The extraordinary complexity of sex determination

I’ve posted this before, but Scientific American reposted it today in light of the Trump memo.

Determination of biological sex is staggeringly complex, involving not only anatomy but an intricate choreography of genetic and chemical factors that unfolds over time. Intersex individuals—those for whom sexual development follows an atypical trajectory—are characterized by a diverse range of conditions, such as 5-alpha reductase deficiency. A small cross section of these conditions and the pathways they follow is shown here. In an additional layer of complexity, the gender with which a person identifies does not always align with the sex they* are assigned at birth, and they may not be wholly male or female. The more we learn about sex and gender, the more these attributes appear to exist on a spectrum.