It is commonly acknowledged that while biological sex is genetically determined, gender is a social construct. A human being cannotโand should notโbe reduced to their biology, or indeed their genitals, because psychologically we are as much a product of the way that other people treat us as we are of our genetic inheritance. Homo sapiens are social creatures: our ability to cooperate is what gave us the evolutionary upper hand over our stronger Neanderthal cousins. You would notice the physiological differences.
But as to interpreting those differences, where would you start? Precisely because gender is a social construct, the evolution of its boundaries and meanings will tell us something fundamental about our society.
Transsexuality is a talking point like never before, and a glance at the figures sheds some light on why. In November , the Guardian reported that 70 per cent of referrals were female. This was a surprising statistic because only 10 years previously the overall ratio had been more like 75 per cent males seeking to be female, and indeed it is still the gender traffic in that direction that dominates the increasingly noisy, divisive and panic-inflected debate.
Right now a legal case is being brought by Susan Evans, a former psychiatric nurse at the Tavistock and Portman NHS Foundation Trust, alongside a parent of an autistic female child wishing to transition to be male, arguing that children are not legally capable of consenting to a gender transition. November last year saw the launch of the Detransition Advocacy Network, a UK group numbering several hundred members.
And in January, the NHS announced an independent review into puberty suppressants and cross-sex hormone treatments, to be chaired by Hilary Cass, formerly president of the Royal College of Paediatrics and Child Health. These vitriolic debates keep bubbling upโespecially online. But there is a much bigger scandal brewing than any Twitterstorm. While there have been a great many thoughtful doctors at the Tavistock, the picture is sometimes disturbing.
