In This Episode

We open with Lauren and Cori on Pride, the Endocrine Society’s annual conference, and the question nobody wants to answer: who is welcomed at Pride anymore? Then Jamie sits down with Dr. Leonard Sax — physician, psychologist, and author — to pull apart one of the most consequential statistical fabrications in the gender medicine literature: the claim that 1.7% of human births are intersex, and how a thought experiment published in a general-interest magazine became the foundation of medical and legal policy for a generation.

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Part One: Lauren and Cori

Pride, the Endocrine Society, and What’s Gay Anymore

First things first: Cori turns 51, and Lauren watched Madonna’s free concert from home — and has thoughts. They compare it to Golden Girls, and honestly, can we get more gay? (We cannot.) Cori also discusses this photo from Indianapolis Pride.

Which brings them to the question of the hour: who is Pride for anymore? And while they’re at it — who is the Endocrine Society’s conference in Chicago for? Lauren and Cori look at what both events say about where gay men and lesbians fit in institutions that increasingly can’t define the words “man” and “woman.”

Part Two: Jamie with Dr. Leonard Sax

Intersex, Anne Fausto-Sterling, and How a Magazine Essay Became Medical Canon

Dr. Leonard Sax is a physician and psychologist, the founder of the National Association for Single Sex Public Education, and the author of Why Gender Matters, Boys Adrift, and Girls on the Edge. He is also the author of the 2002 Journal of Sex Research paper “How Common Is Intersex? A Response to Anne Fausto-Sterling” — one of the most important and consistently ignored correctives in the medical literature.

Jamie and Dr. Sax walk through the full arc of the intersex prevalence claim: where it came from, how it traveled, and why it matters.

The origin: In 1993, Anne Fausto-Sterling published “The Five Sexes” in The Sciences, a general-interest magazine — explicitly a thought experiment proposing five sex categories rather than two. Her own definition of intersex was specific: chromosomal sex inconsistent with phenotypic sex, or ambiguous genitalia.

The inflation: By 2000, Fausto-Sterling’s co-authored paper “How Sexually Dimorphic Are We?” (Blackless et al.) arrived at 1.7% of human births as intersex. The number spread fast — journalists, academics, clinicians, policymakers. Most didn’t look at what she was actually counting.

The rebuttal: Sax’s 2002 paper showed the 1.7% figure included conditions with no relationship to Fausto-Sterling’s own definition — people who are unambiguously male or female. The biggest single contributor was late-onset congenital adrenal hyperplasia (LOCAH), accounting for 1.5 of the 1.7 percentage points. Strip out the conditions that aren’t intersex by any coherent definition, and the true prevalence is approximately 0.018% — nearly 100 times lower.

Why it matters: The number has been used to argue that biological sex is not dimorphic and that binary sex categories are scientifically indefensible. It has appeared in legal briefs, medical society statements, and clinical guidelines. It is not supported by the evidence.

Jamie and Dr. Sax also discuss what intersex conditions actually are, what good clinical care looks like, and why conflating DSD with gender identity harms the people and families who deserve honest medicine.

Resources

* Leonard Sax, “How Common Is Intersex? A Response to Anne Fausto-Sterling,” Journal of Sex Research, Vol. 39, No. 3 (August 2002): 174–178

* Blackless et al. (Fausto-Sterling), “How Sexually Dimorphic Are We? Review and Synthesis,” American Journal of Human Biology 12 (2000): 151–166

* Anne Fausto-Sterling, “The Five Sexes,” The Sciences (March/April 1993)

* Leonard Sax, Why Gender Matters — leonardsax.com

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