Sex, medicine, and moralization

Over the last century, biologists have come to know much more about the two sexes, but they have not seen any need to revise the traditional binary “gametic” account of sex. One would expect that medical controversies would take place against a background of agreement on the sex binary. Recent cultural trends have dashed that expectation. What changed was not science, but politics: the new century’s push for transgender rights sowed doubts about the sex binary, making sex-classification in law, education, sport, and medicine highly controversial. This article explores the manifestation of these cultural trends in academia and medicine, which has been to the detriment of medical standards and the well-being of patients. An instructive case study is the area of medicine in which the hegemony of non-binarism has been most dramatic: the treatment of people—including minors—suffering from gender distress.