When we speak of gender, in a context other than language, it is a recent concept in our culture, both lay and professional. In 1955, John Money, Ph.D. first used the term "gender" to discuss sexual roles, adding in 1966 the term "gender identity" while conducting his gender research at Johns Hopkins. In 1974, Dr. N.W. Fisk provided our now familiar diagnosis of Gender Dysphoria. Previously, one’s sexual role was considered one of two discrete, non-overlapping congenital attributes--male or female. These two mutually exclusive categories allowed for no variation. Of course, we acknowledged the cultural differences in sexual roles, but there still could be only two modes of expression.

Now we know that one’s gender is on a continuum, a blending, analogous to a "gray scale." But, our distribution of gender is bimodal, that is, most people are lumped at the two ends (see graphic) with only a minority in the middle. The great majority will see themselves as either male or female with all that implies.

Probably more upsetting to our conventional view of gender than this fuzziness of gender roles is that we can be a MIX of male and female identities within the same individual. Several researchers have developed theories of how the brain develops prenatally along sexual lines arising from androgen mediation. Dr. Milton Diamond concludes from his research that the brain has four stages of gender imprinting. The first is Basic Sexual Patterning such as aggressiveness vs. passivity. Second comes Sexual Identity (gender identity), third, the Mating Centers develop (sexual orientation), and fourth, the Control Centers for sexual equipment such as orgasm.

Gunter Dörner in Germany, using his research with rats, sees only three stages. He believes that first the Sex Centers develop giving typical male and female physical characteristics, then the Mating Centers (sexual orientation) and then the Gender Role Centers which are similar to Diamond’s "Basic Sexual Patterning."

As a psychotherapist, I don’t presume to enter into the discussion of what develops in what order and how. I take a more pragmatic stance and seek to observe what behaviors are linked, or independent from one another. From this research and observation, I have developed the list of five semi-independent attributes of gender. Not as a fixed dogma, but as a working theory, a map if you will, to help us understand this complex often hotly emotional issue of gender. Consider sexual identity / behavior springing from five semi-independent attributes. These five attributes are:

It is my contention that it is possible for an individual to view oneself and function as male or female to varying degrees in each of the five sub-categories independent of the others. For example, an individual may be XX female (chromosomal female), physically female, have a "female brain," be heterosexual but see her(him)self as male--or any other combination. One can be either male or female in each of the five sub-categories independent of each other. If we use "F" for female identity/function, and "M" for male identity/function and one through five for the semi-independent attributes listed above we could describe each individual according to their particular breakdown:

1M ----- 2M ----- 3M ----- 4M ----- 5F
A Gender Dysphoric, Morphological Male

1M ----- 2M ----- 3M ----- 4F ----- 5M
A Homosexual Male

1F ----- 2F ----- 3M ----- 4F ----- 5F
A Dominant, But Heterosexual, Even Feminine, Female

Since each of these independent attributes are graded, it is easy to see the possible combinations and degrees number in the thousands. With regard to gender, we each can be in a category of one--ourselves.

Whether it’s gender identity, sexual orientation, or brain sex, the expression usually remains constant from childhood throughout one’s life.

Now, for a more detailed description and illustration of the five sub-categories of gender:

The first sub-category, Genetics, is only beginning to be understood. How and how much do genetic influences effect one’s expression of gender? We do know that besides the traditional XX chromosome of a typical female and the XY of a typical male, that there are other combinations such as XXY, XYY, and XO.

A XXY combination results in 47 rather the 46 chromosomes. This condition is called Klinefelder’s syndrome and occurs in one in every 500 births. Individuals with Klinefelder’s are sterile, have enlarged breasts, small testicles and penis, and a eunuch body shape much like the "Pat" character on "Saturday Night Live." They show little interest in sex.

Another 47 chromosome occurrence is XYY Syndrome. In this syndrome, the hormonal and physical appearance of the individual are evidenced as a normal male, but behavior is effected. Typically, XYY Syndrome people are bisexual or paraphilic (pedophillia, exhibitionism, voyeurism, etc.), and show very poor impulse control.

Where Klinefelder’s and XYY Syndrome are examples of an extra chromosome, Turner’s syndrome is a case of a missing sex chromosome. These individuals possess 45 chromosomes (written as XO), are unable to develop gonads, and are free of all sexual hormones, except those crossing over from the mother during fetal life.