The Sweetest Poisons (Part 9)

Preston Sprinkle's "Embodied" Chapter 7A: What About Intersex

This is the tenth installment in my series reviewing Preston Sprinkle's book Embodied: Transgender Identities, the Church, & What the Bible has to Say. Click HERE for a Table of Contents for the full series with summaries and links to each installment.

In Chapter 7 Dr. Sprinkle finally talks about intersex people, differences of sex development, and the theoretical implications that the existence of intersex people on our understanding of trans-ness. I say “finally” not to be glib but because, in this book, he has already postponed this topic several times in chapters 2 (on Definitions), 4 (Male and Female in the Image of God), and 6 (on the subject of eunuchs in the Bible), each time assuring us that Chapter 7 will dispel any potential objections to his arguments based on the existence of intersex people. He goes on to treat the matter as settled in Chapters 8 (Male Brain in a Female Body), 9 (Female Soul in a Male Body), and 11 (Transitioning and Christian Discipleship).

Recapping Dr. Sprinkle’s Bracketing of Intersex People

As a brief recap then. In Chapter 2(A) Sprinkle first punted to Chapter 7 for his claim that “all non-intersex¹ persons (and most intersex persons, as we'll see) are biologically male or female, regardless of how they identify.”¹ the working here is interesting as this does seem to leave open the possibility that at least some intersex people are not “biologically male or female”. Later in the same chapter he defines the term intersex where he now explicitly promises a fuller explanation in Chapter 7 and offers the following assertions (which he implies will be justified by the contents of Chapter 7): “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".

In Chapter 2(B) where Sprinkle defines the terms Sex and Gender grants (without highlighting the fact) that “The American Psychological Association says, ‘Sex refers to a person’s biological status and is typically categorized as male, female, or intersex’” seemingly re-opening the possibility of intersex as a third-sex category. Following that he explicitly brackets intersex people from his treatment of sex for the remainder of the book. In effect Sprinkle has bracketed individuals and data which would challenge or complicate two of his key terms for this book—male and female—promising that Chapter 7 will provide us with reasoning which shows that intersex people, when incorporated into the greater picture of humanity, do not ultimately complicate his conclusions in this book. I will have more on how Dr. Sprinkle tires to go about demonstrating that below but want to highlight here that as far back as Chapter 2, Sprinkle has granted that his use of male and female throughout the book, stand or fall with his success at demonstrating the irrelevance of intersex people to the meaning of those terms, or as I said in that post:

By bracketing any incorporation of intersex people from his definition of sex, male, and female, Sprinkle erases those persons from having an impact on his argument at this point in the book, thereby justifying an over-simplified definition of key terms in the conversation. He is, in effect, cherry picking his human data and justifying it by deferring discussion of counter examples for a future Chapter. In principle that could be sort of technically acceptable if Chapter 7 itself were to somehow demonstrate conclusively that the existence of intersex people in no way impacts his conclusions here.

In Chapter 4 Dr. Sprinkle, while claiming that Genesis 1-2 demonstrate that “Biological sex is ‘an essential datum in any attempt to define the human being.’” makes a point to add that this claim, as he understands it, does not interfere with the claims that “some intersex persons embody both male and female sexes. These intersex people also embody the beautiful truth of Genesis 1:27, that biological sex is an important part of human identity” (I can not help noticing the shift in his quoting of Byrd who called biological sex “an essential datum in any attempt to define the human being” to his own “an important part of human identity”). So in Chapter 7 we are promised an explanation of how and why, although biological sex is binary (male and female only), intersex people nevertheless “embody the beautiful truth of Genesis 1:27, that biological sex is an important part of human identity”. Later in the chapter he punts to Chapter 7 for an explanation of how intersex people do not undermine his claim that “Whatever interpretive hurdles exist, they all—on some level and to varying degrees—affirm that male and female sex distinctions are a creational good that should be honored”.

And in Chapter 6 Dr. Sprinkle cites his work in Chapter 4 (which included punting to Chapter 7 on the ways that intersex people might otherwise complicate his argument) to justify treating as already demonstrated the idea that “the phrase ‘male and female’ in Genesis 1:27 refers to biological sex, not gender roles or identities.” Dr. Sprinkle treats this claim as somehow contradicting the idea that “the binaries of Genesis 1 are polar ends of a spectrum, allowing for hybrids and variations in between”. In case you are feeling lost, let me try to sum this up: It is critical to Dr. Sprinkle’s overall arguments in this book that “biological sex” be binary; intersex people contradict this and in his definition of sex and his treatment of Genesis 1&2 Dr. Sprinkle recognizes that intersex people potentially complicate his argument and punts to Chapter 7. Finally it is in Chapter 6 that Dr. Sprinkle edits a reference to intersex people out of a quote from Linda Tatro-Herzer, a reference to the claim that the existence of intersex people demonstrates that humans exist across a spectrum of sex and not solely within binaries. While I have already offered multiple critiques of Dr. Sprinkle’s argument for those claims, we are now looking at an argument that he has now referenced multiple times as sufficiently supporting the justifiability of his bracketing intersex people. For Dr. Sprinkle the premise that sex is binary is key to his total theology of trans identities and the fact of intersex people does not undermine that key premise.

I do think it would be going too far to say that Dr. Sprinkle’s total position on the validity of transgender gender identities rests on whether his arguments in this Chapter stand or fall on on the quality of his argument in Chapter 7, but it is clear that he is using this chapter to plug holes in his position which will otherwise demand new and different answers.

Prologue

At the outset of Chapter 7 Sprinkle carefully and directly identifies the fact that, while the existence of intersex people is an important data point in our understanding of transness a) intersex people are real and are full persons who are also made in the image of god who deserve dignity and respect and b) intersex people are not (necessarily) trans. As a result it can be tempting to reduce intersex people to talking points in discussions which are not even about them and that this can amount to dehumanization. Sprinkle is absolutely correct on this point and it is, I fear, a point on which trans people ourselves too often fail to live up to our stated values. It is, indeed, too easy to talk about intersex people without ever talking to or hearing from intersex people. To that end I want to remind the reader that, at present and for the last while, a primary focus of activism in the intersex community is the effort to end medically unnecessary surgeries on intersex children, surgeries which do not improved the lives of intersex people themselves beyond fitting them somewhat more easily into our social expectations for the male and female body forms. I recommend reading more about this important issues of intersex dignity and efforts to ensure the bodily autonomy of intersex people HERE.

I do have some concern that Dr. Sprinkle is, himself, not quite listening to intersex voices and advocates insofar as his use of thinkers like Emi Koyama in the book tend to be brief and sort of “proof texting” rather than representing a deep engagement with the intersection and distinctives between intersex and transgender identities and communities. He is, for example, more than happy to cite Koyama in order to reject the claim that “Intersex people are neither male nor female” quoting from Koyama’s keynote speech at the Translating Identity Conference in 2006 that “[M]ost people born with intersex conditions do view themselves as belonging to one binary sex or another. They simply see themselves as a man (or a woman) with a birth condition like any other” but neglects to include the nuancing of that claim just prior to the section where she says “This one depends on how rigidly you define maleness and femaleness, but most people…[emphasis mine]”. Further he is either unaware of, or simply ignores, the fact that Emi Koyama is frequently credited with popularizing the term cisgender and is the author of the Transfeminist Manifesto, a key text in the history of transgender feminism which specifically and sharply disagrees with many of the positions that Dr. Sprinkle espouses in this book. As an example:

As trans women, we have learned that our safety is often dependent on how well we can “pass” as “normal” women; as transfeminists, we find ourselves constantly having to negotiati our need for safety and comfort against our feminist principles. Transfeminism challenges all women, including trans women, to examine how we all internalize heterosexist and patriarchal mandates of genders and what global implications our actions entail;

or

Transfeminism views any method of assigning sex to be socially and politically constructed, and advocates a social arrangement where one is free to assign her or his own sex (or non-sex, for that matter.)

Texts like these make it hard to believe that Sprinkle is listening to intersex people so much as performing sympathy for them while using them where convenient.

“Since Intersex, Therefore Transgender”

Having recognized the humanity of intersex people, Sprinkle moves into his summary of how Christians who do think that the existence of intersex people support a recognition of transgender identities, setting up the argument he will be arguing against. Sprinkle accurately cites Megan DeFranza and Lina Tatro Herzer as people who hold this position and then summarizes what he takes to be their argument.

Virtually every gender-affirming writer argues along similar lines.² The logic almost always proceeds as follows:

• I used to think everyone was male or female

• But then I learned about intersex [sic]

• I now know that there aren’t only two genders (there’s almost always a subtle shift from sex to gender)

• Therefore, a person’s gender identity is a more accurate description of their authentic self than their body

• Because we know intersex persons exit

I actually think that this is a misunderstanding of the argument/logic that is actually used. Dr. Sprinkle has regularly claimed that he values “steel-maning” arguments—engaging with the strongest version of the argument that his opponent might make—and so, taking him at his word, I would suggest that the argument that “gender affirming” people actually make (as it relates to the fact of intersex people) is more like this:

• I used to think everyone was male or female

• But then I learned about intersex people

• I now know that sex does not exist as a simple binary but is a cluster of traits, several of which exist along a spectrum between male and female poles and that several of these characteristics are not discernable without the use of high end technology.

• Therefore a person’s gender identity is a more reliable representation of their authentic self than their body.

• Since bodies as a whole do not represent stable binary categories it is reasonable to allow a person’s fundamental sense of self have a controlling say in our understanding of who they are.

Sprinkle refers to this as the “since intersex therefore transgender” argument. Hopefully the difference between Sprinkle’s version of it and the version I suggest is more representative of trans people’s actual logic is clear. Dr. Sprinkle then proceeds to sort of drop immediate attention on this argument in favor of a central question in two formulations:

Does the existence of intersex persons validate the ontological claim (or assumption) that a non-intersex person’s gender identity is a more accurate indicator of who they really are than their body?

Or, more simply put:

Does intersex prove that a biological female can actually be a man (or vice versa?)

Notice though that these two formulations have significantly different meanings and requirements, far beyond the scope of simplification. To “prove” something is a much higher bar than validating a claim or assumption. To prove something we would need an airtight, deductive argument; to validate a claim or assumption we only need to show that it is reasonable given the evidence that we have. Beyond that the shift from talking about whether sex or gender is a “more accurate indicator of who they are” to “prov[ing] that a biological female can actually be a man” is pretty stark. The first formulation works on the assumption that the fact of intersex people destabilize sex as a binary and easily applied category and suggests that in lieu of sex, gender identity can serve as the category determiner; the second formulation assumes as its premise that “biological female” is a stable and meaningful category and that the fact of intersex people³ creates the option of shifting in or out of it.

Further, Sprinkle’s use of prove significantly moves the goalposts on the conversation. Where someone who affirms trans identities might say that the fact of intersex people introduces sufficient ambiguity into our sex categories to justify using gender identity as the controlling determiner of who a person is, Sprinkle could respond with “ah but it doesn’t prove it does it?” Well, no, but when was proof the bar that we were ever working from? Sprinkle doesn’t claim to prove his point either and the question of how to understand the claims of trans people in the absence of proof is overshadowed by the documented fact that affirmation decreases suffering and contributes to the flourishing of trans folx.

So already the terms of Sprinkle’s investigation of this topic and the question he will be using to guide that exploration are questionable.

What is Intersex?

“Intersex” does not mean “neither male nor female.”

That is Dr. Sprinkle’s opening line for this section of the text and it is the claim he is attempting to justify. It is central to his argument since, as we have seen above, Sprinkle needs maleness and femaleness to be comprehensive, absolute, and stable categories of given-ness⁴. This is a tall order as it will require Dr. Sprinkle to show that the categories “male” and “female” can adequately account for every human person who has ever lived. Any person who can not be accounted for as fitting into this taxonomy will, of necessity, create the need for a third (or fourth, fifth etc..) category within the taxonomy of sex.

Making sense of Sprinkle’s argument in this section and my critique of it are going to require me to review Sprinkle’s varied definitions of “sex” and it’s related terms “male” and “female”. Back in Part 3 of this review series I listed the various definitions of sex that Sprinkle uses throughout the book:

Here is the full list as best I can compile it (the following list are all direct quotes; italics + bold are my emphases):

1. The categories used to classify the respective roles humans play in reproduction are "male" and "female".

2. Females are distinguished from males based on their different reproductive structures.

3. Males and females also have different levels of hormones.

4. Genetically, the presence of a Y chromosome distinguishes males from females.

5. To sum it up, a person is biologically either male or female based on four things:

   • Presence or absence of a Y chromosome

   • Internal reproductive organs

   • External sexual anatomy

   • Endocrine systems that produce secondary sex characteristics

6. Feminist philosopher Rebecca Reilly-Cooper describes "female" and "male" as "general biological categories that apply to all species that reproduce sexually.

7. The American Psychological Association says, "Sex refers to a person's biological status and is typically categorizes as male, female, or intersex. There are a number of indicators of biological sex, including sex chromosomes, gonads, internal reproductive organs and external genitalia."

8. [A]n organism is male or female if it is structured to perform one of the respective roles in reproduction," and "[t]here is no other widely accepted biological classification for the sexes."

9. Male and Female are categories of biological sex based on structures of reproduction.

So this is…difficult. When Dr. Sprinkle claims that “‘Intersex’ does not mean ‘neither male nor female’” which definition is he using? The APA definition which he cites is probably the most representative of the scientific consensus⁵, that “sex” refers to a gestalt based on chromosomes and primary and secondary sexual characteristics. At this point we need to be asking “according to which definitions of ‘male’ and ‘female’ does ‘intersex’ not qualify as “neither male nor female”?

Dr. Sprinkle goes on to specifically list four intersex conditions (or Differences of Sex Development): Klinefelter Syndrome, Turner Syndrome, Late Onset Congenital Adrenal Hyperplasia, and Vaginal Agenesis⁶. He summarizes his understanding of their relevance to this conversation saying “most people with these conditions present little to no ambiguity in their biological sex” which is either accurate or wildly inaccurate depending on which definition of ‘sex’ Sprinkle is using. If he is referring to definitions 4,5, or 6 then his summary is broadly accurate. But if he is depending on any of the other definitions these conditions do indeed present complications to his goal of “male or female only”.

Dr. Sprinkle then spends several paragraphs unpacking these conditions in an attempt to show that people who experience them are easily categorized as male or female. The degree to which he succeeds depends on which definition of sex he happens to be deploying at the time. And of course this is a problem. To take just one example: A person with Klinefelter Syndrome has XXY or XXXY rather than simply XX or XY chromosomes and, while their bodies often develop along more male-typical lines, can also develop some more female-typical sex characteristics; further the vast majority of people with Klinefelter Syndrome are infertile. So then does a person with Klinefelter “present little to no ambiguity in their biological sex”? Lets look.

According to Sprinkle Definition 1 (the role the person plays in reproduction) most people with Klinefelter would not be either male or female. According to Definition 2 (reproductive structures) the answer will depend on what we mean by “reproductive structures” but assuming that Sprinkle is referring to either testes or ova people with Klinefelter would be generally sexed as male. Definition 3 (hormone levels) a person with Klinefelter would be somewhere between a male and a female, would be both , or would be neither. Definition 4 (the presence or absence of a Y chromosome) would categorize someone with Klinefelter as fully male, whereas Definition 5 (Y chromosome, primary and secondary sexual characteristics, and hormone levels) would point to a both, neither, or between response. Definition 6 (back to sexual reproduction) again would seem to outcaste people with Klinefelter from either category, and Definition 7, like 5 (the gestalt of multiple characteristics) points to both, neither, or between. Definitions 8 & 9 are both reproduction centered but with a focus on structure that would likely lump most people with Klinefelter into the “male” category. A similar analysis with similarly varied results could be performed for each of the other intersex conditions Dr. Sprinkle examines in this section of the chapter.

You see the problem here. Because Dr. Sprinkle has deployed and referenced various overlapping but varied definitions of “sex” throughout the book, the legitimacy of his argument here is, suspect to say the least. And all of this comes before Sprinkle addresses the intersex condition which most thoroughly complicates his claim of a binary. At the end of the chapter Sprinkle quotes Claire Graham and Emi Koyama as intersex individuals who challenge the idea that intersex people “are neither male nor female”. His quote for Graham is that she objects to non-intersex people who claim that “our bodies make us ‘not wholly male or female’ for not fitting into your platonic ideal of the perfect body” and claims that Koyama agrees with Graham based on the quote I shared above which, as we have seen, seems to be using Koyama in ways that do not accurately represent the totality of her views. While I have not found much of Graham’s writing beyond the blog that Sprinkle cites in this chapter, Koyama is a prolific writer, advocate, and activist and a simple search of her websites turned up several quotes which shed further light on Sprinkle’s claim here and on his use of Koyama as an “intersex person” whose personhood needs to be respected and voice accurately represented. From the speech Preston first cited, a few rows down Koyama says

“Since human sex is on a continuum, how many sexes there are depends on where one draws the lines—and in that sense, dividing humans into two categories is no different from using five categories [emphasis mine]”.

And from the FAQ page of Koyama’s Intersex Initiative in response to the question “Are intersex people ‘third gender’?”:

Many people with intersex conditions identify solidly as a man or as a woman, like many non-intersex people. There are some who identify as a member of an alternative gender, like some non-intersex people do. While we support everyone's right to define her or his own identities, we do not believe that people with intersex conditions should be expected to be gender-transgressive just because of their physical condition. [emphasis mine]

It seems as though Koyama’s actual point in the quote Dr. Sprinkle shares in his book is not that intersex people should not be understood to constitute a third sex per se but that they should not be pressured or into doing so; that many—but not all—do identify as either men or women, and that that identity should be respected. In fact Koyama is an outspoken advocate for autonomy of intersex individuals to identify based on their gender identity. As Koyama clarifies in her answer to the question “How do we know the correct gender of a child with an intersex condition”?

We won't know the child's gender until she or he is old enough to communicate to us. We recommend that the child be assigned a gender based on our best prediction, and allow her or him to determine for herself or himself once she or he is old enough to do so.

Bye-Bye Binary?

Dr. Sprinkle opens the next section by, to his credit, recognizing that even if his account of the above intersex conditions allowed for those individuals to be neatly categorized as “male” or “female” there are other cases which are less simple. Sprinkle asks:

But what about the 1 percent of intersex persons whose biological sex actually is ambiguous?

The question is followed by a list of four more intersex conditions (Congenital Adrenal Hyperplasia, Complete Androgen Insensitivity Syndrome, Partial Androgen Insensitivity Syndrome, and Ovotestes) before launching into a specific example which he describes using his friend Christian as a case study. Christian is, according to Dr. Sprinkle, a person with both XX and XY chromosomes and “a full male anatomy, and a full female anatomy”. Sprinkle emphasizes that Christian also appears to be ambiguously sexed: “If you hung out with Christian, you wouldn’t really be sure whether they are male or female.” Sprinkle also is careful to emphasize that Christian is a delightful person and a good Christian.

Having described and worked to humanize Christian, Dr. Sprinkle reaches the crux of his argument: his attempt to account for these “more ambiguous cases” while retaining his binary “male or female only” taxonomy. And the case he makes is worth quoting at length. I will quote the full thing interspersed with my own reactions in italics:

Does this mean that people with CAIS or my friend Christian are neither male nor female, or a kind of third sex?

I find it more helpful to say that such people—beautiful people created in God’s image and worthy of respect, value, and admiration—are a blend of the two biological sexes rather than a third sex.

I certainly agree that intersex people are “beautiful people created in God’s image and worthy of respect, value, and admiration” but find Sprinkle’s use of “I find it more helpful” rather alarming. Much of the weight of his argument throughout this book rests on the strength of the argument he is making in this chapter and to couch his conclusion as one that he “finds helpful” is underwhelming given the dire implications that the pastoral and theological recommendations of this book have on transgender Christians.

It may sound like I’m splitting hairs, but I think this is more than semantics. When the Bible and science talk about humans as sexed creatures they recognize two categories of sex: male and female.

OK so remember now that the whole case that the Bible only recognizes two categories of sex is partially justified in this book on the basis of Sprinkle’s claim that intersex people do not constitute a third gender category. By using that conclusion from an earlier chapter as a premise here, Sprinkle is indulging in circular reasoning of the most blatant sort. As I have opined earlier, this massive logical fallacy is masked by the distance between the sections. There is no one place in the book where Preston directly says “the Bible only recognizes two sexes and the objection that the fact of intersex people (including, admittedly, multiple categories of eunuchs) means that the Bible recognizes more than those two is wrong because the Bible only recognizes two.” Intentionally or unintentionally, he breaks up the circular argument across multiple chapters making it harder to pick up on. Thus with one of his two supports for “male and female” as the only two sexes gone, he has only the testimony of “science” to support his claim.

Though some intersex people embody traits form both categories, there are still only two categories of sex.

What? That isn’t how categories work. If I say “here are the categories” and you respond with an example of something that blends definitional traits of both categories and ask me how to group it, I have to either revise my category requirements or create a new category for this new data.

For example, non-intersex male have a penis and non-intersex females have a vagina. Most males and females with an intersex condition also have a penis or a vagina, while some intersex persons have a penis and a vagina. But no intersex person has an innovative new sex organ called a “plankerton” (or whatever) that’s neither penis nor vagina, neither male nor female. They may have atypical features in their male or female anatomy, or they might have a blend of male and female parts. But this doesn’t mean that there are more than two biological sexes.

It does mean that actually. Imagine if Sprinkle were to say that some animals (fish) breathe using gills⁷ and some animals (mammals) breathe using lungs but since there is no third organ for respiration there can be no third category of animal. Beyond that though, Sprinkle’s stated requirement for a third sex—a new thing that is not a combination of the other categories—does exist in the sense of unique combinations across those traits.

It seems more accurate to say that some people exhibit a combination of both—the only two biological sexes.

Some things are black and white. Some things are gray. Most people are male or female. Some people are both.

…yes. Gray is a different color from black or white because of how it combines elements of both.

I am running up against my word limit for this post and will have to address Sprinkle’s return to the applicability of this topic to trans people and the role of the fall in the existence of intersex people in the next one. In the meantime I would encourage you to read Megan DeFranza’s magisterial book on theology and Intersex people: Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God and decide for yourself. And always respect intersex people’s right to identify as they see fit.

1. Sprinkle is not explicit here and I am reading his “as we’ll see” as a reference to Chapter 7.

2. Sprinkle’s citation list for his “virtually every gender-affirming writer” consists of Austen Hartke’s Transforming: The Bible and the Lives of Transgender Christians; Tara Soughers’ Beyond a Binary God: A Theology for Trans* Allies, Cheryl Evans’ What Does God Think: Transgender People and the Bible, “several essays in Christina Beardsley and Michelle O’Brien’s This is My Body: Hearing the Theology of Transgender Christians, Herzer’s Bible and Transgender Experience; Justin Sabia-Tanis’ “Holy Creation, Wholly Creative” in Understanding Transgender Identities: Four Views. I am not really sure why he omitted the work of Megan DeFranza both in her contribution to Four Views and in her Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God though he does reference her and Herzer in the main text as using this argument. Notably he restricts himself to listing trans affirming Christian writers which is understandable but does again betray his apparent lack of research into the arguments of the many secular gender theorists (other than Anne Fausto-Sterling) such as Serano, Butler, Bettcher and so many others who find that the fact of intersex people problematizes his characterization of male and female as stable and sufficient sex categories.

3. I am somewhat baffled by Sprinkle’s sporadic use of “intersex” as a noun.

4. Given-ness here should be read in contrast to categories which are socially constructed. The idea is that in order to support Dr. Sprinkle’s choice to bracket the fact of intersex people throughout this book the male/female sex categories can’t be something that humans came up with as that would open the door to the possibility that other related categories based in gender expression (how we perform our gender) or gender identity (our deeply held understanding of who we are) have at least as much, if not more, of a claim to be the deciding factor in understanding a person’s identity.

5. Here is a short list of articles which explore the complicated and gestalt nature of what constitutes maleness and femaleness:

1. Scientific American - Sex Redefined: The Idea of 2 Sexes is Overly Simplistic

2. Scientific American - Beyond XX and XY: The Extraordinary Complexity of Sex Determination

3. American Medical Association - Issue Brief on Sex and Gender in Medical Education

4. World Health Organization - Gender and Health

5. The Lancet - The Misuses of “Biological Sex”

6. For definitions and explanations of these and other intersex conditions you might want to check out InterACT.

7. As it turns out some fish breathe through their intestines or pharynx and some insects breathe through special holes in their trachea. Nature is fun.