Ask Dr. Gurian
by Michael Gurian, www.gurianinstitute.com
Q: Is there really a “He” or “She” anymore?

A: Yes. But when we hear the question, we must ask:  ‘What are you referring to by He or She?

TIME recently published a cover story, “Beyond He or She,” that was short on actual brain science. It was summarized by the editors of Time this way.

“TIME interviewed dozens of people around the U.S. about their attitudes toward sexuality and gender, from San Francisco to small-town Missouri. Many said they believe that both sexuality and gender are less like a toggle between this-or-that and more like a spectrum that allows for many — even endless — permutations of identity. Some of those young people identified as straight, others as gay, still others as genderqueer, gender fluid, asexual, gender nonconforming and queer. Several said they use the pronoun they rather than he or she to refer to themselves.

“This variety of identities is something that people are seeing reflected in the culture at large. Facebook, with its 1 billion users, has about 60 options for users’ gender. Dating app Tinder has about 40. Influential celebrities, such as Miley Cyrus (who spoke to TIME for this article), have come out as everything from flexible in their gender to sexually fluid to “mostly straight.”

The article is a fascinating read but it blends and blurs the four different aspects of He/She science (gender science) in order to make its point, which is, as I read it: that humanity is ready to finish with “He” and “She.”  I will show in this blog that humanity is not ready to do that nor should it act in that way, but it can finish with the word “or” for sex/gender.  The correct approach to sex/gender should be “He and She.”

This blog is the first of a series. In this first blog, I’ll look at the biological and neural science. Ultimately, to ensure that we and our children love and are loved, we will need to avoid quick assessments of “he/she.” Four aspects of sex/gender (He/She) need to be delineated, especially when we discuss public policy and social study. These four aspects form, to me, four quadrants or chambers of sex/gender (thus, of human love). I won’t overuse the metaphor of the four chambers of the human heart, but I do think there is some resonance since everything about sex and gender does relate in some way to human love.

What Do We Mean by He and She?

“He” and “She” have been used since the beginning of time because these two words represent the chromosomal pattern we are born with: XX for female, XY for male.  You can access the work of the scientists who study these patterns on google or in my books (e.g. Ruben and Raquel Gur, Daniel Amen, Jay Giedd, Sandra Witelson, Camilla Benbow, David Geary, Larry Cahill and many others around the world). As these neuro-scientists have proven, He and She are not going away. Meanwhile, each aspect of He or She can certainly use more scrutiny.

The first of the aspects or “chambers” in sex/gender is, obviously, anatomical. For nearly every human being, this chamber is controlled by reproductive organs, which are built via the X and Y chromosome markers in utero. They are binary, i.e. they are his organs and her organs. These organs work along a hypothalamic-pituitary-gonadal axis to control male/female hormonology.   While there are a few XXY and XYY individuals born every year, 99.99 percent of human beings have these binary reproductive organs and are she/he. When the Bible famously says, “And God created man and woman,” the quote refers to this first aspect (penis/vagina and testosterone/estrogen) set of differences.

David C. Page, M.D., professor of biology at MIT recently captured the profundity of He/She: “Our genomes are 99.9% identical from one person to the next as long as the two individuals being compared are two men or two women. But if we compare a woman and a man, the genetic differences are 15 times greater than the genetic differences for two males or two females.”

Marianne J. Legato, M.D., in Eve’s Rib: The New Science of Gender-Specific Medicine, warns us to be careful about pretending this is not so. The pretense can negatively affect both women and men in getting needed mental and physiological treatment. “Everywhere we look,” she writes, “the two sexes are startlingly and unexpectedly different, not only in their internal function but in the ways that they experience illness. To care for them, we must see them as who they are: female and male.”

The second aspect or chamber of human love is sex on the brain (recently altered in public discourse to “gender on the brain”). This area of sex/gender difference is generated in utero via the XX and XY chromosomes markers that direct the fetus to differentiate male/female in Mom’s womb before the child is born. The differences between XX and XY brains are generally quite distinct on brain scans.

For instance, XY children (He) come out doing language on the left side of the brain while XX children (She) come out of the womb doing their language and word production on both sides of the brain. Similarly, neural females (girls, women, she) process their daily experience through up to 10 times more white matter activity than males (boys, men, he). Males, on the other hand, tend to utilize up to 7 times more gray matter activity to process daily life and learning than their sisters do.
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Like the first aspect of sex/gender, the second requires He and She to be factored into our academic, governmental, media, and social vocabulary if we are to successfully raise and educate children. Scientists have confirmed this worldwide—not just in the U.S.—as they study success patterns among communities that raise girls toward the highest leadership abilities possible.  In Saving Our Sons (2017), I share recent stories from teachers and parents who neglected to factor in “sex on the brain” as they raised and educated boys.  More boys and men fail when they are not taught boy-specifically.  Even churches are now beginning to realize how different the brains of boys and girls are. They, like school systems, are starting to look at failure rates of students, and altering their social systems to include male/female brain difference training. When they do this, both girls and boys are more successful, empathic, and motivated to learn.

The third chamber of sexuality/gender is sexual orientation. This chamber includes the LGB and Q portions of LGBTQ (Lesbian, Gay, Bi-Sexual, Queer). We will look at the T (Transgender) in the fourth chamber below.

Approximately 10 percent of mammals, birds, and primates are LGB or Q. They have a homosexual or same-sex biological attraction. Their sexually dimorphic nucleus (SDN) in the medial preoptic area (POA) of the anterior hypothalamus is shaped and acts like the same nucleus in the other-sex brain.  In clearer terms, this means that, a gay man’s SDN is the same size as a woman’s, and vice versa. A LGBQ person will likely still have a male or female brain (e.g. verbal centers and white/gray matter activity gender differentiated) but can have a cross-sex SDN such that this one aspect of his/her brain opposes the norm for sexual orientation. This means that aspect 1 of sex/gender generally replicates itself in the SDN of the brain for 90% of humans, primates, and other animals, but not for 10%.

The exact reason for this is yet unknown but we do know is that homosexuality has a genetic component–it runs in families. The Harvard Medical Letter publicized this in the early 1990s and since gene mapping (2003), geneticists have been looking at various X chromosome clusters, such as the Xq28 marker, to try to discover the elusive “gay gene.” Meanwhile, we also know that the size and shape of the SDN (gay/straight) is generally set in utero via hormonal surges that format various parts of the brain. Homosexuality, then, is like Aspects 1 and 2, a biological part of the human being.

The fourth aspect of He and She is the gender/sex brain spectrum. While reproductive sex hormones like estrogen and testosterone exist in each female and male cell, they also exist in differing quantities between human beings. Similarly, the extent to which each individual brain is sexualized/genderized for male/female is vast enough to include all 7.3 billion people on earth.  Thus, the first three chambers of sex/gender exist on a spectrum.   On that spectrum, the exceptions prove the rule.

Throughout scientific method, this is the case:  the exceptions will prove the rule.   While approximately 10% of people in the world are LGBTQ, about 20% of people feel that they have male/female brains at or near the middle of the sex/gender-brain spectrum.  For instance, while one boy or man (He) may be or feel very “male” on the brain spectrum, another may be or feel what I call a “bridge brain” (a male who thinks and feels more “female”), and vice versa: a She may think/feel more “male” while her sister knows herself as much more female-female.

Bridge brains can now be seen on brain scans in the same way that the SDN can be seen on autopsies. Our GI team and I show these scans at our lectures and trainings so that participants can see how well differentiated all male/female brains are and, also, how wonderfully subtle the brain spectrum is, including around a 1 in 5 exception rate (bridge brains). But even these 1 in 5 bridge brains (who feel like exceptions) are part of the male/female (He/She) brain spectrum.   Their brains are still male/female brains, even though they know themselves toward the middle of that spectrum..

The TIME survey, including the GLAAD survey results in TIME, reflect this in a fascinating way (though I don’t think they meant to).  The editors of TIME note: “In a new survey from LGBTQ advocacy organization GLAAD, conducted by Harris Poll: 20% of millennials say they are something other than strictly…cisgender.  (Cisgender is the term used for males and females who feel that their own gender identity matches the biological sex they were born into-aspects 1 and 2).  The approximate 1 in 5 millennials noted in the survey enjoy seeing themselves as other than cisgender but as the study proved, 4 of 5 people know themselves as distinctly He and She. The exceptions, again, prove the rule.

Even transgender brains prove the sex/gender rule. Approximately .03 percent of people worldwide are born with an extreme bridge brain in a cross-sex body—e.g. a “male” (he) brain (aspects 2 and 3) in a female body (aspect 1) or vice versa: a “female” (she) brain in a male body. Recent studies confirming this have emerged in the U.S., Spain, the Netherlands, and in many other countries (please see the End Notes in Saving Our Sons for more resources).

Most people, then, self-reflect aspect 4 of the four chambers of this sex/gender heart based on aspects 1 and 2, even if their sexual mating behavior and orientation is LGBQ. This vast majority of people seek to love and be loved; succeed and thrive; empathize and care for others; protect family and country; and generate a forward-thinking society from within He and She. They are people like me who also reserve the right to think outside the box; to expand gender roles and gender thinking; and to support others who don’t want to be restricted in singular, limited notions of gender.

Gender Fluidity and Gender Science

Many young people–especially in the developed West where they are not constantly in survival mode–are discussing gender identity in helpful ways that fit their new privileges. TIME reflects this new “gender fluidity movement” in the article, a movement that helps facilitate conversation and protect vulnerable LGBTQ populations.  The movement is here to stay.

But it is not new. Among us baby boomers in the 70s and 80s, it was called the “androgyny” movement.  We were saying the same things then that are being said now, though we did not have as many words for androgyny.  For me as a mental health counselor, husband, father of daughters, and social scientist, the androgyny movement was useful in expanding ideas of masculinity and femininity for myself and my wife, Gail, and expanding girl power for my daughters. I find the gender fluidity movement equally fascinating.

However, we must remember that it is talking about gender, not sex.  In this context, it is dangerous to conflate all four chambers of the heart into just one: “gender fluidity.” The androgyny movement expanded our horizons nicely but also pretended there were few or no relevant neural difference between females and males. The academic world, then the public, then our governments and legislators jumped on board.  Schools of education at most academic institutions bought so heavily into the androgyny (and now have bought into gender fluidity) movement that they still avoid teaching teachers how to specifically teach boys and girls most effectively.

The result is schools drowning in the mistake.  We have classrooms in which teachers are doing their best to try to adapt to He and She learners but meanwhile they are told He and She learners are an illusion. This lack of in depth teacher training leaves millions of learners falling behind or failing in school and then, because school success is essential to life-success, failing in life. Because of a popular but mistaken belief that “sex/gender is mainly socialized, not natural,” the educational system conflated the four aspects of gender into one, and pretended there is no important or accurate measure of He and She (aspects 1 and 2) in the brain.

Not He or She but He and She

With four “chambers” of the sex/gender heart in mind, I hope you can now look again at these statements by the TIME editors: “Some of those young people identified as straight, others as gay, still others as genderqueer, gender fluid, asexual, gender nonconforming and queer. Several said they use the pronoun they rather than he or she to refer to themselves. This variety of identities is something that people are seeing reflected in the culture at large. Facebook, with its 1 billion users, has about 60 options for users’ gender. Dating app Tinder has about 40. Influential celebrities, such as Miley Cyrus (who spoke to TIME for this article), have come out as everything from flexible in their gender to sexually fluid to “mostly straight.”

The TIME editors are not referring to the first two aspects of sex/gender but, rather, the second two. Because of their interest in the second two, they have set up an article that leans toward inviting “gender dissolution.” This is a term I use to describe the state of being that some people believe best protects humanity—a state in which biological and brain science do not exist or are marginalized and ideological input on sex and gender should run the society.

This kind of gender dissolution was championed by the Department of Education recently when it provided a Dear Colleague letter to schools and communities announcing that Title IX (which refers to equality for the “sexes”) should be altered, both in law and interpretation, to become about “gender.”   To many of us who read this letter, the hope of the ideologically driven DOE was to negate the biological, neurological, and genetic aspects of sex/gender in favor of the ideologically accessible “gender fluidity” concept. “Gender differences” under this kind of thinking became “junk science” or were marginalized; the 60 ways of thinking about gender were posited as replacing He and She.

But He and She are not replaceable:  not only are they set on the brain spectrum but all of us need the anchor point of He and She to mate, love, raise and educate children, and thus survive and thrive.  On www.michaelgurian.com/about you can click a Research page in which you will see more than one thousand brain-based gender studies proving this point.  In contrast, when you read articles, blogs, or Dear Colleague letters that pretend gender fluidity is the whole story, you will generally notice little or no hard science.. This same thing happened during the androgyny movement. Brain scans already existed showing how differently the male and female brains experience education, life, and love, but this science was avoided in the ideological public dialogue.

I challenge TIME to do a cover story on HE and She.  It is time to become fully forward thinking: to see gender science and gender fluidity running parallel. If we do this, we will be able to create family and school systems that work best for boys and girls, while also protecting vulnerable LGBTQ populations. We will be able to understand the needs of boys and girls from the inside out, and we will meet those needs. Prison populations and rates of violence will decline as we give female and male children the nurturing they need. We are not opposite sexes—the gender fluidity movement is correct about that—but we are complementary sexes. Both sexes have existed for millions of years and will exist for as long as humanity survives on this or another planet. They are templated to work together rather than in opposition.
Please generously share this blog in your discussions of sex, gender, sexual orientation, and gender identity.

By Dr. Michael Gurian, www.gurianinstitute.com