Can Women Marry if they have Testicals?

Can men marry if they have ovaries?
By Faye Flam
Inquirer Staff Writer

Recent efforts to pass amendments that define marriage as a union between a “man” and a “woman” are going to run into more than just political opposition.

Scientists are contending there’s no clear definition of the gender divide.

There are at least seven definitions, but not everyone qualifies as male or female across the board, says Galdino Pranzarone, a psychologist at Roanoke College who has argued against marriage amendments on the editorial pages of the Roanoke Times.

Some people are born with a mix of male and female characteristics. The incidence of intersex births is between one in 1,000 to one in 2,500, says Pranzarone. “That’s a lot of people.”

Alice Dreger, part of the medical humanities and bioethics faculty at Northwestern University, has also written on the flaws of the “one man and one woman” equation.

You could define the sexes by their sex organs, Dreger says, but those are vulnerable to birth defects, accidents or cancer. Not to mention that some people have an organ whose size fits somewhere between a small penis and a large clitoris.

You might think you could get out a microscope and use chromosomes, defining men as having an X and a Y, women as having two X’s. It’s simple enough except some people have just a single X, or XXY, or XYY. There are XX men, XY women, and people with a “mosaic” of genetically male and female cells.

As an activist for the intersex community, Dreger often gets asked for advice and recently heard from a 19-year-old man whose medical workup revealed he had two X chromosomes and ovaries.

His situation was due to congenital adrenal hyperplasia (CAH), a hormonal disorder that often causes women to become masculinized. Once in a while it will cause a genetic female to become outwardly male. Dreger said this young man wanted to know what to tell his parents and girlfriend and whether he should have surgery to become a woman. He felt like a man and liked being a man, so she advised him to stay a man.

And as Cindy Stone learned, women can sometimes get a Y chromosome. For her, it was Complete Androgen Insensitivity Syndrome (CAIS). A faulty gene on her X chromosome makes it impossible for her body to respond to her male hormones, so though she has male genetics, she developed along a female pattern.

Stone, who teaches gender studies at Indiana University, said her genitalia look female on the outside, so she didn’t suspect anything until she failed to menstruate. When she was 17 her doctors told her she had a birth defect and would never have children.

But when she reached her 30s, she went to another doctor who had a more complete explanation. She not only had a Y chromosome, she had testicles inside her body and no ovaries or uterus.

And yet, she always wanted to be female, felt female and looked female. In some ways she’s more “feminine” than ordinary women, whose bodies make and respond to small amounts of testosterone. Stone has never had a zit, she says, and grows almost no body hair.

She says like many intersex people, she submitted to surgery she now regrets. Doctors removed her testicles, she said, after which she lost much of her sex drive. Testicles secrete some female hormones, so once hers were gone she had to go on hormone replacement.

Other intersex people got surgery at infancy before they could let anyone know whether they felt more like girls or boys, says Stone.

As for marriage reform, she wonders who her politicians think she should marry. “I have testicles and a vagina. I have an F on my birth certificate but my bloodwork says my cells are all XY.”

Twenty states have already passed constitutional amendments to restrict marriage to a union between a man and a woman, and eight more will be voting on it this November, according to the National Conference of State Legislatures. But Pranzarone predicts that once lawyers start representing intersex cases, these laws will fall apart.