There are two statistical peaks in the distribution of infant outcomes that roughly accord with the states described in middle school, but there is also everything in between and on other sides. Entire textbooks are written on the wide variety of ways sex hormones can manifest during fetal development and throughout life. The exact number of infants born in the domain known as “intersex”—who, for any number of reasons, do not clearly fit into one of the two sexes based on genitalia or chromosomes or both—is difficult to know because for many years, such people were “normalized” at birth by default.
The idea of changing infant genitalia surgically at birth has become an area of intense ethical debate in recent decades, and it stands to only become more relevant, as infants born with ambiguous genitalia are becoming more common—or, at least, increasingly documented—which some evidence suggests is due to exposure to environmental pollutants that affect fetal development.
Human-rights organizations have campaigned against genital surgeries for intersex infants, and in 2017 three former U.S. surgeons general published a report that argued, “While there is little evidence that cosmetic infant genitoplasty is necessary to reduce psychological damage, evidence does show that the surgery itself can cause severe and irreversible physical harm and emotional distress.” A policy from HHS that puts infant genitalia at the center of a person’s identity runs directly counter to this medical advice.
Read: Many pediatricians don’t know how to handle gender-dysphoric kids.
While the relevance of this discussion is not going away, some public intellectuals such as the author Michael Pollan have suggested that bringing this policy memo to the forefront of national conversations is savvy politics just before the midterm elections. “Don’t take the bait!” he tweeted this morning. The implication is that the intention of the administration is to stir a culture war that, rife with misinformation and fearmongering, will rally Trump’s base around the idea that liberals want to destroy the concept of men and women and, so, God and family, desecrating the very idea of America.
Looked at another way, the policy could just as well raise objections among people concerned about “big government” and defending individual rights. Scientific implausibility aside, this is a federal agency proposing widespread genetic testing and keeping records of citizens’ genitals. This is a proposal by the government imposing an expectation that everyone look and act in one of two ways, and that everything in between is somehow not right—an aberration, an anomaly, a flaw, a problem, a disease—rather than a marvel of the natural world, a way that humans survive and thrive not despite but because of our complexity as a species.
Even those who believe a simplistic dichotomy does and should explain the world—regardless of the millions of people who exist as evidence to the contrary—should see reason to question the Americanness of government imposing such a rigid prescription on everyone.