Thread by @ForWomenScot

The most concerning thing about the nonsense spouted about bone marrow transplants & chromosomal conditions yesterday was wondering how this would land with the panel.

Rare conditions are, sadly, too often weaponised (I fear "our" side is also guilty), so a 🧵

First of all, fun fact! Male DNA may be observable in women who have borne male children. This may persist for decades.

It only exists in some cells and does not change the woman's sex.
pmc.ncbi.nlm.nih.gov/articles/PMC40…

Similarly, following a transplant on male subjects, the Y chromosome may be absent in *some* cells, this does not alter genetic sex as determined by the original sex chromosomes.

Even if Dr Upton had a full stem cell transplant, he wouldn't change sex!

Of course, this might throw up anomalies in sex testing, especially when investigating crime, but, thankfully, these issues are explicable.

And they don't change your sex (albeit it's handy to know for budding criminal masterminds).
.pmc.ncbi.nlm.nih.gov/articles/PMC35…

Then there are chromosomal conditions. Some of these involve deletions & some duplications.

Conditions which affect sex chromosomes are often lumped in with DSD conditions, but in cause & effect, they may be more aligned to conditions which affect other chromosomes (eg Downs).

Some were discussed yesterday.
Turners: 45,X0 (deletion)
Occurs when a female is born with only one sex chromosome. Women with Turners are usually shorter than average & have ovarian insufficiency (ie fertility/sterility issues).

They are still women.

Klinefelters: 47, XXY (duplication)
Affects males
May not cause any observable symptoms. If present, can incl weak muscles, hypermobility, undescended testicles, learning/speech disabilities, reduced facial hair, & gynaecomastia.
Main concerns are infertility & increased risk of other health issues.

NB, the X chromosome is present in everyone - one truthful thing that Currer said is that Y0 is not survivable. So, to that extent, it isn't a "female" chromosome and having an extra one alongside a Y and a functioning SRY gene doesn't change a boy's sex.

Jacobs: 47, XYY (duplication)
Affects males
For many there will be no observable symptoms.
Symptoms which might occur incl: taller than average, learning/speech disabilities, increased risk of ADHD/Autism.

Normal fertility.

In addition:
Triple X/Trisomy X: 47,XXX (duplication)
Affects females
Symptoms are usually rare or mild (possible developmental delays).

None of these conditions represent a new sex category - which seemed to be be the suggestion put to & agreed with by Dr Currer. Indeed, the NHS website stresses that those with these conditions are male or female. It is irresponsible & medically incompetent to suggest otherwise.

Of course, what Russell & Currer may be relying on is the lack of knowledge/information about v rare conditions which result in mixed sex characteristics or ambiguous genitalia at birth which might result in sex being "assigned" (the only time we would use this phrase!).

These conditions actually tend NOT to involve chromosomal difference and are usually present in individuals with 46,XX or 46, XY.

The term DSD is helpful, because it makes explicit that the sex development in utero has veered from the typical.

So, for example, de la Chapelle syndrome occurs when an SRY gene translocates to an X chromosome resulting in a phenotypical 46, XX male. This condition is present in about 1:20,000 male births.

Swyers syndrome results when a 46,XY foetus has streak gonads, resulting in a failure to produce anti mullerian hormone or testosterone. This results in a phenotypical female with a mullerian system but no ovaries.

Currer also referred to mosaicism. Slight caveat in that mosaicism might, for example, occur in conditions like Klinefelters where it might be possible to detect 46,XY/47,XXY mosaicism. But I don't think that is what she meant!

46XX/46XY ("true hermaphroditism") mosaicism is extremely uncommon.
Case study here:
sciencedirect.com/science/articl…

This condition & others may result in a degree of ambiguity which requires careful and sensitive handling. Sadly, this is often absent in the gender wars. Real people see their conditions discussed in black and white terms by both sides. There is room for nuance & compassion.

But, one thing we can be clear about. None of this has ANY relevance to whether a man with typical sex development can demand entrance to the women's changing room.

It's as offensive & stupid as saying that because congenital limb anomalies occur, he should be allowed to claim he has no left leg (despite all evidence to the contrary).
Is Ms Russell introducing a claim that Dr Upton has a chromosomal condition or an unknown DSD?

If so, she should note: chromosomal conditions above are sex specific & do not change a person's sex.

DSDs are rare & carry multiple health issues. If Upton had eg de la Chappell or mosaicism, he would not have developed as a strapping 6ft lad with no previous medical history.

There is no condition which means that a healthy young man with typical sex development might really be the opposite sex. It is absurd for a lawyer to propose this line and deeply disturbing for a doctor to indulge it.