Background

The human foetus starts its life with a genetic gender that is determined at the time of egg fertilisation; the XX is expected be a Female and the XY is expected be a male. However, the process of transforming into a particular gender is not an automatic one but instead, nature starts to develop every baby into a female, irrespective of their XX or XY chromosomes.

Four main domains of the human will eventually reflect their gender and they must be carefully guided to a final destination from which their gender identity is derived. These are:

1. Sexual Glands (Gonads): What the internal sexual organs will be, either Testes or Ovaries

2. Hormones: The types and levels of female and male hormones in their body

3. Anatomy: What the outward genitals will look like

4. Psyche: The mind and mentality, the attitude and psychology of their sexuality

In the third month of pregnancy as the foetus progresses towards being a female, the Male Chromosome (Y), if present, must start to instruct each of the domains above to redirect towards being a male. How far the changes go before the baby is born is determined by;

• the absolute timing of the instructions

• the quality of the information sent out to them

• the responsiveness of each recipient organ or body part

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If all of the domains reach the Male-end of the spectrum, the child is male, and if all the domains remain on the female-end, the child is female.

• In reality, it is unlikely with all the complexity, that all domains will perfectly reach one end of the spectrum at all times, and indeed it is more likely that one or more of the domains will rest comfortably somewhere in-between.

• Hence there could be in infinite possibility of gender states that are within the 'straight male' - 'straight female' polar spectrums, although many would have to be grouped together for the sake of simplicity.

• This could explain why a significant number of males have a ‘feminine’ side to them whilst a significant number of females possess a ‘masculine’ side. Different societies accept these to varying degrees and it helps to inflate the number of ‘conventional' male and female genders.  

• However, those outside of these societal definitions are somewhat stigmatised, hence they regularly choose to hide their uniqueness. Those who dare to bare their truth may be pushed even further into an unnecessary minority, and they are often frustrated in their struggle to define their sexuality to a traditionally-unsympathetic rest-of-the-world.

Gender identity challenges may also be as a result of other factors: 

• Gender crystallisation continues until puberty. However, the gender direction in which the infant will develop is usually evident at the time of birth for the majority of cases. Environmental factors, stereotyping and societal expectations thus influence the gender sense of individuals during this journey to puberty

• Physical anatomy is the most visual of the differentiations hence it forms the basis of gender classification at birth. Because the other three important aspects are not readily visible at birth, they are often ignored

• Medical experience suggest that there are many instances where there is confusion about the external genitalia at birth (about 1 in every 100 births). Doctors refer to this as 'Ambiguous Genitalia' and they may offer many types of management of the situation

• When there had been confusion around the external genitalia, the adults responsible for the child prescribe a gender that they feel more appropriate, and the child is given a classification that may be at complete odds to what will eventually become their chosen identity

• It is somewhat clear therefore, that the individual is the only one qualified to define their own sexuality, and others must not judge them, just as people should not be judged by the colour of their eyes.

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In this incredible complexity of nature, it should be easy to explain the various gender identities expressed by humans, and many communities had long realised these basic facts of life. The Samoan Fa'afafine are a worthy example that the rest of the world may learn from. Sadly, the human emotivity overrides objectivity more often than not, and we act based on personal prejudices that we formed from the safety of our comfortable circumstances. It is easy to forget that these safe circumstances were dealt to us by nature, for which we have no conscious part. For others dealt a different set of hands from ours, we routinely castigate. Nevertheless, humans can choose to be kind to others, and can therefore opt to be kind to all, regardless of the gender they identify as.

Impact on General Wellbeing

For the socially defined male and female, gender . Gender identity challenges are predominantly experienced by those who do not entirely fit the male/female classification. If well managed, it should have only minimal effects on their wellbeing. Poorly managed however, the effects can be significant on the mental, social and physical health of the individual.