How Many Sexes Are There? Two.

Conceptual image of the X and Y human chromosomes and their role in determining the sex of an individual (the Y chromosome has been altered in shape and size to appear much larger and more Y-shaped than it really is). Every human cell has 46 chromosomes, of which the other 22 pairs are identical in both males and females. Chromosomes carry genetic information in the form of genes and the sex chromosomes carry the genes which control sexual development.Image credit: Department of Clinical Cytogenetics, Addenbrookes Hospital/Science Photo Library

Foreword

This essay was originally published in Russian in the online magazine Seagull (Чайка) in July 2024. The topic continues to be highly relevant. Denial of the sex binary in favor of a spectrum of sexes is one manifestation of the current ideological subversion of biology, which has led to the politicization of research, the suppression of research findings, censorship, and the distortion of education in the life sciences and medicine. Talks and panels at the recent conference Censorship in the Sciences: An Interdisciplinary Perspective provided insight into the extent of this crisis (see the conference talks “Censorship and Pseudoscience in the Life Sciences,” “Censorship Around Gender Research and Medicine,” and “How ‘Soft’ Censorship in Media and Academia Helped Make the U.S. a Youth-Gender-Medicine Outlier”).

A recent executive order realigned U.S. federal law to the reality that sex is binary. Despite this incontrovertible biological fact, the order was denounced by several professional societies. This led to a counter-campaign by leading biologists, announced by Luana Maroja in her post “Sex in Biology Signature Campaign” on HxSTEM and discussed in detail by Jerry Coyne on Why Evolution Is True.

Recently, the UK Supreme Court unanimously ruled that, in law, a “woman” is “a biological woman,” and a trans woman, even with a “gender reassignment certificate,” does not legally qualify as a “woman,” to the delight of staunch defenders of women’s rights such as J.K. Rowling (see a detailed report by Jerry Coyne here).

The immediate implications of the executive orders in the US and the Supreme Court decision in the UK are that biological men should not be allowed in women’s spaces (e.g., changing rooms, prisons, centers for victims of domestic violence and rape) and should not be allowed to compete in women’s sports. Accordingly, citing the participation of transgender athlete Lia Thomas on their women’s swim team, the Trump administration has suspended $175 million in funding for the University of Pennsylvania and has initiated an investigation of the university under Title IX (the federal statute prohibiting sex discrimination at universities receiving federal funds). On April 28, the Office of Civil Rights of the Department of Education announced that Penn had indeed violated Title IX by “denying women equal opportunities by permitting males to compete in women’s intercollegiate athletics and to occupy women-only intimate facilities.” And in the UK, the British transport police have announced that trans officers will no longer be allowed to strip search members of the opposite sex.

Although the executive orders and the UK court ruling reverse absurd and harmful policies that defied biological reality and common sense, the fight between science and ideology is not over. Trans activists and their allies, which—disturbingly—include practicing biologists, anthropologists, and even medical professionals, continue to invoke the biological complexities of sexual development in order to challenge the reality that sex is binary.

This essay, penned by geneticist Michael Golubovsky, provides fascinating insights into the inner workings of human sex—its determination, its development, and anomalies that can occur—and its societal implications, highlighting the importance of staying true to biological reality. Golubovsky presents cutting-edge scientific findings in a clear and accessible way. He uses wonderful examples from art and classic literature to illustrate the wisdom of human knowledge regarding the binary nature of sex. The erudite combination of scientific rigor, art, and literature makes this essay a true intellectual gem.

— Anna Krylov and Jay Tanzman

Note: This translation was edited and prepared for publication by Jay Tanzman and Anna Krylov.

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How Many Sexes Are There? Two.

An Essay by Michael Golubovsky

What do you think, if a woman wears leather pants, she becomes a man?

Что ты думаешь, если женщина одевает кожаные штаны, то становится мужчиной?

—Vasily Grossman, in In the City of Berdichev

Whoever was born a man, that one
Dressing up in a skirt is strange and pointless:
Someday he'll have to
Shaving the beard, which is not compatible
With the nature of women.

Кто ж родился мужчиною, тому
Рядиться в юбку странно и напрасно:
Когда-нибудь придется же ему
Брить бороду, что несогласно
С природой дамской.

                         —Alexander Pushkin, in The House in Kolomna

It is unlikely that the poor Berdichev Jew, father of seven children, Khaim-Abram Magazannik (wonderfully played by Rolan Bykov under the name Efim in the film Commissar) read Pushkin’s poems. But his wise conclusion, given in the epigraph, and Pushkin’s words are surprisingly consistent. They are united by life experience and common sense. Homo sapiens and his animal relatives are divided into two sexes at birth. According to the poet, this is how nature wanted it, why—it is not for us to judge. But we can study the question and try to understand it.

Analysis of the mechanisms of sex determination is a long-standing problem in genetics. The basic principles have been established. The reasons for many failures and mutations on the path of development from one fertilized egg to the birth and maturation of a person have become clear.

The words in Pushkin’s fairy tale—“the queen gave birth at night, either to a son or a daughter” (родила царица в ночь, не то сына, не то дочь)—are not just a metaphor. Failures of sexual identification are rare, but they happen all the time. Intersexes are born, as the classic geneticist Richard Goldschmidt called them in the 1920s. Deviations from the birth of the typical two sexes are summarized in reproductive genetics and medicine under the heading “disorders of sexual development” (DSD).

The consequences of deviations from “he” and “she” can lead to biosocial collisions, including sporting events even on the level of the Olympic Games. Understanding the basics of sex genetics will help navigate this area. This is the purpose of my article.

Let me start with the heated discussion about transsexuality. The media’s elevated attention to this topic has little to do with other, more frequent and serious disorders of sexual development. However, it has reached the point of denying the realities of biology and litigation.

Human sex matters

On July 1, 2023, a London employment tribunal unanimously awarded Maya Forstater around £100,000 in compensation for her unfair dismissal. The story began six years ago. The formal title of the case is Maya Forstater v. Centre of Global Development. The informal title is “Sex Matters.”

Maya Forstater found herself out of a job after tweeting gender-critical views. Image via BBC

Maya Forstater (hereafter “M.F.”), a business and finance specialist, worked successfully at the Center for Global Development until the end of 2018. But in October 2018, the Center received a denunciation. M.F. had expressed the opinion on Twitter that the division of people into two sexes is a solid biological fact and that “a man cannot turn into a woman.” M.F.’s statement was considered a violation of transgender rights. In December 2018, M.F. was fired. She filed a lawsuit, believing that the dismissal was an act of discrimination, contrary to British law.

There was a heated debate in the media. In June 2020, the famous writer J.K. Rowling, author of the bestselling Harry Potter series, openly supported M.F.:

Dress however you want. Call yourself whatever you want. Sleep with any adult who agrees. Live happily in peace and safety. But throw a woman out of work for saying that sex really exists?

Rowling pointed out the obvious social dangers of the transgender activism craze sweeping society. She doesn’t condemn trans women, she said. But for normal girls and women—and there are 99.9% of them!—there is a clear danger:

When you throw open the doors of bathrooms and changing rooms to any man who believes or feels he’s a woman—and, as I’ve said, gender confirmation certificates may now be granted without any need for surgery or hormones—then you open the door to any and all men who wish to come inside. That is the simple truth.

— J.K. Rowling Writes about Her Reasons for Speaking out on Sex and Gender Issues

Rowling contributed £120,000 to M.F.’s legal support fund.

J.K. Rowling. Image via The Times

In November 2019, a trial court failed to support M.F.’s claim. In the court’s convoluted decision, M.F.’s views were called absolutist. Transgender people might perceive them as “intimidating, hostile, humiliating.” The persistent M.F. filed an appeal. And on June 10, 2021, the appellate court found her claim fair. In a democratic society, the court’s decision stated, the right to express one’s non-extremist views and philosophical position on sex is protected by law, like any other non-extremist views.

On this basis, another trial was held to consider the illegality of M.F.’s dismissal. On July 1, 2023, it ruled to reinstate M.F. at work and to pay her compensation for her years of involuntary unemployment.

Undoubtedly, in this persistent search for justice, a decisive role was played by happy coincidence: the moral and financial support of the famous writer J.K. Rowling and the amazing tenacity of Maya Forstater. The justice legitimized by the London courts is very important since this decision opposes the current social fashion of denying the fundamental biological fact of the division of people into two sexes.

The court victory inspired Maya Forstater to defend her views publicly. She founded the human-rights charity “Sex Matters.” The mission of the organization is to restore the biosocial reality of the division of people into two sexes and to promote “clarity about sex in law, policy and language in order to protect everybody’s rights.” They inform public debate by research, analysis, and stories; educate people and organizations about sex; and make practical legislative and policy proposals.

The “Sex Matters” organization aims to protect women’s rights in areas where gender differences matter—sports, prisons, even language. Rowling has sharply condemned the phrase “people who menstruate.” “If gender isn’t real,” she writes, “then women’s reality is erased globally. The rejection of sex removes the ability to meaningfully discuss our lives.” Rowling continues to be accused of transphobia for her views. She regularly receives mail containing insults and death threats.

Rowling explains why she is deeply concerned about the surge in trans activism among girls. Previously, in rare cases, gender reassignment for medical and psychological reasons was performed mainly on males (removing structures is easier than creating new ones). Surgical reassignment operations are long and painful. This is what the excellent British film drama The Danish Girl (2015) tells us. Those who decided to undergo sex reassignment in their youth may regret it later and dream of returning to their original sex. But their body has changed irreversibly, and they have become infertile.

Girls are particularly susceptible to social fashion, including transsexual fantasies. The rather vague term “gender dysphoria” has emerged—psychological dissatisfaction with one’s biological sex. Rowling is convinced that 60–90% of girls will eventually overcome such negative fantasies: “I’ve been through it myself,” she writes.

It seemed that after M.F.’s long legal battles and her ultimate court victory, everything had settled down. But no. On April 1, 2024, a law came into force in Scotland that criminalizes incitement to hostility not only in relation to age and disability, but also in relation to sexual orientation and transgender identity. J.K. Rowling said that even if she has to go to prison, she will not give up her position.

In the United States, the situation has gone particularly far. School boards often indulge teenagers’ transgender fantasies without even informing their parents. In one school in Wisconsin, parents sued because teachers began calling their 12-year-old daughter by a boy’s name without informing the parents. The district court ruled that the school had violated fundamental parental rights. But due to the stressful situation, the parents were forced to transfer the girl to another school.

In April 2023, The Economist magazine published a special issue titled “What America Gets Wrong About Gender Medicine” which included the editorial “The Dangers of Gender Medicine.” The transgender craze that had emerged in the United States had led to a sharp increase in the number of teenagers who claimed to be unhappy with their gender. They were readily given gender reassignment surgeries. Writer and philosopher Ayn Rand used the figurative term “comprachicos of the mind” in such cases.

Operations do more harm than treatment, writes The Economist. The number of teenagers who want to return to their biological sex (“detransitioners”) is growing. But their bodies are irreversibly changed. Contrary to US practice,¹ gender reassignment surgeries under age 18 are prohibited in Britain, France, Sweden, Norway, and Finland. Help is usually based on psychotherapy and the principle of “do no harm.”

In 2020, a comprehensive book by Abigail Shrier was published that analyzes this problem in detail. Its title is eloquent: Irreversible Damage: The Transgender Craze Seducing Our Daughters. More than 10% of girls who take this path commit suicide.

Abigail Shrier, Irreversible Damage: The Transgender Craze Seducing Our Daughters

Sex determination during development

The establishment of sex during development is a complex stepwise process. Four successive stages or levels can be distinguished, when, from the moment of cell divisions of one fertilized egg, differences in “he” and “she” arise successively: 1) the level of genes and chromosomes, 2) the level of sexual organs and their hormones, 3) secondary external sexual characteristics (phenotype), and 4) sex-specific differences in brain structures and brain-gonad dialogue.

Gene and chromosome level

A person has 23 pairs, or a double set, of chromosomes—one from the mother, the other from the father. Each pair differs from the others in structure and set of genes. Sex cells receive a single set of chromosomes during a special cell division. After fertilization, the original double set is restored. One pair of chromosomes is special. These are the sex chromosomes, designated X and Y. Women have the set XX; men, XY. In the language of genetics, this is called the chromosomal mechanism of sex determination.

The eggs that are released once a month to meet the sperm carry only the X chromosome. But the sperm carry either the X or Y chromosome in 50% of cases each. The random entry of one sperm carrying the X or Y chromosome into the egg is the initial signal. The XX set is potentially “she”; the XY set, “he.” The probability of each option is 50%. This determines the approximately equal sex ratio at birth.

The Y chromosome almost exclusively contains genes that determine the developmental pathway that will lead to sperm production. The remaining sections are genetically empty. However, it is not the Y chromosome itself that determines male sex, but only one gene localized on it. This is the key sex regulator gene, designated SRY (Sex Regulator). It was identified and studied only in the early 1990s. It is the structure and activity of the key SRY gene that determines whether the fertilized egg will develop in the male or female direction.

The emergence of any traits during development is based on the following principle: a) signal; b) selection by cells under the influence of the signal of a certain development path and c) the final formation of a given trait (differentiation). The following is fundamentally important: normally, each gene must act in a given place, at a given time, and with a given activity. Let us remember this position.

Further sexual division

In the embryo, up to the 8th week of development, the rudiments of the gonads are not yet differentiated into male and female. For the gonads to develop into males, a gene signal is needed—the activity of the SRY gene. The protein controlled by the SRY gene is perceived by the receptor target gene in the rudiment of the gonad. When the signal is perceived, the process of converting the sex-neutral gonad into the male side is launched. This takes 4–6 weeks. Special cells of the testicle then begin to produce male sex hormones (androgens). The first of these is testosterone. When the sex of the gonads is established, the third stage begins—the formation of the external genitalia (genitals). Then, during growth and puberty, secondary sexual characteristics appear. The hormonal dialogue between the gonads and the brain begins to be established. It is specific for each sex (4th level).

So, four levels at which the choice of development in the male or female direction occurs. At each stage, mutation failures and deviations from the norm are possible. If a mutation occurs in the SRY gene that reduces its activity, then the development of a potentially male XY will go in the female direction - either partially or completely.

Chromosomal mutations with deviations in sexual development

First of all, there may be failures in the strict pairwise distribution of sex chromosomes during the period when sex cells are formed. Instead of the usual sets of XX and XY, genomes that either lack or have an extra X or Y chromosome may arise, for example, sets of XXY, XYY, or X0. Such deviations occur with a fairly noticeable frequency of 1:1000–2000 births. In these cases, sexual development disorders occur—partial or complete sterility or morpho-psychological deviations.

In all cases where the Y chromosome is preserved in the genome, even if there is an extra X chromosome (XXY), development still goes in the male direction, but still with a number of deviations from the norm. Men with two Y chromosomes XYY are distinguished by their tall stature (more than 185 cm), increased emotionality, impulsiveness and decreased fertility. The frequency of their births is 1:1000.

With an accidental loss² of the Y chromosome in the genome during the first divisions of the egg, the development of the fetus occurs in the female direction. Women with the X0 genotype have undesirable deviations from the norm: short stature, underdeveloped breasts and ovaries, and they are sterile. But their intelligence is preserved within the normal range. Rare cases of identical twins of different sexes are known: a boy with the XY genome and a girl with the X0 syndrome.

Mosaics, hermaphrodites, intersexes

There are also such developmental failures when the organism contains a mixture of cells, some of which are XX, others are XY. Such XX/XY individuals are called mosaics or chimeras. What sex will a mosaic person have? It depends on the proportion of XY cells containing the Y chromosome. Here is one of the mechanisms for the emergence of such mosaics.

In 2003, in the article “Postzygotic Diploidization of Triploids as a Source of Unusual Cases of Mosaicism, Chimerism, and Twinning” and then in 2006 in the article “Mosaic/Chimeras and Twinning in the Current Reproductive Genetics Perspective” in the journal Human Reproduction (Oxford), I predicted that XX/XY sex mosaics can occur when an egg is fertilized by two sperm rather than one. Abnormal double fertilization occurs with a noticeable frequency of up to 5%. Embryos with three genomes are produced. X:X/Y—one maternal (in bold) and two paternal. They are not viable and are almost always aborted.

But to the surprise of geneticists, it turned out that embryos with three sets have a regulatory ability to return to a normal double set of chromosomes. One of the extra paternal sets is thrown out of the dividing fertilized egg. And instead of an unwanted “marriage for three” (ménage a trois), a return to the norm occurs. When an egg is fertilized by two sperm, one of which carries an X and the other a Y chromosome, then during the return to a double set, XX/XY mosaic individuals can arise. And in rare cases—unusual mosaic twins. They have the same maternal set of chromosomes (bold), but can differ in sex.

In 2007, an international team of pediatricians, cytologists, histologists, and geneticists published an article in which the twins I had predicted were discovered. The article was titled: “A Case of True Hermaphroditism Reveals an Unusual Mechanism of Twinning.” One of the twins had purely male genitalia, with most of his gonadal cells having an XY pattern. However, the other twin was a hermaphrodite. His genitals combined male and female characteristics in their structure. And at the cellular level, they contained equal numbers of XX and XY cells. Inside his gonads, they found a mixture of cells capable of producing both eggs and sperm. That year, many scientific news outlets and newspapers (including Nature and Time) wrote about this new unusual type of twins. In 2019, a second similar case was discovered in Australia.

Marble stature “Sleeping Hermaphrodite” (Greece, 500-600 BC), Louvre, Paris

Hermaphrodite people,³ combining male and female sexual characteristics in their appearance, have been known since ancient times. There are beautiful Roman statues of such people. Pushkin, familiar with such images, was very disappointed when he had to meet a real hermaphrodite in his Caucasus travel. Here is how he described it in A Journey to Arzrum:

Here we learned that there was a hermaphrodite among the prisoners. Raevsky, at my request, ordered him to be brought in. I saw a tall, rather fat man with the face of an old snub-nosed Chukhonka. We examined him in the presence of a doctor. He was a man with female breasts, rudimentary sexual glands and a small, childish organ. We asked him if he had been castrated. “God,” he answered, “castrated me.” A completely worthy answer.

Тут узнали мы, что между пленными находится гермафродит. Раевский по просьбе моей велел его привести. Я увидел высокого довольно толстого мужика с лицом старой курносой чухонки. Мы осмотрели его в присутствии лекаря. Это был мужчина с женской грудью, зачаточными половыми железами и органом маленьким и детским. Мы спросили его, не был ли он оскоплен. «Бог, отвечал он, кастрировал меня». Ответ вполне достойный.

In recent years, the term “hermaphrodite” has been replaced by the more general term “intersex” reasonably based on knowledge of the chromosomal mechanism of sex determination. The term intersex has been proposed to denote all those cases when the chromosomal sex of an individual does not correspond to the individual’s external (phenotypic) sex, or when the deviations of primary sexual characteristics from the norm are such that they are difficult to classify as male or female.

The incidence of intersex at birth is 0.018% or one case in 5,500 births. Surveys have shown that most people with such deviations do not object to the term “intersex.” There are no serious reasons to classify intersex people as a third sex,⁴ for this is only one case of many congenital or mutational deviations in the process of formation of two sexes.

Insensitivity to male sex hormones—Joan of Arc syndrome

Joanne of Arc miniature. Image source: Contamine, Philippe (2007), “Remarques critiques sur les étendards de Jeanne d'Arc”— “Critical remarks on the banners of Joan of Arc” (doi:10.11588/fr.2007.1.45032). Image via Wikimedia commons

In the second stage of sex determination, the male sex hormone, testosterone, must be perceived by a special receptor gene, called the androgen receptor (AR). It maps to the long arm of the X chromosome. The AR gene is inherited by sons from their mothers (like the hemophilia or bleeding gene). If this target gene is damaged, then failures in the development of the male sex occur. The frequency of such a mutation among babies born with the XY genotype is 1:20,000–60,000.

Currently, about 400 mutations of this gene have been found. Some of them have a weak effect. Others are intermediate, leading to intersexuality. But carriers of a mutation with zero activity of the receptor gene, despite the male XY set, develop towards the female sex. They are indistinguishable in appearance from ordinary women. However, their female gonads are not developed, there is no uterus and menstrual cycle, and they are sterile. At the same time, these women with the male XY genotype are remarkable in their physical and psychological properties. They are tall, stately, energetic, athletic and attracted to men.

Women with genotype XY, but with a mutation in androgen-insensitivity gene. Image via Wikimedia Commons

The photo shows beautiful women, but with a mutation of the testosterone target AR gene. The heroine of the French people, Joan of Arc (1412–1431), had a similar set of features, characteristic of the androgen-insensitivity mutation. According to descriptions, she was tall, strongly built and strong. She was distinguished by her love of physical military exercises and willingly wore men’s clothing. She never had menstruation. Hundreds of volumes are devoted to the determination, resourcefulness, energy, and will of Joan of Arc during her captivity and 5-month inquisition. The arguments in favor of the hypothesis that Joan of Arc had the XY genotype with the androgen-insensitivity mutation were substantiated in detail by the famous geneticist Vladimir Efroimson in the book Genetics of Genius.

The tragedy of unwanted sex reassignment

By the will of fate, one tragic experiment on changing a normal boy at birth was conducted in the 1970s and 1980s. Here we have a terrible family tragedy and an ethical-scientific drama. We are talking about the rise and fall of the American sexologist and psychologist John Money (1921–2006). He is known for having introduced the terms “gender” and “sexual orientation” into the literature on the biology and sociology of sex to denote male and female self-perception or self-identification.

John Money ran a sex change clinic at Johns Hopkins University in Baltimore. According to his “theory of neutrality,” sex differences depend on the conditions of human development and upbringing. Therefore, sex can be redefined by surgical and hormonal interventions in combination with upbringing in a “male” or “female” environment. Indeed, this is possible. But! But only in cases where intersexuality occurs as a result of mutations or developmental failures. However, Money mistakenly believed that a sexologist could change a person’s sex in one direction or another, even when there are no genetic abnormalities. Therefore, he could not resist the temptation to confirm his position in one dramatic involuntarily experiment.

In 1966, a young couple from Winnipeg named Reimer gave birth to identical twin boys named Brian and Bruce. At the age of eight months, the twins suffered from inflammation of the foreskin (phimosis), which is not uncommon for boys, causing difficulty urinating. Circumcision of the foreskin for therapeutic purposes to prevent phimosis and sexually transmitted infections was widely practiced in those years. In the United States in 1979, such an operation was performed in clinics in 64.5% of cases and in 2010 in 58.3%. For centuries, this has been a common religious procedure among Jews and Muslims. Christians celebrate the feast of the circumcision of Jesus Christ on the eighth day of his birth. (If you enter the famous St. Isaac’s Cathedral in St. Petersburg, take 10 steps to the left and turn to the wall, you will see a large panel “Circumcision of Jesus Christ”).

St. Isaac’s Cathedral, “The Circumcision.” Image via Flickr

At the hospital where the mother brought the twins for circumcision, there was an inexperienced doctor on duty. As a result of a botched operation, Bruce was left without a penis. The mother cancelled the operation for the second baby (his illness soon passed). However, the parents began to fear for Bruce’s fate. Having learned about the successful experiments of sexologist Money in changing gender, the parents turned to him for help. The doctor convinced them that if they agreed to surgery and hormonal treatment and raised Bruce as a girl, their son would grow up to be a girl.

The baby’s testicles were removed, a rudimentary vagina was created, and female hormones were regularly injected. By the age of five, it seemed that the feminization of Bruce (he was renamed Brenda) was proceeding successfully. Soon, Money included in his important articles an anonymous photo of a pair of identical twins, originally boys, one of whom he had “redefined” as a girl. It was a powerful argument in favor of his concept. One twin remained a boy, and the other twin had been remade into a girl. Here, they said, it is all about the ability of medicine to control the nature and doctor’s technical skills.

However, Money hid the fact that Bruce had been desperately resisting forced feminization since school age, he was irresistibly drawn to boys' toys and their company. At the age of 13, during another visit to Money, he said that he would commit suicide if he was taken to this doctor again. In 1980, the parents decided to tell the child who he was from birth. Bruce underwent reverse operations (removal of breasts that had grown by the time of puberty and phalloplasty), and he received a new name, David. But his life was broken, and in 2004 he committed suicide.

When the story became public, Money's clinic was closed and he was forced into retirement. In 2000, the tragic story was told in a best-selling nonfiction book by journalist John Colapinto, As Nature Made Him. The Boy Who Was Raised as a Girl.

John Colapinto, “As Nature Made Him: The Boy Who Was Raised as a Girl” (2026)

The biological norm and is there a third sex?

From the fact that many mutations lead to intersexuality, some sociologists and sexologists have concluded that there is a third sex or non-binary gender. For example, in his book The Third Sex: The Fates of Nature's Stepchildren (2000, in Russian) sex psychologist Aron Belkin argues:

The usual view that the human race consists of men and women does not stand up to strict scrutiny. There is no clear boundary between the two sexes. There is a vast neutral space. There is a biological basis for sexuality falling outside the norm.

It is interesting that the author admits that in the area of sex there is a norm—these are the two sexes. But the fact is, there is a norm and there are various deviations from it—this is, according to genetics, the most common situation throughout nature. There are no serious reasons to deny the norm. Without the concept of the norm with its variations and mutational deviations, there is no medicine.

There is quantitative polymorphism of human morphological and psychological characteristics—weight and height at birth and in adulthood, predisposition to various inclinations and abilities, temperament, and character. But variation in the scope of quantitative characteristics has its limits, going beyond which is considered abnormal (e.g., weight at birth, blood pressure, and blood sugar level).

When we go to the doctor, the first thing they measure is our blood pressure. And the doctor can conclude that your blood pressure is high—above normal. Or, on the other hand, that your blood pressure is very low—below normal. Despite all the heterogeneity of human populations, there is a species norm.

So it is with the division of people into two sexes. There are 23 pairs of chromosomes in the genome, one of which is responsible for determining sex and inheriting sex-linked traits. We have two legs and two hands with five fingers on each. In relation to such human species norms, “Russians and Chinese are brothers forever” (русский с китайцем братья навек), as the Soviet song goes.

Here is a clear example: a dominant mutation of six fingers or toes (polydactyly). The Bible mentions a Philistine with a rare full manifestation of the mutation: “a tall man, having six fingers on each hand and six toes on each foot, twenty-four in all” (2 Samuel: 21–20). Such a bilateral manifestation of the mutation is rather rare. A six-fingered deviation from the norm could be perceived negatively as the action of some evil force. This is the reaction of Grigory, Fyodor Karamazov's servant, to the birth of a six-fingered baby, and his own reaction in the famous Dostoevsky’s novel The Brothers Karamazov:

When he was born, his heart was struck with grief and horror. The fact is that this boy was born with six fingers. Seeing this, Grigory was so devastated that he not only kept silent until the very day of the baptism, but also deliberately went into the garden to keep silent. It was spring, he spent three days digging beds in the vegetable garden. On the third day, the baby had to be baptized; by this time, Grigory had already realized something. Entering the hut, where the clergy had gathered and guests had arrived, and finally Fyodor Pavlovich himself, who had appeared personally as godparent, he suddenly declared that the child “should not be baptized at all. A dragon, a confusion of nature had occurred….”

Когда же родился, то поразил его сердце скорбью и ужасом. Дело в том, что родился этот мальчик шестипалым. Увидя это, Григорий был до того убит, что не только молчал вплоть до самого дня крещения, но и нарочно уходил молчать в сад. Была весна, он все три дня копал гряды в огороде в саду. На третий день приходилось крестить младенца; Григорий к этому времени уже нечто сообразил. Войдя в избу, где собрался причт и пришли гости и, наконец, сам Федор Павлович, явившийся лично в качестве восприемника, он вдруг заявил, что ребенка «не надо бы крестить вовсе. Дракон, смешение природы произошло…».

The remarkable Russian poet Vladislav Khodasevich has a completely opposite, touching attitude towards this mutation in “Dactyls,” dedicated to his father:

My father had six fingers. Lucky ones are born that way.
Where the pears stand near the green border...,
My father had six fingers. Sometimes he was like a magpie.
Let's play in the evening, sitting on our favorite sofa.
Here, on my father's hand I carefully bend
Fingers one after another—five. And the sixth is me...
My father had six fingers. Like a little extra little finger.
He was very good at hiding it in his clenched left hand.

Был мой отец шестипалым. Такими родятся счастливцы.
Там, где груши стоят подле зеленой межи...,
Был мой отец шестипалым. Бывало, в сороку-ворону
Станем играть вечерком, сев на любимый диван.
Вот, на отцовской руке старательно я загибаю
Пальцы один за другим - пять. А шестой - это я...
Был мой отец шестипалым. Как маленький лишний мизинец
Прятать он ловко умел в левой зажатой руке.

His father’s mutation manifested itself only in an extra little finger on his left hand. Sex symbol Marilyn Monroe had six toes only on her right foot, while Stalin had six toes on his left (according to the descriptions of secret police agents). The ethnic aspect of polydactyly—an influence of the external and genetic environment—is also interesting. Among Caucasians, its frequency of occurrence among newborns is 1:1340, while among the peoples of Africa and among dark-skinned Americans it is 1:140, ten times higher! Such an ethnogenetic feature requires special study.

Deviations from the norms of male and female sex occur with much less frequency than six-fingeredness. Therefore, there is no reason to believe that there is some kind of “third sex.” Of course, we should not treat various deviations from the norm in sex development in the same intolerant way as Fyodor Karamazov and his servant Grigory treated the mutation of six-fingering. An example is Khodasevich's calm tolerance of his six-fingered father.

However, depicting various DSD anomalies—such as those included by the activists in in their ever growing alphabet after the original LGB (LGBTIQ+—lesbian, gay, bisexual, transgender, intersex, queer/questioning—the “+” sign at the end is, as the Russian saying goes, going there without knowing where—что пойди туда, не зная куда)—is also wrong. Treating the anomalies in sex development as evidence against the norm of human sex binary is an anti-scientific distortion of biology, taking us outside the bounds of medical practice and social traditions.

Social norm and fashion for transsexualism

About 30 years ago, a transsexuality clinic opened in St. Petersburg. It was the first to perform surgery for the rare, intractable condition in which a person’s male or female physical appearance does not match their sexual self-identification (transsexualism). This is a genetic and psychological deviation from the norm in the sphere of the fourth level of sex determination discussed above. What could cause this?

One can imagine a situation. A person at birth turns out to be a mosaic of XX/XY, and he has an unequal distribution of XX and XY cells in different organs of the body. For example, most of the cells in the organs of the body are “male” XY and the appearance is purely male, but in the cells of the brain, “female” XX cells dominate. Then a conflict of self-identification could arise.

Such cases of biological and psychological conflict between body and soul are very rare. According to the authoritative encyclopedia Sexualia: From Prehistory to Cyberspace (Konemann, 2001), “transsexualism is rare, affecting about one in 100,000 men and one in 130,000 women. It has a huge psychological impact on the individual, resulting in feelings of isolation within society and alienation from their true selves.”

Sexualia: From Prehistory to Cyberspace (Konemann, 2001)

The famous writer, publicist, and literary critic Alexander Melikhov spent a lot of time in this clinic. He spent hours confidentially talking with the head doctor and patients, asking about everything. The “trans” turned out to be very different—but uniformly highly intelligent and accomplished in their domains. They deserved understanding and tolerance. But at the same time, Melikhov rightly believes, we must preserve historically established norms. Because the architecture of social norms and values ​​that has developed over centuries is no less important than the natural environment. I will cite an important social conclusion of the writer, with which I fully agree:

The norm should not trample anomaly without extreme necessity. But it should not, as is now often the case all the time, curry favor with it, creating a fashion for anomaly and increasing the number of tomorrow's victims. Norms can only stand when deviation from them is not too easy, much less prestigious.

Норма без крайней необходимости не должна топтать аномалию. Но она не должна, как это теперь нередко бывает сплошь и рядом, перед ней заискивать, создавая моду на аномальность и увеличивая число завтрашних жертв. Нормы могут устоять лишь тогда, когда отступление от них не является слишком легким, а тем более престижным делом.

References

Claire Ainsworth. 2015. Sex Redefined. Nature 518 288-291

Cliford Bishop and Xenia Osthelder. 2001. Sexualia. From Prehistory to Cyberspace. Koneman, Germany

Michael Cummings. 2003. Human Heredity. Principles and Issues. Brooks/Cole (6th edit)

Aby Gardner. 2004. A Complete Break Down on the J.K. Rowling Transgeneder-comments Controversy. Glamour, Sep 3 2024

Michael D. Golubovsky. 2003. Postzygotic Diploidization of Triploids as a Source of Unusual Cases of Mosaicism, Chimerism and Twinning. Human Reproduction, 18 236-242

Michael D. Golubovsky. 2006. Mosaic/Chimeras and Twinning in the Current Reproductive Genetics Perspective. Human Reproduction 21 2458–2460

Michael Mosley. 2015. The Extraordinary Case of the Guevedoces. BBC News, 20 Sep 2015

Steven Pinker. 2002. The Blank State. The Modern Denial of Human Nature. Viking

Joanne K. Rowling. 2020. J.K. Rowling Writes About Her Reasons for Speaking out on Sex and Gender Issues, In My Own Words, June 10, 2020

Leonard Sax. 2002. How Common Is Intersex? A Response to Anne Fausto-Sterling. J. Sex Research 39 174-178

Abigail Shrier. 2021. Irreversible Damage. The Transgender Craze Seducing Our Daughters. Regnery

John Whitfield. 2007. ‘Semi-identical' Twins Discovered. Hermaphrodite Reveals Previously Unknown Type of Twinning. Nature, 26 March 2007

Disorders of Sexual Development (DSDs). Cleveland Clinic; accessed 03/30/2024

Special Issue of The Economist. 2023. Cover: What America Gets Wrong About Gender Medicine. Articles: The Dangers of Gender Medicine (p. 9) and Trans Substantiation (p. 16-18), April 2023

1. Editors’ note: On May 1st, 2025, the U.S. Department of Health and Human Services (HHS) has released a comprehensive review of the evidence and best practices for promoting the health of children and adolescents with gender dysphoria. According to the HHS press release, “The review highlights a growing body of evidence pointing to significant risks—including irreversible harms such as infertility—while finding very weak evidence of benefit. That weakness has been a consistent finding of systematic reviews of evidence around the world.”

2. Editors’ note: Such accidents can happen if the sex chromosome is missing from the male or female gamete (aneuploidy) or if a sex chromosome (Y or X) is accidentally lost from the genome during the first divisions of the egg.

3. Editors’ note: Hermaphrodites in the biological sense must have the machinery for producing both gametes (see, for example, Hermaphroditism: A Primer on the Biology, Ecology, and Evolution of Dual Sexuality by J.C. Avise; Columbia University Press. pp. 1–7.) In humans, only a handful of cases of individuals with ovaries and testicles have been reported, and there are no examples of an individual capable of producing both gametes.

4. Editors’ note: The sexes are defined by gamete type, and intersex people do not produce a new kind of gamete. For the history of the gametic definition of sex, see “Colin Wright Gives a History of the a Gametic Definition of Biological Sex” by Jerry Coyne on Why Evolution Is True.