Life Without Gender?

Click here to check out photos of transgender Americans

This spring, an Australian named Norrie May-Welby made headlines around the world as the world's first legally genderless person when the New South Wales Registry of Births, Deaths and Marriages sent the Sydney resident a certificate containing neither M for male or F for female.

For a few days, it appeared that the 48-year-old activist and performer had won a long legal battle to be declared "sex not specified"—the only category that felt right to this immigrant from Scotland. May-Welby's journey of gender identity can only be characterized as a long and winding road. Registered male at birth, May-Welby began taking female hormones at 23 and had sex-change surgery to become a woman, but now doesn't take any hormones and identifies as genderless. The prized piece of paper May-Welby sought is called a Recognised Details Certificate, and it's given to immigrants to Australia who want to record a sex change.

But the victory was short-lived. After so much publicity, it was perhaps inevitable that the New South Wales government would backtrack—which it did a few days later, saying the registry didn't have the legal authority to issue a certificate with anything but male or female. May-Welby (who now goes by the single name Norrie) has filed an appeal with the Australian Human Rights Commission.

It's easy to dismiss this case as just one more bizarre news story from Down Under, but May-Welby's case could also represent the future of gender identity. Although no one is keeping statistics, researchers who study gender say a small but growing number of people (including some who have had sex-change operations) consider themselves "gender neutral" or "gender variant." Their stories vary widely. Some find that even after surgery, they simply can't ignore previous years of experience living as another gender. Others may feel that their gender identity is fluid. Still others are experimenting with where they feel most comfortable on what they see as a continuum of gender. "For some, it's a form of protest because gender is such a strong organizing principle in our society," says Walter Bockting, an associate professor and clinical psychologist at the University of Minnesota Medical School who has been studying transgender health since 1986. "Their identities expand our thinking about gender."

In fact, some researchers compare the evolution in thinking about gender to the struggle that began a generation ago for gay and lesbian rights. Dr. Jack Drescher is a member of an American Psychiatric Association (APA) committee that is currently reviewing changes to the fifth edition of the Diagnostic and Statistical Manual, which is used around the world by clinicians, researchers, regulatory agencies, and insurance companies to classify mental disorders. DSM-5, as it's called, won't be published until 2013, but Drescher's committee is reconsidering the diagnosis of gender-identity disorder, which encompasses people who do not identify with the gender assigned to them by biology.

The current debate echoes the controversy over the APA's 1973 decision to modify the second edition of the DSM by declaring that homosexuality could be considered a mental disorder only if it was disturbing to the patient. Drescher's committee thought about dropping the diagnosis of gender-identity disorder altogether, but realized that if it did, people who wanted treatment (sex-change surgery, hormones, or talk therapy) wouldn't be able to get the diagnosis they need for insurance coverage. Instead, Drescher says, the committee is proposing changing the name to "gender incongruence" and making the diagnosis contingent on the person feeling significant distress over their gender confusion. "We didn't want to pathologize all expressions of gender variance just because they were not common or made someone uncomfortable," Drescher says.

But that seemingly simple change of language could help usher in a new era, in which a person's gender could be expressed or experienced as male, female, "in between," or "otherwise." "People who work in this area have very flexible notions of gender," Drescher says. "We don't want to force people to fit into a doctor's categories," even though, he concedes, most cultures "tend to think in binaries."

Bockting predicts that such binary thinking will eventually disappear. Many scientists, he says, see gender as a continuum and acknowledge that some people naturally fall in the middle. Gender, Bockting says, "develops between the biological and the environmental. You can't always detect gender by physical evidence. You have to ask the person how they identify themselves; in that sense, it's psychological."

And gender isn't synonymous with sex, he says, although the distinction may elude the layman. Sex, Bockting says, is assigned at birth based on the appearance of external genitalia. But, he says, "to determine a person's gender identity, you have to wait until they grow up and can describe how they identify their gender." And being genderless or gender-neutral isn't the same thing as being asexual. "If you are asexual," he says, "you are not interested in having sex with other people," while gender-neutral people may be attracted to men, women, both sexes, or other people who are gender-neutral.

And while May-Welby's story may seem out there, Bockting says it's not uncommon for people undergoing sex changes to find that surgery doesn't resolve all their gender-identity issues. "With time," he says, "they accept a certain amount of ambiguity … We have this idea that people take hormones and undergo surgery and become the other gender. But in reality it's more complicated."

Even before the advent of sex-change surgery, there were always people who felt they didn't fit into either gender. In India, a group of people called hijra have existed for centuries. They are typically biological males who dress as women but consider themselves to have neither gender, Bockting says. There is also a long tradition of eunuch culture. Even today, other countries are more comfortable with the idea of gender variance. Drescher says that France has removed transsexuality from its list of psychiatric disorders and put it in the category of rare diseases. The British government has also declared that transsexuality is "not a mental illness," but people who want a sex-change can get treatment under the National Health Service.

How all the debate will play out in this country is still unclear, but college students may be among those leading the charge for change. Many campuses—including Harvard, Penn and Michigan—now offer gender neutral housing and more unisex bathrooms to accommodate students who don't fall neatly into male or female categories. The Common Application, which is used by most college applicants, just announced that it is considering adding voluntary questions that would give students a broader array of choices to describe their gender identity and allow them to state their sexual orientation, after gay advocates urged the change. How long before such changes begin to show up in other parts of society is unclear. But Drescher says he is certain of one thing after a lifetime of working with gender: "There is no way that six billion people can be categorized into two groups." Now if we could only figure out the pronoun problem.