Sex Difference in Christian Theology

Male, Female, and Intersex in the Image of God

Megan K. DeFranza

• Publisher: Eerdmans
• Year: 2015
• ISBN:
  9781467442954
• Topic: Teología y religión
• Subtopic: Teología cristiana

How different are men and women? When does it matter to us -- or to God? Are male and female the only two options? In Sex Difference in Christian Theology Megan DeFranza explores such questions in light of the Bible, theology, and science.Many Christians, entrenched in culture wars over sexual ethics, are either ignorant of the existence of intersex persons or avoid the inherent challenge they bring to the assumption that everybody is born after the pattern of either Adam or Eve. DeFranza argues, from a conservative theological standpoint, that all people are made in the image of God -- male, female, and intersex -- and that we must listen to and learn from the voices of the intersexed among us.

Part I

More Than Two:
Challenges to the Binary Sex Model

Chapter 1

Intersex: Medical and Sociological Challenges
to the Two-­Sex Model

I begin this chapter by exploring contemporary medical descriptions of intersex. I will trace the history of intersex from the time before medical technology — when intersex existed at the margins of society — to the virtual erasure of intersex by the medical establishment. We will then hear objections to the medicalization of intersex, paying particular attention to the voices of intersex persons themselves. Lastly, we will hear from those who lay the blame for the abuse of the intersexed at the feet of the two-­sex model and ask whether Christianity is to blame for the binary.

What Is Intersex?

Typical Sex Development

“Intersex” is a term used to describe persons who do not fit into standard medical descriptions of male or female. It is important at the outset to establish what is considered normal or typical by the medical community so that variations from the norm can be understood. In this book “normal” is employed according to the classical sense of “norm,” “standard,” or “type.” Thus, “abnormal” does not indicate “freakishness” but atypical development.

Brown University biologist Anne Fausto-­Sterling describes what is considered “typical” or “normal” by medical practitioners today:

We define the typical male as someone with an XY chromosomal composition, and testes located within the scrotal sac. The testes produce sperm which, via the vas deferens, may be transported to the urethra and ejaculated outside the body. Penis length at birth ranges from 2.5 to 4.5 cm; an idealized penis has a completely enclosed urethra which opens at the tip of the glans. During fetal development, the testes produce the Müllerian inhibiting factor, testosterone, and dihydrotestosterone, which juvenile testicular activity ensures a masculinizing puberty. The typical female has two X chromosomes, functional ovaries which ensure a feminizing puberty, oviducts connecting to a uterus, cervix and vaginal canal, inner and outer vaginal lips, and a clitoris, which at birth ranges in size from 0.20 to 0.85 cm.1

Intersex as an Umbrella Concept

The term “intersex” is not a diagnosis but an umbrella concept used to cover a wide range of variations in sex development. Many intersex conditions result in ambiguous genitalia, either at birth or throughout the life course of the individual; however, not all intersex conditions are indicated by genital inspection. The Consortium on the Management of Disorders of Sex Development lists the following as intersex-­related conditions: “congenital development of ambiguous genitalia, congenital disjunction of internal and external sex anatomy, incomplete development of sex anatomy, sex chromosome anomalies and disorders of gonadal development.”2 Each of these will be described in what follows.

“Intersex is not a discrete or natural category.”3 While most people believe they know what makes a person male or female — chromosomes, gonads, genitals, secondary sex characteristics — it is not clear what type and how many variations to these norms it takes to classify a person as intersex. Should a person with external female genitalia who has XY chromosomes and testes be considered male, female, or intersex? How large does a clitoris need to be before it is considered a micropenis? These decisions are made by humans, typically by doctors. What doctors believe about physical norms and variations, the usefulness of the intersex designation, and gender value all factor into decisions about sex assignment. These beliefs also contribute to debates over which conditions “count” for estimates of frequency rates.

It will be helpful for the reader to become familiar with certain intersex conditions before entering the debate over which variations “count.” An exhaustive list of intersex conditions is not possible or necessary here. Instead, I will describe some of the more common variations and their implications for what follows.

Types of Intersex Conditions

Androgen Insensitivity Syndrome (AIS) AIS is an intersex condition that occurs roughly once in every 13,000 births.4 Androgen insensitivity comes in two types: complete (CAIS) and partial (PAIS). Persons with AIS are born with XY chromosomes (i.e., as in a typical male). XY chromosomes set into motion the normal development of testes, which begin to secrete higher levels of testosterone in XY individuals as early as the eighth week of gestation.5 But people with AIS are unable to process male hormones (androgens). Because their cells lack the proper receptors, persons with CAIS develop female external genitals. They retain undescended or partially descended testes. They usually have a short vagina and no cervix, though some lack a vagina altogether. Because genitals appear normal (for females) at birth, CAIS is not usually discovered until puberty when menstruation does not occur.

Given this description of androgen insensitivity, the reader may not find it surprising that these “girls” do not menstruate. What is surprising, however, is that these individuals do develop secondary sex characteristics typical of pubescent females. The Intersex Society of North America (ISNA) explains how feminizing puberty is possible. “At puberty, the testes are stimulated by the pituitary gland, and produce testosterone. Because testosterone is chemically very similar to estrogen, some of the testosterone converts back to estrogen (‘aromatizes’) in the bloodstream. This estrogen produces breast growth, though it may be late.”6 Thus, higher levels of testosterone during puberty result not in the typical masculinization of those with androgen receptivity (i.e., growth of underarm and pubic hair, Adam’s apple, voice descent, increased muscle mass); rather, higher levels of testosterone have the opposite effect — increased feminization of XY individuals. CAIS has been called “classical testicular feminization” in recognition of this process. It has also been labeled “male pseudohermaphroditism.”

The designation “male pseudohermaphroditism” gained parlance in the Victorian era. During the nineteenth century, doctors looked to gonads to determine sex assignment when genitals were “unclear” or, in CAIS individuals, when normal sex development — such as menstruation — d...

Table of contents

• Acknowledgments
• Preface
• Introduction: Male, Female, and Intersex in the Image of God
• Part I: More Than Two: Challenges to the Binary Sex Model
• Part II: Critique and Construction: Theological Anthropology in the Postmodern Period
• Bibliography
• Index of Subjects and Names