Anatomy does not determine sex, say experts

How to define the identity

The researchers say that gender identity comes from the brain, not the body. Some say it more frankly: it starts between your ears and not between your legs. But the forces that acted on the brain to shape that identity are not understood, and the physical or chemical differences in the brain that may be related to sex have not been well defined.

Nobody really knows why body and mind sometimes do not fit. But being transgender is not a matter of choice, said Dr. Safer. This is not a fad or a whim. For transgender people, it is usually overwhelming to think that their gender is not the one on their birth certificate. And the genre is not about who they are attracted to, but who they are.

The distress caused by mind-body inadequacy can become particularly intense around puberty, and the risk of suicide increases in young people in this situation. Traditional medicine has begun to recognize how serious the problem was: last month, the American Academy of Pediatrics released its first-ever policy statement regarding the care of transgender children and adolescents, as well as those who are "sex-differentiated" or not, which means that they are neither clearly male nor female.

The pediatric statement advocated a "gender-affirming approach", which translates into the respect and support of even young children in "their personal identity". The company also noted that transgender youth "have high rates of depression, anxiety, eating disorders, substance abuse, self-harm and suicide."

Last year, the Endocrine Society – the professional group of experts in glands and hormone producing organs – published recommendations for the treatment of transgender people. They claimed that gender identity was of biological origin and urged federal and private insurers to cover the medical needs of transgender people.

It's not as simple as X and Y

In addition to transgender issues, other conditions clearly indicate that defining men and women is not so simple. For example, there are people with XY chromosomes – which makes them genetically male – who look, act and feel like women because their bodies can not react to male hormones.

In other cases, some women with an illness who exposed them to high concentrations of testosterone before birth identify themselves as men – but many others do not exhibit the same problem are not.