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Public arguments about biological sex often become tangled because several different questions are treated as though they were the same. Chromosomes, hormones, genital development, secondary sexual characteristics, and identity are placed into one conceptual pile, and the resulting complexity is then offered as evidence that sex itself must be a spectrum.
In his 2025 commentary, “Why There Are Exactly Two Sexes,” Colin Wright argues that this confuses the definition of sex with the mechanisms that determine it and the traits that ordinarily develop from it.
His central claim is straightforward: in anisogamous species, including human beings, sex refers to one of two reproductive functions. Male organisms are organized around the production of small gametes, or sperm; female organisms are organized around the production of large gametes, or ova. There is no third gamete type and, therefore, no third reproductive sex.
The qualification concerning biological function matters. Children, elderly people, infertile adults, and people with developmental conditions do not become sexless because they are not presently producing gametes. They belong to the reproductive class their bodies developed toward, even when that reproductive system is immature, impaired, or nonfunctional.
Five Sources of Confusion
Wright addresses five arguments commonly used to deny that sex is binary.
First, some fungi and slime moulds are said to possess hundreds or thousands of sexes. Wright explains that these organisms have numerous mating types: compatibility categories determining which organisms can reproduce with one another. Mating types are not sexes because they are not organized around the production of sperm and ova.
Second, variations such as XXY, X0, XX males, and XY females are offered as evidence that chromosomes create more than two sexes. This confuses how sex is determined with what sex is. Different species use chromosomes, temperature, environmental signals, or other mechanisms to direct sexual development. These mechanisms vary enormously, while the two reproductive functions remain the same.
Third, differences or disorders of sex development are presented as positions along a sexual continuum. These conditions demonstrate that sexual development is complicated and can produce ambiguous outcomes. They do not, however, produce a third kind of gamete or reproductive system. Difficulty classifying a rare individual does not create another reproductive class.
Fourth, sex is sometimes described as a cluster of chromosomes, hormones, anatomy, neurological features, and secondary characteristics. Since these traits vary, the argument goes, sex must also vary along a spectrum.
Wright’s answer is that these traits are causes, indicators, or consequences of sex, not its definition. A trait can only be described as male-typical or female-typical because males and females have already been identified by some independent standard. Remove the reproductive distinction, and the labels “male-typical” and “female-typical” lose their biological reference point.
Finally, multilevel models speak of chromosomal sex, hormonal sex, anatomical sex, behavioural sex, and sometimes gender identity as though each were a separate component of an individual’s sex. Such models may help physicians describe a patient’s particular biology, but description should not be confused with definition. A medically useful inventory of sex-related traits does not establish the existence of additional sexes.
Variation Does Not Abolish the Categories
The most useful distinction in Wright’s paper is between variation in sex-related characteristics and variation in the number of sexes.
Hormone levels vary. Bodies vary. Secondary sexual characteristics overlap. Sexual development can proceed atypically, and a small number of people may be difficult to classify unambiguously. None of this is denied by the reproductive definition.
A category can contain substantial variation without becoming a spectrum of categories. Human beings vary enormously in height, strength, appearance, fertility, and hormone levels, but this variation occurs within and between the two reproductive classes. Complexity at the level of traits does not generate additional reproductive functions.
A competing commentary by Brian Earp, Morgan Carpenter, and Sebastian Porsdam Mann accepts the existence of two gamete-based reproductive plans, but argues that “sex” can have additional, context-dependent meanings when classifying actual bodies in medicine or public policy. That is a serious practical consideration: a physician may need more information than a male-or-female box can provide.
It does not, however, refute Wright’s biological argument. Medical forms may require detailed information about anatomy, hormones, medications, pregnancy capacity, or surgical history. Recording those facts improves patient care without turning each combination of traits into another sex.
What the Paper Does — and Does Not — Establish
Wright’s paper is a scholarly commentary synthesizing evolutionary and developmental biology, not a new experiment or dataset. It provides a clear biological definition and tests several prominent objections against it.
Its argument is directly relevant when someone claims that chromosome variations, intersex conditions, overlapping characteristics, or numerous fungal mating types prove that human beings have more than two sexes. They do not.
The paper does not, by itself, settle every dispute involving transgender people. Biological description and public policy are related but separate questions. How society should handle identity, medical treatment, legal documentation, privacy, or sex-separated spaces requires additional evidence and moral reasoning.
That boundary strengthens rather than weakens the argument. Human dignity does not depend upon pretending that biological categories are unreal, and biological categories do not spaces requires additional evidence determine how every person must be treated in every circumstance.
There are two sexes because sexual reproduction in human beings is organized around two gametes and two corresponding reproductive functions. Developmental variation is real, sometimes medically significant, and deserving of humane treatment. It does not supply the missing third gamete required to create a third sex.
Complexity should improve our descriptions. It should not be used to erase the biological distinction that makes those descriptions intelligible in the first place.

Evidence note: Wright’s article was published as a commentary in Archives of Sexual Behavior. He is a salaried employee of the Manhattan Institute and has provided paid expert testimony on related issues; both are disclosed in the paper. The article is open access and can be read in full here.
The Alberta Medical Association and the Canadian Pediatric Society want Canadians to believe the debate over pediatric gender medicine is settled. It is not.
When Premier Danielle Smith announced restrictions on transgender medical interventions for minors, major medical bodies responded with the language of emergency. The Canadian Pediatric Society warned that Alberta’s policy would undermine the rights of transgender children and youth. The Alberta Medical Association’s pediatrics section argued that the government was targeting an already vulnerable population. The public message was clear enough: responsible doctors affirm; politicians interfere; children suffer.
But that framing hides the central problem. There is no stable international medical consensus on pediatric transition. In fact, several European jurisdictions have moved in the opposite direction from Canada’s professional bodies, not because they have stopped caring about distressed children, but because they have begun applying more ordinary standards of evidence to extraordinary interventions.
That distinction matters. Puberty blockers and cross-sex hormones are not counselling, kindness, or protection from bullying. They are medical interventions into the development of physiologically healthy children and adolescents, often at an age when identity, sexuality, mental health, peer influence, family conflict, and neurodevelopmental conditions are still in motion. A serious medical institution should be able to say that without sounding frightened of its own profession.
Instead, Canadian medical institutions often speak as if caution itself is the danger.
The most revealing example is the suicide argument. Parents and voters have been told, sometimes openly and sometimes by implication, that restricting pediatric transition will kill children. The activist version is familiar: would you rather have a dead daughter or a trans son? The political version is not much better. Former Calgary mayor Naheed Nenshi told Premier Smith that “votes aren’t worth a few dead kids.”
That is not clinical reasoning. It is emotional coercion applied to frightened parents.
The evidence does not support the crude version of the claim. A 2024 Finnish register study in BMJ Mental Health examined more than 2,000 adolescents referred to gender identity services and compared them with more than 16,000 matched controls. The authors found that suicide deaths were rare, and that once psychiatric treatment history was accounted for, gender-referred youth did not show higher all-cause or suicide mortality than controls. The study does not say these young people are not distressed. It says the simple story — affirm or they die — is not evidence-based medicine.
That should change the conversation. Many adolescents presenting to gender clinics also carry depression, anxiety, autism, trauma histories, eating disorders, family instability, social isolation, or other serious mental-health burdens. If those burdens are treated as secondary to gender identity, medicine risks narrowing the diagnostic lens at exactly the moment it should be widening it.
This is one of the main lessons of the Cass Review in the United Kingdom. Cass did not recommend abandoning children with gender distress. It called for a more holistic model of care, better assessment, stronger evidence, and far more caution around medical pathways. NHS England subsequently stopped the routine prescription of puberty blockers for gender dysphoria in minors, moving them into a research setting rather than ordinary clinical use.
That is not a small update. It is a major warning to every country that imported the affirmative model and then treated dissent as bigotry.
The “pause button” metaphor has also aged badly. Puberty is not a decorative inconvenience. It is a central developmental process involving bones, brain maturation, sexual function, fertility, and identity formation. Cass specifically warned against assuming that drugs used for precocious puberty will have the same outcomes when used for children and adolescents with gender dysphoria. The medical context is different. The child is different. The purpose of the intervention is different. Pretending otherwise is not compassion; it is bad reasoning in therapeutic language.
The pathway concern is equally serious. If blockers were merely neutral time-buying devices, we would expect many children to pause, mature, and then step away from medicalization. But the available evidence shows high rates of progression from puberty blockers to cross-sex hormones. That does not prove every case is mishandled, and it does not prove no patient benefits. It does mean the intervention may help create the very path it claims merely to delay.
Other countries have noticed. France’s National Academy of Medicine urged “great medical caution” in treating gender-related distress in children and adolescents, citing vulnerability and the possibility of serious complications. The UK has moved puberty blockers away from routine use. Scotland paused new prescriptions for minors after the Cass Review. These are not fringe developments. They are evidence institutions pulling back after years of clinical momentum.
Canada’s professional bodies should be wrestling publicly with that reversal. Instead, they often sound as though the old consensus still exists.
“Institutional capture does not mean every doctor is corrupt. It means the institution has absorbed a political frame so deeply that it struggles to distinguish care from affirmation, caution from cruelty, and disagreement from harm.”
This is where the word “capture” becomes fair, but only if we are precise. Institutional capture does not mean every doctor is corrupt. It does not mean every pediatrician agrees with activists. It does not mean every child with gender distress is confused, lying, or socially influenced. It means the institution has absorbed a political frame so deeply that it struggles to distinguish care from affirmation, caution from cruelty, and disagreement from harm.
That is dangerous in any field. It is worse in pediatrics.
Children with gender distress deserve serious care. They deserve protection from bullying, family cruelty, humiliation, and ideological exploitation from every direction. They deserve psychological assessment, treatment for co-occurring mental-health problems, family involvement where safe, and adults who can tolerate uncertainty. The modern clinic population is also not the same as the older, smaller cohort of mostly childhood-onset cases; many services have seen a sharp rise in adolescent presentations, often with complex psychiatric and developmental profiles. A small number may continue to experience severe, persistent dysphoria into adulthood and may eventually choose medical transition. But that possibility does not justify allowing pediatric care to default into an affirmation-first pathway.
The honest position is not “do nothing.” The honest position is slow down, assess carefully, treat comorbidities, use exploratory psychological care rather than ideological confirmation, stop using suicide as a rhetorical weapon, and stop pretending that uncertain evidence becomes settled science because a professional association says so.
Medicine earns public trust when it disciplines itself. It loses that trust when it borrows the moral posture of activism and then demands deference as science.
The AMA and CPS still have a choice. They can defend vulnerable children by telling the whole truth: that distress is real, that cruelty is wrong, that some cases are complex, and that the evidence for routine medical transition in minors is weaker than Canadians have been led to believe. Or they can continue treating democratic oversight and parental caution as the real threat, while countries that reviewed the evidence more seriously move toward restraint.
“Medicine earns public trust when it disciplines itself. It loses that trust when it borrows the moral posture of activism and then demands deference as science.”
The issue is not whether vulnerable youth should be helped. They should.
The issue is whether Canadian medical institutions can still tell the difference between helping children and protecting an ideology from scrutiny.
Right now, the answer is not reassuring.






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