Whatever sex and gender may be, there is often a conflation in most discussions when trying to define these terms between what they are ontologically, in themselves (in se or per se), and what they are epistemologically (esse ad aliud, being toward another).
Hence people try to define sex and gender along ontological considerations, what is this thing in itself regardless of how people perceive it; arguments of this sort tend to say something like, "A person is this sex/gender even if he/she or anyone in the world doesn't realize it. The person's sex/gender is determined by genetics."
When defining sex and gender along epistemological considerations, arguments of this sort tend to emphasize the social construction and interpretation of each notion, ultimately explaining both as different because of performative qualities.
Yet people on both sides of the spectrum (ho ho...) of this argument will unconsciously conflate both types of argumentation. Hence you'll see some social constructionist or antiessentialist types refer to the "genetic realities/differences" of sex but go on to emphasize the psychological and social perceptions, intuitions, self-consciousness, etc. that predominate any consideration of what sex and gender ultimately are concretely considered for this individual. Something like: "Yes, although her chromosomes are XY, she is a woman because she knew, etc...." Hence the psycho-social, epistemological dimension of the definition of sex/gender dominates the ontological and becomes in turn a new ontological definition, *the* only ontological definition that matters.
Genetic/essentialist types will take the opposite approach: "Whatever she 'thinks' she is, because of the chromosomes XY, she is actually a he." Or more crassly, it's "lipstick on a pig."
However, it seems clear that both dimensions, the ontological and epistemological, are necessary to keep distinguished and present when discussing sex/gender, for these ultimately can be understood only by both aspects.
It must be remembered that the effects produced causally by genes will always have exceptions; this does not mean that biological sex is somehow more complicated or varied than the binary of male-female. It simply illustrates a basic facet of causality in reality: the transition (ho ho...) from cause to effect is not always and everywhere perfectly accomplished. This is precisely the importance and meaning of final causality in such discussions. All things being equal, this cause tends to produce this range of effects; this cause tends to result in this range of effects if nothing impedes or hinders the causal chain. The fact that not all things are equal or that circumstances occur in which that causal chain is impeded does nothing to change the fact of its final causality. We would never say a lightbulb under any circumstances gives birth to a baby; such an effect is in no way possible given its teleology. But certainly the lightbulb can fail to emit light for any number of reasons; such a failure does not mean the lightbulb is "more complex" than a certain light-producing entity powered by electricity. It simply means that the cause, for various reasons, failed to result in the range of expected effects. We may or may not know why that happened, but that is immaterial to the causality itself.
Hence the mere existence of intersex conditions says nothing about the biological finality of genetics; it says something about the chaotic nature of reality itself, in which not every cause leads inevitably, always and everywhere, to its intended effect. A definition, therefore, cannot be based on an accidental exception foreign to the intrinsic nature of the cause itself, a nature that becomes clearly discernible over time through scientific investigation and peer review.
Investigation and peer review bring us to the epistemological consideration of sex/gender. We judge the sex/gender of others based on sensible signs that accrue from gradual observation. Mischaracterization of peoples' sex/gender boil down to a threefold possible failure: 1) on the side of the misgendered person, who perhaps gives off ambiguous signs about his/her sexual/gender identity; 2) on the side of the interpreter, who failures to interpret properly those signs; or both. There are an innumerable number of possible reasons why such a mischaracterization may occur.
This distinction can obviously be further expanded, but I'll leave it there for now.
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