When Redefining ‘Normal’ Hurts Those It Purports to Help

COMMENTARY: False compassion, even when it feels good and is sincerely motivated, can prevent those who need help from getting it.

(photo: fieldwork via Shutterstock)

I didn’t want to write this commentary. I knew it would be misrepresented, taken out of context and overall misunderstood by both sides of the debate. I felt, however, compelled to write it anyway.

Over successive weeks, logical fallacies were repeatedly placed at my feet as statements of fact. The well-meaning persons expected the illogical to put me immediately in my place and turn my logic upside down. Instead, it amplified a small voice in my head, which grew increasingly loud and, finally, impossible to ignore.

And so here we are. I speak reluctantly of the debates over gender identity, specifically about individuals who are intersex or those who identify as transgender.

Intersex people are those who have been born with both male and female reproductive organs. This designation can include genetics that don’t follow the typical XX/XY pattern. Individuals who consider themselves transgender are those who identify as a sex that doesn’t match the sex they are biologically, which can cause serious distress. This condition is also called gender dysphoria. Both people who  identify as transgendered and intersex people are often referred to as “gender nonconforming,” meaning that they do not conform to the typical male or female archetypes.

Over the last few months, I have been barraged with opinions on how every variation of human sex and gender is simply one point on a normal spectrum. These opinions are supposedly backed up with science and medicine.

It began with a link to an article quoting a high-school biology teacher on how, in other organisms, like insects, there are not X and Y chromosomes that determine sex and how, in human beings, many people do not have simple XX and XY genetics. This teacher’s Facebook post was said to have “destroyed every excuse for transphobia with cold, hard facts.” The teacher is quoted as saying that anyone who thinks “XX and XY are the only two indicators of sex” is a “narrow-minded fool.”

As someone who is a biology teacher, works in a research lab with fruit flies and also is certified to perform genetic testing in humans, this piece almost made me laugh out loud. Not because the teacher was factually incorrect — insects do indeed have different sex chromosomes than humans, and many humans do have genetic disorders like Klinefelter (two or more X chromosomes in men) and Turner (when a woman is partly or completely missing an X chromosome) syndromes — but because the overall message was that any variation in human beings is totally normal and anyone who thinks otherwise is a “narrow-minded fool.”

It is true that fruit flies do not have an XX/XY genetic pattern, but they are still sexually dimorphic with a binary system. This means there are two sexes, male and female. My job mating them to make new genetic strains would be very difficult if it were not for this fact.

Also, the examples the teacher gives of human beings without typical XX/XY genetics are called “a wide range of sexual behaviors.” Actually, the examples given are bona fide genetic disorders. This means that they are not “behaviors” and are not normal genetic states for human beings.

I quickly realized that my background working in a hospital genetics lab was showing. In the medical field, “normal” is not just a setting on the dryer. It is an actual, meaningful designation. Anyone who has ever had blood work done knows whether or not their values were “normal.” In the genetics lab, we use “normal” all the time to indicate those without a particular genetic pathology.

In medicine and science, however, what “normal” is not, nor ever should be, is a statement of a person’s worth or inherent dignity. Lots of people are abnormal, myself included, with various genetic, congenital or acquired abnormalities, both physical and psychological. This does not make them any less human or any less deserving of dignity or respect. Identifying what is abnormal, however, does make it easier for doctors and scientists to diagnose, treat and research what ails humanity.

Then I was given another article by a friend who insisted that there are not two sexes in human beings, but instead five. Again, I was told that is biologically “normal.” The article describes the typical male and female sexes and then adds three intersex categories.

I pointed out that being intersex is not entirely “normal,” since a large number of intersex individuals are infertile. Infertility is not normal. There is a billion-dollar fertility industry that would not exist if it were.

Finally, another friend of mine insisted that transgender individuals are simply people on a normal spectrum of gender. He sent me a link to a ScienceDaily.com article to prove his point. But the very first sentence states, “Disorders of gender identity affect as many as 1 in 100 people.” Gender dysphoria is in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, also called the DSM-V, as a diagnosable psychological disorder.

I was left scratching my head.

Why were so many people holding up genetic, congenital and psychological disorders of sex as examples of normality and expecting me to agree?

Then it hit me. My friends, and increasingly the rest of society, are confusing medical diagnoses with feelings of worth and validation.

When someone calls any gender-nonconforming condition abnormal, the accusations of hatred and bigotry are sure to follow — because it is seen as a comment on the dignity of the person, not as a medical designation.

It doesn’t help that I have seen Christians call intersex and transgender individuals “freaks,” “psychos” or “sickos.” I find these remarks beyond repugnant. In fact, I have great compassion for people who do not choose to be gender-nonconforming. I cannot imagine what it is like to have both male and female sex organs, or a serious sex-linked genetic disorder, or what it is like to always feel that your body is not your own. It must be a heavy cross to bear. Like all human beings, they deserve love, respect and prayers, not ridicule. So I understand the urge to label all those who struggle with gender nonconformity as “normal.” We think this validates their humanity and eases their burden. It also makes us feel better about ourselves.

I fear, however, that this approach will ultimately hurt, not help. Let me explain.

I have major depressive disorder, also in the DSM-V. Before I was successfully treated, I spent years of my adult life praying that a Mack truck would hit me and put me out of my misery. That is not normal. I am very much abnormal. It took many years and many different approaches to finally get relief.

People could tell me that my depression is simply on a spectrum of normal moods, thinking it would make me feel better about myself and validate me as a person. It may soothe me initially, but it would not touch the deeper pathology.

Imagine if, because of political correctness and a misplaced desire to help, I went into my doctor and was told that my depression was “normal” and that there is no longer treatment covered by my insurance, no longer research into the causes of depression, no more support groups and no more therapy — all because it is now considered medically “normal.”

Imagine if we did the same with anorexia, another body dysphoria — or autism, or Down syndrome.

I argue that it is actually unwise to indiscriminately label intersex and transgender conditions as “normal,” because it shuts off avenues for research and treatment, and it ultimately will impede the advance of medicine in these areas. I also fear that scientists and doctors will not be able to identify such conditions as outside the norm due to fear of social or political repercussions. That is not progress.

It is oft quoted that persons who identify as transgender have an attempted suicide rate as high as 40%. As someone who has woken up many mornings disappointed I was still alive, I believe this is a devastating figure that cannot be ignored. Gender-nonconforming individuals do not need empty platitudes. They need help if they want it — help that they will not get if we keep changing “normal” into a politically-correct, feel-good, vapid expression that illuminates nothing and serves no one. 

Rebecca Taylor is a clinical laboratory specialist in molecular biology.

She writes about bioethics on her blog, Mary Meets Dolly.