Trump’s new policy on “gender ideology” and “biological truth”
Trump’s Executive Order of 20 January 2025 on “gender ideology” and “biological truth” uses a gamete-based definition of sex, which is not directly tested for at birth (nor, of course, at conception)
Genetic and pre-birth screening is possible, of course, including testing for number of chromosomes, and specific genetic traits. The UK, for example, includes a number of specific intersex traits in a list of traits that it is acceptable to eliminate from the gene pool. Parents and siblings of people with intersex variations in Australia and in many other jurisdictions are encouraged to avail of these tests for “family planning” purposes. But gamete production capacity is not actually directly tested.
The problem is that gametes are only one of multiple different methods of determining and classifying sex in people alive today, including visual inspection of body at birth, chromosomes, presence or absence of an SRY gene, micturition (method of urination). In almost all cases, a simple visual inspection is the dominant method of classifying sex.
For almost all people, this multiplicity of different methods doesn’t matter. They produce consistent outcomes in determining the sex of people without innate variations of sex characteristics. For children with innate variations of sex characteristics, different methods of determining sex can sometimes produce different outcomes (Carpenter 2024)
For children with innate variations of sex characteristics, additional methods come into play, including the likely outcomes of so-called “surgical options” for feminising or masculinising surgery. For example, all children with XY chromosomes and so-called “ambiguous genitalia” seen at a Brisbane gynaecology clinic underwent feminising surgeries, according to a paper published in 2019 (Adikari et al. 2019). This appears to occur soon after diagnosis, preempting individuals’ rights to express their own views about their treatment. Without personal informed consent, these are human rights violations (Australian Human Rights Commission 2021).
In Australia, additional options for sex assignment at birth (other than female or male) exist in many jurisdictions. The evidence here is that the rare parents choosing an alternative sex marker do so on the basis of their values and preferences and not the sex characteristics of their child – what we mean by this is, for example, a preference for raising their child in a gender neutral way. It appears that children with innate variations of sex characteristics continue to be assigned female or male, and subject to unnecessary and often harmful medical interventions to reinforce sex assignment. It is not helpful or appropriate to construct intersex as a third sex or gender category – the population is far more diverse than this. Current Australian gender recognition guidelines are internally incoherent, harmful, and we have called for their reform for over a decade.
Despite this diversity of approaches, and despite the near universality of phenotype observation as the predominant method of determining and classifying sex, many commentators adhere to a single and different approach. In doing so, commentators discussing individual cases in the media frequently apply a single method of determining sex that is different from the method applied to the individual when they were born (Carpenter 2024).
By adhering to a single method of determining and classifying sex that is not actually applied to people with intersex variations at birth, or at conception, and which does not reflect actual lived experiences, Trump’s Executive Order is likely to harm people with intersex variations where gamete-based definitions do not fit either their material circumstances or their personal histories of medical assignment and treatment.
We know that Trump is going to attack transgender people and other minorities – trans and non-binary people are the main target of these decisions, and some intersex people are also transgender or non-binary – but the collateral impact of Trump’s policy on cisgender women and men with intersex variations is also important to acknowledge.
These issues have also arisen in sport and, in a short open access paper (Carpenter 2024), I comment on why it is never ok to reclassify someone out of their birth-observed sex without personal consent.
For people with innate variations of sex characteristics, society, medicine, and the law produce material effects at least as significant as biological characteristics (Carpenter 2024).
We’re taking the unusual step of commenting on the policy of a new US government because of its impact on our friends and neighbours, because of local and international debate on the implications, and because of concerns regarding the potential impact on decision-making at home and internationally.
We want to express our solidarity with all the people affected by Trump’s new orders, including gender diverse people, and also all women impacted by the deletion of the US government’s reproductive rights website. We also want to express our concern at the withdrawal of the US government from the World Health Organisation.
We also want to take the opportunity to encourage policy-makers to read a welcome US government document published earlier in January, on advancing health equity for people with intersex variations.
- InterLink and Intersex Peer Support Australia can provide support for people in Australia, Aotearoa NZ and the Pacific impacted by these issues.
Bibliography
Adikari, T, B O’Brien, T Bagchi, and RMN Kimble. 2019. ‘Presentations and Outcomes of Patients with Disorders of Sexual Development (DSD) in a Tertiary Paediatric and Adolescent Gynaecology (PAG) Service’. Presented at the RANZCOG Annual Scientific Meeting 2019, Melbourne. https://ranzcogasm.com.au/wp-content/uploads/2019/10/243.pdf.
Australian Human Rights Commission. 2021. Ensuring Health and Bodily Integrity: Towards a Human Rights Approach for People Born with Variations in Sex Characteristics. Sydney, Australia: Australian Human Rights Commission. https://humanrights.gov.au/intersex-report-2021.
Carpenter, Morgan. 2024. ‘Is It Ever OK to Reclassify Someone Out of Their Birth-Observed Sex Without Personal Consent? How Do We Manage Competing Methods of Classifying Sex?’ The American Journal of Bioethics 24 (11): 18–20. https://doi.org/10.1080/15265161.2024.2399853.
InterAction for Health and Human Rights. 2020. ‘Genomics and Genetic Selection’. https://interaction.org.au/genetics/.
InterAction for Health and Human Rights. 2019. ‘Identification Documents’. 4 January 2019. https://interaction.org.au/identities/.
Trump, Donald J. 2025. ‘Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government’. The White House. 21 January 2025. https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/.
US Department of Health and Human Services and Office of the Assistant Secretary for Health. 2025. ‘Advancing Health Equity for Intersex Individuals’. https://www.hhs.gov/sites/default/files/intersex-health-equity-report.pdf.
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