[CuriousCosmic]

> Not really, just biological reality. People can't actually change their sex (only their gender expression), so 'male lesbian' is a statement of self-contradiction.

This is where you are mistaken. You can change your sex with a sex reassignment surgery. While gender is identity based, sex is defined via the phenotypes (physical characteristics). If you make the alterations necessary to match the physical characteristics of a certain sex, you become that sex for all intents and purposes.

You may have different chromosomes than what is standard for that sex but by no means does that mean you aren't that sex. There are plenty of women who are born female, grow up female, present female, and identify as female who find out down the line that they have a Y chromosome. The same goes the other way with men who discover they have 2 X chromosomes.

I mean hell while not the exact same circumstance, something like 1 in 2500 males are discovered to have a karyotype of 47,XXY with the actual predicted prevalence (due to low rates of identification) being closer to 1 in 1000 or 1 in 500. The previously mentioned circumstances are of course less common than this (closer to 1 in 20000 or 1 in 80000) but in the context of the global population that is still a significant number.

My point being that sex is a lot fuzzier than most people realise and the only viable way of defining it is via phenotypes, which can of course be changed with medications and surgery. Defining by karyotype causes the entire definition system to break down because while chromosomes are of course important in determining your sex, they ultimately don't define it and there are so many other biological factors that play into you ending up whatever sex you are. And this isn't a "feel good" inclusive answer, this is just the scientific/medical reality because karyotypic/genetic sex just isn't a useful definition compared to phentotypic/physical sex.

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TLDR: It's not biological reality. Biological reality is that your sex is defined by your physical characteristics and while your chromosomes play a part in deciding which characteristics you develop, they don't provide a clean or consistent determination. If you sufficiently adapt your physical characteristics, for all intents and purposes both medically and otherwise, you are the sex your characteristics match.

[throwaway675309]

"You become that sex for all intents and purposes"... i'd argue that you are perceived as that sex for all intents and purposes.

Having SRS you still lack the ability to carry a baby in terms of impregnation for MTF, which most biological women are automatically capable of unless they have some extraneous condition/syndrome/etc.

In addition I often wonder how the cocktail of female hormones including estrogen (versus mostly testosterone in biological males) play a part in neurological development and influence as a prepubescent.

[CuriousCosmic]

> unless they have some extraneous condition/syndrome/etc.

How is this any different than SRS? You can call it a condition or whatever but it results in the exact same state.

> In addition I often wonder how the cocktail of female hormones including estrogen (versus mostly testosterone in biological males) play a part in neurological development and influence as a prepubescent.

It does play a significant part however it plays an even bigger part in the actual operation of the brain itself. So people who transition find themselves much closer neurologically to the sex with which they are hormonally equivalent to than their original sex.

Now take in the consideration of trans individuals who attempt to transition during or before puberty. Is there a difference now? The lasting effects (of which none actually disqualify you from the sex you transition to) are lesser so it should be even harder to differentiate now.

The point being, a MTF individual with SRS and HRT is of the female sex and vice versa for FTM individuals. They may be their sex with additional caveats or medical considerations but they are that sex. If we want to be scientific about it there is fundamentally no difference between a transitioned individual and any number of individuals of that sex who have some disorder or circumstance that gives them the identical physical characteristics.

[lanfeust6]

> You can change your sex with a sex reassignment surgery.

You can surgically change genitals and pump hormones, the gametes don't change, nor chromosomes.

> you are the sex your characteristics match.

You're conflating gender and sex. Even for medical reasons alone, biological sex is an important consideration. We can show our appearance any way we like.

[CuriousCosmic]

You aren't necessarily though which is the point. If you medication to regulate your hormones in the way a female's hormones would be regulated, your body largely acts as if it was female. The significant majority of sex related differences from a medical perspective are almost entirely hormone driven.

he exception to this rule are genetic disorders and sex-organ specific health considerations. The genetic disorders are karyotype specific but they aren't sex specific. Likewise sex-organ related issues still apply if you don't have the same chromosomal match-up.

A 46,XX male doesn't have a Y chromosome but they still have all the standard male biology. They have some additional health considerations (mainly infertility) but otherwise they are biologically male and are subject to near identical medical concerns as an average male.

Similarly a 46,XY female has a Y chromosome but they have otherwise physically normal female biology. The caveats being often needing hormone supplements and infertility.

Hell there are even a statistically significant number of people who don't have the same karyotype in all their cells. See 46,XY/45,X0 mosaicism and 46,XX/46,XY mosaicism.

My point being: In every case where the karyotype does not match the phenotypes, the driving characteristics that determines sex in the medical community is the phenotypes/physical expression.

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Now with that out of the way:

Is a man without their sexual organs still a man? Well how do you tell?

- By the chromosomes? Well obviously that doesn't work given the previously mentioned differences between karyotype and phenotype.

- By their sexual organs? Well in this case that doesn't work because they don't have any and/or had them removed.

- By the way they look? There are women who look like men and vice versa and this is quite subjective so it's not an entirely scientific way of making the separation.

- By their hormones? Well this is probably the best one since hormones regulate nearly all expression in the body and with hormone levels typical for a male, the body largely acts male and vice versa. But suppose we don't want to use this. What do we use?

Now do the same for a woman without their sexual organs.

In the end, if you remove the organs the only definitive differentiator between sexes is hormone levels. If you don't want to use hormone levels and you can't use sexual organs, there isn't any other differentiator that cleanly separates between male and female. Every other differentiator has N or 2^N caveats.

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So with respect to trans individuals undergoing sex reassignment surgery, if the differentiating sexual organs are removed/converted (a penis is biologically just an enlarged clitoris) and the hormones are completely replaced to levels equivalent of the sex they are transitioning to, what is left to differentiate them? Doubly so if they decide to transition before or during puberty.

Once again, biology is a lot fuzzier than people seem to realise. There is a lot of grey space and fluidity in sex just like with everything else in biology. The grey space is smaller in humans and mammals in general than in other species but it is well established in the scientific and medical community that sex is fuzzy and can change given the right circumstances.

[lanfeust6]

This is abysmally wrong.

Physicians don't suddenly stop needing know one's biological sex by virtue of reassignment surgery - if anything it's even more important. The mere virtue of having to constantly inject hormones to alter expression to a limited degree evidences what sex is in play. Some medication may react differently owing to sex, not just ratio of testosterone and estrogen.

You're reducing sex to something it isn't. I'm not sure to what end, because it helps no one.

> Is a man without their sexual organs still a man?

Yep.

> Well how do you tell?

A rudimentary exam could do it.

> the driving characteristics that determines sex in the medical community is the phenotypes/physical expression.

In terms of cursory glances only. In terms of actual examination, no. Absolutely not.

> The significant majority of sex related differences from a medical perspective are almost entirely hormone driven.

Entirely wrong.

> Hell there are even a statistically significant number of people who don't have the same karyotype in all their cells. See 46,XY/45,X0 mosaicism and 46,XX/46,XY mosaicism.

These aberrations exist but are incredibly uncommon. I think I'd read of a single woman thus far with XY chromosomes.

> what is left to differentiate them

What do you think is driving the need for constant hormone replacement?

Stop conflating sex and gender. Seriously, the fact that biological sex is a thing does not jeopardize gender expression and flexibility.

[CuriousCosmic]

> A rudimentary exam could do it.

But what does this exam actually entail? I am looking for an actual specific class of test or set of tests.

> Entirely wrong.

Please elaborate. What mechanism drives those characteristics if not hormones?

> These aberrations exist but are incredibly uncommon. I think I'd read of a single woman thus far with XY chromosomes.

A woman having a 46,XY karyotype has odds of about 1 in 100000 which would put the likely number of women with a 46,XY karyotype at almost 40k people across the globe. It's undoubtedly rare but that is still a lot of people. While these women have lower hormone levels without treatment, they have otherwise completely healthy female bodies which results in most women never identifying that they have the condition in the first place. Unless a genetic test is performed, it just appears as if these women have hypogonadism which can occur for any number of other reasons.

The opposite (a man with a 46,XX karyotype) is even more common with about 1 in 20000 odds which sits the population at close to 200k people. But once again, because it results in relatively little to no health issues or abnormalities beyond low hormone levels and infertility (hypogonadism), it is often either left untreated or is treated without identifying the cause.

Similarly, a male with a 47,XXY karyotype has a very similar if not almost identical experience as a 46,XX male. With odds of 1-2 in 1000, that's 4 to 8 million people who don't fit that standard sex definition.

> What do you think is driving the need for constant hormone replacement?

Remember this is talking about an individual without their sex organs. If they are removed or are non-functional, the individual almost always needs hormone replacement because without those organs to produce sex-related hormones (which effectively serve as the control switch/regulatory system), significant chunks of the endocrine system stop regulating themselves properly and the individual ends up with hormone imbalances.

In the case of SRS, the hormone producing sex organs (either testes or ovaries) as well as anything else that isn't needed any more are removed and the remaining organs are reshaped to match the form of their counterpart for the other sex. At that point all sex-hormone production is artificial/manual just as it would be for an individual of that sex who had those organs removed due to health issues (or that have those organs non-functional).

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Trust me I've looked for any medical or biological evidence that human sex characteristics excluding the primary reproductive organs (testes, prostate, penis, ovaries, fallopian tubes, vagina) are driven by anything other than hormones. I can't find any evidence to support that fact. The prevailing opinion of the medical community seems to support the fact that sex is driven by hormones and organ presence rather than any other mechanism. If you can find a medical source that supports otherwise I would love to read it and this is a serious request because if by chance I'm wrong there's no benefit in me staying that way.

[lanfeust6]

> Trust me

This is common rhetoric with people who have nothing to say.

You're arguing in bad faith. Stop wasting my time.

> sex is driven

SEX IS NOT DRIVEN. Gender expression is driven. Sex is: gametes, chromosomes.

> If you can find a medical source that supports otherwise I would love to read it and this is a serious request because if by chance I'm wrong there's no benefit in me staying that way.

I encourage you to put the bare minimum effort to educate yourself on what sex is, and you'll come to this conclusion.