The biological male/female/other distinction is arguably a distinction in nature—sex is “there” before culture, social decisionmaking, and individual learning. Full-blown gender is a mix of the biological, the culturally produced and perceived, and the personally felt. Gender identity seems to be a still more complicated psychosocial stew. Some of it may come from inside, seemingly unbidden and unlearned; we just perceive something in ourselves— a masculine or feminine flavor, so to speak. But there are inputs from the outside too. A person thinks of himself as male based not only on introspection, but after looking around at the world and comparing himself to models of masculinity. What we see out there is not fixed and inevitable. Different cultures send extremely different messages. Likewise, the strength of our gender identity doesn’t depend on inner feelings alone, but also on how much and in what way gender is stressed by people around us

If your gender identity is female, though a doctor would count you as male, are you really a woman or a man? If your gender identity is mixed, though biologically you’re female, then what are you really? Perhaps “really” and "not really” don’t matter so much here. What matters is choosing to handle sex and gender in the way most conducive to well-being. Many societies are deciding now that the best choice is to let biology create the initial categorization, but allow a person’s experience of gender identity to supersede it. Gender-wise, we are as we persistently identify.

Does this make sense? A skeptic might point out that there are people who think of themselves as young, despite being old. We don’t knock decades off their birthdays, to respect their selfunderstanding. We insist on objective, chronological age. Why acquiesce and accommodate so much more, when it comes to gender? This is not an easy question to answer, but there’s this: age dysphoria is common and fairly shallow, whereas gender dysphoria is unusual and very deep. I would advise the skeptic to think first about intersex kids. If intersex kids ought to be counted as boys and girls, regardless of their “other” biology, then in principle there can be no objection to letting gender identity supersede biology.

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