Here are 7 reasons why this sex spectrum graphic by Scientific American is wrong.
🧵
1. There are no units on this spectrum to quantify it.
2. The sheer number of overlapping arrows is evidence that sex cannot be plotted on a spectrum.
3. There is no objective method to decide where individual DSDs are placed on the spectrum.
4. Congenital Adrenal Hyperplasia is placed farther to the male end than XX male syndrome, implying that XX males (with fully developed penis and testes) are more female than an XX CAH female with ovaries, uterus, vagina, and a slightly masculinized clitoris.
5. Androgen Insensitivity Syndrome is placed in the center, implying that people with this condition are literally in between male and female.
6. Mixed Gonadal Dysgenesis is placed in the center, also implying people with this condition are literally in between male and female.
7. In reality, DSDs are singular, discrete conditions, each unique, and they cannot be placed on a continuum between male and female.
A major error in this graphic is the conflation of sex determination mechanisms with sex.
Yes, the mechanisms involved in developing males and females are complex.
That does not mean the end result is complex or that male and female themselves are challenged.
The conflation of how sex is determined vs how sex is defined shows up all the time in discussion on this topic.
Before the 6th or 7th week, fetuses are phenotypically undifferentiated, with both sets of ducts that will later develop into the male or female systems.
One set stays and develops, while the other will disintegrate.
Developing as female happens when the bipotential gonad differentiates into ovaries, thanks to the absence of SRY and the activation of transcription factors FOXL2, WNT4, and RSPO1.
The Müllerian duct develops further and the vestigial Wolffian duct disintegrates.
(Left) Male development
(Right) Female development
2. Biological sex is not defined by chromosomes or sex characteristics.
It's defined with respect to gamete type in all sexually reproducing organisms.
We can observe the sex of a person by the structures that support the production and release of either gamete type.
3. Some people can produce both sperm and eggs.
Wrong. There are zero documented cases in humans of a person fulfilling both reproductive roles. The two reproductive ducts (Wolffian and Mullerian) are mutually exclusive. They cannot fully develop together.
It’s scientifically specious because on the surface, it may seem like the word applies to rare DSDs, but in reality, the word is a scientific term for a sexual system where the male and female reproductive roles are found in the same individual organism.
Hermaphrodites have both the full male system and the full female system, allowing them to fulfill both roles.
Humans with DSDs do not have this. Instead, you have males and females with congenital disorders, where their reproductive systems are malformed or underdeveloped.
No human has both the male and female reproductive anatomy to produce and support both gamete types.
What you see in some rare DSDs is that a male might have some vestigial female structures (partial uterus, for example), but no full female system. Likewise, for females.
In the cases of a male with a partial uterus for example (Persistent Mullerian Duct Syndrome), a gene mutation causes lack of the hormone AMH, which then allows the vestigial Müllerian ducts to not degenerate fully, which can leave a partial, non-functioning uterus in a male.
We know they’re male because they develop down the small gamete reproductive pathway: they develop a penis, testes, and a full Wolffian structure.