|Many of these women have Androgen insensitivity syndrome and are genetically XY despite appearing as "normal" women. All of them have disorders of sexual development and as such are on the intersex spectrum.|
Treatment of intersex individuals is controversial, with the old method being immediate surgical assignment of a single sex at birth based on the appearance of the genitals. This is not only traumatic to the child, but can cause serious psychological issues if the individual does not identify with that gender as an adult. Modern methods still involve assigning a gender, but assignment surgery is not recommended until the individual can make a decision for themselves what (if any) surgery they want. The only surgeries that should be done are necessary, some even saving a child's life. Assignment is also not based on external anatomy, but rather tests such as hormone panels.
|A transwoman (male-to-female) who's in the Spanish legislature|
|A transman (female-to-male)|
The reasons given above are why, in many ways, sex and gender should be defined on a spectrum. This is especially true of gender, since gender categories are far fuzzier and more numerous than sex. There are some cultures that are more accepting of people who are outside of gender norms, including those who accept more than two genders. Hopefully, the cultural trends toward acceptance will continue.
Sources are Intersex Society of America, CNN, TransGenderCare, Transgender Law and Policy Institute, Psychology Today, and All Mixed Up. Images are from Wikimedia Commons and are under Creative Commons licenses or are copyright free: one, two, three, four.