~Proposed by Stephen Baird, MD, Emeritus Professor of Pathology School of Medicine University of California San Diego
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Sen. Marsha Blackburn (R-Tenn.) asked Justice Ketanji Brown Jackson during her Supreme Court confirmation hearings to define the word “woman.” What this has to do with eligibility to be elevated to the Supreme Court is unclear. KBJ refused. Here, for Senator Blackburn’s edification, is an attempt to answer his question.
The most common human female has two X chromosomes and no Y. This results in a typical female habitus, with much variation in the shape and size of various anatomical attributes. Inside, she has a uterus, two ovaries, and a vagina for entry and exit. She is able to conceive and bear children for about three decades, from menarche to menopause. Its predominant sex hormones are estrogen and progesterone. Most, but not all, women are sexually attracted to men. Some are attracted to other women and some are attracted to both.
It is the most common female mammal, but there are many variations. Variation is the rule in all species on Earth.
In no particular order, some of these variants are an X and not a Y, commonly referred to as “Turner syndrome”. These people have a female habitus but are reproductively sterile and have learning disabilities. For more information, see Turner Syndrome.
There are also women with three X chromosomes and no Ys. This is commonly referred to as triple X syndrome and is associated with a wide range of developmental disabilities, none of which. Most women with Triple X are taller than average. For more information, see Triple X Syndrome.
We also very rarely see women with four X chromosomes. This syndrome is associated with many other defects in development and physical appearance. As Casey Stengel once said, “You can look it up.”
Not all of these variations have a Y chromosome. But there are “females” who have a Y chromosome, like XY, but with a non-functional testosterone receptor. They develop a normal, even beautiful, external female habitus, but have no uterus or ovaries and a short vagina. The testicles have not descended so, from all outward appearances, these people are female. During childhood, they are brought up as girls. At puberty, they don’t start menstruating, which may be the first time they see a doctor. There are several well-known examples in history and in our current society. They lead a normal “woman” life, except that they have no children of their own. They are usually sexually attracted to men.
And, there are mosaics: people who have XX cells and XY cells. The effects on their body habitus are quite variable.
Now let’s move on to people with two or more X chromosomes and one Y. The first is XXY, called Kleinfelter syndrome. These people look like normal men. There can be a variety of physical signs, but most often there are none. They often have low but not absent fertility and are probably undiagnosed throughout their lives.
All of the other X chromosome numbers described above can also have a Y chromosome, making the person look like a man, but often with other physical signs.
Finally, there are people with an XY genotype, who all their life feel, or should be, female. They are often intensely unhappy and are often treated by other children and adults as monsters, which increases their unhappiness. This leads to a very high suicide rate. Surgical techniques and hormone therapy are available to create a female body habitus and some of those who undergo these treatments, with proper psychological counseling, lead happy and fulfilled lives. They are usually sexually attracted to men. Incidentally, there are also people with two X chromosomes, who all their life feel, or should be, men. There are also surgical techniques and hormone therapy to convert these people to the male habitus, although surgical techniques to change from male to female are easier.
Finally, there are babies with XX or XY genotypes, who are born with ambiguous genitalia. They often have defects in the estrogen and androgen synthesis pathways. There are a number of different variations. Surgical “correction” is usually performed in early childhood. And, usually, raising these children as women is the most successful. At puberty, hormonal and psychological therapy is often necessary to make a woman’s life as normal as possible.
So, “Can you define the word ‘woman’?” Senator Blackburn, does that answer your question?
We might also note that the biblical story of God creating woman from man’s rib is completely upside down, as described in the lyrics of the song “How to Make a Man”, which is attached .