recommended that Ahs and Andras not be left with ambiguous gender identities. Doctors thought, for surgical as well as psychological reasons, that it would be easier to make them girls.
The prevailing theory back then was called “psychosexual neutrality at birth,” a fancy way of saying that children form their gender identities purely through experience—how parents and others treat them, how they are taught to conform, how they identify with and imitate adults, and how just looking at their own bodies confirms their sense of who they are. This, said the theory, is why boys (usually) think of themselves as boys, act as boys, and, in due course, choose girls as their sexual partners. Girls, it was thought, become women psychologically because of a very different, complementary set of experiences. Children and adults who didn’t fit—cross-dressing boys, “tomboys,” gays, lesbians, and others—supposedly turn out as they do because of family psychology while they were growing up, reinforced by peers and school environments.
Today we know that the process, although surely affected by culture, does not depend on it entirely; in fact, culture is not even close to being the key determinant.
The not-very-numerous Ahs and Andras, along with their families, have often entered patiently into studies of gender identity, and it turns out that by many measures they are more boylike in their behavior than their sisters or other matched girls: they pick boys’ games, toys, and clothes more often and like dolls and dresses less. In drawing tests, like boys, they tend more often to draw mobile and mechanical objects with dark or cold colors seen from a bird’s-eye view, while unaffected girls tend to draw people, flowers, and butterflies in light and warm colors and depict these living things in a row on the ground. As children, the Ahs and Andras are less likely than other girls to say that they someday want to be mothers.(I am not saying motherhood is a preferable choice; I am only stating some facts about differences in tendencies.) And, in fact, once they’re grown up, more of them say that they do not feel like women (although most do), and more fall in love with and have sex with women. They take this developmental path despite having had hormonal treatments, especially in puberty, that gave them more or less typical women’s bodies.
Not everyone interprets these facts in the same way, but for many scientists, they confirm what was known from lab studies: not just the body but the brain, too, is bathed in sex hormones in the womb, and in typical males androgens masculinize the brain. In one classic study, pregnant monkeys carrying female fetuses received testosterone only in the latter part of pregnancy, long after the formation of female anatomy. Even before puberty, with its impressive hormonal makeover, male monkeys one to two years of age are much more aggressive in their play than typical females the same age. But exposure to testosterone before birth gave otherwise normal females an in-between level of this monkeying around, known as rough-and-tumble play.
That’s one of thousands of experiments with many different species—rats, mice, hamsters, rabbits, ferrets, dogs, and several kinds of monkeys, a whole menagerie. These experiments show shifts in at least three kinds of behavior: aggression (playful or serious), sexual activity, and responses to infants. There is also an impact on brains; male hormones affect only small areas, but these are in circuits involved in sex, nurturance, and physical aggression. The differences in the brain (mainly in the hypothalamus) and in two behavioral categories—aggression and nurturance—are clear before adult sex hormones come into play. In almost all studies, the early exposure to androgens—the exact timing depends on the species—pushes females in a male direction, while castration or anti-androgen treatment makes males more like females. For these reasons, many