Well, what do you know.

It turns out that there are people who actually know a thing or two about gender determination from a scientific and factual point of view.  They’re called “scientists”.  And they have to educate the Governor and the North Carolina General Assembly, who don’t bother to educate themselves before passing laws.

Here’s a letter from twenty pediatric endocrinologists explaining that gender is not binary.

April 17, 2016

Dear Governor McCrory:

As North Carolinians and Pediatricians with specialty training in Endocrinology, we respectfully request that you reconsider Public Facilities Privacy and Security Act (HB2).

A law that defines biological sex as “the physical condition of being male or female, which is stated on a person’s birth certificate” is inherently flawed and potentially harmful to a group of children that we care for in our pediatric practices. As professional experts in the field of chromosomes and genital anatomy, we provide professional consultation to our colleagues on babies in whom assigning sex may not be possible at the time of birth. For example, there are babies born in whom chromosomes suggesting one sex do not match the appearance of the genitalia. This can be due to multiple biological causes such as chromosome abnormalities, abnormalities in anatomic development, environmental exposures during pregnancy, genetic mutations in the synthesis and actions of adrenal and gonadal hormones, and tumors that make sex hormones. For these children, gender assignment at birth is challenging and takes substantial time- sometimes requiring re-evaluation over months to years.  Severe hormonal imbalances at birth may also result in gender assignments at the time of the birth that may require reassignment later in life.

Our patients already face major medical and social challenges and HB2 creates unnecessary hardship for these vulnerable youth. We respectfully ask you to repeal this hurtful bill.

Respectfully,

Deanna W.Adkins, MD Assistant Professor of Pediatrics, Division of Pediatric Endocrinology and Diabetes Duke University Medical Center	Evelyn Artz, MD Pediatric Endocrinology Mission Children’s Specialties Mission Children’s Hospital
Robert Benjamin, MD Assistant Professor of Pediatrics, Division of Pediatric Endocrinology and Diabetes Duke University Medical Center	Ali S. Calikoglu, MD Professor of Pediatrics Division of Pediatric Endocrinology University of North Carolina at Chapel Hill
Cathrine Constantacos, MD Assistant Professor of Pediatrics Section of Pediatric Endocrinology Wake Forest Baptist Health Brenner Children’s Hospital	A. Joseph D’Ercole, MD Professor Emeritus of Pediatrics Division of Pediatric Endocrinology University of North Carolina at Chapel Hill
Elizabeth Estrada, MD Clinical Professor of Pediatrics Chief, Division of Pediatric Endocrinology University of North Carolina at Chapel Hill	Michael Freemark, MD Robert C. and Veronica Atkins Professor of Pediatrics Chief, Division of Pediatric Endocrinology and Diabetes Duke University Medical Center
Nancy E. Friedman MD Associate Clinical Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Duke University Medical Center	Pinar Gumus Balikcioglu, M.D. Assistant Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Duke University Medical Center
Nina Jain, MD Assistant Professor of Pediatrics Division of Pediatric Endocrinology| University of North Carolina at Chapel Hill	Kateryna Kotlyarevska, MD Pediatric Endocrinology New Hanover Regional Medical Center
Jennifer Law, MD, MSCR Assistant Professor of Pediatrics Division of Pediatric Endocrinology University of North Carolina at Chapel Hill	Nancie MacIver, MD, PhD Assistant Professor of Pediatrics, Division of Pediatric Endocrinology and Diabetes Duke University Medical Center
Shipra Patel, MD Adjunct Faculty of Pediatrics Division of Pediatric Endocrinology University of North Carolina at Chapel Hill	Elizabeth Sandberg, MD Incoming Fellow Division of Pediatric Endocrinology University of North Carolina at Chapel Hill
Robert Schwartz,MD Professor Emeritus of Pediatrics Section of Pediatric Endocrinology Wake Forest Baptist Health Brenner Children’s Hospital	Maureen A. Su, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology University of North Carolina at Chapel Hill
Bradly Thrasher, DO Fellow Division of Pediatric Endocrinology University of North Carolina at Chapel Hill	Lory Wagner, MD Pediatric Endocrinology Mission Children’s Specialties Mission Children’s Hospital

Yup.  Let’s set aside transgender people and consider this, from Slate story from 2004 which highlights another issue — the intersex birth. Step too far outside established lines and you’ve become a “disorder” (emphasis mine):

Approximately 10 times a year in Houston, at the birth of a certain type of baby, a special crisis team at Texas Children’s Hospital springs into action. Assembled in 2001, the unusual team includes a psychologist, urologist, geneticist, endocrinologist, and ethicist. Its mission: to counsel parents of infants sometimes referred to as “intersex” babies—that is, babies of indeterminate physical gender.

That such a team exists—and that it often counsels deferring surgery for infants who are otherwise healthy—reflects a radical new thinking among doctors about gender identity and outside efforts to shape it. Instead of surgically “fixing” such children to make them (visually, at least) either male or female, a handful of U.S. specialists now argue that such infants should be left alone and eventually be allowed to choose their gender identity. The approach challenges decades of conventional wisdom about what to do with infants whose genitalia don’t conform to the “norm.” Until very recently, such children were automatically altered with surgery, often with tragic consequences.