Frederik B O Nel April 2019
Discussing sexual orientation can be a lot more complex than allowed for by the time and space available today. We are confronted with acronyms like LGBTI+ LGBTIQ (lesbian, gay, bisexual, transgender, intersex and queer/questioning), which already shows us how complicated sexual orientation is – even for those who wrestle with it in their personal lives.
For most of us, it is often easier not to deal with the complexities around us at all, and this is also true of the cultures we live in that shape our thinking. Thinking about sexual orientation challenges us to move out of our comfort zones and look at the world from the perspective of those who do not fit nicely into a gender system with only two safe boxes to tick, male and female.
The World Health Organization understands gender as follows (https://www.who.int/gender-equity-rights/understanding/gender-definition/en/):
“Gender refers to the socially constructed characteristics of women and men – such as norms, roles and relationships of and between groups of women and men. It varies from society to society and can be changed. While most people are born either male or female, they are taught appropriate norms and behaviours – including how they should interact with others of the same or opposite sex within households, communities and work places.”
Gender (male/female) is thus a social construct with limitations. It does not relate to all the different ways in which people prefer to express their sexuality, irrespective of their sexual organs. Sure, for many persons their physical sexual organs and their gender do coincide, but this can’t be taken for granted.
In short: while generally speaking our chromosomes (XX or XY) determine our sex, they are not the only factors that affect our gender. Further on we will also see that determining our sex is more complicated than looking only at our chromosomes.
1.1 Sexual orientation on a spectrum
The two-sex system, male and female, is deeply embedded in most cultures and religions in the world and is also the social construct that society works with (ID books, for instance). But it is not adequate in terms of encompassing the full spectrum of human sexuality (Anne Fausto-Sterling). It narrows life’s possibilities down and it creates systems that perpetuate gender inequality. Although cultures around the world have simplified sex categories (and gender categories) into male and female, this does not give expression to the complexities around sexual orientation that we find in our societies. In short: Sexual orientation exists on a spectrum, and requires nonbinary thinking.
If we think about the colour spectrum, certain colours like red, blue, orange and yellow can clearly by determined by their different wavelengths. But there are also many other colours (orange; light green and dark green; pink and purple) that are more difficult to determine precisely.
As an example – and one that is close to our heart – consider Mokgadi Caster Semenya, with her very high testosterone levels. The IAAF struggles to deal with her and others like her, mainly because they think only in terms of male and female growth hormones. 
1.2 Physical and psychological sex
Our sex, as indicated by our physical anatomy, might differ from the sexual identity we have in our inner being (what our brain tells us). There may not be synchronicity between one’s genitals and gender identity.
To an important degree sexual identity seems to emerge from prenatal (before birth) hormonal actions in the brain of the foetus.
As humans we belong to the biological class called mammals, which diverged from the other lines of animals about 200 million years ago. Mammals possess mammary glands. The inclination to suckle, and knowing how to suckle, is mediated by the brain. Ellis & Solms (2018: 92) describes it as follows:
“Mammalian sexuality is greatly complicated by the fact that the sexual body and the sexual brain develop along different trajectories in utero. The male brain is created when testosterone is converted to oestrogen and the male body is created when testosterone is converted to dihydro-testosterone (DHT).”
According to Michael S Pepper (2015:746):
“Gender identity is therefore programmed into our brains while we are still in the womb”.
This identity develops as the child develops and gets a better idea of what it means to be male or female. Until the age of two or three the concepts of male and female are quite flexible. It seems that before the age of five children don’t seem to think that gender has any permanence at all. A little boy might say that he wants to grow up to be a mommy. This is not an indication of the boy’s gender identity
1.3 Development of physical and psychologicAL sex:
Our sex (male/ female) is not only a product of our chromosomes – XX (female) and XY (male). There is a growing interest in epigenetics, which is a study of changes in organisms caused by the modification of gene expressions rather than changes in genetic code like DNA.
Rather, our sex is a product of our total genetic makeup and the functions of genes during the development of the foetus. The sexual differentiation of the internal reproductive organs and external genitalia occurs at 9-15 weeks of gestation. In this period a Y chromosome (SRY gene) is required for male development.
“All fetal bodies are initially female and if there is no interference, the female body will continue to develop. …Thus, the gender of the brain and the body does not necessarily harmonize, and multiple permutations (and degrees of permutations) are possible. In short, we mammals are all bisexual to a degree.” (Ellis & Solms 2018: 92)
In 1989 the SRY gene (Sex-determining Region Y), which helps to send the embryo down the masculine path, was discovered on the tip of the short arm of the Y chromosome. But it is not as if this SRY gene directly determines the sex of an embryo. It only acts as a blueprint, or facilitator, for a protein which allows other proteins to attach themselves to other genes.
The bottom line of all these processes is that there is now an understanding that genes on the X chromosomes can turn males with XY chromosomes into females, and genes on the Y chromosomes that can turn females with XX chromosomes into males. By allowing some genes to gain entrance and by blocking the entrance of others, a male can be turned into a female and a female into a male.
About 1 in 20 000 men have no Y chromosome but, instead, have two X chromosomes, and the same frequency of females have XY chromosomes instead of XX chromosomes.
It is estimated that there are about 30 genes that play an important role in the development of humans (and in mice). Three of the 30 genes are located on the X chromosome, 1 on the Y chromosome and the others on other chromosomes.
The complexity of what makes us male or female should not be underestimated. A percentage of women with an XY chromosome and the SRY gene have a condition known as Complete Androgen Insensitivity Syndrome (CAIS). This group lacks androgen receptors and has no form of “masculinisation”, much less than the average woman with XX chromosomes.
“The sexual differentiation of the brain starts in the second half of pregnancy. Testosterone masculinises the foetal brain, whereas absence of the dominant effect of this hormone results in a female brain.” (Pepper 2015:746)
Research has already indicated that certain processes can go wrong and suppress the masculinisation process. In the window period between the development of the sexual organs and the development of sexual identity (in the brain) certain influences, such as endocrine disrupters, can affect the alignment between the sexual organs and sexual identity.
“The increasing importance of the intrauterine environment on gene expression (DNA) is being recognised, and is embodied in the rapidly emerging field of epigenetics” (Pepper 2015:746).
2 Transgender, transsexual and intersex
Transgender/ transsexual and intersex people should not be confused with each other.
In general, transgender/ transsexual people are born with specific male and female anatomies, but emotionally they feel that they are in the “wrong body”. A person feels as if they are of the other gender than the one indicated by their body. Their internal experience is that of the other gender. This is also called gender dysphoria.
People with the intersex condition have an anatomy that is not considered typically male or female.
“There are at least three dozen well-documented variations in humans that result in something called “intersex”, or non-standard male and female anatomy.” (Alice Dreger on the website of the Intersex Society of North America www.isna.org).
There was a time when doctors operated on babies with an intersex condition to make them either male or female, which was sometimes called “normalisation or corrective” surgery. The assumption behind this operation was that being intersex is not desirable and this was determined by binary thinking. With the knowledge we have today we know that there can be great variety along a wide spectrum of sexual diversity. We also know today that you can’t determine gender identity just by doing surgery on a baby in his/ her infancy.
In many of these cases the dominant anatomical features and the person’s own view of their sexual identity coincide. There is a small percentage of persons with an intersex condition who are also transgender/ transsexual. In these cases, people with an intersex condition may have an internal desire to have a different sexual identity, and may opt for an operation.
Intersex is an inborn condition, but the intersex condition does not always show up at birth. In some cases it is only discovered around puberty, or due to infertility. At this stage the criteria are additionally not very clear and it is also acknowledged that “intersex” is a social category indicating biological variation, rather than a clearly defined category. Nature often presents us with sexual anatomy that appears on a wide spectrum, with great variety. The basic anatomy of breasts, penises, clitorises, scrotums, labia and gonads can come in many different shapes and sizes. Then there are the situations where the internal and external sexual organs differ. Some people are indeed born with both an apparent penis and apparent vagina. Others are born with both ovarian and testicular tissue. Some are female in appearance when they are born, but have XY chromosomes, or are male in appearance, but have XX chromosomes. There are also people who want to define an intersex condition as not being something physical, but as something determined only by the person concerned, and only if that person thinks of their sexual identity as complex.
According to reports, Caster Semenya has internal testes because of a chromosomal abnormality. Her condition is described in the media as hyperandrogenism, which is when the female body has high levels of male sex hormones such as testosterone.
Given the different definitions, it is not possible to say exactly how common the intersex condition is. The numbers are at least one out of about 1500-2000 births. But if only small variations in sexual anatomy are concerned, the percentage can be a lot higher. Research done by Anne Fausto-Sterling of medical records between 1955 and 1998 indicates that in one out of 100 births there is a difference between the so-called standard male and female sexual organs.
3 Where do same-sex relationships fit in?
Same-sex relationships also bring us to the pitfalls of binary thinking, as if there are only two groups, namely “same sex” (homosexual) relationships and “opposite sex” (heterosexual) relationships. In general, homosexual or gay relationships refer to the attraction between people with the same sexual orientation, physically and emotionally.
It is interesting that homosexuality occurs in about 8% of individuals, irrespective of culture and ethnicity. Egyptian letters on papyrus from 4500 BC describe love between people of the same sex. Several studies have come to the conclusion that homosexuality is familial. So far not a single major gene has been found to support this, but there are indications that a region in the X chromosome (Xq28) and chromosome 8 may be associated with the development of male homosexuality. The possibility is that homosexuality is epigenetically determined.
A small percentage, about 14%, of gay men can be called effeminate. The percentage of gay women who can be described as “butch” is also relatively small. The majority of gay men and women can’t be physically distinguished from heterosexual people.
Many people ask: what causes homosexuality? The more appropriate questions may be what causes all the different forms of sexuality, including homosexuality and heterosexuality. Hopefully it has already become clear that the answer is complicated.
Orientation is not only about choice. What is, however, a choice is when a person who accepts his/her gender can also accept the gender identity that they feel most comfortable with.
“Die klassifikasie van mense in slegs twee geslagte is aanduibaar uitgedien” (Jurie van den Heever)
Many biological features, including sexuality, are a lot more complex than they appear on the surface. What makes us who we are is the result of interactions between our genetics; embryological development; hormones; physical and emotional circumstances, etcetera.
It is important to open ourselves to the knowledge available and accept that numerous genders exist on a continuum between male and female, and we should accept this as part of life. We have to rethink words like “normal” and “abnormal” when we refer to sexual identity. Total inclusivity is what is necessary to truly build a non-discriminatory society in which people are not judged by the colour of their skin, education, age, wealth, social status or the sexual identity they are comfortable with. In the church it is important for us not to dehumanise people any longer, or to encourage prejudiced views through our actions, talk or decisions.
We have the benefit today of knowledge that previous generations did not have. That body of knowledge is constantly growing. The challenge we face lies in our ability to grow in our own understanding of life as more knowledge becomes available. What this requires from us is an ability to revisit our interpretation of Scripture and culture and traditions. We should not let a lack of knowledge and fear of the unknown drive our prejudices, making us stagnant in our reading of Scripture.
The Dad wo Gave Birth: ”Being pregnant doesn’t change met being a trans man” The Guardian 20 April 2019
Parents’ grief and joy as son prefers to be a girl. Sunday Times 28 April 2019, page 9
Frederik B O Nel April 2019
Word Count: 2452
 “Die manier waarop die IAAF tans seksualiteit benader, is gebaseer op die aanname dat daar slegs twee geslagte te wete heteroseksuele mans en heteroseksuele vrouens bestaan, dat hulle positief uitgeken kan word op grond van die hoeveelheid testosteroon wat die geslagskliere (testes en ovaria) afskei en dat die hoeveelheid testosteroon in die sisteem ‘n direkte invloed op sportprestasie het” (Dr Jurie van den Heever).
[Translation: “The way in which the IAAF currently approaches sexuality is based on the belief that there are only two genders, that is heterosexual men and heterosexual women, which can be positively identified based on how much testosterone is secreted by the sexual glands (testes and ovaria), and that the quantity of testosterone in the system has a direct effect on sporting permormance.”]
 Pepper, Michael S 2015. Gender and Sexual diversity -changing paradigms in an ever changing world. Editorial South African Medical Journal (SAMJ) September 2015, Vol 105, No 9, 746-747
 Ellis, George & Solms, Mark 2018. Beyond Evolutionary Psychology. How and Why Neuropsychological Modules Arise.
 This is according to a study done by prof Aubrey Theron at the University of Pretoria. See Jean du Plessis 1999. Oor gay wees, p 9.
 [Translation: “The classification of people into only two genders is clearly obsolete”