In fact, under the defense of
marriage laws now in place, and the Constitutional amendment being proposed by the
president -- the one which limits marriage to “a man and a woman” -- she [a
woman with Turner’s syndrome] could not have been legally wed in the first
place. In other words, although advocates of the proposed amendment believe
they possess the final moral word on the subject, they have yet to consider the
medical technicalities of such a radical legislative proposal, and the endless
complications that could ensue.
Women have two X chromosomes
(XX) in each cell nucleus. Men have one X and one Y chromosome (XY). But this
young lady had Turner’s syndrome (XO), giving her only one X chromosome instead
of two. That is why her aorta was predisposed to dissect at such a young age.
Like all people with Turner’s syndrome, she was infertile, and although she
certainly looked female, technically, she was not.
Turner’s syndrome is not the
only intermediate form on the continuum between man and woman. Indeed,
Harrison’s *Principles of Internal Medicine, 15th Edition* requires 12 large
pages of tiny print for its chapter entitled “Disorders of Sexual
Differentiation,” which lists endless intermediate-gender conditions, including
odd combinations of X and Y chromosomes, the presence of more than one type of
cell line in the same person, and ambiguous genitalia resulting from a host of
causes.
Then there are those people who
feel they are not the gender they appear to be. Others are instinctively
attracted to their own sex rather than the other. Some men who are attracted to
women look effeminate. Some women who are attracted to men look masculine. The
variations and gradations between man and woman are practically unlimited.
Therefore, if marriage is
limited to “a man and a woman”, how do we then decide who qualifies? Shall we
do genital examination? Shall we grade size, shape and function? (If your
sex-change surgeon is gifted, you can marry; if not, forget it.) Shall we
examine chromosomes? Hormones? Rely on lie-detector
tests? Letters of recommendation?
Do we want to spell out every
conceivable sexual variation in the amendment itself, or spend years in court
sorting it out?
According to the latest studies
homosexuality is almost certainly at least in part genetic. What if
homosexuality is ultimately shown to be all or mostly genetic -- the result of
genes rather than choice? How can a condition some people (and members of many
other animal species) are born with be a sin? After all, there are laws
protecting disabled people, so why should one particular genetic condition be
grounds for legal discrimination, when another isn’t?
Although most people don’t
realize it, we all know, or like, and perhaps love someone who lingers
somewhere in the realm between entirely male and entirely female. Some of us
even *are* those individuals. Like the rest of us, they are good and bad, smart
and dull, kind and cruel. None of them chose the genes that shaped their minds
and bodies, nor the families that shaped their early
years. Many suffer greatly as a result of the genetic hand dealt to them and
should not be saddled with the additional burden of being further ostracized by
a random legislative decree.
Both “defense of marriage” laws
now in place and a proposed Constitutional Amendment limit marriage to a man
and a woman. Ignored is a seemingly
silly, but important question: who
decides (and how do they decide) who is a man and who is a woman?
Of course, it seems
simple. We generally assume that
everyone is one or the other, and it is easy to tell who is what. However, millions of people can testify, from
painful personal experience, that life is not that simple.
Women have two X chromosomes (XX)
in each cell nucleus. Men have one X and
one Y chromosome (XY). But there are also people with XO, XXY, XXX, XYY, XXYY,
XXXY, and XXXXY chromosomes. What gender
are they?
Some people have had a mutation
early in fetal development, and have “chromosomal mosaic”--more than one cell
line in their bodies, such as X/XX, X/XXX, X/XY, and XY/XXY. Some people have XY chromosomes like a male,
but the Y is not expressed, so they appear female. Some people have XX
chromosomes, but appear male because part of the Y chromosome translocated to the X chromosome. What gender are they?
Some people have ambiguous
genitalia, the result of partial virilization of a
fetus due to too much or too little androgen due to various problems during
fetal development. Doctors and parents
of these people generally choose a gender for them, and genital surgery may be
done early in life. But, as adults,
these people are often very unhappy with the choices made on their behalf.
All these people presumably were not the
intended target of the laws and amendment. Their situation is genetic--beyond
their control and not of their own choosing.
Do we allow them to marry? Which
gender? Should we let them marry anyone so long as one agrees to be designated a man and the other a
woman? If not, how do we decide who qualifies? Shall we do genital examination? Shall we grade size, shape, function? If your
sex-change surgeon is gifted, you can marry, if not, forget it. Shall we examine chromosomes? Hormones? Lie detector tests? Letters of recommendation?
Do we want to spell out every
conceivable sexual variation in the amendment itself, or spend years in court
sorting it out?
Some people do not even know they
are in one of the above categories. So,
depending on how we define man and woman and what tests are required, there is
a very small chance that even if you think you know what gender you are,
you could be wrong! And
banned from marriage.
But the terrain between man and
woman is more complex still. About one
person per 50,000 persistently feels he or she is not the gender he or she
appears to be. About 3-5% of people and
some members of many other animal species are attracted to their own gender
rather than the other. Some men attracted to women look effeminate. Some women
attracted to men look masculine. Few of us would do well in a competition to
choose the most female or the most male individual our species ever
produced. The variations and gradations
between man and woman are almost unlimited.
But here again, evidence is strong that these variations are largely
determined by genetic, intrauterine, and early childhood, influences.
Think about it: Why would someone choose to be a
target for ridicule and discrimination?
But then, when there are laws
protecting disabled people, why should one particular genetic disposition
instead be grounds for legal discrimination?
These conditions are not
rare. Although you may not realize it,
you probably know and like, perhaps love, and possibly are someone
somewhere in the realm between entirely male and entirely female. Like the rest of us, they are good and bad,
smart and dull, kind and cruel. Like us,
none of them chose the genes that shaped their mind and body, or the family
that shaped their early years. Many of
them have suffered greatly as a result of the genetic hand they were dealt.
Perhaps if we are going to choose
a simple phrase appropriate for marriage in our real world, it should not be “a
man and a woman”, but rather, “live and let live”.
ãCopyrigth 2004 by John Uhl, reprinted here with
permission. All rights reserved otherwise by the author, subject to normal fair
use.
Read or purchase his book : Uhl, John
A., M.D. Life on a Crowded Planet:
How You Can Help Create a Sustainable Future. At Lifeonacrowdedplanet.com, 2002,
2005.
_________________________________________________________
Dr. John Uhl is an Emergency Physician in
He may be
reached at http://www.lifeonacrowdedplanet.com/
I wrote
this to Dr. Uhl:
I think
that the psychological reaction of many "conservative" (??) people to
the idea of gay marriage is based on their impression that somehow gay marriage
(and gay "upward affiliation) insults their idea of kinship, biological
family, and meaning attributed to the whole "tender trap" thing--many
people of previous generations or even in many cultures today believe that you
live for 'family first' before you define your own purposes.
He wrote
back:
You may be
right. But people need to understand that where one sits on the continuum
between the most male and the most female person in the world (however they
wish to define that) is largely determined for one by one's chromosomes,
intrauterine hormonal environment, and early childhood influences, none of
which we can control. Furthermore, near the middle of the continuum, it
is extremely difficult, (or arbitrary or capricious) to assign a gender at
all. In that context, defense of marriage laws either penalize many who
were unintended (like the young married lady with Turner's syndrome who died)
or excuses them "because their situation is genetic", and specifically discriminates against
homosexuals, whose situation is also
at least in part genetic. A law so simple simply cannot apply to a situation so
complex.
In fact, my
personal argument for gay marriage would be more "live and let live".
but whether Paul was a johnny-come-lately
apostle bigot, or a mouthpiece of God is debatable without scientific
foundation. On the other hand, the arguments in the essays
(