What makes ‘HER’ female?

Heather Little-White, Ph.D.

The controversy over Caster Semenya, who won the 800-metre race in the recent World Championships in Athletics, in Berlin, Germany, and the request by the authorities for a gender verification, brings into sharp focus the elements of the human sexes.

One common stereotyped assessment of male versus female by the common man is penis equals male and no penis equals females. Later, add breasts to better define females at first glance compared to men. Facial features and voice further help to identify the sexes.

Unique system

Each sex has a unique reproductive system which influences their sexuality and reproductive capabilities designed to transport the egg or the sperm. The female reproductive system is located entirely in the pelvis. If one were to examine the female, there are distinctive elements to differentiate male from female. The external part is known as the vulva, meaning ‘covering’ for the vagina and other reproductive organs inside the pelvic area.

The mons pubis is the fleshy area just above the top of the vaginal opening.

The labia are the two flaps of skin (lips) surrounding the opening to the vagina.

The clitoris is a small organ with a bundle of nerves located toward the front of the vulva where the folds of the labia join.

Between the two lips (labia) are openings to the urethra and the vagina. Contrary to what many people think, including females who do not know their own bodies, the urethra is the canal that transports urine from the bladder to the outside of the body. Urine does not come through the vagina.

Hollow tube

The internal reproductive organs of the female include the vagina, uterus, fallopian tubes and ovaries. The vagina is a hollow tube made up of muscles and extends from the opening to the uterus, running three to five inches long. The muscles in the vagina allow the vagina to expand and contract during intercourse and childbirth. The walls of the vagina are lined with mucous membrane to keep it moist and protected.

A thin sheet of tissue called the hymen, with one or two holes, partially covers the opening of the vagina. The hymen is different from one female to another. Most females may stretch or tear the hymen during their first sexual experience and the hymen may bleed slightly. However, some women who have had sex do not experience much change in their hymens.


The vagina connects to the uterus or the womb at the neck of the womb or cervix which has thick, strong walls. The uterus which is only about three inches long and two inches wide, has thick lining and strong muscular walls that expand and contract to accommodate a growing foetus and to help push the baby out during delivery.

At the upper corners of the pear-shaped uterus are the fallopian tubes, about four inches long with a tiny passageway as wide as a piece of spaghetti. When the ovary releases an egg, it enters the fallopian tube and is propelled toward the uterus. The ovaries or gonads produce the female hormones, oestrogen and progesterone.


When a baby girl is born, her ovaries contain hundreds of eggs which stay inactive until puberty. At puberty, the pituitary gland in the brain starts to produce hormones that stimulate the ovaries to produce female sex hormones, including oestrogen, which develops a girl into a sexually mature woman.

During puberty, girls begin their monthly period and release an egg as part of the menstrual cycle. Approximately once a month, during ovulation, an ovary sends a tiny egg into one of the fallopian tubes. If the egg is not fertilised by a sperm while in the fallopian tube, it dries up and leaves the body about two weeks later through the uterus with a flow of blood and tissues from the inner lining of the uterus. This is the menstrual flow which may last three to five days. A girl’s first period is called menarche.


When the sperm meets an ovum (egg), an embryo is formed and acquires chromosomes which will determine the sex of the child – XX for female and XY for male. After about six weeks of pregnancy, ovaries develop in females and testes develop in males. Abnormalities in development may be caused by genital defects or hormonal imbalances in the uterus. For example, if the female does not start producing oestrogen, there may be physical defects in the female like a vagina and no uterus.

An XX girl may be exposed to high levels of testosterone in the womb which could lead to the development of an enlarged clitoris or a small penis. If there is an extra X or Y chromosome, sexual differentiation may be difficult. Children may have genitalia ‘in between’ or resemble parts of either sex. If males do not start producing testosterone, abnormalities may result and they may not develop a penis and may resemble a girl even with the XY chromosome.


Hormonal abnormalities may occur as a girl develops to womanhood. Dr Mark Hill, writing in UNSW Embryology, a publication of the University of New South Wales, describes human genital abnormalities as ‘Disorders of Sex Development’ (DSD) and includes chromosomal, gonadal dysfunction, tract abnormalities, external genitalia and gonadal descent. The previous human sex development terminology for abnormalities such as intersex, psuedohermaphroditism, hermaphrodites and sex reversal are outdated and stigmatising and should be classified as DSD.

If the physical features (such as facial hair, ripped muscles, masculine demeanour) of a female places doubt as to her sex, a sex test or gender verification test can be done to authenticate the sex. The question, why not just a physical, strip test to check the genitals? The answer is gender verification test is necessary because ‘gender’ goes beyond genitals with hormones playing a huge role in defining sex.

Sex tests

Sex hormones tests measure levels of the sex hormones, including oestrogen, progesterone and testosterone. Sex hormone tests are ordered to determine if secretion of these hormones is normal. Several different types of tests are used to evaluate the different sex hormones to help diagnose problems or disorders, and to monitor pregnancy.

To determine ‘femaleness’, testosterone levels are ordered to evaluate ambiguous sex characteristics which places doubt as to whether the person is female or male. Testosterone stimulates sperm production (spermatogenesis) and influences the development of male secondary sex characteristics.

Masculine features

Overproduction of testosterone in females, caused by ovarian and adrenal tumours, can result in masculinisation, the symptoms of which include cessation of the menstrual cycle known as amenorrhoea, imbalance of masculine features and excessive growth of body hair (hirsutism) (www.lifesteps.com).

Sex testing or gender verification is done on sportswomen who look like or perform as men. According to The Times, ‘suspect athletes’ will have their external appearance assessed by experts who will test their sex hormones, genes and chromosomes. According to DollyMix, all these tests sound pretty humiliating to say the least, but it does raise the question: how can it be so hard to tell? (http://www.dollymix.tv/)

Buju Banton Starts Facebook page

Buju stands against gays according to today’s Star News

Using the popular website Facebook, Buju Banton is taking a stand against gay rights activists by forming the ‘We Support Buju Banton’ group. This comes shortly after the singjay was forced to cancel his seven-city tour of the United States due to protests from gay rights groups.

However, Banton’s Gargamel Music
yesterday confirmed that the tour is still on, and that Banton will be kicking off his anticipated ‘Rasta Got Soul’ US Tour on September 12 in Philadelphia.

It was reported in The STAR earlier this week that The New York Times and major networks like NBC had confirmed that promoters in Chicago, Houston, Philadelphia, Los Angeles, San Francisco, Las Vegas and Dallas had called off shows Banton was scheduled to headline.

violence against homosexuals

Banton’s ‘Rasta Got Soul’ tour was to have begun on October 2 at the House of Blues in Chicago. However, protests from the Los Angeles Gay and Lesbian Center stopped the tour due to claims that Banton’s 1992 hit Boom Bye Bye encourages violence against homosexuals.

A release sent by Gargamel Music stated, “We are disappointed by the hasty cancellation of a few shows by Live Nation/House of Blues and Goldenvoice/AEG, but fans will be happy to know we have over 30 confirmed shows that are definitely playing and we are working to replace the cancelled dates.”

The release further explained the reason and meaning of the infamous song. “Buju Banton was all of 15 years old when he wrote Boom Bye Bye in response to a widely publicised man/boy rape case in Jamaica. It was not a call to violence. The song was re-released on a popular dancehall rhythm in 1992 and caused a huge uproar after receiving commercial radio play in the States. For the record, it is the only song he ever made on the subject – and he does not perform it today,” the release said.

facebook group

While Banton has been promoting his own Facebook group calling for support, NBC reported that the gay activists also recently launched a campaign on the website to block the US tour.

In the meantime, the ‘We Support Buju Banton’ Facebook group already has over 500 members and the names and contact details for members of the various Live Nation groups. Fans are asked to, “Stand up and make your voices heard by flooding their phones, email boxes and fax machines with testimonials in support of Buju Banton. Remember to be respectful when contacting these executives. We want them to take us seriously.”

This is not the first time Banton has had tour dates cancelled due to efforts by gay and lesbian lobbyists. Since Banton’s career took off in the US in 1995, gay rights activists have targeted his shows in that country.

my two cents: I hope facebook monitors carefully the verbiage coming from that group and do not allow any patois laced cleverly with intent to kill actions.

…..and the Circumcision discourse continues

Is circumcision no longer recommended, let’s take another look, thanks to my avid reader Schifrah here is another point of view from the Huffington Post dealing with that and the HIV myth as written by Ali A. Rizvi. (click image or follow the links for the full take)

Previous posts on the subject from here:
Male circumcision no silver bullet …
Male Circumcision opposing views
Stephen Lewis : Male Circumcision & AIDS Prevention (FORATV)
Should men be circumcised (Gleaner article 2008)

Here is an excerpt from the Huffington Article:

This year, 1.2 million male babies in the United States will have between 35 and 50% of healthy, functioning penile skin — containing over 20,000 nerve endings and the five most sensitive areas of the penis — removed in a procedure that all of the major medical associations in the world, including the American Academy of Pediatrics and the Canadian Paediatric Society, have deemed medically unnecessary.
Overall, routine, non-therapeutic circumcision costs over $2 billion a year; in most states, it is still covered by Medicaid, at a cost of tens of millions of dollars to the taxpayer. Despite near-universal recommendations against performing it routinely, it is the most common surgical procedure performed in the United States.

Having started among ancient Egyptians and ancient Semitic peoples as a religious sacrificial ritual, the practice didn’t take hold in Western societies until the late 1800s, when Western society was mired in masturbation-related hysteria. Dr. John Kellogg (yes, the Corn Flakes guy) was seminally (ahem) influential in the fight against what he called the “practice of solitary vice”, to prevent which he ardently recommended circumcision, writing:
“The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed.”

This recommendation was accepted and implemented widely for male children, likely buoyed by the belief that circumcision was, after all, part of Abraham’s covenant with God, who doesn’t really like dickheads. Because the application of phenol to a girl’s clitoris wasn’t part of this covenant, this second recommendation from Dr. Kellogg to prevent female masturbation — an “excellent means of allaying the abnormal excitement” as he wrote in his book Plain Facts for Old and Young — wasn’t embraced as enthusiastically.

How medical male circumcision reduces HIV/Aids risk

How medical male circumcision reduces HIV/Aids risk


Three studies that were done in Uganda, Kenya and South African confirmed that Medical Male Circumcision reduces the risks of a man who is circumcised to acquire HIV virus from a woman or partner who is HIV positive by at least 60 percent. But many of us have been wondering how this works.

The Assistant Commissioner Health Services (National Disease Control) in the Ministry of Health , Dr Alex Opio explained that the inside part of the uncircumcised penis is rich in cells known as Langerhans cells which are normally targeted by the HIV virus.

The removal of the foreskin through medical circumcision, reduces on the number of these cells and the only place where they can be found in the meatus(opening of the penis)

Dr Apio also says the removal of the foreskin exposes the tip of the penis to the underwear and fresh air. When the tip of the penis is exposed, it becomes thicker than the one which is covered by the foreskin.

When it is thicker, it becomes less susceptible to bruises that a penis may sustain during sexual intercourse and ease the transmission of the virus. In medical language, the thickening of the penis is called Keratinization.

He further explains that when a man is not circumcised, a large surface area of the penis tends to be exposed to the vagina during sexual intercourse because the foreskin is over pulled back and incase the woman is infected, the chances of a man contracting HIV would be high because during sexual intercourse, the fiction between the vagina and the penis may create tiny tearing which can only be seen through a microscope thereby exposing the man to infection. However, the risks would be minimal if a man is circumcised since a smaller surface of the penis would be exposed to the vagina.

An uncircumcised man is also said to be more susceptible to sexually transmitted diseases especially those that cause sores in the private parts (genital ulcers). Examples of such diseases include syphilis and Herpes Virus. The wounds ease the penetration of the virus into someone’s body. Dr Opio also explains that circumcision doesn’t prevent HIV transmission 100 per cent.

Other benefits of circumcision

* A circumcised penis is easier to clean and is normally free of smegma that may cause the cancer of the penis, says Dr Alex Opio. Smegma is a sticky white thick secretion that is accumulated under the foreskin of a penis of an uncircumcised man. Many older men, who have bladder or prostate gland problems, also develop difficulties with their foreskins due to their surgeon’s handling, cleaning and using instruments. Some of these patients will need circumcising. Afterwards it is often astonishing to find some who have never ever seen their glans (knob) exposed before.

* If man continues injecting smegma in a woman, her risks of her getting cancer of the cervix are increased, Dr Opio adds. Cancer of the cervix in women is due to the Human Papilloma Virus. It thrives under and on the foreskin from where it can be transmitted during intercourse. An article in the British Medical Journal in April 2002 suggested that at least 20 per cent of cancer of the cervix would be avoided if all men were circumcised.

* Lots of men, and their partners, prefer the appearance of their penis after circumcision, It is odour-free, it feels cleaner, and they enjoy better sex. Awareness of a good body image is a very important factor in building self confidence. Sexual function is not adversely affected by circumcision. On the contrary, published evidence shows that circumcised men have a wider variety of sexual activity, and women prefer circumcised men, mainly because of better genital hygiene.

* Balanitis is an unpleasant, often recurring, inflammation of the glans. It is quite common and can be prevented by circumcision.
* Urinary tract infections sometimes occur in babies and can be quite serious. Circumcision in infancy makes it 10 times less likely.

Gender Selection – Are you male or female?

(hhmmm the debate continues on embryonic development, female by default?)

Eulalee Thompson – BE WELL

It is generally believed that the embryo by default is female. Females carry two X chromosomes (XX) among the 23 pairs of chromosomes in each cell. In about the seventh week, the embryonic presence of the Y chromosome (XY) provides instructions for the development of male characteristics. The hormone, testosterone is produced and the structures become male.

However, as Dr Leslie Gabay, Kingston-based paediatric endocrinologist, points out, many things can go wrong in the change process.

“On the Y chromosome, there is a code that converts the primitive gonad to testicles. The testicles then produce testosterone then change (the embryo) to male,” he said. “(But) we could have XY but don’t get the code across so stay female … or hormones are like keys that (have to) fit in a lock so that we can get the effect of the hormones. So we could have normal testicles, testosterone but don’t have the lock to fit in, so don’t get the conversion to male. This is called androgen insensitivity syndrome,” he added.

The literature points to many chromosomal conditions of the sex chromosomes that affect sex deter-mination (that is the display of sexual characteristics of male or female), sexual development and fertility. Some of the conditions are mild, others severe and can be associated with either structural changes in the chromosomes, missing a copy of the chromosome, or having extra copies.

Sex verification tests

This topic of what makes us male or female would be an ongoing interest of genetic scientists, but has become an issue of public discussion after the International Association of Athletics Federation (IAAF) announced that South African Caster Semenya, the 800m women world champion, was undergoing sex-verification tests. The athlete looks male but, in various published interviews, her father and other relatives indicate that she is in fact female and considers herself female.

“What makes us male or female? That is like saying, ‘Who is God?’ Or, ‘Who am I?’ As I say to people, you have to look at what the purpose of your sex is. If the purpose of chromosomes is to transfer genetic material from one generation to the next, then you will take a particular perspective,” Gabay opines.

He believes that at the end of the day, socially, it is one’s body type (how we look) and genitals which are important in determining sex. A recent issue of The New Scientist reports the case of a unnamed seven-year-old girl with a Y chromosome, accidentally discovered when she was genetically tested before birth. The report indicates that the child “doesn’t have ambiguous gonads, shrivelled testes or other developmental defects. She instead has a normal vagina, cervix and set of ovaries”. A team led by Anna Biason-Lauber of University Children’s Hospital in Zurich, Switzerland, thinks the patient’s normalcy is due to mutations in a poorly understood gene on chromosome 17 called CBX2.

Sex vs gender

Any good student of sociology knows that sex, the biological designation of male or female characteristics, is different from gender, a social construct ascribing roles, behaviour and relations between men and women. Gabay believes that superimposing the issue of gender on sex further complicates the question of what makes us male or female.

“We now have gender, and that is how we see ourselves. I may be in a male body but my psychology is female and how I see myself is female. And a lot of people will want to make the link between this topic and homosexuality, but it is not the same thing,” he said.

Jamaica has its fair share of unclear sex-identification issues. Gabay indicates that between four to six cases of ambiguous genitalia (which is where the clinician is unable to clearly define the sex of the child) are identified here each year. The diagnosis of androgen insensitivity syndrome is less common and is only seen about once every five years.

Eulalee Thompson is health editor and a professional counsellor. Email: eulalee.thompson@gleanerjm.com.