Along the primrose path of childhood children learn something fundamental. At a most basic level they incorporate that Dads and Moms are designations with very different implications. Up front, it is accepted that Dads are men and Moms are women; that Dads and Moms do different things at home and elsewhere. Simultaneously children learn that boys play rough and girls play nice and they usually like to do different things. Then kids learn that boys grow up to be Dads and girls grow up to be Moms.

Interestingly, this is the standard pattern children incorporate even when they know these rules have exceptions. They almost always know families where its Mom who is the outside-the-home money earner and Dad who stays home, and where boys are nice and quiet while girls are hellions. The basic stereotypes, however, seem somehow branded on their psyche in the every day course of growing up. The input is from family, friends, media, religion and even politics. And most of middle-class society colludes, in turn, to transmit social and cultural normative expectations with essentially the same rules. With a certain degree of schooling and maturity children learn that the sexes to which we are referring are male and female. It further comes to be understood that male and female are terms used to incorporate a whole catalog of physical and behavioral differences.

As a designation of male or female, sex, with the child's increasing sophistication and learning becomes understood as a descriptive set of terms and meanings that encompass the most common biologically accepted attributes --physical differences-- of males and females; the terms imply certain gonads, internal and external genitalia, sex chromosomes and genes, sex hormones and so on. The student learns that a male is an individual that has penis and scrotum, testes, and accessory glands (prostate, seminal vesicles, bulbo-urethral glands); a female is a person with ovaries, a uterus, ovarian tubes, a vagina and clitoris. An intersexed individual is understood to have a mixture of these attributes. And these basic understandings hold for the term sex as they did for the terms Dad and Mom; wide variations and departures from the basic generalities can be known without nullifying the common wisdom.

The term gender first became familiar to most of us in language class when, for those of us with English as a common tongue, we learned that nouns such as table and chair could be either masculine, feminine or neuter. Of what use are such distinctions still remains lost on linguists. Why languages as different as French and German need these artifices while English and most Australoasian languages, for instance, can get along quite well without them is subject for thought. Many languages do not even have sex identifying pronouns. But understanding of gender or sex-typical behaviors (the older expression for gender specific traits) serves quite practical use. And no known language is without gender identifying nouns.

General usage of the term gender began in the late 1960s and 1970s, increasingly appearing in the professional literature of the social sciences. The term came to serve a useful purpose in distinguishing those aspects of life that were more easily attributed or understood to be of social rather than biological origin (see e.g., Unger & Crawford, 1992).

Males and females, as biological entities, were accepted as essentially similar cross-culturally but men and women, by virtue of the multitude of different roles they played in diversified societies, were not so easily catalogued. These anthropological life-style differences came to be accepted as social and cultural constructs. Indeed, the terms sex and gender came, for most investigators, to signify and reify these different areas of consideration; sex would refer to biological traits while gender would refer to social/cultural ones. At least this was generally so among those investigators more sensitive to biological studies. Among those more aligned with sociological and anthropological thinking these differences did not appear so clear cut. For this latter group the terms sex and gender were often used interchangeably.1

In 1978 Kessler and McKenna (Kessler & McKenna, 1978), in their now classic work, challenged how the relationship between sex and gender might be considered. They even challenged if the two concepts were different or interchangeable. In "just-so" story fashion the fact that males and female are sexually --biologically-- different is what leads to the gender differences seen and manifest by men and women in their behavior patterns and roles. It is certainly understood that way by the majority of the lay public as well as many scientists. But, questioned Kessler and McKenna, if this were so clear cut, why do transsexuals in their pursuit of the life-style of the "opposite" sex work so hard in trying to prove to the outside world what they feel they are on the inside? In doing so, Kessler and McKenna point out that transsexuals seek to reconstruct their sex to coincide with their psychological gender. Doesn't this imply that it is their gender which is primary and their sex secondary? Analysis of the thinking of transsexuals is simultaneously used as a foil to bolster the Kessler & McKenna argument that the study of gender benefits from insightful and detailed analysis of the thinking of individuals as they make significant gender related decisions. This is part of the ethnomethodological approach they espouse.

In demonstrating their point, Kessler and McKenna take the rhetorically clever position of accepting that transsexuals are what they say they are (they interviewed fifteen transsexual individuals). A male transsexual has the body of an anatomic male but the conviction (mind-set) of actually being a woman and a female transsexual has the body of an anatomical female but the conviction (mind-set) of actually being a man (Benjamin, 1966). Then, to rectify the dichotomy, the transsexual is seen as not wanting to change gender but change genitals and body. It thus appears that sex is variable and gender invariant; a reversal from the way the two had come to be considered. But the transsexual, according to our authors, then sets about learning or perfecting how to be the man or woman of mind's desire. In so doing, the transsexual proves to Kessler and McKenna that gender is a construction that doesn't necessarily follow from anatomy.2

For its time this was a novel way of approaching the subject and it remains so today. To me the value of the theory and the book is in its heuristic strength. It forces not only investigators of sex and gender to consider a broader range of possibilities in the study of human development or the forces involved in behavioral execution, but so too scientists of other stripes as well. And the book challenges all researchers to be more critical of how they approach their analysis. These are legitimate questions and considerations that were appropriate for their time. They remain worthy of contemporary deliberation.

The thrust of the Kessler and McKenna thesis, that gender and sex were actually both variable and not immutable became popular particularly among sociologists, women's studies scholars and some psychologists. It also enhanced the widely held nurturist belief that all or at least most of the gender differences were culturally induced and widely malleable. For most biologically oriented scholars and others that studied behavior, however, the questions or thesis posed had little resonance. This can be gauged by recognizing that, for the years 1978 to 1995 only two references to the Kessler and McKenna book, both in psychological journals, could be found in the Science Citation Index (Deaux, 1985; Deaux & Major, 1987). In the Social Science Citation Index, however, references and reviews to the work abound. They were in wide ranging publications associated with sociology, psychology, homosexuality, philosophy and other disciplines (e.g., Bixler, 1979; Morris, 1979; Vaughter, 1979; Wylie, 1986). For these groups involved with interpreting and reinterpreting society's structures, social scientists identified as feminists in particular, the topic of gender has become particularly relevant and new ways of approaching the topic are seen as valuable.3

This presentation, however, also posed problems for them. Most sociologists, many psychologists and others at the time had thought that gender was a function of upbringing and social forces, e.g., Bandura & Walters, 1963 and Mischel, 1966, or cultural conditions, e.g., D'Andrade, 1966. Others had thought an individual's gender developed from and along with cognitive maturity e.g., Kohlberg, 1966, and some even attributed it to a sort of imprinting phenomenon (Baill & Money, 1980) or socio-cultural expectations leading to self-fulfilling prophecy (Snyder, Tanke, & Berscheid, 1977) and of course there was the classical Freudian model of gender development (Freud, 1925; 1953). Since transsexuals are brought up in accordance with their genitals, chromosomes and other aspects of their biology, and socially rewarded and encouraged appropriately to match their social milieu and culture and presumably with "Freudian parents" like everyone else, the questions naturally follow of: "Where does this atypical gender desire come from? Why have transsexuals not succumbed to the same influences of social and cultural attribution that have others?" They obviously haven't. Kessler and McKenna didn't follow up that apparent question and challenge to their thesis. Instead, they turned their attention to another fascinating question : "Why was the gender stronger than the sex?"4

If the book were written today, Kessler and McKenna probably would tackle the transgender phenomenon to make their argument even stronger. Unlike the majority of transsexuals that "feel they were born that way" many of those identifying themselves as transgendered or gender-bending or gender-blending persons are attracted to the concept of a constructed gender and see themselves and their lives as evidence of it (see e.g., Bullough & Bullough, 1993; Denny, 1998; Devor, 1989). Eschewing any strict male-female dichotomy, transgendered persons instead reach for a wide range of admixtures of male and female restructured anatomies and manifest masculine and feminine life-styles.5 For those most unique in their display, to reflect the socially bizarre nature of their expression, the term "gender fucking" is used by outspoken transgenderists themselves and others as well. The term is not seen as pejorative but apt. Whether this freedom of expression comes from outside attribution and induction or outside release (tolerance) of an internal self-perceived identity is open to debate. Most non-transsexual transgenderists would probably say it is the latter. But there are no data or research to support this and would again beg the question for Kessler and McKenna: "Why do these individuals have such feelings while the majority don't." Again they would have to deal with the question of origin for these socially disdained behaviors and feelings.

Surely, there are many other ways that sex and gender can be considered. And it remains to determine what values accrue to understanding and science with each of the different perspectives. Recently Kulick (1997), for instance, reports that in Salvador, Brazil "Gender . . . is grounded not so much in sex . . . as it is grounded in sexuality." Men are those individuals that insert and women are those that are inserted into. The Brazilian travestis is a male prostitute who, in many ways, appears similar to the American transsexual. He assumes female behaviors and dress but, unlike his American counterpart, does not necessarily self-identify as a women nor desire to be one. For instance, he would not want to lose his penis while he does want to gain breasts and rounded hips. He aspires to be his idea of a "perfect homosexual" man. And recalling the discussion of language above, the travestis will change the gender forms of language used to describe his customers or himself depending upon the sexual actions performed.6

I see sex and gender interacting in yet another way. One is born with a biological psychosexual predisposition that is fixed by genetic-endocrine heritage and with it a propensity for certain sexual and gender patterns to be expressed (Diamond, 1968; 1976, 1995). Which patterns will be expressed, however, I see dependent upon the societal and cultural mores and the degrees of tolerance they allow (Diamond, 1979). With this comes another concept. Every individual lives with two simultaneous visions of self; an inner private sexual identity and an outer social and public gender identity.7 One's sexual identity is prenatally organized as a function of the genetic-endocrine forces and emerges (is activated) with development. One's gender identity, recognition of how he or she is viewed in society, develops with post-natal experiences. It comes from general observation of society's norms and expectations and from comparing self with peers (Diamond, 1997; 1999; Harris, 1998) and asking: "Who am I like and who am I not like?" "With which group, males/boys or females/girls am I similar or different?" The transsexual or travestis or homosexual or indeed everyone, male, female, or intersex, reconciles these two images and answer those questions. For most individuals these identities are in concert so reconciliation occurs more or less easily with the ups and downs that come with puberty, a challenge to keep up with peers through adolescence, and then an acceptance of life's vagaries in adulthood. For some, however, attaining this reconciliation remains a constant struggle. Transsexuals, who I believe are intersexed, have the body and genitals of one sex and the brain of the other (see e.g., Diamond, Binstock, & Kohl, 1996; Goy, Bercovitch, & McBrair, 1988) making reconciliation of their sexual and gender identities problematic. They solve their problems of reconciling, their disparate sexual identity and gender identity, by saying, in essence, "Don't change my mind; change my body."

As scientists we are forced to ask "Why does the mind take precedence?" I think it is because the brain template for sexual identity is forged by more significant forces and events (Diamond, 1965; 1979). These early engrams are more potent than the later ones activated by rearing. This, for instance, was the force telling John/Joan and other males who had been sex-reassigned they were not girls although they had no penis and were reared, rewarded and reinforced as girls (Diamond & Sigmundson, 1997).

John/Joan was an individual widely written about in dozens of psychology, sociology and women's study texts. According to the original reports (Money, 1975; Money & Ehrhardt, 1972) John was a male twin who, due to a surgical accident wherein his penis was burned off, was subsequently sex reassigned as a female. The thinking was it would be better for an individual without a penis to be raised as a girl with a constructed vagina than to be a boy without a phallus. John was thus castrated, had a vulva prepared and given estrogens and reared as a girl, Joan. Contrary to the early reports of success, however, Joan never did accept the transition (Colapinto, 1997; Diamond, 1982; Diamond & Sigmundson, 1997).8

John, and other males sex-reassigned as females, "knew" they were not girls despite their castration, absence of male genitalia, female rearing, and the administration of estrogens. The gender that was attributed to them was not in accord with their sexual identity. In trying to understand the discrepancies they saw in their lives, they attended to and recognized it was the characteristics of males in general and females in general, and the realities they saw of both sexes around them in every day life, that led them to recognize, in their cases, the male in themselves (Diamond, 1997; 1999). This works similarly, on the other side of the coin, for those individuals mal-assigned as males who discover the female in themselves (Diamond, 1997a; 1997b).9

It is in this regard that I see Kessler and McKenna's view of the sex and gender interaction and mine as coming together. The transsexual or the intersexed individual and everyone else has to integrate the gender attributions of society and its constructs with feelings of self. I think all do so and match these feelings with some brain template of "similar or different" which is more crucial than penis or clitoris, more central to their sense of being than is a scrotum or vagina, and more important than their familial rearing. The individual comes to identify as a member of one of those groups (boys or girls, men or women) with whom he or she feels more "similar" and less "different. " Fortunately, for most of us, these factors of brain template and the sex-typical biases and inclinations it imparts, are usually in concert with anatomy and cultural construction of gender. When they are not, the mind will usually rule even when in conflict with societal expectations. It is my hope, and I think Kessler's and McKenna's as well, that society will come to accept and incorporate these discrepancies.

As this is being written Kessler has just published a new book (Kessler, 1998). It will probably prove as stimulating to the thinking of social scientists as the book we are discussing here. I trust, however, this time it will be read and appreciated and discussed by others as well.



Baill, C., & Money, J. (1980). Physiological Aspects of Female sexual development. In M. Kirkpatrick (Ed.), Women's Sexual Development (pp. 45-59). New York: Plenum Press.

Bandura, A., & Walters, R. (1963). Social Learning and Personality Development. New York: Holt, Rinehart & Winston.

Benjamin, H. (1966). The Transsexual Phenomenon. New York: The Julian Press, Inc.

Bullough, V. L., & Bullough, B. (1993). Cross Dressing, Sex, and Gender. Philadelphia: University of Pennsylvania Press.

Case, M. A. (1995). Disaggregating Gender from Sex and Sexual Orientation: The effeminate man in the Law and Feminist Jurisprudence. 105 Yale L. J., 1, 9.

Colapinto, J. (1997). The true story of John/Joan. Rolling Stone, December (11), 54-58, 60, 62, 64, 66, 68, 70, 72-73, 92, 94-97.

D'Andrade, R. (1966). Sex differences and cultural institutions. In E. E. Maccoby (Ed.), The Development of Sex Differences. Standord, CA: Stanford University Press.

Deaux, K. (1985). Sex and Gender. Annual Review of Psychology, 36, 49-81.

Deaux, K., & Major, B. (1987). Putting Gender into context: An interactive model of gender-related behavior. Psychological Review, 94(3), 369-389.

Denny, D. (Ed.). (1998). Current Concepts in Transgender Identity. New York: Garland Publishing.

Devor, H. (1989). Gender blending: Confronting the limits of duality. Bloomington, Indiana: Indiana University Press.

Diamond, M. (1965). A critical evaluation of the ontogeny of human sexual behavior. Quarterly Review of Biology, 40, 147 - 175.

Diamond, M. (1968). Genetic-endocrine interection and human psychosexuality. In M. Diamond (Ed.), Perspectives in Reproduction and Sexual Behavior (pp. 417 - 443). Bloomington: Indiana University Press.

Diamond, M. (1976). Human sexual development: biological foundation for social development. In F. A. Beach (Ed.), Human Sexuality in Four Perspectives (pp. 22 - 61): The John Hopkins Press.

Diamond, M. (1979). Sexual Identity and Sex Roles. In V. Bullough (Ed.), The Frontiers of Sex Research (pp. 33-56). Buffalo, N.Y.: Prometheus.

Diamond, M. (1982). Sexual Identity, Monozygotic Twins Reared in Discordant Sex Roles and a BBC Follow-Up. Archives of Sexual Behavior, 11(2), 181-185.

Diamond, M. (1995). Biological Aspects of Sexual Orientation and Identity. In L. Diamant & R. McAnulty (Eds.), The Psychology of Sexual Orientation, Behavior and Identity: A Handbook (pp. 45-80). Westport, Connecticut: Greenwood Press.

Diamond, M. (1997). Sexual Identity and Sexual Orientation in Children With Traumatized or Ambiguous Genitalia. Journal of Sex Research, 34(2), 199-222.

Diamond, M. (1999, In Press). Management of Ambiguous Genitalia. Journal of Urology.

Diamond, M., Binstock, T., & Kohl, J. V. (1996). From fertilization to adult sexual behavior: Nonhormonal influences on sexual behavior. Hormones and Behavior, 30(December), 333-353.

Diamond, M., & Sigmundson, H. K. (1997). Sex Reassignment at Birth: Long Term Review and Clinical Implications. Archives of Pediatrics and Adolescent Medicine, 151(March), 298-304.

Ellis, L. (1996). A discipline in peril: Sociology's future hinges on curing its biophobia. American Sociologist, 27, 21-41.

Freud, S. (1925). Some psychical consequences of the anatomical distinction between the sexes. In J. Strachey (Ed.), Collected Papers by Sigmund Freud (Vol. 5, ). London: The Hogarth Press.

Freud, S. (1953 (originally published, 1905)). Three essays on the theory of sexuality. Standard edition 7. London: Hogarth Press.

Goy, R. W., Bercovitch, F. B., & McBrair, M. C. (1988). Behavioral masculinization is independent of genital masculinization in prenatally androgenized female rhesus macaques. Hormones and Behavior, 22, 552-571.

Harris, J. R. (1998). The Nurture Assumption. New York: The Free Press.

J.E.B. (1994). J.E.B. v. Alabama, 114 S. Ct. 1419.

Kessler, S., & McKenna, W. (1978). Gender: An Ethnomethodological Approach. New York: John Wiley & Sons.

Kessler, S. J. (1998). Lessons from the Intersexed. New Brunswick, NJ: Rutgers University Press.

Kitzinger, C. C. (1999, In Press). Gender, Sex and Knowledge: The construction of the John/Joan Case in Social Science Textbooks. Gender & Society.

Kohlberg, L. (1966). A cognitive developmental analysis of children's sex-role concepts and attitudes. In E. E. Maccoby (Ed.), The Development of sex differences. (pp. 82-173). Stanford, Ca.: Stanford University Press.

Kulick, D. (1997). The gender of Brazilian Transgendered Prostitutes. American Anthropologist, 99(3), 574-585.

Mischel, W. (1966). A Social-learning view of sex differences in behavior. In E. E. Maccoby (Ed.), The Development of Sex Differences (pp. 56-81). Stanford, Ca.: Stanford University Press.

Money, J. (1975). Ablatio penis: Normal male infant sex-reassignment as a girl. Archives of Sexual Behavior, 4(1), 65-71.

Money, J., & Ehrhardt, A. A. (1972). Rearing of a Sex-reassigned Normal Male Infant After Traumatic Loss of the Penis., Man and Woman/Boy and Girl (pp. 46-51). Baltimore: John Hopkins University Press.

Snyder, M., Tanke, E., & Berscheid, E. (1977). Social perception and interpersonal behavior: On the self-fulfilling nature of social stereotypes. Journal of Personality and Social Psychology, 35, 656-666.

Unger, R., & Crawford, M. (1992). Women & Gender: A feminist psychology. New York: McGraw-Hill.

Wylie, H. L. (1986). Gender: An Ethcnomethodological Approach; Gender and Work: A comparative Analysis of Industrial Societies (Book Review). Social Forces, 65(2), 575-577.

Zhou, J.-N., Hofman, M. A., Gooren, L. J. G., & Swaab, D. F. (1995). A sex difference in the human brain and its relation to transsexuality. Nature, 378(2 November 1995), 68-70.

Zucker, K. J., & Bradley, S. J. (1995). Gender identity disorder and psychosexual problems in children and adolescents. New York: The Guilford Press.



1 Supreme Court Justice Antony Scalia, in an attempt to clarify usage of the terms has written (J.E.B., 1994) "The word gender has acquired the new and useful connotation of cultural or attitudinal characteristics (as opposed to physical characteristics) distinctive to the sexes. That is to say, gender is to sex as feminine is to female and masculine is to male," According to Supreme Court Justice Ruth Bader Ginsburg, however, the words are interchangeable. She relates that she used them in composing her legal briefs about sex/gender related matters so the word sex would not appear on every page. Supposedly her secretary encouraged this saying: "Don't you know those nine men [on the Supreme Court, when ] they hear that word and their first association is not the way you want them to be thinking." (Case, 1995)

2 This is certainly true of the transsexual who comes late to his or her awareness or execution of such awareness in making a transition. For many, however, these feelings and manifestations of transsexuality occur early and apparently spontaneously (Benjamin, 1966; Zucker & Bradley, 1995). Usually, for these young appearing transsexuals, it is easy for them to just "do" gender (behave in the role they prefer). For the late transitioning individuals, however, it is often difficult to "just be." If all that was involved is accepting and adapting the gender attributes of the other sex it would be easy. The transsexual, however, often has difficulty overcoming his/her own sex-limiting propensities and physical conditions.

3 It is unfortunate, but probably inevitable to a large degree, that students in one discipline rarely read material they feel is far afield even when it would be most relevant. Behaviorists, zoologists, physicians, many psychologists and others were not aware of the Kessler and McKenna book until many years past since its publication and the social scientists were not aware of, or actively avoid, the research being reported in more biologically attuned fields. The sociologist Lee Ellis (1996) has termed this "biophobia." Sex-typical behaviors, however, had long been subject to analysis by biologically focused researchers of different fields and Kessler and McKenna rarely referred to their work. For instance a major challenge to a purely socially constructed imposition of gender independent of biology, not mentioned in the Kessler and McKenna book were in early works of my own on how sex and gender (biologically, psychologically and sociology) interact (Diamond, 1965; 1976).

4 Kessler and McKenna, using the information available to them at the time, assumed that transsexuals "were 'biologically normal' but underwent some type of gender transformation." There is increasing evidence that they actually are, however, biologically different (e.g., Zhou, Hofman, Gooren, & Swaab, 1995).

5 The term transgender is relatively new and amorphous. Presently it seems to include, but is not limited to, male and female transsexuals, transvestites, cross-dressers, she-males, drag artists, "butch dykes" and others that transgress societal norms and expectations of sex and gender.

6 The word travesti is grammatically masculine in Brazilian Portuguese.

7 Kessler and McKenna use the term gender identity to represent the way individuals experience themselves as male or female. I divide the concept into two components; one for the inner experience of self the other for the outer social experience. The transsexual works to bring his or her external gender identity in concert with his/her internal sexual identity. Our use of the term gender role is similar.

8 In the 30 years that such sex-reversals have been practiced there has never been a single confirmed report of a successful sex reassignment wherein an unambiguous male has accepted imposed life as an androphilic female (Diamond, 1999).

9 It will be interesting to see how future texts will report on the propensity of so many people to readily believe the constructionalist interpretation of the original John/Joan story when so much other evidence, e.g., Diamond, 1965, 1976, 1979; 1982 was against it. See Kitzinger, (in press).

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