TWed Talk: Katie Chastain on "Breaking the Gender Schema" (6p, 24 Oct)

Key Takeaways

all right good evening we all do it how we doing twit of the fall 2018 season the next the next few Wednesday evenings are going to be up the hill again is our guy our users group there's gonna be a talk by Hanna thinking I think Anna's next three weeks well in a human amount of time um just a couple of dish like just extend look is going we are streaming live out to the Internet everybody say hi to the inter Internet all right thank you very much Katie this is Katie's in 20 on various different topics she's gonna focus on policy expression with on college mom she's gonna focus on I'll let her describe it so gender binary or lack thereof alright so and questions are welcome it's wrong I ran the discussion shouting I just don't storm into the streets don't don't form a caravan exactly yeah alright so take your weight like notion of biological sex and like sort of teasing what exactly that means because it can be a variety of different things actually um some terminology focusing on transgender issues you know because I know a lot of terminology is new and might not be familiar to everyone um some some of the basics of lake where we are in terms of health across the gender spectrum think of it and it's sort of a little bit about the history of how we got there and then I took a look at some of our favorite ontology is sort of examine how they handle gender and you know I just want to thinking about you know so preliminary how we might be able to improve this representation to be more complete and more after it hopefully in a way that would be beneficial and excuse me to more people in the medical field so biological sex operator we have sort of like the traditional few x axis women X Y as a man on so biological sex could be your chromosomes but there are also a variety of disorders of sexual development that can result in intersex conditions on some of which involve duplication or deletion of these sex chromosomes so you I can't actually be sure unless you're tested your comes with me get your chromosomes tested you know if you are actually xx and XY Oh hormones testosterone estrogen progesterone we have been different levels in our bodies depending on how our life's told us useful they differ in different people they differ across genders they differ over time so it's really if you're looking only at hormones the sex is a very fluid thing in that regard we also have the primary sex characteristics the gonads that produce either eggs or sperm the reproductive organs as well to make you baby the external reproductive organs it may be baby and that would be you know the doctors generally will aside a judgment birth these of the external genitalia to look at the baby what you see is is a boy or girl and there's also the secondary sex characteristics which are generally affected by the organs and these include things like how your body distributes muscle mass fat and body hair it's like you know sort of the dreaded things that happen when we go through puberty right you start getting fat and hair in different places and that's affected also by your hormones and sometimes we use sex and gender interchangeably I think generally gender is used more to encompass these social rules whereas sex is generally more of you know these different biological functions but you know it also encompasses certain social roles which may also differ across societies so here's some terminology transgender is gendered so transgender is don't identify with the gender that you were assigned at birth and cisgender is the opposite of that so if you do identify with the gender your sideburns they are cisgender and all the trans community is sort of working to highlight both of these terms to promote the idea that one is it's not like you are normal for you or transgender oh they're both normal conditions that can occur in people and which accept a massage there's just different degrees event occur to sisters but yeah okay it's like this but incident or trans okay yeah and then we have differences between gender identity and gender expression essentially identity is what you feel on the inside who you are what gender you identify with personally and this may be the same or different as your gender expression which is sort of the external you can almost think of it as a performance socially of your gender gender expression would be short hair versus long hair I wear makeup but I wear your colors you know the sort of style of clothing that you wear and and so forth may also be like certain mannerisms or speech patterns and again that's a lot of this is largely dependent on your even your social group the difference across races and cultures and then um you'll see sometimes the terms like assigned male at birth or designated female at birth and that sort of um with some basic terminology to convey that you know when the baby is born the doctor essentially you know looks that is okay this is my best guess of the baby's sex essentially and so you may have you would have male or female birth certificate at birth and that may or may not be you look at that person that you're going to rule identified as witnessed a girl walk and so we sort of use this terminology to sort of highlight that um this is the sex that they were assigned at birth and you know maybe for most people they identify with that same sex later in life but not for everyone gender dysphoria is um your distress between your your physical sex and your gender identity like what you were assigned at birth and what you are inside and this is actually the the dsm-5 right now they use the term gender dysphoria now replacing gender identity disorder cannot remove the stigma behind it it's not really a disorder or so much as it's like there's this in congruence and you know we're developing more info fees that we are able to treat this and fix it to make them feel more like the person that you identify as and sometimes this is in the form of a sex reassignment surgery also called gender confirmation surgery and this actually covers a variety of different procedures alterations to the primary sex characteristics or to the secondary sex characteristics on you can have it there some individuals will choose to undergo some of these procedures none of these procedures you know different combinations of them so it's sort of up to the individual how exactly they want to pursue this sort of this medical transition through surgery but that is that it not everyone has the same experience essentially and not everyone goes to necessarily all of these or in the set to go from male to female or female to male and so beyond just you know and moref in the checkboxes we have as I mentioned the variety of intersex conditions Klinefelter's syndrome androgen insensitivity syndrome which by itself has several degrees of expression Turner syndrome trisomy X's our chromosomal disorders with illumination or duplication of an X chromosome and then there are a variety of gender identity terms that you may see crop up especially in the last several years you have come to understand more about who we are and how we want to identify and so that could be things like a gender just non-binary gender neutral um which is sort of an identification with a lack of gender um there's my gender and pangender for sort of more of a it comes in both there's gender fluid for it sort of changes and there's things like Debbie boy male center for um maybe identifying more with one gender but not completely and then we also have some ideas like a third gender and the Native American teen spirit which often come to us from other other cultures non-western traditions which in a lot of cases for a very long time have had sort of different of social genders in addition to what we think it was male and female so this is a lot of varieties of ways that this comes up in a variety of places and it's important because different bodies have different needs so we can't really accurately describe everyone with just a checkbox or a straight we have to take it to account maybe even if history thing is how they self-identify and this is also important because there's a lot of this lack of research in many areas on you know different areas on certain minority populations and also social climates especially in the last 150 years I've had a lot of effect on what we you would go talk about in terms of human sexuality and I think that you know the medical field hurts for this that you know we're not speaking has been careful as we should be or could be as Brenda's mentioned in her talk last semester there's a lot of examples of women being under-represent in clinical trials aluminum clinical trials this was an article I found there looking at heart conditions and they just you know men and women have problems with cardiovascular trouble but they don't have the trial involving women for treatments and also the addressing various inclusion of pregnant women in clinical trials the abstract is discussing women who basically had Lake dropper they're bipolar disorder medication called Turkey because they just didn't know what it would do while she was pregnant and so it's sort of like you know you understand that there are some reasons for care with pregnancy in clinical trials but it's just something you know their hormonal changes going on there that they can't be important to your care needs and requirements on trans individuals often are excluded and they often have also avoid seeking treatment preventive treatment order reactive treatment because of barriers including transphobia and also just general lack of understanding um it looks like there's a lot of research in particular into HIV treatment and transmission among trans individuals which is sort of a societal pressure thing as they're very especially trans women are very susceptible to HIV because social barriers to employment force a lot of them into sex work unfortunately and so like on one hand it's good that we are doing at we is to better you know treat people with those conditions but we also you know you need to make social changes but also we need to look at other health requirements that these populations have and then part of how we got here is there was - person Feldon Arthur kronfeld opened essentially a sexology Research Institute in Weimar Germany in the early 1900s between ORS and they actually had a lot of work a lot of publications they employed a lot of gay lesbian a trans people you know even in roles such as housekeeper and so forth today where they were see the sort of a safe space for the homosexual community and they did research into you know cisgender homosexual health and as well as oh excuse me trans health and in that Institute a director was the first woman up you know about to undergo sort of the gender confirmation surgery procedures and then in 1933 we lost all of this information that had been collected and researched when the Nazi is seized the entire collection in their ministry so we could have a lot more information that you know we could be building upon what they've learned in the early nineteen hundred's unfortunately lost a lot of that knowledge and so as a result it's not maybe discussed as much as it could be I know I spoke with Terry Schuster the health educator yeah and she said that you know a lot of places you know I bring this from other doctors as well a lot of places you don't get as much education on human sexuality so you know it's not necessarily malicious thing but a lot of doctors just don't know and so we have you know lots of these questions that we need better address where can a woman code a house prostate cancer screening what options are available to men with syphilis you have cervical cancer and you know and going back to the example bipolar disorder life like and she's safe and take and how can we include people like her in clinical trials safely and effectively and just sort of in more general social sense how can you make the doctor's office a safer and more comfortable place for transgender gender non-conforming patients mm-hmm and then how did the different sex hormones affect various disorders like there's fairly recent research into estrogens effect on pain and migraines and there are other diseases that are known to affect women more often than men or men more often than women and so they may be sort of hormonal aspects that we can examine more to sort of get a better idea of excuse me what what members of different populations need and so I looked at some of the apologies that we use and vocabularies just sort of see what the notions of gender are sno-med CT has it as a type of general general clinical state and they have sort of a variety of enumerated types essentially um which I think it's fairly comprehensive but they they talk about the surgical transitions without really specifying what sort of surgery um you can have testes removed as a trans woman and then obviously wouldn't be at risk of testicular cancer but um breast reduction breast augmentation surgery is quite still you might still develop breast cancer so I feel they need a bit more granularity there especially in terms of like the surgery and also as some individuals like to not go through surgery but still use hormone replacement therapy that's something that also needs to be accounted for spending science integrated ontology has it as sometimes an object quality so they're not they have male/female intersexed it's the based on reproductive function so it's sort of a narrow definition in that sense but I feel like it was a very targeting since if they're talking specifically about the reproductive organs human phenotype ontology I was looking through that and that looks like it's mostly focused on um sort of the genetic expression so they have coverage of like some of the genetic mutations and so forth and the resulting symptoms but they don't really have definitions for gender or sex there and so I don't know better for my representation I feel like we need like sort of a multi axis factoring it was say with the sex male female on the birth certificate is the principal component of here it's really little turn of it so you have your sex designation at birth how you solve identify chromosomal abnormalities the size of your hormones and any any surgeries you've had which you know maybe you for multiple population might be fairly you might see it's fairly straightforward but in order to sort of account for variety of types of people there I think it's important to represent all of these things together and you know John mentioned it and I've thought about it like do we maybe you know sex in Japan your ontology and things outside the doctor's office um you can customize your sim as gender now I forget exactly witness jobs but um they had the sort of gender customization into the Sims and they weren't actually with um glad the gay lesbian a information every or they might just be glad now they would have gotten here the afternoon anyway they were to install a group that focuses on LBGT rights sort of get a respectful representation of gender customization so they they have a physical frame masculine feminine clothing preference masculine feminine and then was able to get pregnant get others pregnant or either can the same use the toilet standing Jessica so it's almost kind of binary but you know I feel like you know we're getting there and also probably notice Facebook has numerous options for gender identification be but at the same time they will still take out photos of breast cancer survivors sharing their surgery scars and is not video of like a breast self-exam where they're like he did show a woman how to do it on her own body so we'll show you how to do it on a man's body instead because i forget there was a documentary that i heard about is well aware um it was a person who is female them now I was they wanted their surgery and there the process of their transition documented and they went through I was called the top surgery which is for female the male was the brass removal and like apparently for half of the video in the surgery room they censored the nipples and then at some point they stop censoring the nipples and it's just like it's this it's literally the same nipple but yeah so it's you know we still have like social barriers to overcome like rap scare them just some of the looking at specifically transgender patients so there's some studies that have been done I need to give this more to see sort of what things they're researching specifically other than SAE journey is very common bread in transgender studies excuse me I'm also just didn't know the the migrant I get migraines so I was bringing my great articles and apparently they're they've linked it to you estrogen and thanks for coming questions comments to you know to a biggie stem each other kind of use case driven each one is coming from the applications I mean so and there's a sorry it's a couple failures one is a failure of that application domains and required more expressiveness yeah but also there's always a failure of imagination which is a kind of a big part of what we're talking about so how how do these involve or do you need another authoritative ontology like we were chatting about that kind of resent this and then they they kind of get Aysel class tip yeah I guess like my my what I've seen of you know my my work on medical debate projects is they really like have a spreadsheets and boxes to check and so I feel like if we you know sort of provide like multi axis sort of a like you looking at for a certificate versus self-identified gender versus you know levels and so forth long you know sort of like pro finding those those sort of boxes to fill out it will sort of be like here use more that you need to think about in a way sort of I guess sleep I certainly bring out the schema that we have right now justice MF checkbox BB with the intersex baby with the undo so do you actually see like a so yes so we have mm or I don't want to answer yeah yeah yeah a generic thing um but part of the point here I come back to that you're getting at or even maybe between the lines it is what what is the question that needs to be answered I mean why do you feel that they it so simplified then they're kind of overloading a man AF yeah there's lots of different reasons you know but there in order to to make some of these to to try out some of these distinction being there is what do you actually need to know what is the information that needs to be known yeah in the medical record yeah but also so that's one side of it one did some specified they're also part of what you've said is we got a trained doctors brings an apple or researchers for example on what they need to know you mean some of that just we don't have the trials oh yeah we don't have the medicine yet actually more and more laboratory is asking what's in your pants which well ends a lot of trans people and often it hasn't really got a guy what information they it was really required I think so follow the partner was not in the gun and I think you know Brenda's talk class was the last term that's not oh that's that was a coming in one directions we really really need to know and do these studies to do medicine right okay so that's one end of the Electra another Barney act end of the spectrum is you don't need to know mmm there's there's two sides yeah it's sort of like the the intersectional feminism issue is you know we talked about you know women's health women's clinics women's rights you know in the medical domain but also you know what I was saying like where is a woman where can she go to safely and comfortably get screened for prostate cancer if that's something that she requires said that's a procedure that she requires for um how can you help a trans man sort of you know get screened for cervical cancer you know and in a way that like the questions will be asked respectfully they will eat you they'll be respected and that also that just meets their needs so and you know in a lot of cases it sounds like trans trans individuals will avoid the doctor altogether because they don't dirt there isn't an obvious you know safe way to ask these questions when we get these cookies done so they're all be a the one on one and maybe I'm remembering this totally wrong but I thought that you know one of that the one of the Defense Department's arguments against trans some military boys we don't know how to deal with them from a medical strands related related surgery or the treatments you're feeling grandma Gail is there like really lock required to do this yeah or because he wanted to do this you're gonna love it yeah so this particular cell so this is is this a sub this is all that's in it's no been under this or they had it on this this they have gender as a so positive general clinical state and then they have this property is interpreted by and they had this this list of choices and this is the best yes so be what's going on there there's the surgically transgender transsexual male to female there's a search for transgender transsexual I guess that more general or is that yeah yeah transgendered now and you don't use is like the transgendered this is getting to your earlier slides hmm yeah gender versus sex yeah so is there any work going on in terms of ontology developments in this space oh I was looking into it a little bit Maneri traveling found paper from 2006 at ontology her journey but as an example a little you know class mail has gender or only female you know their cosmetics generally you know generally it's a very fine area that sense there is good example but I I definitely wanted you more da guia sort of see if I was looking under that but yeah so in terms of supports so or person and I guess it trans me do you think they should play in girl sports team or the boys varsity and same in the opposite direction and I say this because I guess your upper physical structure might of an effect on any performance and sport actually but it's it's shows that any pre-transition suffocating hormone replacement therapy transition that will be volatile male who actually going from female to male you actually gain an inch like taking testosterone that you would want to have if you look at male and vice versa if you take as you can do to keep secondary sex characteristics because the muscle the muscle tone follows so you are found that you aren't hormones you know naturally like you're not making your gender choice right so including their testing athletes if your hormones don't fall within ticular range they're now saying let's you're gonna have to take pills to counteract that and so if you're you know if you are female and you have too much testosterone that's that is an unfair advantage oh so it's like if you're a cisgender female who just happens to me I don't just examples that young sprinter hmm yeah this is just like one run down I'm wicked fast and it's really it's crazy tired and good for you and I okay this is the atomic so it's like you know different different so so this is this is what's really interesting is most of time that wouldn't necessarily matter um except when there's perhaps a medical situation where we matter or some artificial construct like when you we give you it's potentially an advantage it's a reason to take away your gold medal you know which bathroom do we let you hide enduring is from shooting yeah there was a school shooting drill at school in Virginia he was like a primary school had a transgender student and they the parents part of the drill is requested the students way in the restroom to the locker room we have this trans student who's going to leave them outside during this safety you know don't leave those who are female or like on campus or you like the third floor ladies social issues howdy what is your take on how whatever stamped on your forehead yeah basically I know that like in the intersex community there's big push right now they do sort of assignment surgery they sort of leg well you don't fit in one of these two boxes so you will sort of fix everything so it looks like it fits into one of these two boxes which is you know obviously create a big upward and the intersex community because these are infants having operations done without the consent so I know that's that's going to you know if we're completely just counting the existence of transit or intersex individuals within that community very hurt by that and it will sort of perpetuate what's essentially you know a human rights violation on intersex people to enforce you know surgery of that nature and it will definitely be a massive problem for the transgender community and I think because you know if we if we sweep it under the rug and don't talk about it you won't get more research and we just won't learn you know what we need in these communities like we might make advances you know we'll continue making advances and you know health care for cisgender women hopefully but you know we will still have these issues you know it's kind of like with marijuana as well to mediaforce a lot like we don't know what medical benefits because no one's been able to study it so it was definitely such a research back and also just in general people who you know we're already afraid to self-identify and you know it will be it will force a lot of you know people who are already reluctant to seek medical care further in the ground so you know I guess it this impacting I think this you're getting at this impact and of the research yeah you know government-funded research where you would have any number of surveys national surveys that collect data yeah no one's going to check that box well you know well yeah if the opportunity so I was thinking if the opportunity is even there to check an alternative on do you okay if if if politics is requiring sort of a traditional casting of this information you can continue to not collect sufficient information yeah okay you know so and this directly gets into what's to prevent what exactly I'm moving well what's to prevent moving ahead on in developing ontologies which more accurately Express when you originally expressed it's things like don't mean that policy that explicitly goes against that you're not going to have the data collection which is going to leverage you know that those vocabularies you're just not going to have it cuz knuckle paper you know you're not going to give the opportunity to select those your the point you're about to make is is people going to be reluctant to check those boxes now say they're not gonna have those boxes yeah high rates of violence and so forth and so it's already not a place very except maybe on voter registration which case they know how to exclude yeah and it was originally they call it they call this Social Hygiene movement in like the early part of the 20th century which was sort of came directly from the social purity movements of the previous century and it was essentially to combat Constitution and basically it enforced these sort of Christian morality you over human sexuality and as a side effect a lot of those people were involved in genetics and you can imagine that sort of it was I think it was discredit later on but obviously these still filler percussions about now sort of moralistic you getting muddled with the science I'm thankful we're putting this video on the web to help inform these guys any other questions this is been a great conversation so far about your biological sex life so so looking at these but at what point is it generally thought of you know like where you social roles actually influence I I imagine else to do with designation at birth and sort of like what you're socialized that's growing up um you know you'll even see like you know they start marking toys as boys and girls boys very early on and you got like boys who were reluctant to you know play with toys and feminine and parents who are reluctant to let their parents you know fictional rivet words that aren't gendered they feel properly for their kids and so I feel like that's sort of the socialization starts very young by it so yeah a group on this but sometimes you don't know where it comes from yeah you know me it's there's lots of influences and it's not necessarily overt influence yeah it's not necessarily you know parents buying the little boy iron man toys and little Barbie sometimes there's just influences there yeah there's knows where it comes from but yeah so I just read a story on Twitter last actually man bury one thread about how his son loves football gets dirty like loves you know there standard you know boy but he also likes to carry around the first because he likes carrying around and stuff he loves me right nail polish and he's a kindergartner and his parents raised him very you know Oh penny whatever you want before college to kindergarten and it hits me what a Monique law you know to get called triangle daylight on Mohammed take the nail polish off me like all the kids are making fun of me so even if you as a parent do the right thing there I was you know sometimes I think the dad said to the friend you know five feet this kid is five five years of preaching the whole love and honesty one day you know that's the other parents yes like who cares if you were to apology or not these are these are learned yeah yeah you know this was a huge point you know my my kids were very lucky but the the school system they were raised in Vermont was one where there were lots of to mom families and a few to dad families and those sorts of things and it was in fact and more okay mom and and this it's a pretty special environment it's kidding because they it's a normal thing all the way through um it's pretty rare rare situation so it it's uh yeah anything yeah but so at least the school I'm not saying that the other parents would necessarily like you said doing the right thing yeah at least the school is doing right though and then a fellow students mostly other other questions so I thought this was good include a why is demo semantics general do you get like how would you is there do you see a solution for how to change the market certificate - yeah yeah demo the old I don't feel like like personally I think that would be pretty easy that'd be very invasive you know but I think it's you know having it you know if the government wants to know what you know male or female I feel like there's no like easy solution to this especially because it's a bit we're very accustomed to um but I also feel like it's be easy to change if you self-identify differently right um this the laws are different from state to state oh that's really creepy but yes some laws required like notice from the psychiatrist to get your birth certificate or your driver license driver's license to change some of them actually require that you have proof you've undergone gender reassignment surgery oh I was doing a little bit about some other countries apparently there are some countries in Europe that actually require you to retire for sterilization yeah undergo surgery I see you must be sterilized and I think in some cases do we have some cases like your eggs or sperm or whatever you can't have any like frozen and save for later to go undergo gender reassignment surgery it's we're just like you know just leave that the laws are different from place to place which complicates everything but I think what is the actual purpose silverfish Bob Anderson F yeah there's a purpose November yeah but so I guess my point is isn't isn't it sufficient to say so uh my wife's birth certificate actually said baby girl carry her a scary yeah that's specifically to accommodate it seems like you know if you want to do for identification you know something fingerprint yeah yes fingerprint well basically the foot minutes are any reason why gender is because very intense yeah no I mean if you look at my church record is baby girl role born to do so and so and so and so on such a day and that's the dirt is the birth of birth certificates and that's pretty much where it came from it's a cultural artifact yeah I believe it oh yeah the start of this process is that there are many systems of trepidation that you know don't basically here is that they want to be family yeah and naturally it surprises something that emerged I think in the early legends or 20th century yeah because I do remember as we talked about this 13 used to be birth certificates yeah you know that there was some record in the church record and the other thing is as birthright citizenship became that's probably on down we might not even trying to be something I'm afraid of admitted by I was in philosophy interest in infinite combinations but you know it is an interesting challenges you know as you think about um defining or defining medical studies in mind of clinical trials are sufficient so that we get some understanding but also which conditions don't matter which conditions which states of existence matter and don't matter and how can you map those on to others so so these being able to divine those out of out of studies that we can know it's really important or no it's it's not important and also collecting people they'll send out you know calls heard you know certain types of people and you know there'll be very different terms for different racial communities like I think sort of link will be think of it what the butch lesbian sort of more masculine presenting lesbian ugly they're colored studs in the african-american lesbian community so you know put out a call for butch lesbians are you going to have you know black women attending are they gonna show up and so you sometime - there's also the race factor is also really intricately tied in especially with like the that will be teaching community uses a lot of the difference of terminology differences everything really so it's like so just dump search when you when you put this up before but what I was kind of thinking of is this is such a sofa first glance this is a collection of different vocabulary hmm but it's also a very purpose to them you know these these aren't all interchangeable there's these are these are coming from different it they're there to have clear distinction is perhaps important in a certain situation a situation or you can be very a value their application specific and yeah many ways you're going to use it in some places activism in other yeah that was kind of when I was thinking before is like where it's important to specify where they are so you're saying we should turn it over to the otologist no you wouldn't even you would have see how taken by psychiatrists to a lot of these states I mentioned the KT the idea of the birth get birth sex being the person is whatever the whole thing is because it's actually it's a combination of like twenty thirty different genes expressed in two different ways regulatory something to be regulated its accomplish it's a complex mechanism so are you proposing again gender I can [Laughter] second gender would be like everybody cooks at Thanksgiving right yeah anyone can mow the lawn yeah yeah watch the kids yeah definitely a feminist issue in the sense that you know moving away from the equates is generator no sexual male perspective to be more inclusive but I think you know we also help I think it would help serve you know male communities is follow people get different you know we say like if you have like a path back to be that's you know you lots of primary sex characteristics but you don't stop meeting ma'am so you know we have been taking like that into consideration you know also let's clamp