On sex, gender and their consequences: interview with Louise Antony

Introduction

At the Freethinker, one of our aims has always been to foster a culture of free speech and open debate. It was from this perspective that, as editor in 2022, I first became interested in the debate over the possible meanings of ‘sex’ and ‘gender’, and the consequences for women, men and transgender people. There was a concern that voices critical of the claims of transgender activism were being suppressed or demonised across much of the mainstream liberal intelligentsia, both in Britain, America, and elsewhere. There was also a concern that transgender activists and their supporters might be putting pressure on public and private institutions to adopt their views unquestioningly.

For these reasons, the Freethinker has so far published four articles exploring objections to the claims of transgender activism: an opinion piece by the gender studies researcher Eliza Mondegreen; two interviews, one with the journalist and campaigner Helen Joyce, and the other with the philosopher Alex Byrne; and a report by Kunwar Khuldune Shahid on the spread of the ideology to South Asia.

It has been difficult to find any defender of at least some of the claims of transgenderism who would be willing to talk to us. We are therefore delighted to publish the below interview with Louise Antony, Professor Emerita of Philosophy at the University of Massachusetts, Amherst (‘UMass’), who describes herself as a ‘socialist intersectionalist feminist’. Over a long and distinguished career, she has published widely on the philosophy of mind, epistemology, feminist philosophy and atheism. In October last year, she debated Alex Byrne at the Houston Institute on The Ontology of Gender.

I spoke to Professor Antony across the Atlantic via Zoom. Our conversation lasted three hours. Below is a condensed transcript of the interview, which she has read and amended to ensure that it accurately reflects her views.

Readers will observe that, in the gender debate, everything is open to question: language, science, subjective experience, objective fact, culture, nature, relations between the sexes, and what it means to be human. Hardly surprising, then, if this dialogue ends in a state of aporia or bafflement.

~ Emma Park, Editor

Interview

The Freethinker: Which areas of philosophy have you been interested in over the course of your career, and how did you come to the gender debate?

Louise Antony: I started graduate school interested in the philosophy of language. When I went there, I discovered cognitive science. I was at Harvard. MIT is just down the road, and people there, like Noam Chomsky, Jerry Fodor and Ned Block, were diving into the idea that there could be a science of the mind, which was a view that had been in disrepute before the ‘60s. Behaviourism, which I did not find interesting, had, up till then, ruled the day. One of my teachers at Harvard, Willard van Orman Quine, said that we should study knowledge naturalistically: we should ask how we actually have knowledge. (This seemed to me exactly what cognitive science was doing, but ironically Quine never embraced it.) Quine’s philosophical outlook was called ‘naturalism’: it was the idea that philosophical questions are continuous with questions in science. That outlook coloured everything that I became interested in, including language, philosophy of mind, and the relationship between the science of psychology and the other sciences, in particular biology. Throughout my work, I have always wanted the philosophical claims we make to be consistent with and informed by the relevant science.

In the 1990s, I edited a volume of essays with my friend Charlote Witt called A Mind of One’s Own: Feminist Essays on Reason and Objectivity. That was my entry into feminist philosophy. I also became interested, somewhat serendipitously, in writing about atheism and religion. I edited a book called Philosophers Without Gods: Meditations on Atheism and the Secular Life, where I invited philosophers who self-described as atheists to talk about their relationship to religion.

Freethinker: As a woman, have you found that academic philosophy is a tough environment? And if so, has that changed at all over the years?

Louise Antony: From an early age, I was aware that I did things that girls were not supposed to do. One of the things that I got in trouble for was arguing with people. When I first started taking philosophy at Syracuse University, I had no idea what it was. But when I got into the classroom and found it was just arguing about things, I thought, yes. I found myself naturally fitting into the ethos of asking questions, making objections. I loved the norm that when you asked somebody a question or made an objection, they were supposed to say something relevant back to you. Philosophy felt like home to me. That is not every woman’s experience, but it was mine.

That’s not to say it was easy to be a woman in the academy – there was a lot of prejudice against women, and a lot of inappropriate treatment.  There were not many of us – that has changed a little.

Freethinker: How would you define your philosophical conception of feminism as you have developed it over the years?

Louise Antony: Feminists disagree about many fundamental things. What we all have in common, I think, is commitment to the full personhood of women and its social recognition and material support. Where we differ is over the things like the nature of the obstacles that need to be overcome, and what other changes are necessary, such as in the law. That kind of reform is as far as some feminists want to go. I and my socialist feminist friends want to go much further.

Freethinker: So you would describe yourself as a socialist feminist?

Antony: I am a socialist and intersectionalist feminist. The idea is that there are different parameters or vectors of oppression, and your social location is a matter of what point you are at in a multidimensional grid. Parameters include race, disability, economic status, relationship to geopolitics, and being a woman. The thing that women have in common is their occupation of a social role that fundamentallyinvolves the idea that women are for other people: for men, for children, for the elderly and sick, anyone who is in need of care.

Freethinker: What, in your view, is ‘sex’, what is ‘gender’, and how do they relate to each other?

Antony: I am a realist about biological sex. I think it is a robust dimorphism in the human species. There are intersex conditions, where an individual has some of the characteristics typical of one biological sex, but not all of them. The estimates of the occurrence of these conditions seem to range from about one and a half to three per cent. So I do not think the existence of intersex conditions means that we do not have a robust biological phenomenon here. This puts me at odds with many other feminists. However, I do not think that biological sex determines gender, which is a social construction.

In a paper I published in 2020, ‘Feminism Without Metaphysics or a Deflationary Account of Gender’, I drew an analogy between gender and parenthood. I use the terms ‘man’ and ‘woman’ to refer to genders and the terms ‘male’ and ‘female’ to refer to sexes. That is just an orthographic rhetorical convenience – the terms are highly contested, and indeed, in ordinary language, they are ambiguous.

I think the existence of the biological dimorphism explains why there are systems of gender – what I call ‘gender regimes’. By that, I mean social roles that are constructed and elaborated differently at different times and places in human history, but that all have the function of trying to discipline people into particular social roles on the basis of actual or presumed biological differences. The analogy with parents is that I call contributing biological material to the development of a child being a ‘progenitor’, a matter of biology, just as being ‘male’ or ‘female’ is a matter of biology. But not all progenitors are parents, and similarly not all male or female people are men or women.

When people ask if biological sex explains gender, my answer is that in a sense, it does, because the fact that we socially divide human beings into men and women, boys and girls is due ultimately to the biological dimorphism. But there is not a deterministic relationship between being biologically male or female and being a man or a woman. There is a lot of social elaboration that is necessary.

Freethinker: Don’t the central cases, whether in being a man or woman, or in being a parent, all have a biological foundation? On this view, the central case of being a parent is a biological parent; the central case of being a man or woman is biological.

Antony: I do not know. Statistically, there are probably more biological parents who are parents in virtue of biological connection to the child than there are other kinds of parents. But in contemporary society, in the United States, for example, there are a lot of adoptive parents, there are a lot of step-parents whom we do not think of as marginal cases of parents. The central cases of parents are individuals who accept and carry out responsibility for the physical well-being of the child, have a secure emotional connection to the child, foster the child’s psychological, intellectual, maybe spiritual development, and so forth. People who fit pretty squarely inside our conception of what it is to be a parent do not need to be biologically connected to the child.

 No one thinks of anonymous sperm donors as fathers. There are cases of a so-called ‘surrogate’ mother that are very difficult. There are cases where she has contributed the egg. There are cases where she is carrying an embryo developed from an egg contributed by some other woman. Is she a mother or not? There have been court cases of so-called surrogate mothers wanting to keep the child. I think that being a parent is not so much about whether you meet the biological condition, but about how much of the total conception of parenthood you fulfil.

In the case of gender, statistically, overwhelmingly, the individuals who are socially women are going to be biologically female. And similarly, the individuals who are socially men are going to be biologically male. I do not know how significant that fact is.

Freethinker: On both these questions – the definition of ‘man’ and ‘woman’, and the definition of ‘parent’ – is there not an objection that you are putting the cart before the horse? In the case of parents, would it not be preferable to say that biological parents are, since ancient times, the natural kind, and foster parents, step-parents and so on are caregivers – substitute but not literal parents? This debate about progenitors versus parents, biological versus socially constructed men and women, is this only even possible nowadays because of where we are scientifically?

Antony: The donation of an egg to another woman who is going to carry a child is certainly a new thing. But adoption is an old institution. There are a lot of societies that institutionalise the bringing of a non-biological child into, say, a royal family. There has also been a widespread practice among women of getting pregnant by another man when their husband is impotent or sterile, without acknowledging this. So in a sense, sperm donation has been going on for a long time.

There is much that is very new to our species, technologically speaking, which is tremendously important in shaping our social life. But even if many of these questions only arise because of recent technological advances, what would follow from that about gender and sex?

Freethinker: One might think that what we mean by a man or woman, or a parent, is very old. Do innovations in science mean that we need to fundamentally revise central concepts like these? Or instead, do the possibilities of sperm donation and surrogacy, or of using surgery and medicines to become more like the opposite sex, not change the meaning of our central concepts, but simply expand their range?

Antony: In philosophical terms, I think concepts are primitive in the sense of being the smallest unit of thought. On this view, a concept like ‘dog’ gets connected in thought to dogs in the world by some process. I have spent a lot of my career trying to figure out what this process is. It has something to do with the causal relations between dogs and a tokening of that primitive element of thought, dog. Words then get their meaning by being attached to these concepts.

Now, what is it that ‘man’, as a concept in my mind, gets connected to in the world? That relation is fixed independently of what I think or believe about men, or what I want men to be. It just means that when I think a thought in terms of ‘man’, it is going to have a certain set of truth conditions in the world. That does not have any bearing on who that term should or does apply to in a public language which we share.

Whatever my concept of man is, when I talk with you, a kind of negotiation can go on between us about what we want that term to pick out. And this negotiation can be very explicit, as it is when we make laws like which people are going to be allowed into a bathroom when the sign says ‘men’.

What you are calling a concept, I would call a conception: a body of ideas, beliefs, emotional stuff – a big mess. There are some beliefs that are central to that conception, and there are some that are peripheral and that get changed all the time. Every time you change your mind about something, you are changing the conception associated with the component concepts.

Take the concept of flying. For the vast majority of our history on the planet, human beings could not fly. Can we fly now? We can get in airplanes and travel through the air. Is that ‘flying’? Does it matter? It does if you are writing legislation on flight safety. There has to be a legal use for the term ‘flight’ or ‘flying’ that covers that.

The whole debate over the concept of ‘man’ or ‘woman’ is misspent philosophical energy. What we should be figuring out is, do we want people to be able to use bathrooms that align with their sense of who they are? Do we want individuals who have gone through male puberty to play at an elite level in women’s sports? These are the questions that people really have about transgendered individuals.

Freethinker: That sounds like a practical answer. In the UK, there is an organisation called Sex Matters. According to their website, their aim is ‘to promote clarity about sex in law, policy and language in order to protect everybody’s rights.’ In other words, as far as I understand it, their position is that there are some areas of life where, regardless of what ‘gender’ may be, it is sex that matters – for instance as to whether biological males should be allowed in women’s prisons.

Antony: What do you mean by a ‘biological male’? I do not mean to say that ‘you can’t define “male” so we don’t have to talk about it’. But it is important to recognise that many trans individuals have altered their biology in important ways. If you have got an individual who has XY chromosomes, has had their penis removed and fashioned into a vagina – ‘fashioned’ is a bad word, I’m sorry, reconstructed as a vagina with a clitoris – has had their testes removed so they are no longer producing the same level of endogenous testosterone that they had been, is taking hormones, has developed visible breasts… Is this a man?

Freethinker: Certainly there are extreme cases of people who try to alter their physical condition.

Antony: They do not just try, they are successful.

Freethinker: Would you say that a man who had undergone these changes had in fact become a biological female?

Antony: I think that biological categories are fuzzy in general.

Freethinker: You did say that sex is real.

Antony: Sex is real. In nature, you can sometimes give definitions and characterisations of categories. But in biology, the category of ‘species’ does not have clean boundaries. Does that mean that there is a big issue about what is and is not a dog? In fact, there is a division of expert opinion about whether wolves and dogs are members of the same species or members of different species. Because when you have creatures that are at the boundaries of fuzzy categories like ‘species’, the criteria will not classify them clearly one way or the other.

Trans individuals, especially if they have undergone medical or surgical alterations, are at the boundary of the male-female categorisation system, just as intersex individuals are. For example, the runner Caster Semenya has never thought of herself as anything other than a woman, but in fact, she is an XY individual with very, very severe androgen insensitivity. Is Semenya a male or a female?

Freethinker: These are questions of biological categories. Semenya may well be right at the boundary. But are we talking about sex or about gender? You have mentioned people who go through some sort of biological change or have a specific biological condition. Should we make a distinction between asking, (a), whether a man who has had his penis cut off and so forth should be allowed in a women’s prison, and (b), whether a man who identifies as a woman but has not undergone any medical treatment should be so allowed? In all these areas – prisons, sports, et cetera – is it a matter of biological sex or is it a matter of gender self-identification?

Antony: It might vary from question to question. It depends on the particularities of the biological differences. On the question of whether trans individuals should be allowed to compete in sports categories according to their identity, the empirical evidence seems to vary between studies. Some say they should, others say it is dangerous for biological males to compete with biological females. But there are lots of things to take into account when we look at the particular case of trans individuals in sports.

Freethinker: Is there not a biological asymmetry here: unlike trans women in women’s sports, surely no one ever worries about trans men competing in men’s sports, because it is clear that they will never win?

Antony: It is not true that trans men never win. They do sometimes. Trans women do not always win in their categories – although they often do. Caster Semenya does not win every time she runs, but she wins a lot of the time. Just looking at her, you can see that she has more well-defined muscles than biologically paradigmatic women generally have.

One of the things that needs to be asked when addressing the sports question is safety. I do not take seriously the idea that having trans women or cis men competing in a different category from cis women arises from concerns about the latter’s safety. If people were concerned about the well-being of athletes, American football would not exist.

Sports categorisations are supposed to put people who are physically alike into the same category, so that the only determinant of the winner is talent and effort. But what happens in elite sports is that they select for freaks. If you are a man above seven feet tall in the United States, your chances are apparently one in seven of becoming an NBA basketball player.

Freethinker: Certainly some men are stronger than others, some women are stronger than others. But is it not the case that in general, men are just, as a matter of biological fact, stronger than women – by quite a considerable margin?

Antony: Who cares? What is the point of citing the average? My husband is exactly my height. He is below average height for males. I am probably a little stronger than the average woman of my age and height because I have a personal trainer who helps me to gain strength. The interesting questions are, what needs to be done, who can do it? If I need help getting something from a tall shelf in Whole Foods, I look for a tall person: I look along the parameter that is actually relevant to the task.

Freethinker: Wouldn’t a logical consequence of this position be that there is no point in having women’s sports at all, because women are almost never going to beat men? Why not just throw open women’s sports to all men?

Antony: Take boxing, where there are weight categories. The point of categorisation is to try to equalise for fixed physical conditions, so that winning reflects inherent talent and effort. In women’s sports and men’s sports, it is not just that men are bigger or stronger, it is that their physical talents are distributed in different ways. In basketball, upper body strength is an important feature. Even very tall women are not going to be able to compete at the most elite levels, are probably not going to shoot as well, or as far as the men at top levels. Sports categories are proxy indicators because you cannot really get into the precise physiological details.

In an ideal world, there might be exceptional tall women who would compete in an NBA height-based category alongside shorter men. The system that we have now excludes a lot of men from elite competition, when they could win if they played against women. The whole system of elite sports is going to leave out most of both of the populations of men and women.  A different category system would be more inclusive in many ways.

Freethinker: In which categories, if any, do you think biological differences between men and women matter, and how far? There are so many areas we could talk about: not only prisons, but medical statistics, women’s charities and refuges, whether trans women make appropriate representatives for women, trans women who want to date lesbians, and so on. Are there any areas where biological differences ought to be the starting point?

Antony: I do not want to say in a blanket way that trans women should be excluded from any of these designated women’s spaces. I am open to the possibility that there might be specific reasons why trans women should be excluded, but not qua trans women. If there is a support group for people who have suffered miscarriages, that is not open to all women to begin with, only to those who have had miscarriages. A trans man who suffered a miscarriage should be allowed in that space.

We have to look at why the space is designated as a women’s space, what the specific nature of the gathering is such that designating it a women’s space is a good proxy for the specifically pertinent characteristic of the space.

The cases that I struggle with are those where the space is a women’s space because of the presumption that women have been exposed to certain kinds of socialisation and social pressures. Women in academia suffer – from people not recognising them when they raise their hands at meetings, for instance. This is low-grade suffering, but not getting credit for contributions, having one’s published work neglected and so forth, can have a large impact on one’s career. Women like to get together and discuss what they can do about it.

From what I have read of the experiences of trans women in philosophy, they discover that they are not getting called on as much as they used to before they transitioned. And so they are beginning to understand in a different way what it is to be a woman in the field. But I think there might be spaces where trans women should be quiet and allow the experiences of women who have grown as women, have gone into the profession and been socialised as women, to take centre stage.

Freethinker: It is interesting that you might see the case for giving women more space in issues where they have suffered from discriminatory social, rather than biological, pressures. But returning to biology, as a woman, would you not agree that when you have a child, it completely changes you (speaking as someone who has also been through it) – and in a way that only someone who is biologically female can be changed? There are scientific studies on the way the brain changes during pregnancy.

Antony: The study that you refer to was very small – which is one of the many problems with brain imaging studies. I do think that pregnancy was a singular, extraordinary experience for me, but it is different for different people.  All experiences ‘change our brains’.

Freethinker: Would you agree that it is an experience that a man cannot have?

Antony: I have several female women friends who have not been able to become pregnant for one reason or another. Yes, pregnancy is a singular experience, and some people who cannot have that experience are very sad about that.  But why do we have to pick it out by proxy and say it is a woman’s experience? When you have a child, you stop being the main character in the story of your life. That is a profound change – whether you adopted the child or had the child biologically. But I am the same person I was before my pregnancies. My personality is the same. I have learned things from having children, but we learn things from a lot of the experiences that we have. I find it romantic and unnuanced to say in a blanket way that the biological fact of having  a child changes you in some uniform way.

Freethinker: Is it not the case that there are clear, obvious biological changes to your body once you have a child? The shape of your pelvis changes, your hair falls out, and so on. And I am not a scientist, but perhaps women in general also bond with their own child in a special, biologically grounded way, as mothers.

Antony: The literature on the biology of childbirth and motherhood is partisan. People have axes to grind. But women successfully raise children under all sorts of adverse circumstances, and women fuck up their children under all sorts of propitious circumstances. This single biological parameter does not provide much information about the quality of your connection to your child, or the nature of the way you relate to them.

Freethinker: Nevertheless, would you accept that bearing a child does make a difference to a woman, and is one experience that a woman can have and a man cannot?

Antony: It is true. I would like to have a penis, because I think there are some experiences that men can have that I would be interested in having. So what? Of course pregnancy and childbirth change you, but there is very little you can say in a general, uniform way about this change, except for the things that have to do with the social implications of being a parent – which are eminently changeable, and that affect adoptive and step-parents as well.

Freethinker: You might also say, as some feminists have been saying for a long time, that being a woman should in general not matter. Biological considerations aside, women should be able to do everything that men can do. Why not?

Antony: I do not want to frame my aspirations for women in terms of something relative to men. I want people to be able to flourish – that is the goal of feminism.

As a socialist feminist, I think there are things that we can do socially that we cannot do individually, or not do as well. Many of the things women have traditionally done – caring for children, educating children, caring for the sick and the elderly – these are responsibilities that ought to be borne socially. Social support for these things will help more children flourish, and will enable women to flourish in more ways.

Freethinker: What about other areas where biology might be said to be relevant to the way in which women and men are treated? For example, in prisons – where women might not want biological males to be there because they say they have flashbacks to a man who raped them. If, on the other hand, trans women are likely to be ill-treated in men’s prisons, why not have a third category of prisons, or prison facilities, for transgender people?

Antony: We’re going to build separate prisons for trans offenders? That is not going to happen. But it is not clear that we have to have what we think of as women’s prisons and men’s prisons. The particularities matter. You cannot just say there is a woman who is going to feel triggered if she sees a penis. That is not the end of the story – it is an element of what we have to consider.

Freethinker: Is it fair on biological women to allow trans women in women’s prisons?

Antony: This is going to sound like I am anti-woke, but I do think that talk of triggering has gotten out of hand. People can be triggered by stuff that is not systematic. If there was a spider in my prison cell, I would go nuts.

Freethinker: Do you think that biological women should ever have the right to a space which excludes biological men?

Antony: Not a fundamental right and not a right per se. Do you think people in general have a right to not be exposed to experiences that are triggering for them?

Freethinker: I would agree with you that there should be no blanket right, though I would have thought that there should be room for protection against triggering in cases, for example, of clear psychological trauma. But in the case of trans women in women’s prisons, might they not also pose the additional risk to women of actual physical harm?

Antony: I know of no evidence that cis women are more vulnerable to sexual violence, either in restrooms or in prisons, by the presence of a transgender woman. If you are a cis male rapist and you are after cis women, what better place to go than a women’s bathroom where there are likely not to be any other cis men? If it were a gender neutral bathroom, there would be a chance that there would be other cis men there to deter you from realising your intentions. A woman’s actual safety is not secured by having women-only bathrooms.  A cis-woman colleague of mine was assaulted in a ‘women’s room’ in our university building.

If you put a trans woman into a male prison, what is going to happen to her? She is going to be brutally assaulted and possibly killed, certainly raped, by some cis men in that prison. That is perfectly predictable. So why would you add to the already existing problem of rape and assault in male prisons by putting someone there who identifies as a woman?

Freethinker: But then, on the other hand, they might be a real threat to women if they went into a women’s prison. As in the case of Isla Bryson, who was convicted for raping two women as a man, and then transitioned during the trial; or the case of the violent offender, Tiffany Scott, who transitioned from man to woman during a life sentence and applied to be transferred to a women’s prison.

Antony: Did these individuals rape anyone once in prison?

Freethinker: No. In the event, Bryson was not in the women’s prison estate for very long, and Scott’s transfer was blocked. Scott had been previously been convicted of violent offences while in a men’s prison. Both Isla Bryson and Tiffany Scott also retain male genitalia. In any case, is the problem not that someone’s rights are at risk either way round?

Antony: I do not accept the assumption that a trans woman is more likely to commit a violent assault than a cis woman. Cis women commit battery and rape, too.

Freethinker: Although it seems well established that biological women in general commit a much small percentage of violent crimes than biological men. In any case, with a pre-operative trans woman, who still had male genitalia, would you accept that such a person would, in general, present a greater risk in a women’s prison than another woman?

Antony: Suppose I grant that such a person would be physically capable of raping a woman: still, how do we know when a person is sincerely claiming a gender identity that does not accord with their current physical properties? I would like to see some evidence that cis men dishonestly claiming identity as a woman is a serious concern. There is, in at least some people’s minds, an exaggerated likelihood that a biological male is going to the trouble of really pretending to be someone who identifies as a woman for the sake of winning some athletic competition or serving their time in a women’s prison. If you have someone who has been living as a woman and enduring the difficulty and opprobrium that that still brings with it in our societies, and they are doing it for a significant amount of time, that is good evidence that they sincerely have a different gender identity.

Trans women are people. To put a person into an environment where they are likely to suffer severe degrees of physical abuse is a serious harm. There is no conservative, harm-free alternative here. For a person who has the gender identity of a woman but the biological characteristics of a male, the question is whether the possibility that that person is going to cause severe psychic or physical distress to some women incarcerated in the same place, high enough to justify putting that person into a male prison – an environment where there is a high probability that they are going to suffer severe physical harm.

Freethinker: So is it a matter of weighing the risk to the trans person versus the risk to the women?

Antony: You say ‘risk to the women’. We need to consider all persons. I am not a utilitarian, but I do think it matters what the consequences of our actions are, morally speaking. And when you look at the consequences, you have got to look at not just the possibilities, but the probabilities. I would bet that most women prisoners are far more concerned about being raped by the guards than by a transgender woman. (See this article.)

Freethinker: Another problem with failing to distinguish between trans women and women on biological grounds arguably comes in scientific research and the compilation of medical data. Would it not be problematic if a trans woman was labelled female on the medical record, and then their data was used to contribute to a picture of how diseases affect women’s bodies? Would doing so not risk skewing the data – if you accept that women’s bodies are biologically different from men’s and have, to some extent, different susceptibilities to different diseases?

Antony: Maybe medical science should ask more directly about the conditions that they are concerned about. If you are an XX individual, there are certain regularities that are captured when we taxonomise in terms of men and women, whether those medical regularities are the result of innate biological differences or the differences that result from being socialised as men or women. Take, for instance, the appalling difference in the rate of maternal mortality between black and white women in the US. Is that the result of some biological similarity among black women versus white women, or is it the result of the social conditions under which black and white women typically give birth?

There are a lot of people who are uncontroversially women or uncontroversially men who are biologically atypical – and their data goes into the samples. That is why we have statistics to find central tendencies and to try to tease out causally relevant factors.

Freethinker: But men, for instance, can get prostate cancer. Women can’t.

Antony: That’s right.

Freethinker: Women can get endometriosis. Men cannot get endometriosis because they do not have a womb.

Antony: In this case, people without wombs cannot get endometriosis – including women who do not have wombs.

Freethinker: Is it not the case that people with XX chromosomes, which are found in every cell of the body, have different genetic susceptibilities to certain diseases and conditions from those with XY chromosomes? Women are more susceptible to breast cancer than men, for example.

Antony: Maybe so. But there is a much higher mortality rate for men who have breast cancer than women, partly because it is standardly believed that men cannot get breast cancer. It is clear that the parameter for effective medical intervention is being susceptible to breast cancer.

Freethinker: But how would we even know that biological men could get breast cancer in the first place, or that they had a higher mortality rate, if patients were simply able to designate themselves ‘male’ or ‘female’ on medical forms regardless of their biological sex? Wouldn’t the statistics get muddled?

Antony: Hang on. If somebody comes to the hospital with a lump that may be a sign of cancer, the diagnostic procedures are the same. Classifying them as ‘man’ or ‘woman’ does not add any information to the clinical situation.

Freethinker: But would it not add information for the future, for people down the line who wanted to know what percentage of biological males and females get breast cancer, whether one sex was more susceptible than the other?

Antony: Look, there are generalisations. It makes sense to put information about menstruation in places where girls are going to see it, despite the fact that some of those girls are going to be amenorrhoeic. There might be some androgen insensitive XY individuals among the girls. There may be some atypical XX individuals who are in the boys’ room. It is very difficult to craft generalisations in precise terms.

Freethinker: In statistical science, the way you make patterns is by amassing data. The patterns help you to make diagnostic predictions, even if they are not always accurate for all patients, who may differ amongst themselves. But even to compose the general pattern, don’t you need to have some parameters – some truth basis, such as knowing whether it represents males or females or both?

Antony: I was with you up to ‘truth basis’. What I am challenging is the claim that, for medical purposes, the proxy classifications, man and woman, are preferable characterisations. Take information about endometriosis. Why shouldn’t the pamphlets in the doctor’s office say, ‘If you have a womb, read this pamphlet’?

Freethinker: How about, ‘If you are a biological female, read this pamphlet.’ Wouldn’t that be the same thing?

Antony: Why not just say, ‘If you have a womb’? That is the specific circumstance where you need to be concerned about endometriosis. Why is it better to say ‘biological female’?

Freethinker: Because biological females may not all have a womb, but they almost all do. Even if they do not, their body still has most of the same features as other females. Would you not agree that biological males and females involve two types of body with some broad differences and which to some extent behave in different ways?

Antony: I agree that there is a robust sexual dimorphism in the human species, but it does not follow from that that we cannot do better than using the proxy categories ‘man’ and ‘woman’ for scientific purposes.

Freethinker: If you believe in sexual dimorphism, why not just use ‘male’ and ‘female’?

Antony: Because when we get down to specific conditions like endometriosis, we can do better even than male and female, because there are borderline cases and furthermore because there are trans cases. Those pamphlets on endometriosis might be picked up by a trans man with a womb.

Freethinker: Why not say ‘biological female’, then, since trans men are biological females?

Antony: Because the thing that I said is more informative and does not involve having to take a stand on this issue about the biological female.

Freethinker: Do you think that trans men are biological females or not?

Antony: I do not think they are biologically female. ‘Biologically female’ is a biological category that has fuzzy borders. Trans men are in the fuzzy border region.

Freethinker: What about trans men who are clearly biologically female – as presumably some of them are, especially, say, if they are pregnant and stop taking testosterone supplements and so forth?

Antony: I do not see the usefulness of the term ‘biologically female’. There are some lasting changes from having taken the masculinising hormones. What are we adding in terms of human well-being or understanding by insisting that a trans man who stops taking masculinising hormones in order to become pregnant is biologically female?

Freethinker: Isn’t it the truth?

Antony: I do not know if it is the truth, because you have not really told me what is required to be biologically male. My point is, what are we gaining either in terms of human well-being or understanding by insisting that we take those who are in the border and classifying them one way or the other? What is gained by saying, he is really a woman or she is really a man?

Freethinker: I was using the terms ‘biologically male’ or ‘biologically female’, rather than ‘man’ or ‘woman’, at this point.

Antony: But what you seem to be pressing on is a case where someone does not fit the full criteria for being biologically male or biologically female and insisting that I classify them on the basis of one of the determinants of being biologically male or biologically female.

Freethinker: You yourself have been talking about XX and XY individuals, rather than biological males and females. Is it not the case that an XX person cannot change all the chromosomes in their body to become XY, or vice versa? So in the great majority of cases, except for those very rare instances on the border, is there not a fairly clear sense in which someone is immutably either XY or XX?

Antony: I agree there is this classification. It covers, as I am prepared to concede, 98.5 per cent of the human race. But why insist that we apply the classification to the ones who do not fit the complete profile? Why do we have to decide whether somebody is biologically male or female? Even if the vast majority of human beings can readily be so classified.  There are individuals who look morphologically like XX females who have an XY karyotype.

Freethinker: One final question. For you as a socialist intersectionalist feminist, what is fundamentally at the heart of this debate about sex and gender?

Antony: I am a gender eliminativist. I believe that gender is real, but I think it should not be. People should be allowed to flourish in all sorts of different ways, depending on their different aptitudes, proclivities, characteristics and so forth. It is a fundamental injustice to try to package people into these socially preformed categories of man and woman, boy and girl. The elimination of that kind of categorisation is very important to me. As a feminist, I think that anyone who is being gender transgressive is putting us on the right road. So I want to give absolute support to trans people.