasize the "cross-sex" element rather than the therapeutic element of this medical procedure. He doesn't justify the choice but by now I can't help being suspicious.

• Surgical Transition is one Sprinkle gets wrong right off the bat. He says that it "goes by various names: 'gender confirmation surgery' (GCS), 'sex reassignment surgery' (SRS), and a few others." In fact, and he halfway alludes to this further into the paragraph, surgical transition designates all the surgical procedures that a trans person might undergo as part of their transition including but not limited to GCS. He instead tries to lump some of those other surgeries—top surgery, ffs, etc—under the rubric of GCS/SRS after acknowledging that each term has ideological justifications. He makes a hash of it, and his reference to facial feminization surgery and top surgery as "cosmetic" is just inaccurate—those surgeries are medically necessary (when prescribed) therapies for the treatment of gender dysphoria; they are not cosmetic.

Transman and Transwoman

These are terms where what I am going to call Sprinkle's "reporting bias" really comes into play. Sprinkle gives two paragraphs to state that transman is "a biological female [sic] who identifies as male" and that transwoman is "a biological male [sic] who identifies as female". And he adds that these terms are sometimes "shortened as FtM (female to male) for transmen [sic] and MtF (male to female) for transwomen". 

All of that is...wrong? Or rather it is wildly distorted specifically because it omits a lot of relevant information. In fact the terms transman and transwoman written in that way are deeply controversial and have been rejected by the mainstream of transgender discourse. The correct expression of these terms are, respectively, trans man and trans woman (or transgender man and transgender woman) separated into the distinct terms "trans" and "man/woman"(3). This may seem like a minor distinction from the outside but, in fact, the distinction holds significant ideological value. 

In English "transgender/trans" is an adjective. Placing it as a word before "man" or "woman" indicates the sort of man or woman we happen to be talking about so that "trans man" indicates a man who is trans, and "trans woman" indicates a woman who is trans just as "short man" indicates a man who is a short and "short woman" indicates a woman who is short. In contrast the terms transman and transwoman are neologisms which seem to designate not types of men and women but novel categories. It would be odd to encounter a text in which there are men and then also there are shortmen and I imagine that short men would be inclined to take ideological umbrage with such a text arguing that they are men and not some novel new category. The same argument is made by trans people. I am a trans woman because I am a woman and "trans" designates the type of woman I am. I am not a transwoman because I am a woman just as I am not a christianwoman because I am a woman who is a Christian. 

Now it will become clear to any reader that this ideological divide is what actually forces Dr. Sprinkle into the transman/transwoman formulation. He does not believe or grant that trans women are women, that trans men are men or that non-binary poeple are non-binary. Thus for him to use "trans woman" would be to impute a status to me (womanhood) that he does not believe I possess. 

On one level, then, Sprinkle's choice to use transman/transwoman makes sense. It allows him to use terminology which communicates the object of his writing without granting a premise he will not allow. And if he had only acknowledged as much this critique would have been little more than a footnote. Instead Sprinkle doesn't even mention the controversy or justify his choice despite using what are clearly non-standard forms. There are two explanations I can think of and neither is especially reassuring: on the one hand Sprinkle may have chosen these terms and neglected to mention the distinction because he was unaware of the controversy and it's meaning. The research citations in his book evidence far more reading in the trans-denying corpus where the versions Sprinkle uses are routinely deployed and thus he may simply have not done enough research to be aware of a basic terminological distinctive; or Sprinkle may have known about the controversy but chosen to ignore it in an effort to suppress contrary views to his own in this text. 

On a final note it does also need to be said (referring back to Sprinkle's initial explanation of these terms) that "MtF" and "FtM" are, not at all "shortened" versions of the terms he claims to be defining. They are specialized terms used only as necessary (and generally frowned on even then—I am not "an MtF" I am a woman who is trans) to designate both the gender that a given trans person was assigned and the gender they actually are. I can't think of a reason beyond either sloppy research or sloppy writing for Sprinkle to have suggested that they are.

Cisgender

Sprinkle's bit on this term is both short and important enough to justify quoting in full:

Cisgender is a recent term that refers to those who identify (and are comfortable) with their biological sex. (Cis means "on the side of.") Basically, cisgender refers to everyone who doesn't identify as trans*[sic].

Since the term sometimes comes with ideological assumptions and connotations, I'll avoid it in this book unless the context or quote demands it. Instead, I'll use the more neutral term non-trans* to refer to people who don't identify as trans*

I have... a lot to say. First, of course, it has to be noted that when Sprinkle feels the need to justify avoiding a term, he is quick to highlight that it "comes with ideological assumptions and connotations"—trransman/transwoman do too but he didn't bother saying anything there, just smuggled in the "ideological assumptions and connotations" that happen to support his position. Second, beyond that (hypocrisy? academic sloppiness? motivated reporting?) I want to highlight Sprinkle's claim that cisgender refers to... "everyone who doesn't identify as trans*". He will, in fact, go on to include all sorts of people who by his own account here would otherwise fall under the category cisgender or non-trans*.(4) Third, I think we see here one (there will be more) weakness of Sprinkle's not having read Julia Serano's Whipping Girl.(5) The book was first published in 2007 and in it, Serano discusses uses of the term extensively. She identifies the terms as one that was coined in 1995 and was in the course of gaining currency between 2005 and 2007. She also provides significant discussion of the term, none of which Sprinkle shows evidence of understanding.(6) Of course "recent" is a relative term so Sprinkle's use of it here can, of course, be justified. With that said, by all accounts transgender studies is a rapidly developing field such that a term that has been in mainstream use within our community for more than fifteen years now, is hardly a "recent term"; in any case many of the terms Sprinkle uses throughout this book are far more recent.

But most importantly, while Sprinkle did identify the fact that the term cisgender "comes with ideological assumptions and connotations" he declined to identify them and I suppose that means it falls to me. 

Much of this analysis is taken from Whipping Girl and from Serano's subsequent work on the subject. in essence cisgender, by providing a complimentary term to transgender, gives all of us the capacity to talk about ways in which cis-ness impacts the way people experience and process reality. It makes cis-ness a thing and in so doing situates it as one potential option describing ways in which people related to the gender they were assigned at birth. Serano provides the following Koyama quote which nicely summarizes the utility of the terms cisgender, cissexual, and cissexism: 

...they de-centralize the dominant group, exposing it as merely one possible alternative rather than the "norm" against which trans people are defined. ... I felt it was an interesting concept - a feminist one, in fact - which is why I am using it.

In sum, cisgender "comes with ideological assumptions and connotations" because it implies that trans people are not freaks but one variation in the human experience and that cisgender people are likewise another variation. Those are the assumptions and connotations that Sprinkle wants to avoid. 

Intersex

Sprinkle defines Intersex  as "a term used to describe the sixteen or so medical conditions where a person is born with one or more atypical features in their sexual anatomy or sex chromosomes". It is not clear to my why Dr. Sprinkle sees a difference between "sexual anatomy" and "sex chromosomes". He then identifies "differences/disorders of sex development" as "the medical term for intersex conditions". His reflection on the term largely punts to Chapter 7 which is devoted exclusively to the topic, but thinks it is "important to know two things" now:

(1) Intersex is different from transgender. (2)  Ninety-nine percent of people with an intersex condition are biologically male or female (and the other 1 percent are both). In other words, intersex does not mean "neither male nor female".

He then moves on to sex and gender which I will cover in the next part of this series, but before I can move on from this topic (I will address his stance on intersex people fully in my own review of chapter 7) I need to very clearly state that both (1) and (2) there are complicated and much discussed topics in the intersex and trans communities (the existence of brain sex theory really complicates (1), and (2) is an ongoing discussion within the intersex community, various intersex individual understand themselves and their relationship to sex/gender in a significant variety of ways.

Series Index

Intro

Part 1—Chapter 1: People

Part 2—Chapter 2A: Terms

Part 3—Chapter 2B: Sex and Gender

Part 4—Chapter 3: Varieties of Trans 

Part 5—Chapter 4: Male, Female & The Image of God

Part 6—Chapter 5: Gender Stereotypes

 

Footnotes:

(1) I find it rather peculiar that Sprinkle chooses to use the - in "non-intersex" but declines to do so in non-binary where he uses the formulation nonbinary. If there is some discussion about this in non-binary circles please let me know.

(2) In point of fact, while trans men do typically take testosterone, trans women will typically take a testosterone blocker, estrogen and often progesterone until and if the blocker becomes...unnecessary.

(3)GLAAD maintains a media reference guide for publishing about trans people and, notably, it includes the separated form of the terms, and notes that "trans woman" rather than transwoman is the correct form

(4) The question of whether or not a person who chooses not to identify as trans but who bears certain distinctives of trans people (such as a person who identifies as gender dysphoric but rejects the label trans) are, or should be referred to as, trans is a complicated one and I am not in a place to suggest an answer. It is very much still being discussed. My inclination is to try to use the terms for people that they choose and I would be personally loathe to, in any serious way, assert that someone who rejects the term is trans.

(5) For the record, Serano also supplies us with an extensive glossary of trans related terms—one that Sprinkle would have done well to have consulted for this chapter so that, even when he deviates from the terms or definitions she supplies, he would at least have written the chapter with an awareness of how these terms and ideas are more frequently expressed and used among trans people. 

(6) Notably, Serano cites Emi Koyama as the source from which she first encountered the word and Koyama's citation is the one that identifies a 1995 coinage by trans man Carl Buijs. Sprinkle has interacted with Koyama's work as some level (he cites Koyama's work in his Chapter 7: "What about Intersex"—Koyama is an intersex feminist activist) but seems to be ignorant on this count.

A Christian Defense of Intersex Persons

I frequently recommend Megan DeFranza's brilliant book Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God. It is a phenomenally good analysis of the subjects of sex and gender, and it provides a solid historical overview and a brilliant theological analysis and exegesis of the Bible's treatment of the topics. DeFranza's analysis includes, among other things, an few bits of exegesis—most notably her exploration of the Adam and the Eve in Genesis 1-3 as progenitors of human diversity rather than normative archetypes—and historical context—the six-seven different genders acknowledged by second-temple Rabbis—which I regularly include in my Christian defense of the gender identities of trans persons. While I very much stand by my usage of these arguments, I was convicted recently that in my use of DeFranza's book I have been guilty of a particularly damaging sin. Specifically I have been guilty of treating Intersex persons and the research which arose out of concern for topics and attitudes which have oppressed them as mere means (and not as ends in themselves) for the defense of other (most often transgender) people.

That is not to say that the Christian defense of trans people is in any way a bad thing; much to the contrary, I believe it a Christian's duty to defend the dignity and gender identities of our trans friends, family, and neighbors. But that duty does not grant any sort of licence to treat another population as mere means to that good end. The sin was not one of commission but one of omission. While using DeFranza's work to defend the identities of trans people, I did not use them to defend or really even specifically mention, the very real concerns of Intersex people. I hope to do correct that omission here.

For those who are not aware, Intersex people are people whose bodies do not fully conform to the more typical patterns which we (and most modern societies) use to assign people to one of two sexes (female or male). Numbers are hard to pin down because there are a lot of different ways that a person can be intersex and there are ongoing disagreements about what "counts" as an intersex condition so I have seen everything from 1 in 2000 to 2% (1 in 50) depending on who is counting and what degree of variation the counter allows for.

There are, so far as I know, two specific areas of concern wherein intersex people most frequently encounter, and are subject to, injustice. The first area of concern is simple recognition of their existence not as defective iterations of males or females, men or women, but as intersex persons who may be male, may be female, may be another sex, another gender, none, or both. That is to say the first area of concern has to do with recognizing the existence and dignity of intersex persons qua intersex. The second area of particular concern for intersex people has grown out of the intersection of the first area with technological development in the field of medicine. Because western society is generally uncomfortable with facts and events which complicate the categories we use to understand our world, it has become almost standard practice for doctors to surgically intervene when healthy intersex children are born and conduct surgeries on them in order to make their bodies conform to the more typical male or female pattern. Now, because sex is determined by more than just a person's genitals (some intersex people have fairly typically male external genitalia, some have typically female external genitalia, while some have external genitalia with is ambiguous) this is not a case of "correcting" a person's genitalia to conform to what they "really" are (what the person "really" is is an intersex person in any case). These surgeries which are often not at all medically necessary introduce all sorts of horrendous complications into the lives of these intersex people. The stories about this are heartbreaking and, rather than relate them myself I will encourage you to check out the documentary Intersex and Faith or to hop on Youtube and watch one of the many interviews and documentaries there. Intersex activists have made the claim that these surgeries, and the treatments which often accompany them, amount to genital mutilation and something like involuntary child abuse.

Now, working backwards through these two areas of concern, it strikes me that there is no reason why a Christian of almost any theological bent should not join in the efforts of intersex activists to end medically unnecessary surgeries on infants and children. The obvious alternative—recommended by many intersex activists—is to hold off on medically unnecessary surgical manipulation of a person's primary and secondary sex characteristics until they are old enough make an informed decision and let their own wishes be known.

I said just now that there is no reason that a Christian should not support ending these unnecessary surgeries and treatments. It would have been more accurate to say that there is no justification. There are, unfortunately, several reasons that some Christians do oppose these efforts; it is just that their reasons are not reasonable. The primary reason—I suspect—that a theologically conservative Christian might support the continued implementation of infant genital "modification" surgeries grows directly out of the first area of concern where intersex people encounter injustice: preservation of the "gender binary". Theologically conservative Christians are, despite a paucity of Biblical support for this view, often deeply wedded to the idea that sex is a binary category and that all people must be, in some real way, finally either female or male. While this commitment on their part does not logically demand that they support genital "modification" surgery in intersex infants since those intersex children may well grow up to identify with one or the other of the binary options, it does entail a profound discomfort with the ongoing ambiguity which is represented in a person whose body is not "clearly" male or female. Effectively, some theologically conservative Christians (as well as some Christians of other theological stripes) may be tempted to support genital modification surgeries on intersex infants in order to assuage their own emotional discomfort with the existence of those infants as intersex individuals. Thought they may provide other justifications (each of which should each be analyzed and responded to on its own merits, I am not supporting the use of bulverism here) it strikes me as rather likely that their motivation has to do with a desire to remain in comfortable denial about the fact that the taxonomy we have labeled "physical sex" is far more nuanced and complex than they want it to be and they are thus willing that these surgeries should be performed despite the negative consequences such "treatments" will have on the intersex children themselves. Once more, this is my hypothesis for why some theologically conservative Christians may support genital surgery on intersex infants despite the fact that there is no compelling Biblical or theological case that they ought to. There are other possibilities, but if I am at all correct in this then it is evident that Christian opposition to intersex people in the second area of concern derives primarily from Christian opposition to intersex people in the first area of concern: contemporary theologically conservative Christians, together with many other people in contemporary Western society, harbor a deep discomfort towards the existence of people who problematize their neat biological taxonomies.

Intersex people can become the scapegoats of people who fear uncertainty

The question (a philosophical one) which is at the heart of both the intersex non-affirming Christian's concern and the first area of concern for intersex folks may be summarized as follows: "Are female and male the only real or final sexes which can possibly be true of human beings?" Here there are some interpretive and theological arguments which are sometimes used to justify answering in the positive and denying that there are can be anything beyond male and female sexes. The first thing to note though, is that our current understanding of biology actually points towards a negative response, so that, despite what they will often claim, "modern science" actually counts against the case of the non-affirming Christians—their whole case must rest on a fideistic reliance on their theological argument. The process of determining a human person's sex on a biological level is a complex one which involves factors beyond that person's genotype (their "sex" chromosomes whether XX, XY, XXY, XYY, XO, or some other combination) and phenotype (the shape their body takes on) and, while most people sort fairly easily into one of two groups, intersex people are specifically those people who do not fit neatly into either. Factors like a person's genes, hormone levels, and genitalia are all more complex that a simple binary but in order for a person to be determined typically female or male each of them must point rather unambiguously in a single direction and that direction needs to correspond to the direction that each of the other's is pointing. If your genes point in a typically male direction (XY) and you hormone levels do as well (you have relatively high levels of androgens like testosterone) but your genetalia and eventual "secondary sex characteristics" point in a typically female direction, you are in a situation which a simplistic "male and female only" taxonomy of sex is unable to handle.

So the biological case is all in favor of recognizing that a binary taxonomy of sex is insufficient to describe the totality of people who actually exist in the world. But what is the theological argument which intersex non-affirming Christians cling to? It comes down to two claims: the first (which turns out to be false) is that the Bible only mentions two genders: "male" and "female"; while the second is that the Genesis account chronicles the creation of "man and woman" as "very good". As regards the first claim, Megan DeFranza has already established pretty conclusively that second temple Jewish thinkers had six or seven item list of possible sexes and that Jesus seems to be referencing people on this list when, in Matthew 19, he refers to a number of "types" of eunuch. So the claim that "male" and "female" are the only sexes which appear in the Bible is flat wrong.

The second claim is one I find especially objectionable just because it presents a premise "God declared 'very good' the creation of a man and a woman" as equivalent to the conclusion "Male and female are the only two sexes which God acknowledges as good". Has it never occurred to them that Genesis contains no explicit divine recommendation of ice cream sundaes or roller derby? Still it could be pressed that the declaration of the Adam (male/man) and the Eve (female/woman) as "very good" implies that it is "very good" for the total diversity of the human experience to be confined to those two sexes—but I don't see how such a claim could be sustained. As DeFranza has pointed out, the creation account in Genesis follows the pattern of things being created and declared good. Those things constitute several of the rough taxonomies with which we understand the world: night and day; dry land from sea; fish that swim, birds that fly, and animals that crawls along the ground etc... . In each case, the taxonomies Genesis uses are perfectly appropriate for suggesting "all of the stuff in the relevant category" but if picked apart and taken in the restrictive sense that the intersex non-affirming Christian wants to take the Adam and the Eve creation account, would contain gaping holes. The same argument which wants to pronounce sexes beyond "female" and "male" as "not good" must then turn around to similarly decry dawn and twilight (which are neither day nor night), marshes (which are neither dry ground nor sea), amphibians, penguins, and platypuses (which are not swimming fish, flying birds, or land-crawling mammals). Clearly the reading of Genesis which restricts "goodness" to those things which can be pedantically sorted into the categories explicitly described in the creation account is a poor reading of the text. DeFranza suggests that a far more robust reading of the Genesis account would be one which understands the categories used in that text to be representative of the total diversity which is associated with the list. Thus when God declares day and night good we are to understand that the whole 24 hour rhythm is a good creation of God; when God declares the land and the sea good we are to understand that all manner of terrain is a good creation of God; when God declares the various types of animal good we are to claim that the whole diversity of living beings is a good creation of God, and when God declares the Adam and the Eve "very good" we are to understand that the full diversity of human sex and gender is a very good creation of God.

But seriously, how could they not be good?

Now while I worked on correcting the sinful error I had made in omitting a recognition (and attendant defense) of intersex people from my work in defense of LGB relationships or of the gender identities of transgender people, I noticed that the sin I had committed or participated in has already had its effects compounded. I am not suggesting that my own small contribution to this much larger conversation has, on its own, had some sort of out sized effect on the spiritual and social well being of intersex persons, rather I notice that my own error is one which has frequently (though not universally) been matched by others who have engaged in this arena. Intersex people and the great variety of intersex conditions have been cited frequently by those of us who are affirming of trans identities as a fact (because the existence of Intersex persons is certainly a fact) which undermines the typically non-affirming claims that gender and sex are ontologically binary. And that argument is valid. The problem is that in presenting the argument, in using the existence of intersex people merely as a tool in our defense of LGBT folks without also recognizing and—where necessary—defending the dignity of intersex people themselves, without also including a full argument in defense of intersex individuals, we have associated intersex people with the rest of the LGBT community in the minds of people who are not predisposed to affirm the LGBT community and then failed to support them as persons themselves. In effect we have dragged intersex people into the battle and then abandoned them to the "mercy" of people who feel threatened. We need to face the fact that intersex people might have received a far more supportive and welcome response from theologically conservative Christians if they had not been associated in those Christians' minds with the rest of the LGBTQI community. It is never right to use a person as a means to any ends, even good ends, if you are not at the same time, treating that person as an end in themselves.

On a final note. I want to make two things clear:

1. I know that there is much more to be said about intersex people: that they are not "a product of the fall"; that, in their particularities, they can help those of us who are not intersex to better understand ourselves, our world, and God; that the intersex experience is far from homogenous—it is diverse and complex, and much more. 
2. I am almost certain to have got some things wrong here and I would appreciate any corrections or suggestions on my analysis or understanding of the facts.

Most of the information about intersex people in this piece comes from one of the following sources which I strongly encourage you to read to become more acquainted with intersex people, their awesomeness and their concerns:

• Intersex and Faith
• InterAct
• Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God
• National Geographic's Gender Revolution