In *The Five Sexes, Revisited* (published July 2000), American sexologist Anne Fausto-Sterling (1944–) follows up on her 1993 paper *The Five Sexes*, which provocatively proposed an alternative model of gender containing a continuum of five sexes: male, female, merm, ferm, and herm. Fausto-Sterling opens the paper by describing Cheryl Chase, an intersexual woman and intersexual rights activist, who has found a voice in the medical community after much resistance. >Her talk, titled “Sexual Ambiguity: The Patient-Centered Approach,” was a measured critique of the near-universal practice of performing immediate, “corrective” surgery on thousands of infants born each year with ambiguous genitalia. Chase herself lives with the consequences of such surgery. Fausto-Sterling goes on to criticize how "In the idealized, Platonic, biological world, human beings are divided into two kinds: a perfectly dimorphic species." But this is a myth and those who do not fit neatly into these categories are intersexual. Fausto-Sterling shares statistics on rates of intersexualism: - The intersexual birth rate is 1.7%, representing all chromosomal, anatomical, and hormonal exceptions to the dimorphic ideal. - Between 1/1000 (0.1%) and 1/2000 (0.05%)  intersexuals potentially subject to surgery as infants. - Furthermore, some populations possess relevant genes at higher frequents, so intersexual birthrate is not uniform throughout the world. - The frequency of the gene for congenital adrenal hyperplasia (CAH) varies widely: In New Zealand it occurs in only forty-three children per million; among the Yupik Eskimo of southwestern Alaska, its frequency is 3,500 per million. Fausto-Sterling describes cases of intersexual individuals who had sex-assigning surgery performed as infants and were raised as that sex but later came out as another sex: David Reimer and Max Beck, assigned female, and Cheryl Chase, assigned male. Fausto-Sterling then shifts to discuss transsexual and transgender people: >Transsexuals, people who have an emotional gender at odds with their physical sex, once described themselves in terms of dimorphic absolutes--males trapped in female bodies, or vice versa. As such, they sought psychological relief through surgery. >Although many still do, some so-called transgendered people today are content to inhabit a more ambiguous zone. A male-to-female transsexual, for instance, may come out as a lesbian. Fausto-Sterling challenges the simplification of gender and sex along a male-female continuum, emphasis mine: >It might seem natural to regard intersexuals and transgendered people as living midway between the poles of male and female. But male and female, masculine and feminine, cannot be parsed as some kind of continuum. Rather, **sex and gender are best conceptualized as points in a multidimensional space.** Fausto-Sterling calls out the current medical system as being rooted in the Victorian approach, which defined “true" hermaphrodites as 1/100,000— supporting the ideas of humans as an absolutely dimorphic species. The North American Task Force on Intersexuality (NATFI) is proposing a new sex nomenclature consisting of: - Type I intersex: Development of masculine physical traits. (Virilization) - Type II intersex: Development towards masculine traits starts but gets interrupted along the way. - Type III intersex: The reproductive organs (gonads) don't develop as expected for either males or females. Fausto-Sterling closes out by criticizing her proposed five sex classification as giving priority to genitals, when what has primacy in every day life is the gender one performs. She calls for the legal protection of intersex and transgender people. Lastly, she denies the allegation that she's advocating for a pastel, androgynous world. Rather, she wants a world where all the varieties of gender may coexist. --- Overall, I thought the paper was reasonable, if a bit dated. But Fausto-Sterling seems like someone who has a good grasp of, and been a strong advocate for, intersex and transgender people. I did think this paragraph raised some interesting questions: >Treatment \[for intersex infants] should combine some basic medical and ethical principles with a practical but less drastic approach to the birth of a mixed-sex child. As a first step, surgery on infants should be performed only to save the child’s life or to substantially improve the child’s physical well-being. Physicians may assign a sex--male or female--to an intersex infant on the basis of the probability that the child’s particular condition will lead to the formation of a particular gender identity. If there are cases where performing surgery on an intersex child is necessary, it’d be crucial to ensure you’d make decisions that are most likely to align with the child’s gender identity. This has important consequences. First, that seems to be strong evidence that gender identity is innate and not particularly fluid. Second, that’d necessitate research into finding out which biological traits are most correlated with innate gender. Could this lead to a situation where we’re essentializing gender based off of biology? What effect would this have on transgender people and their “validity”?