sex and gender

The third gender

Your Health DR GITA MATHAI

The terms sex and gender are often interchanged, even in official forms, under the erroneous impression that they mean the same thing. Actually, “male or female” is the sex, “masculine or feminine” the gender. Gender is the self-identified perception of the individual. This can be different from the sex medically assigned at birth. People can choose to identify themselves as male, female or the “third gender.” Most people are “cisgender” or comfortable with the sex they are born with. One in 1,000 people exhibit a dissociation between the genetic sex, psychological gender, and social sex. They may be uncomfortable with the roles they have to play in society. Sometimes the physical attributes signifying a sex get interchanged. A woman may be hairy with a deep voice and a man may have scanty facial hair and a high-pitched voice. This makes it difficult for the person to psychologically identify with their attributed sex. One in a hundred persons may have intersex characteristics. This may result in them trying to change the sex through entensive surgery. Men who have changed themselves into women do not menstruate and cannot have children. Women who transform themselves into men usually have their uterus and ovaries removed. They can also call themselves the “third sex,” neither male nor female. They can just “cross dress” as a person of the opposite sex without undergoing surgery. They can take hormones for masculinisation or feminisation. A woman may develop a deep voice, facial hair and male pattern baldness. If these changes occur in adolescence, they may have difficulty determining which sex to identify with. This is increasingly common with the widespread occurrence of PCOS (polycystic ovary syndrome). It may occur as a result of tumours of the adrenal gland or ovary or as a side effect of medication. In men too, facial hair may be scanty, there may be breasts and a high-pitched voice. This can be the result of liver disease, tumours or medication. Psychological and social confusion may be created in the minds of children because of cross dressing by parents. Boys dressed as girls is a social “no no” for whatever reason. Girls dressed in pants and shorts, on the other hand, is totally acceptable. They usually wear feminine accessories such as earrings, necklace, bangles and hair clips. The Supreme Court of India, in a landmark judgment, has recognised the existence of a third gender. You can “declare” yourself any gender (male, female or the third). No surgical procedure needs to be performed nor any medical or legal proof provided. If we can declare our gender as whatever we are comfortable with, it opens up many questions. Does it mean that men who perceive themselves as women can occupy the “reserved for women areas”, participate in sports in the female category and get jobs in the women’s quota? Or, is everything going to be changed into “male, female and NOTA” (the third gender)? Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in