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Sex abnormalities and transgender

Abnormal sexual development has nothing to do with choosing which ‘gender’ you would like to be.

Timothy D., from the Philippines, wrote:


Dear CMI, I have come to you seeking advice and rulings regarding the two ‘complete gonadal dysgenesis’ syndromes, 46XY Swyer and 46XX de la Chappelle. In both syndromes, affected individuals develop the external and some internal genitalia of one sex, despite possessing the chromosomes of the other. Because of this, the LGBT agenda is using it as an argument in favour of their claims that “gender is relative/a social construct”, etc.In light of this, I ask for advice regarding how to refute this argument, and rulings on what gender they are to be raised and treated as, and what gender are they allowed to marry. Also, what about people in the past who were born with this defect, before genetic testing became available? Where does that put their state of salvation, assuming they were Christians? This extends to modern cases, who were born prior to testing becoming available, and discovering only after they had already grown up as the opposite genetic sex.

Dr Don Batten, CMI biologist, responds:

Dear Timothy,

Thanks for your interest in our work. I hope I can help you with your question, which is certainly an important one in today’s world.

I think you will find a substantial part of your answer in this article: Hermaphrodites and homosexuality, which responds to the attempts of activists to justify homosexual behaviour by appealing to defects in sexual development that result in confused genitalia. The principles apply to the syndromes that you mention.

The incidence of these conditions for each one is about 1 in 20,000 births. In other words, these are quite rare. Neither of them has anything to do with homosexual behaviour or transgenderism; people with these syndromes are not necessarily homosexual or transgender in their outlook. They are like anyone else in that regard.

Protein SRY

Although the XY Swyer1 person appears to be male in karyotype (chromosomes), specific genes that are normally on the X or Y chromosome that are involved in conferring maleness in development are mutated or missing (e.g. the SRY gene on the Y-chromosome). This results in the person having a female sexual anatomy. However, further research is warranted to understand the genetic basis of all cases. Thus, it is not entirely correct to say that the person has male chromosomes. Superficially, yes, but not in detail, as important parts that confer maleness are missing or damaged (mutations break us, not make us!).

However, with XY Swyer the ovaries do not develop properly and thus there is no hormonal trigger for the onset of puberty (and no periods). It’s usually at this point that the condition is noticed/diagnosed. With modern medicine, hormone replacement therapy assists with normal female development at that point (breasts, etc.). This is the appropriate route to take.

It is somewhat the reverse with the de la Chapelle syndrome, where the karyotype is XX, but in about 80% of cases the SRY gene has inadvertently been transposed from the father’s Y chromosome to an X chromosome during meiosis (during the production of sperm).2 Thus, while there is no clear Y chromosome present, important parts of the Y-chromosome that confer maleness are on one of the X chromosomes. The person is a male anatomically, although they seem to be missing a Y chromosome. Testes often do not develop properly and hormone replacement therapy is needed for puberty to proceed with the development of adult male characteristics.

In both cases, the people are sterile/infertile.

Regarding morality, in these very unusual circumstances, the Swyer person would be acting completely morally to behave as a woman and the de la Chapelle person would be acting completely morally to live as a male. In times before the modern study of genetics, a Swyer person, for example, would have simply lived her life as a female.

Of course, if a person knows that they have one of these conditions and they are contemplating marriage, he/she would have to act honourably in being honest about their respective infertility to their prospective partner. But note that it is possible for a Swyer female with full uterus development to get pregnant with a donated egg, and thus bear a child. Other than being honest, there would be nothing immoral involved.

From this, I hope you can see that this does not impinge upon salvation. That a person is born this way is not due to their sin, or their parents; it is one of the consequences of living in a post-Fall world. Our salvation depends on Christ’s work on the Cross, not being normal in our sexual development. See:

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, 9not a result of works, so that no one may boast. 10For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them. Ephesians 2:8–10

We are all broken in terms of sin. Jesus had compassion on the sick, the blind, and the lame. Likewise today. Christians more than anyone should welcome those who are broken physically as one of the consequences of the Fall. Jesus’ work as ‘the last Adam’ (1 Corinthians 15:45) centres on undoing the effects of the Fall, and ultimately the redemption of all things.

Note that these conditions have nothing to do with choosing which sex (‘gender’) you would like to be. They have nothing to do with transgenderism (‘feeling like I am a female trapped in a male body’, etc.). There is no physical basis for transgenderism; it is in the mind. A parallel is people thinking they are fat when they are actually thin (anorexia). We don’t do operations on, or give hormones to, anorexic people to make them thin! There is a woman in Sweden who thinks she is a cat trapped in a human body. Such people need compassionate counselling to help them think right (Philippians 4:4–9), not hormonal and surgical interventions.

But the bottom line is that the LGBTQi+ crowd assert that you can choose your ‘gender’ apart from the physical realities of your body’s sex, so they are being rather inconsistent to use this argument anyway; it is just a tool to browbeat you into submission!

I hope this helps.

Don Batten

Published: 25 June 2022

References and notes

  1. For more information see: Rare Genetic Disease Database, rarediseases.org/rare-diseases/swyer-syndrome. Return to text.
  2. 46,XX testicular disorder of sex development, MedlinePlus (National Library of Medicine), medlineplus.gov/genetics/condition/46xx-testicular-disorder-of-sex-development. Return to text.

Helpful Resources

Affirming God’s Image
by J. Alan Branch
US $17.00
Soft cover