> You can change your sex with a sex reassignment surgery.
You can surgically change genitals and pump hormones, the gametes don't change, nor chromosomes.
> you are the sex your characteristics match.
You're conflating gender and sex. Even for medical reasons alone, biological sex is an important consideration. We can show our appearance any way we like.
You aren't necessarily though which is the point. If you medication to regulate your hormones in the way a female's hormones would be regulated, your body largely acts as if it was female. The significant majority of sex related differences from a medical perspective are almost entirely hormone driven.
he exception to this rule are genetic disorders and sex-organ specific health considerations. The genetic disorders are karyotype specific but they aren't sex specific. Likewise sex-organ related issues still apply if you don't have the same chromosomal match-up.
A 46,XX male doesn't have a Y chromosome but they still have all the standard male biology. They have some additional health considerations (mainly infertility) but otherwise they are biologically male and are subject to near identical medical concerns as an average male.
Similarly a 46,XY female has a Y chromosome but they have otherwise physically normal female biology. The caveats being often needing hormone supplements and infertility.
Hell there are even a statistically significant number of people who don't have the same karyotype in all their cells. See 46,XY/45,X0 mosaicism and 46,XX/46,XY mosaicism.
My point being: In every case where the karyotype does not match the phenotypes, the driving characteristics that determines sex in the medical community is the phenotypes/physical expression.
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Now with that out of the way:
Is a man without their sexual organs still a man? Well how do you tell?
- By the chromosomes? Well obviously that doesn't work given the previously mentioned differences between karyotype and phenotype.
- By their sexual organs? Well in this case that doesn't work because they don't have any and/or had them removed.
- By the way they look? There are women who look like men and vice versa and this is quite subjective so it's not an entirely scientific way of making the separation.
- By their hormones? Well this is probably the best one since hormones regulate nearly all expression in the body and with hormone levels typical for a male, the body largely acts male and vice versa. But suppose we don't want to use this. What do we use?
Now do the same for a woman without their sexual organs.
In the end, if you remove the organs the only definitive differentiator between sexes is hormone levels. If you don't want to use hormone levels and you can't use sexual organs, there isn't any other differentiator that cleanly separates between male and female. Every other differentiator has N or 2^N caveats.
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So with respect to trans individuals undergoing sex reassignment surgery, if the differentiating sexual organs are removed/converted (a penis is biologically just an enlarged clitoris) and the hormones are completely replaced to levels equivalent of the sex they are transitioning to, what is left to differentiate them? Doubly so if they decide to transition before or during puberty.
Once again, biology is a lot fuzzier than people seem to realise. There is a lot of grey space and fluidity in sex just like with everything else in biology. The grey space is smaller in humans and mammals in general than in other species but it is well established in the scientific and medical community that sex is fuzzy and can change given the right circumstances.
Physicians don't suddenly stop needing know one's biological sex by virtue of reassignment surgery - if anything it's even more important. The mere virtue of having to constantly inject hormones to alter expression to a limited degree evidences what sex is in play. Some medication may react differently owing to sex, not just ratio of testosterone and estrogen.
You're reducing sex to something it isn't. I'm not sure to what end, because it helps no one.
> Is a man without their sexual organs still a man?
Yep.
> Well how do you tell?
A rudimentary exam could do it.
> the driving characteristics that determines sex in the medical community is the phenotypes/physical expression.
In terms of cursory glances only. In terms of actual examination, no. Absolutely not.
> The significant majority of sex related differences from a medical perspective are almost entirely hormone driven.
Entirely wrong.
> Hell there are even a statistically significant number of people who don't have the same karyotype in all their cells. See 46,XY/45,X0 mosaicism and 46,XX/46,XY mosaicism.
These aberrations exist but are incredibly uncommon. I think I'd read of a single woman thus far with XY chromosomes.
> what is left to differentiate them
What do you think is driving the need for constant hormone replacement?
Stop conflating sex and gender. Seriously, the fact that biological sex is a thing does not jeopardize gender expression and flexibility.
But what does this exam actually entail? I am looking for an actual specific class of test or set of tests.
> Entirely wrong.
Please elaborate. What mechanism drives those characteristics if not hormones?
> These aberrations exist but are incredibly uncommon. I think I'd read of a single woman thus far with XY chromosomes.
A woman having a 46,XY karyotype has odds of about 1 in 100000 which would put the likely number of women with a 46,XY karyotype at almost 40k people across the globe. It's undoubtedly rare but that is still a lot of people. While these women have lower hormone levels without treatment, they have otherwise completely healthy female bodies which results in most women never identifying that they have the condition in the first place. Unless a genetic test is performed, it just appears as if these women have hypogonadism which can occur for any number of other reasons.
The opposite (a man with a 46,XX karyotype) is even more common with about 1 in 20000 odds which sits the population at close to 200k people. But once again, because it results in relatively little to no health issues or abnormalities beyond low hormone levels and infertility (hypogonadism), it is often either left untreated or is treated without identifying the cause.
Similarly, a male with a 47,XXY karyotype has a very similar if not almost identical experience as a 46,XX male. With odds of 1-2 in 1000, that's 4 to 8 million people who don't fit that standard sex definition.
> What do you think is driving the need for constant hormone replacement?
Remember this is talking about an individual without their sex organs. If they are removed or are non-functional, the individual almost always needs hormone replacement because without those organs to produce sex-related hormones (which effectively serve as the control switch/regulatory system), significant chunks of the endocrine system stop regulating themselves properly and the individual ends up with hormone imbalances.
In the case of SRS, the hormone producing sex organs (either testes or ovaries) as well as anything else that isn't needed any more are removed and the remaining organs are reshaped to match the form of their counterpart for the other sex. At that point all sex-hormone production is artificial/manual just as it would be for an individual of that sex who had those organs removed due to health issues (or that have those organs non-functional).
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Trust me I've looked for any medical or biological evidence that human sex characteristics excluding the primary reproductive organs (testes, prostate, penis, ovaries, fallopian tubes, vagina) are driven by anything other than hormones. I can't find any evidence to support that fact. The prevailing opinion of the medical community seems to support the fact that sex is driven by hormones and organ presence rather than any other mechanism. If you can find a medical source that supports otherwise I would love to read it and this is a serious request because if by chance I'm wrong there's no benefit in me staying that way.
This is common rhetoric with people who have nothing to say.
You're arguing in bad faith. Stop wasting my time.
> sex is driven
SEX IS NOT DRIVEN. Gender expression is driven. Sex is: gametes, chromosomes.
> If you can find a medical source that supports otherwise I would love to read it and this is a serious request because if by chance I'm wrong there's no benefit in me staying that way.
I encourage you to put the bare minimum effort to educate yourself on what sex is, and you'll come to this conclusion.
You can surgically change genitals and pump hormones, the gametes don't change, nor chromosomes.
> you are the sex your characteristics match.
You're conflating gender and sex. Even for medical reasons alone, biological sex is an important consideration. We can show our appearance any way we like.