A Way Beyond the Rainbow

#74 - On Gender Atypical Individuals and Intersex

February 04, 2022 Mobeen Vaid and Waheed Jensen Season 5 Episode 9
A Way Beyond the Rainbow
#74 - On Gender Atypical Individuals and Intersex
Show Notes Transcript Chapter Markers

In this episode, we continue our discussion of gender nonconformity with Br. Mobeen Vaid, and we discuss the notions of gender atypical individuals from an Islamic perspective, as well as the concepts of intersex/disorders of sexual development from a medical perspective.

What are the differences between al-khunthā al-mushkil (ambiguous khunthā), al-mukhannath al-khilqī (congenital mukhannath) and al-mukhannath ghayr al-khilqī (affected or non-congenital mukhannath)? Does khunthā represent a third gender? To what extent does Islam accommodate gender atypical individuals and guarantee their legal rights under Shari'a? Who is the verse in the Qur'an about "men who possess no sexual desire for women" referring to exactly? Biologically and medically speaking, how do intersex syndromes arise and how can they be treated? These and other questions are explored in this episode.

References used in this episode:
- “And the Male Is Not like the Female”: Sunni Islam and Gender Nonconformity (Part 1) by Mobeen Vaid
- “And the Male Is Not like the Female”: Sunni Islam and Gender Nonconformity (Part 2) by Mobeen Vaid and Waheed Jensen

Extra resources:
- Intersex Society of North America - official website
- Support and advocacy groups for intersex individuals - here and here

Waheed  00:38
Assalamu alaikom warahmatullahi ta’ala wabarakatuh, and welcome back to “A Way Beyond the Rainbow”, this podcast series dedicated to Muslims experiencing same-sex attractions who want to live a life true to Allah subhanahu wa ta’ala and Islam. I'm your host, Waheed Jensen, and thank you for joining me in today's episode. In today's episode, inshaAllah, we will continue our series on gender, gender nonconformity, gender dysphoria, as well as transgenderism. And as you guys remember, in the last episode, Br. Mobeen Vaid joined me, and we spoke about gender and gender nonconformity, and in this episode, Br. Mobeen is joining me again, and we will be talking about gender atypical individuals from fiqhi and social perspectives. And we'll also be talking about individuals with disorders of sexual development, also known as intersex persons or intersex syndromes. In the first portion of this episode, we will be talking about Br. Mobeen’s article ““And the Male is Not Like the Female”: Sunni Islam and Gender Nonconformity (Part I)”, the link to which you will find in the episode description. And towards the end of this episode, inshaAllah, I will be diving deep into the medical perspectives with regards to individuals with disorders of sexual development (or intersex syndromes), inshaAllah. So let's get started with today's episode. 

01:59
Br. Mobeen, assalamu alaikom. 

Mobeen  02:01
Wa alaikom assalam warahmatullah. 

Waheed  02:03
Welcome back to our second episode in the series on transgenderism and gender dysphoria. Br. Mobeen and I will be talking today about the intersex syndromes, the mukhannath and al-khunthā, and the trifurcation of gender atypical individuals. Br. Mobeen has written part one of the article in 2017 ““And the Male is Not Like the Female”: Sunni Islam and Gender Nonconformity (Part I)”, and you have broken down the issue of intersex or gender atypical individuals. And basically you have discussed how, according to Islam, there is a legal trifurcation into three categories of gender atypical individuals: The first being al-khunthā al-mushkil or the ambiguous khunthā, the second being al-mukhannath al-khilqī who is the congenital mukhannath, and the third is al-mukhannath ghayr al-khilqī which is the affected or non-congenital mukhannath. And we will be talking about these three categories, inshaAllah, in today's episode. 

So the first category is al-khunthā al-mushkil or the ambiguous khunthā. And it's important, according to the fuqaha’ (religious scholars), as you have laid out in your article, to kind of identify the true gender of the ambiguous khunthā whenever possible, and you went into the examples of gonadal agenesis and the hermaphrodite - gonadal agenesis being when the gonads (sex organs) did not form, versus the hermaphrodite, which is the opposite side of the spectrum, where the male and the female genitalia are present in the same individual. And now the question would be, well, back then, this is what they had known, but nowadays, with the advancement of medical technologies, and obviously the large number of people, you would find that within given populations, there would be individuals who fall under the “intersex” umbrella. So with the cases of, for example, ambiguous genitalia, or particular intersex syndromes, would they fall under the category of al-khunthā al-mushkil, in this case, given our modern understanding of that? 

Mobeen  04:13
Bismillah (in the Name of God), wassalatu wassalamu ‘ala rasuli Allah (and peace and blessings on His Prophet (PBUH)). So let me say that there are a number of different categories today that fall under what they call as “disorders of sexual development”, and those can incorporate or involve different forms of, again, they're just different physiological and biological disorders, not all of them, obviously, will correspond to something as a al-khunthā al-mushkil, in the sense that when we're talking about the al-khunthā al-mushkil, we're talking about an individual that is affectively ambiguous in attempting to identify or determine what their gender is. Many disorders of sexual development are things that are atypical, sometimes extremely or exceedingly atypical, but they are not the type of things that otherwise obscure a person's gender. They are things that may be uncommon, extremely uncommon, as I mentioned, for one gender or another, but the individual in question is clearly and unambiguously a woman or a man. Those particular specific conditions that make the determination of whether or not the person is a man or a woman, or provide us the means by which we can discern what gender that person is, that's when that category of al-khunthā al-mushkil really comes into consideration and sort of the view of how we need to look at the condition in question. 

Waheed  05:41
Alright. And you also outline in your article that the fuqaha’ have used particular means that were available to them at the time. So, for example, they would identify where exactly the urine comes from, in the case of a hermaphrodite, for example, or by physically examining the body to try and see to which gender this individual belongs, versus today, for example, with the advancement of medical technology, we have genetic examinations, we can identify the XX or XY chromosomes, or any variations thereof, as well as the different hormonal levels, we have imaging techniques like ultrasound, for example, we can look inside the body and identify if a uterus or ovaries are present or not, and so on. So can you share with us an overview of how the fuqaha’ would address the issue of ambiguous genitalia at the time? 

Mobeen  06:29
So, what you mentioned, the primary or principal means by which the fuqaha’ and scholars used to attempt to determine gender, especially in a pre-adolescent individual, was to really look at how the urination is occurring. So that was really the means that was examined. And the idea is that we have someone that is physiologically ambiguous, there are some androgynous features here, and we're trying to make good faith reasonable determination as to what gender that person is, by investigating or interrogating some aspect of their biology that could give us insight into that. And they did that at young ages, although it wasn't exclusively what they had done, or what they used to do. Obviously, they would wait for a person’s sexual development as well. And so, you know, if a person, for instance, goes through menses and begins having their period, then it becomes obvious that that's a woman. If the pubescent development is more male or masculine, then they make the determination that it is a male, right? 

So, these categories were oftentimes temporary categories until we could arrive at looking at such a person as a male or a female. In rare situations, al-khunthā al-mushkil remained a khunthā mushkil, where you have a person who really is just physiologically and fundamentally androgynous in many, many ways, and there's nothing that is really elucidating for us what gender we can sort of regard that person as. And in those situations, they would simply continue to look at that person as a khunthā mushkil, and there is an entire canon of juristic literature that exists that talks about the different rulings of the khunthā mushkil. So, when it comes to things like inheritance, or whether or not the khunthā mushkil can get married, or testimony, or just any number of things. Can the khunthā mushkil lead prayer? Where should the khunthā mushkil stand, with men or women? You know, all of these things come up, and in some ways, it really goes to show just how thorough the jurists were in outlining a detailed exposition of juristic and religious literature that really accounted for situations and used cases were people existed within some territories that had androgynous and physiologically ambiguous characteristics that did not yield a clear gender identification. 

Waheed  09:11
Right. You also tell us that the fuqaha’ would generally say that, if the physiological gender could be established according to one of the methods that they use, like the bodily examination, or if they could identify that the urine is coming from this place, then okay, this is a male or a female. Many current day fuqaha’ are of the view that surgery would be permissible in this case to provide a corrective removal of what they would consider to be superfluous sexual organs, in the case of hermaphrodite, for example, we're referring to that. And in the case that such methods would fail - they wouldn't be able to identify what the actual sex of the individual is - then the ambiguous khunthā remained ambiguous and was not permitted to marry, according to the majority of jurists, but you mention a minority position is reported from Imam Al-Shafi’I, allowing the khunthā to make a non-retractable gender selection, after which he/ she would be required to live by the conventions and abide by the rulings of the chosen gender. 

Now, that was way back when. But, nowadays, with advancements of medical technology, we could identify based on chromosomal sex to which sex the individual belongs. And then once gender is established, we would treat the individual according to his/her newly established gender. Correct me if I'm wrong, is this right? 

Mobeen  10:31
You're absolutely right, I think the general rule that most of the fuqaha’ have sort of agreed upon is the whole notion of corrective surgeries being permissible, in some cases strongly encouraged, especially when you're dealing with situations where risks are being reduced, and sometimes some of the disorders of sexual development, if they're not addressed, you run the risk of gonadal tumors, you could have contra-sexual pubertal changes, or things like that that are certainly at stake. And so, in situations the person needs to pursue corrective surgery, there's no problem at all with that, where, obviously, the fuqaha’s objection is with the attempt to socially engineer physiological and biological changes through the imposition of what we're seeing with the transgender movement, by way of hormone therapy, puberty suppression, and then full medical and surgical modifications.

Waheed  11:31
Right. Absolutely. Now, given this discussion, I got a question from a brother who asked, how should Muslims respond to the claim that intersex people or individuals who have disorders of sexual development, those prove that sex is not a binary, or it actually proves that sex is a social construct, because the gender determination methods of the fuqaha’ seem arbitrary or have changed over time? How would we respond to this question? 

Mobeen  12:01
No, well, I mean, number one, disorders of sexual development are quite rare, it depends on how people categorize or classify that category, there are people today who incorporate more into disorders of sexual development than are typically or have been traditionally evaluated. So, for example, there are certain things that are a bit more common, but also, those are the types of things that don't even appear at the surface and oftentimes are not readily identifiable; the person is still sort of unambiguously male or female, they may just have some, you know, when it comes to different hormonal imbalances, things like that, and they may conflate all of those, i.e. every single situation in which you have non-conforming physiology of some sort or a biological complication with an individual and sort of refactor that and present it as a disorder of sexual development or a intersex individual, whereas those people aren't really intersex, certainly not physiologically as sociologically, and even physiologically they’re probably not, regardless of the sort of challenges and situations that they're dealing with, ones that oftentimes can be corrected through medical intervention, and many of which don't even require any medical intervention, because they don't present as something that severe, problematic or medically implicative, let alone biologically or physiologically present. 

So, in any event, there is that. In addition to that, I think a person can, in any situation, take a look at certain exceptional use cases and try to use the exceptions to underride for override the norm and the general rule through which Allah subhanahu wa ta’ala created His creation, and the idea that, okay, we have certain individuals, statistical minority at that, very rare minority, that has a disorder of sexual development, therefore, the entire category of male and female, or to speak of humanity as being comprised of men and women, is an entire category error or too simplistic or reductive and doesn't account for these sorts of more marginal or rare cases, and if someone wants to take that logic and expand upon it or advance it in any other arena of life, well, you would just destabilize any category. You would destabilize the way in which we think and talk about anything. Not only that, but our entire perception of how we look at these particular issues, i.e. our perception of what counts as a disorder of sexual development is predicated on our understanding of gender in a particular way. If we did not understand men and women through a particular light, we wouldn't even be able to identify them, and those things are so obvious and intuitive that that becomes the presumptive prism through which we end up evaluating and looking at people and trying to determine whether or not there are complications that exist when it comes to their own sexual development. 

So, I think sometimes these types of criticisms are thrown in as ways to simply problematize the more obvious norms through which human beings look at the world, as opposed to being ways in which to really deeply understand those exceptions. That's been my experience at least, that “Oh, you know, we have this rare exception, and therefore, you know, this whole binary stuff is just not really meaningful!” as opposed to, well, how do we understand this in light of the fact that we have this gender binary? Well, it actually is not a terribly difficult thing to do, the same way that we understand exceptions in any other sort of form of life and domain. And, in fact, when you start taking into account the fact that many of these disorders of sexual development do not completely extricate the individual in question from having a clear gender identity, even if, in certain cases, there has to be surgical and medical corrective intervention, and here I’m talking about fully androgynous end to end, that's a very, very rare exception. And so, you know, in some ways, it just goes to further prove that binary and just show how total it is and is part of the human condition. 

Waheed  16:26
For sure. Now, in the part II article, you mentioned something in footnote 184, in particular, which is the opinion held by Imam al-Qurtubi based on Surat Ash-Shura, verse 49, where Allah says “​​To Allah belongs the kingdom of the heavens and the earth. He creates what He wills. He grants females to whom He wills, and grants males to whom He wills.” And so, basically, the opinion that Imam al-Qurtubi held was that sexes outside of the binary may exist and that this doesn’t pose an issue, because Allah may create what He wills based on this ayah (verse). In other words, a khunthā is not necessarily a male or female whose true gender is merely ambiguous to us, but that a khunthā may actually be neither male nor female. So according to al-Qurtubi, it's legitimate that some people are actually neither male nor female (physiologically speaking). So the question is, how valid or popular is al-Qurtubi view? And is it something that we as Muslims can use in our discussions with people who follow the trans or feminist movements? What do you think? 

Mobeen  17:34
Yeah, Jazak Allah khair, that’s a good question. I'll start with the easiest one, which is how popular is this view - I don't know. I guess, perhaps there is a scholar who's actually done more research on this particular comment of Imam al-Qurtubi (may Allah have mercy on his soul), where he talks about the verse (يخلق ما يشاء يهب لمن يشاء إناثاً ويهب لمن يشاء الذكور), that there are some that He blesses with daughters and others whom He blesses with sons (Qur’an, 42:49). The question here I'll talk about it in a couple of ways. I think the first is the notion of the khunthā, obviously, he's saying that it doesn't undermine this; this distinction between male and female is not undermined by the presence of the khunthā, especially in cases where the khunthā is fundamentally and totally and essentially indeterminate to us. And there may be situations where someone is entirely indeterminate, and again, we're talking about a very, very small statistical probability and likelihood amongst mankind, where we simply cannot identify or discern what gender that person is. So, in those situations, the whole point is that we do have a category called the khunthā. And I think what we're seeing from Imam al-Qurtubi (may Allah have mercy on his soul) is simply an observation that accounts for that statistical possibility, even if it’s low, and it just doesn't sort of ignore it. He's simply saying that the khunthā, in fact, can exist and coincide with or alongside this verse that speaks of men and women. That doesn't undermine it, even though their true gender is something that we're unable to determine, and the person him/herself is unable to determine as well. We just don't know. 

I'd say, you know, when it comes to discussions with trans and feminist movements, I don't know how we'd use it with them, because there is, in this, still something of an acceptance of gender essentialism that's occurring, in the sense that the reason that this person is so indeterminate to us is predicated on our inability to make a discernible judgment on the basis of biology and other attending factors that typically reveal to us a person's gender one way or another. In the absence of that, we are in a place where we cannot simply do guesswork, because so much of the Shari’a is predicated on an understanding of the person's gender; when we don't have a clear picture of what that is, what we do is we treat that person as a khunthā mushkil, sort of indeterminate hermaphrodite, or an ambiguous khunthā. That's very different from the trans movement insofar as the trans movement is really saying that an individual's gender preference and self-identification must be honored, and they are, in fact, the gender that they claim. 

Waheed  20:51
Based on their subjective experience, right? 

Mobeen  20:54
Based on anything, based on their subjective experience, based on little more than their self-claim to that gender. Based on a little more than their claim to that gender. The history behind it or whether or not they have a well substantiated claim, or have they shown a persistence in gender dysphoria, all of that is largely irrelevant when we start thinking about transgenderism, the popular claim of simply affirming people on the basis of their self-reported claims to being a different gender. In fact, gender dysphoria itself as a category has shifted the underlying problem from what was previously regarded as gender identity disorder. Gender identity disorder found that disjunction itself as something of an issue. In fact, it was a disorder, right? So we're seeing it as something that was psychologically pathologized or looked at as an issue or a problem. Now, gender dysphoria says, no, the actual problem is the anxiety that the person feels about the dysfunction; if there is no anxiety, depression, or attending difficulties in the person’s psychosocial state, then their mere consideration or thinking or belief of themselves as being a different gender is actually not a problem at all. The problem are those people who are making that person feel alienated, unwanted, they aren't affirming their humanity in the fullest sense of the word. That's where the problem comes in for them. 

And so, for the trans movement, this entire discourse is profoundly dehumanizing, it is, in the minds of many people, a form of violence, in fact, to have a larger paradigm or worldview [like ours], even if that worldview is sensitive to people in situations where there may be ambiguities, there may be differences that require us to work with that person to try to arrive at a good faith identification of who that person is, vis-à-vis their gender and their biology, which is the essential thing that we're looking at here. And likewise, with the feminist movement, I don't know that the feminist movement would necessarily be bolstered by this history. In fact, there's an extent to which the feminist movement may even object to a lot of this and simply look at it as an artifact of patriarchy and oppression and everything else. And so, I think we have to be careful, I mean, one of the things that I think is very tough to do is to produce, out of thin air, or even based on the rudiments of the tradition, a refactored or reconfigured story of religion that somehow fits these intellectual currents that dominate the societies that we're in. If we end up doing that, more often than not, what we're going to likely produce is something that is unsatisfactory to them and actually risks being inconsistent with Revelation. 

And so you're sort of stuck in between people who are not going to accept you short of you putting together a full throated confession of what they're saying. There is a type of conversion that is required in many of these groups and spaces for a person to really be incorporated, included and assimilated into their larger program, as opposed to them looking at something like this and saying, “Whoa! This Islam really is something that is so rigorous and robust in how it views gender!” I think much of this would probably still strike a number of them, perhaps a majority, as still an outdated, medieval, out-of-touch, those types of things. 

Waheed  24:50
Alright, so that's as far as al-khunthā al-mushkil, or the ambiguous khunthā is concerned. And the second category is that of al-mukhannath al-khilqī, or the congenital mukhannath. Unlike the first category, this category of mukhannath has no anatomical or developmental ambiguities. The mukhannath is identifiably and unambiguously male or female, and in the case of the female, she would be called a mutarajila who adopts the male mannerisms (versus the mukhannath who adopts the female mannerisms). So, they manifest the mannerisms and affectations of the opposite gender. So, that could be the pitch of the voice, the gait, the involuntary absence of facial hair, and attributes that may be deemed belonging to the opposite gender. The source of this predisposition is considered by a lot of the jurists, as you mentioned, to fall outside of any reasonable control, with the result that this congenital mukhannath is considered blameless insofar as he or she exhibits traits that are dispositional, or khilqi, to that person. And there was also a debate or disagreement among jurists to what extent this person is required to at least make a reasonable effort to change his/her mannerisms or not. So, can you tell us a little bit about this? And what would be the legal recommendations in the case of al-mukhannath al-khilqī

Mobeen  26:16
Yeah, jazak Allah khair. So when we're talking about al-mukhannath al-khilqī, as you noted, we're talking about our dispositional attributes of their behavior, or their presentation – not necessarily, I don't want to say presentation, I'd say, you know, it really is just their own development, as it were their biological development, that seems to or appears to coincide more readily with the opposite gender. So, again, these are things that are unavoidable. Oftentimes, we're talking about mannerisms, and the fuqaha’, in general, do not blame individuals for things that occur in such a manner, congenitally, and are not being done deliberately. And the two [attributes] that you noted that are consistently repeated are really voice and gait (i.e. how someone walks). The most common discussion here really relates to the mukhannath, or the effeminate male, who perhaps sounds like a female or walks with a particular sway that is more common to women. All the jurists say that, if a person does that in a way that is not deliberate, he is not trying to be provocative, but it's simply something that they were born with, then they are not blameworthy for that particular characteristic or feature of their being. 

Some of the scholars said that individuals that have these characteristics and mannerisms and behavioral traits are required and obligated to make a reasonable effort to change them, a reasonable effort to change them. And so, if there's a way for them to normalize how they walk, for instance, they should in fact do so. If they can speak in a way that sounds more masculine, then they should, in fact, try to do so such that they grow accustomed to having perhaps a deeper voice. Some said this though [i.e. held this legal opinion], it's a minority. I mean, the majority of scholars simply said that there is no blame on such a person, and they are not religiously condemned or morally responsible in a negative way or censured in any capacity for simply having that sort of manifested set of mannerisms. So you talked about sort of the legal implications of that, that tends to be what the jurists said on that particular point. 

Waheed  28:53
Alright, sounds good. And with regards to, I mean, when I read your paper the first time, the discussion on al-mukhannath al-khilqī, in particular, it gave me this feeling that Islam is not as rigid in forcing people into categories, or “You have to behave this way! You have to conform!” but rather it opens the door for you to “express yourself” in a way - well, I'm using the modern terminology here! - to kind of “just be yourself”, as long as you don't trespass particular boundaries that are set by Allah subhanahu wa ta’ala. Because technically, you said that the majority opinion of the fuqaha’ in this regard, with regards to the congenital mukhannath, is that there is no blame on you, and you don't really have to change (i.e. change your gait, your mannerisms, your voice, etc.), as long as that is beyond your control? 

Mobeen  29:52
Correct. Yes. They say he's under no obligation to change or under no obligation to even to try, so long as those behaviors are innate and not deliberately affected. I think, in general, one of the things that's really remarkable in this particular discussion is how much ink has been spilled, in general, by the tradition, by scholars, on these categories of the khunthā and the mukhannath, and just all of the dialogue on it, given the fact that many of these, even as social realities, are quite rare, right? I mean, al-khunthā al-mushkil is not a sort of common occurrence, certainly not common enough that one would expect long, lengthy legal discussions on the khunthā. And yet, we do find a times very lengthy discussions on the khunthā. And likewise with the mukhannath, you do have a lot of literature that abounds concerning the mukhannath, and different use cases and questions and considerations that go into the mukhannath’s participation in the social life of the community, and so all of that is discussed in a lot of detail. And the fact is that they accounted for such individuals in a way that was sensitive to things that were simply a byproduct of how Allah made them, as opposed to those things that became a test for the individual insofar as they were cosmetically and affectively performing, or deliberately behaving like the opposite gender. And so, to your point, there are those red lines, and then there are other situations and circumstances where there's a great deal of latitude. 

Waheed  31:37
For sure. And another issue is that, if you look way back when, I think that society was more accommodating to those individuals, as in there weren't any “hate crimes”, if I'm going to use this term, or they didn't punish them, they didn't laugh at them, or make fun of them, and actually, they punished those who would say something against them in a bad way. Whereas, nowadays, in many of our Muslim countries, even though those men or women have tried their best to adapt and to change their ways, - even though they're not obligated to do that - they still face a lot of hate and abuse and crimes from people. And this is a very common question that I get asked, that's not on them, that's not their choice, it's not their decision. And yet, they're trying to live righteously and abide by the rules of Allah subhanahu wa ta’ala and be righteous Muslims, and they get a lot of hate, and they might even be killed, or at least abused, all over. I don't know to what extent we can actually answer this, because this is kind of beyond us, but how do we, as Muslims deal with this? I think that this is a social/cultural issue, it's more than a religious issue, because religion is kind of clear where these things stand. But how do we respond to this, because this is kind of a counter argument that a lot of the trans activists use? 

Mobeen  32:53
Yeah, and I think it segues well from the discussion that we had last time, which is to say that we do recognize how deeply gender is something that is biologically inscribed, it is not simply the plastic workings of a social order. Nonetheless, we do understand that there are certain aspects of how gender is made up socially that is in fact constructed, that does refract certain social conditions, and that does place people in situations where the conditions impose on individuals certain norms, and those norms guide how those people behave in society, or the way that they dress, or the way that they look at themselves. And these things can be at times quite oppressive, right? I mean, we're not denying that. 

So, consider, for instance, something that I think is quite clear in Islam, which is the notion of telling another person that you love them, that you love them for the sake of Allah subhanahu wa ta’ala. This is, in fact, something that is meritorious, the Prophet (PBUH) encouraged this, and he instructed this, “If you love your brother, tell him that you love him for the sake of Allah subhanahu wa ta’ala.” There are du’aas (supplications) that a person responds with “may the One for Whose sake you love me love you”, etc. These things were not uncommon things to do. Based on just how, in some ways, perverted the sexual schema is of the modern West on the one hand, and on the other hand, the type of guidelines that drive how people should interact and behave with one another, something like that, which is in fact a meritorious thing, it actually carries with it, in the minds of even normal just everyday Muslims, it can carry unwanted implications that make a person uncomfortable. And so, suddenly now, telling another, telling your brother or your sister that you love them is something that's not uttered as frequently, right?  

Waheed  34:47
Unfortunately. 

Mobeen  34:48
Because, suddenly, now everything becomes suggestive of some form of nonconformity, or a person who does that may be looked at as “Oh, like, maybe that person's gay or lesbian or something!” And it’s like, no, you can't even tell another person you love them for the sake of Allah subhanahu wa ta’ala! In many Muslim societies, I've noticed this myself, just perhaps a decade ago even, in many ways, it was very, very common for men to hold hands while walking, very common, and there were no sexual implications that were there, right? There's nothing sexual about it. It was simply a loving, brotherly, platonic relationship, and you walk in the street and you're holding hands. It's two brothers in faith. I've noticed that now, that doesn't happen almost at all, and I think that, to a large extent, that is the internalizing of a certain Western social norm as to how men and women are supposed to participate in society, and now, in some Muslim societies, even places where this was normal, now if two men were to do it, there would be that suggestion, or certainly that implication and insinuation that, you know, a person might look at that and say, “Well, you know, maybe that person is this or that.” 

And to add to your point, to actually just speculate about people that way is, in fact, un-Islamic. It is un-Islamic. And we do have a large set of legal literature around the concept of qadhf, or slanderous accusation, where a person makes an accusation against a person, even in mockery, which the scholars were very strident against and opposed in the strongest possible terms. So that's not something that I think we should take lightly, and I think it is a reflection of some of the social and moral deterioration of our societies, that we're seeing our gender norms and our social and sexual norms in majority Muslim societies effectively being reconfigured to reflect the West and non-Muslim societies. And when that happens, the underlying assumptions of that society give away and give life to the types of social challenges that we have here [i.e. in the West] that exists in the domain of gender and sexuality. So, it's only a matter of time, even if these trends are not as prominent, in any of these countries, once you have the edifice in place, you know, everything else is just going to take root over time, which is itself a big problem for us. 

Waheed  37:23
For sure. But here also the issue is with a lot of the Muslim countries, I mean, the Muslims around the world not understanding that there's actually leeway for people who are mukhannath khilqī, it's okay for them to adopt these mannerisms, and they're not doing anything wrong. I mean, a lot of us kind of shame them, we slander them, or sometimes commit hate crimes against them. And I think that this is one of the counter arguments that are used against us as Muslims by the LGBT community, they're like, “We have open spaces to accept those people, you are not doing a good job to accept them yourselves!” So, I guess what we're trying to say here is that religion, or Islam per se, has actually given those individuals the space to exist and to be loved and cared for without us having to do anything against them. Whereas the reality is nowadays, because of the Muslims’ understanding and the cultural implications of us being raised a certain way or internalizing a lot of different concepts than what Allah has intended. This is what I'm trying to say here. 

Mobeen  38:29
Oh, no, and I don't know if what I was saying was necessarily complementing that, I was hoping it was. But the point I was trying to make is simply that, when you have a society where platonic love between the same gender is something that is not immediately frowned upon, and in fact, is religiously encouraged in many senses, and you have a social and spiritual order that does, in fact, include deep components of inclusion insofar as we're all part of the jama’a [group/community], we’re all praying in the same row and in the same line, we all have available access to the faith and to increasing our own spiritual conviction and commitment to Allah subhanahu wa ta’ala as brothers and sisters in Islam, it’s not something that we're rejecting against people on the basis of some arbitrary forms of gatekeeping or cosmetic and superficial judgments. 

Then, in some ways, you have a society, to your point, that becomes far easier for people to negotiate themselves into when they look at themselves and see themselves as being slightly different than others. And there's a lot of ways for people who find people who are slightly different and don't rush to the place of judgment, but, in fact, see them as participating in their spaces as full equal brothers and sisters in the faith. And that's something that we see, in fact, often. In fact, one of the things that this does remind me of is just how many of the companions of the Prophet (PBUH) were people who were socially alienated and ostracized in Jahiliyyah (pre-Islamic period). Before Islam, they’re in a society where they're looked at as being unsuitable, for various reasons, and some of those characteristics were simply a function of class or their absence of belonging in a particular tribe, and this and that. And with Islam, they became people who were not simply Muslim, but really full members of the community and loved and honored and revered, and what raised them was their piety, and what blemished that was absence of piety, right? 

And you find people who, before Islam, were nobodies, and after Islam, they are people who, to this day, we say, “May Allah be pleased with them” after their names, we don't even say their names just plainly like that! We're constantly praying for them and making du’aa for them because they lived such virtuous lives. I think that's an example for us in how the Muslim community seeks to uplift other Muslims and to channel their lives into a life of piety, virtue and moral fulfillment, as opposed to a life just based on personal desires, which the modern, LGBT-affirmative discourse, in fact, does. In its claims of affirmation, all it does is dispossesses that person of any moral character and virtue, and it puts them in a place where they're simply expressing themselves in ways that can be quite base. And Allah knows best. 

Waheed  41:43
Alright, and the third category is that of an al-mukhannath ghayr al-khilqī, or the affected or non-congenital mukhannath. So, in contrast to the previous al-mukhannath al-khilqī, this category is basically individuals who are not congenitally predisposed, but they choose deliberately to adopt the affectations. You know, the voice, the gait of the opposite sex; the man takes on feminine mannerisms voluntarily, or the woman takes on masculine mannerisms voluntarily. And according to Shari’a, this is blameworthy, and the person is sinful for doing that. And then, in the article, you cite a couple of ahadeeth from the Prophet (PBUH), I'm going to just go through them very quickly. 

The Prophet (PBUH) is recorded as cursing “effeminate men and mannish women (al­-mukhannathīn min al­-rijāl wa-l-mutarajjilāt min al-­nisāʾ).” A number of the “cursing” reports include additional instruction to “evict them (i.e., the mukhannathūn and the mutarajjilāt) from your homes.” And, in a few lesser ­known hadith collections, the Prophet (PBUH) is described as “not entering homes in which a mukhannath was present.” In a hadith reported in al­-Ṭabarānī, the Prophet (PBUH) describes as cursed in this world one whom “God has made a man then he feminized himself and imitated women.” And you also mention, “Three will never enter paradise,” including the “mannish woman” (al­-rajila min al-­nisāʾ) as one of the accursed three categories. And, finally, in a report recorded in the Sunan of Abū Dāwūd, the Prophet (PBUH) encounters a mukhannath who has dyed his hands and feet with henna. Upon witnessing the man’s dyed limbs, the Prophet (PBUH) inquires of others as to why the man has done this, to which they respond, “He imitates women.” Afterwards, the Prophet (PBUH) decides to banish this man to a town called Naqī.

Now, for people reading these ahadeeth, and me personally, I was taken aback by them. But then I remembered that this is the category of al-mukhannath ghayr al-khilqī. So, this does not refer to the previous category of al-mukhannath al-khilqī, who does not deliberately do that, it's just something congenital. Whereas those people [i.e. al-mukhannath ghayr al-khilqī] actually did it deliberately. So, is this correct? Are these ahadeeth referring to the al-mukhannath ghayr al-khilqī in this case? 

Mobeen  44:02
Correct. It's referring to a person that is acting deliberately to impersonate the opposite gender. Even with the al-mukhannath al-khilqī, you know, the mutarajjila, if we're looking at those categories of al-khilqī, it would include them if they went and began impersonating the opposite gender in ways that go beyond what's dispositional to them, such that they take on that full identity and begin dressing like women and all of that, or vice versa [for mutarajjila]. And so what we're talking about here is the moral condemnation of an individual who begins to simulate and put on the dress, especially, but just overall begins to behave as a woman or a man. And so that's the category that we're taking on in terms of imitation here. 

Waheed  44:53
Right. Absolutely. And then the question that comes to my mind personally and to a lot of the people listening probably is, why would the Prophet (PBUH) curse them or evict them or not enter a house that they're in, rather than actually help them with their maladies? What is the wisdom behind such a prohibition in general? Because if we were to think of it like nowadays, in the modern times, I get a lot of questions from men and women, in regards to same-sex attractions, not with regards to the mukhannath, they would be kicked out of the house just for having these attractions and not having acted upon them, and their parents would kick them out of the house. And this is a huge problem nowadays. When we look at the examples of these ahadeeth, some of the parents might actually kick out their kids for cross-dressing, or behaving like and adopting the mannerisms of the opposite sex in general. Our approach nowadays, whether it's same-sex attractions or gender dysphoria, is trying to understand the root causes to help those people instead of kick them out. But when people read those ahadeeth, they'd be like, “Okay, well, should we kick them out? Should we curse them? What is going to happen?” You understand my logic, right? So how do we respond to this? 

Mobeen  46:14
The specific hadiths that actually make mention of “evict them from their homes” (أخرجوهم من بيوتكم), or as he said (PBUH), that particular wording is in response to the specific hadith of Hīt, and we'll talk about that, inshaAllah, in some of the subsequent questions and discussions we have here. But what the Prophet (PBUH) is really saying is: “No longer allow him to be in the company of women privately.” It's not a general command to evict mukhannatheen from their homes, to kick them out of your houses, or to expel them from society or something like that. That's not the general response. The response here is that, this was a man that was permitted to be in the private company of women, at this point, it's no longer allowed, because of the fact that he violated their confidence by revealing things that he should not, that were divulged or revealed to him in that private company. So that's really the significance of that wording, and so it doesn't foreclose or preclude the possibility of actually helping a person. All it's saying is that, if this particular individual was provided a particular permission, or allowed to do something, that permission through that wording was simply being revoked. That's what we have going on there. 

And so, in some ways, many of these reports when we talk about censure are relating to the fact that there's potentially again, you know, a violation of individual trust that's taking place or risk like that that's going on. These are also things of discouragement and deterrence, and so, you know, when you do have strong moral reprimands that are associated with them, obviously, that they do serve as a deterrent as well when it comes to certain forms of transgressions. But yes, I mean, look, it's not a black-and-white situation, especially when it comes to a person that is still at the state where they're psychologically struggling with this, and they haven't done anything. When a person is now fully sort of endorsed and doing something like that, I think there's a recognition of the way in which social contagion can occur in societies, and the way in which, you know, when you have a class of people that are participating like this, they almost serve to encourage others. So there's an attempt to try to nip that in the bud and make sure that if individuals are to have this, that they're actually being perhaps worked with, and if they're individually struggling, to try to reorient themselves morally, as opposed to a society that's just giving them carte blanche space to essentially parade around in front of everybody else, and in so doing, have a larger potential to influence and affect others who would not be affected otherwise, and Allah knows best.

Again, I think some of this obviously is of us attempting to interpret the wisdom of the Prophet (PBUH) and the censure that he applies for certain types of sin. Clearly, this is the case with many other sins too, where the Prophet (PBUH) sort of speaks very, very strongly about, for instance, the thief, “May Allah curse the thief”, he steals this much, you know, his hand is amputated. And the way that Allah subhanahu wa ta’ala speaks about backbiting (أيحب أحدكم أن يأكل لحم أخيه ميتاً فكرهتموه) - a person can get taken aback. Allah subhanahu wa ta’ala is speaking about backbiting, “Would one of you love to eat the dead flesh of your brother, you would hate it” (Qur’an, 49:12). And it's like, “Whoa, backbiting! I'm just making an offhand comment about this person, and suddenly now you're like fronting me with this image of being a cannibal and cannibalizing a brother of mine!” Like that can, in fact, be a very sort of traumatic image in a person's mind. But, in some ways, what they help us do is just realize the gravity of certain types of sins. You know, our sort of subjective social circumstances that we find ourselves in may not be those sins that are terribly significant, or they may look at them and say, “Well, you know, they're just so prevalent and they proliferated so much that we shouldn't treat them with the degree of seriousness that they should be treated with.”

But these types of ahadeeth and religious guidance are, in fact, a reminder of just how serious, in the case of backbiting, the sins of the tongue are, in this situation, the sins of our behavior, right? And the way that we're presenting ourselves in society when a person is doing this, it's not a small thing, right? Now, the sort of moral censure is always counterbalanced by the continued presence of repentance, rehabilitation and rectification and tawbah. Many of us, all of us, in fact, do commit sins of the tongue. We backbite, we do this, we say this, we say things we shouldn't say, we're dishonest, right? We will perhaps say things that we look back and regret having said them. And that's just one sort of category of sin. There are many categories of sin, and all of us are sinners, and the Prophet (PBUH) said as much (كل ابن آدم خطّاء), that every single son of Adam sins, (وخير الخطائين التوّابون), and the best of those who sin are the ones who repent. 

So, even if people do end up acting on vice, you know, part of the rehabilitation process, the door that's always available for anybody who does end up sinning is the door back to Allah subhanahu wa ta’ala. That's the door back. And I think that a lot of the prophetic guidance on these types of issues should indicate to us and tell us just how grave some of the sins are that we might look at as being marginal. And Allah knows best. 

Waheed  52:26
Indeed. Barak Allah feek. Going back to the previous question that I asked you before, similarly here, but in the case of having these explicit ahadeeth, cursing or evicting those individuals, don't these kind of give precedence to a lot of the hate crimes that are happening in a lot of the Muslim countries around the world? I mean, one thing is to kind of take those individuals and talk to them, give them counsel, and see what is the reason that they are adopting these mannerisms or cross-dressing or doing all sorts of things, and maybe giving them help, because they need that, and another thing is to kind of be like, “Okay, well, the Prophet said so, then let's do that!” How do we navigate this issue? 

Mobeen  53:06
You don't have any physical punishment being doled out in the reports. At most, what we have are individuals being reprimanded, and it's usually after they commit a sin that they should not have. And I think a lot of times people bring up the questions of individuals today who are struggling with gender dysphoria, and they try to talk to their parents about it, or they're struggling with same-sex attractions, and they try to talk to their parents about it, the parents kicked them out of the home. There are ahadeeth, and, in general, the notion of maintaining the ties of kinship, just as a general ruling, is very, very strong in Islam. In fact, you have a hadith of a man who came to the Prophet (PBUH) and he said, “I have a relative, and that relative is not good to me, that I do good to them, and they curse me, and I keep insisting [and I'm sort of paraphrasing here], I keep insisting and going out of my way to be good and kind and loving and caring, and every single time I make these efforts, I'm being rebuffed.” And the Prophet (PBUH) responded to that, and he said that, “If the situation is as you have said, don't stop, the reward is with Allah, and that's what you're going to get.” 

Again, I'm sort of paraphrasing the general meaning of the hadith here, but the Prophet (PBUH) didn't tell him, “Hey, if your relative is really treating you this way, cut them off, leave them alone, you shouldn't have to deal with that. That's disrespectful.” That's not the response, right? You know, in fact, he says, the wording actually more specifically is “if it is as you say it is, it is as if you are feeding them hot ashes, and you will be supported against them in front of Allah subhanahu wa ta’ala, so long as you continue doing so.” So, the Prophet (PBUH) is saying that you have a responsibility in front of Allah to not cut off the ties of kinship. And this is just for a relative, we don't know which relative it was, there's no indication, for instance, the brother, sister, cousin, what sort of relative this was, or who this was in relation to the person that was asking this question. 

Now, you compare that and just the general imperative to maintain the ties of kinship with relatives who aren't even good to you, with your own son or your own daughter, who is struggling with something and is seeking assistance and guidance from the very people who are duty-bound to really provide them that guidance, to nurture them and to help them through difficulties, and responding to that with eviction, to me, seems like, especially if it's simply a knee-jerk thing, appears to be a particularly callous way to respond. I think, in general, even for older children, you know, how long do we let children continue living in the home and all that? It's like a very modern thing. But I think, even on that, you know, the option of really kicking out somebody, I think, should be a last resort, certainly not the first one. And it needs to be something that is invoked with care, it needs to be done in situations that are very existential, and in which there may be no alternative or no other option, it is being done either with an eye towards what's in the best interest of the person, that perhaps this will help them, or if the negative effect is so corrosive through that person's presence, that you are now at a point where you're concerned about their impact and influence on others. And in any of those situations, you're not cutting them off totally. All you're doing is saying “We can’t cohabitate with you, we cannot reside in the same residence because of the impact that you're having on others.” But again, I think that, in general, as a rule, that should be something that is invoked with extreme care, and definitely not as a first option.

And by last option, you would hope in the vast majority of situations, it would never get to that. Because what we're dealing with here are people who are experiencing a fair degree of psychological challenges, right? They have psychosocial problems with this whole identity discourse, there is a lot that is beckoning to them and calling to them, and especially in our society, and in our context, parents are put in a situation now where they have to try to counteract all of that. And so, it's going to take time, a person should recognize that this is not the type of issue - whether it's gender dysphoria, or whether it's same-sex attraction - that is simply going to go away after a couple of conversations, that “We had a sit down, why are we still talking about this? I thought we were over it!” Like that's just not how it is, and I think sometimes parents get accustomed to dealing with their children's problems that are somewhat temporary, right? They're struggling with a class in school, or somebody is bullying them, and those are real issues, but they're the types of issues that have a time frame to them. There's a timeline, we started, we struggled through it, we got over it, we made some calculated decisions to help move along the journey, and now we've grown up. And I think sometimes there can be a lack of patience with dealing with those types of issues that aren't really amenable to that same type of timeline. 

You say, “We’re having a couple of discussions, we're taking you to talk to somebody, we're doing this, we're trying to give you a little bit of support, and that should all work itself out!” That’s usually not how it is, it's usually the type of thing that requires sustained support, and perhaps some people get to a place at a certain age where they're good about themselves, and they don't need the same degree of reinforcement and support. But the idea is that these are things that, for a great number of people, they're living with for the long haul. And I think that families have to be prepared for that, especially today. They're probably also going to have relatives that are supporting them in the other direction, and are telling them “No! Embrace your gender dysphoria, embrace a trans identity, embrace a gay identity, embrace a lesbian identity”, all of those things are going to happen. And when you build up this frustration, it's very difficult, because you come off as sort of the irrational one, the least supportive person that they actually have in their lives, whereas everyone else seems to be so embracing and loving and caring and telling them that if they just embrace this identity, if they just open themselves up to it, if they only liberate themselves from all of this internalized guilt - that internalized guilt is seen as being so harmful, because it's being imposed upon them through their parents and their family and all of that - well, then you're basically confirming that narrative in their minds, you are all but telling them “look, move forward in this path!” 

So, our goal here with anybody who is struggling with anything has to be islaah, some form of reconciliation, resolution and reformation to come closer to Allah subhanahu wa ta’ala. And this is something that we see, even in the Qur’an, when Allah subhanahu wa ta’ala speaks to the Prophet (PBUH), (ولو كنت فظاً غليظ القلب لانفضوا من حولك), “if you are harsh and hard-hearted with them, they would have turned away from you” (Qur’an, 3:159). And if you have children who are confiding with you in these issues, realize today that many children don't confide in their parents about these issues and don't tell them about it at all, keep them in the dark for a long time. Schools in the West, many of them explicitly instruct administrators and teachers to not tell parents. And so these are really significant issues, and I think parents have to be prepared for them in a way that is proportional, that at times may require a bit of tough love, so it doesn't all have to be just one sort of mode of being empathetic, right? Empathy and care can require different forms of responses to different people, and sometimes those responses can be situationally appropriate. There is no one-size-fits-all approach. But I think the idea of just kicking a child out almost reflexively is rarely going to be the right move, and more likely is going to alienate that individual enough where, you know, the idea that they're ever going to come back to the path of Allah may in fact be quite slim. And Allah knows best. 

Waheed  1:02:45
Indeed. Jazak Allah khairan. So when we talk about cross dressing, this applies to all men and all women, regardless whether they are mukhannath or not. So the question here is if an individual is al-mukhannath al-khilqī, so congenitally adopts these affectations or mannerisms, the cross-dressing prohibition also applies here, right? 

Mobeen  1:03:09
Correct. Correct. It would apply here. 

Waheed  1:03:12
So, in this case, if someone asks us, “So how do we differentiate as individuals if someone is adopting the cross-gender affectations, how do we differentiate whether they are al-mukhannath al-khilqī or not?” Because, obviously, if they're cross dressing, then that's a different issue, since that's prohibited anyway? 

Mobeen  1:03:29
Absolutely. You know, in some ways, if a person talks to us or speaks to us, I don't know that this is as difficult a situation insofar as most people hopefully would not try to modify or manipulate the way that they sound, just to sound like the other gender, right? You know, there are different reasons why a person may soften their voice, perhaps it's a way to emphasize something, but that isn't sort of permanently feminizing my voice, or permanently trying to sound like a male if I'm a woman. And those are very rare things to try to keep up for as a permanent posture. A person’s going to slip at some point, as opposed to a person where that's their natural voice. And so, I don't think that we necessarily have to put ourselves in a position where we're policing whether a person's voice or the way that they're walking is natural and unnatural. I mean that's really not the type of responsibility that we have to shoulder in some ways. We can just treat people in a normal way insofar as they speak to us, they walk, they behave, and things like that. And that we should refrain from jumping to conclusions, obviously. But if there are situations that are brazen, insofar as people are going out of their way to behave certain ways, then those are things that we should remind people of, right? 

Waheed  1:04:57
For sure. Absolutely. In one hadith related by al-­Bukhārī, you cited that in your paper as well, al-­Zuhrī remarks as a matter of opinion that one should not pray behind a mukhannath, unless absolutely necessary. Again, the mukhannath here is the third category, correct? 

Mobeen  1:05:14
Correct. So, what I’ll say here is that this relates to a discussion within jurisprudence tied to the moral probity and how do we religiously regard an open sinner, a faasiq. Many scholars are of the view that the faasiq is someone who should not be prayed behind. 

Waheed  1:05:41
In general, regardless of the fisq?  

Mobeen  1:05:43
That’s a general rule with regards to an open sinner. So for instance, I was reading recently of one scholar who was talking about a male wali (guardian) over his daughter who is refusing to marry his daughter off for reasons that have no religious justifiability to it. The scholar I was reading to recently - let’s say its Sh. Ibn Uthaymeen (may Allah have mercy on his soul), I will have to go back and check - but he said that such a man is, in fact, a faasiq for refusing to marry his daughter to suitable religious and good Muslim candidates that are coming to wed his daughter, and if he's just withholding that in sort of a domineering, authoritarian way, he said that such man is a faasiq, and he said that he shouldn't be prayed behind. I think he associated that position to Imam Ahmad ibn Hanbal (may Allah have mercy on his soul), again I'd have to go back and check, but I'm pretty sure that this was a position attributed to Imam Ahmad. 

Again, it's not a new position, necessarily, but it's a position that reflects certain sins, and it reminds us that standing in front of the community and being an Imam is an important thing, a person who does that should have moral probity. They shouldn't be people who are known for certain sins and be profligate or public about them, and it's also a way to deter people from acting on those sins, right? And so, the question is, you know, well, who is this person talking about? Well, it's representing this entire discussion al-­Zuhrī, when he makes a comment, he's just refracting that overall juristic opinion and position about fussaaq (plural of faasiq) and the faasiq, and whether or not the faasiq should be prayed behind in general. And Allah knows best. 

Waheed  1:07:29
Ok. Jazak Allah khair. When we go back to the story of Hīt, so you said that the Prophet (PBUH) gave him permission to be in the private assembly of women, and, again, this is a person who was known to be a mukhannath, and then at some point, the Prophet caught him revealing the physical features of one of the women to a man, suggesting her to the man for marriage. He was describing her, and then the Prophet (PBUH), when he heard that, he forbade him from entering the women's assembly, and, in some reports even, he was banished to the outskirts of the city. And then you quote, Ibn ʿAbd al­-Barr, who said, “Among the jurisprudential [rulings] drawn from this hadith is the permissibility of the mukhannathūn entering the company of women, even if they are not their unmarriageable kin (maḥram). The mukhannath for whom remaining in the company of women is not problematic is [the one] known among us today by [the term] muʾannath (feminine, effeminate); he is the one who lacks sexual desire for women, nor does he indicate [to others] matters that are [private] to them. This is the muʾannath mukhannath, for whom remaining in the company of women is not problematic.” And then he continues later, “But if he comprehends [the distinct] characteristics of men and women as this mukhannath (i.e., Hīt) did in recounting [what he did] in the hadith, then it is not permissible for the women to sanction entry [for such a mukhannath] into their assemblies, nor is it permitted for him to enter their company in any way whatsoever. [By comprehending the interactive relations between women and men], he is no longer [considered] from those of whom God has said “the attendants who possess no sexual desire” (Qur’an, al­-Nūr 24:31 – غير أولي الإربة من الرجال). The mukhannath is not the one specifically known for committing a (grave) sexual transgression (fāḥisha) and has it attributed to him. Rather, the mukhannath is [the one who] possesses acute effeminacy in his disposition to the point of resembling women in his gait, speech, [manner of] looking (i.e., at others), tone of voice, and in his mindset (ʿaql) and behavior, and this is the same whether he possesses the blemish of sexual transgression or not.” 

To all of that, you comment, and I’m quoting you here, “Conspicuous in Ibn ʿAbd al-Barr’s description of the congenital mukhannath is his inclusion not only of effeminate mannerisms of gait and speech but of mindset (ʿaql) as well. Mindset did not figure into the definition of effeminacy for the majority of jurists, who limited their definitions of effeminacy to discrete physical manifestations. Such characteristics included, but were not limited to, effeminate speech, gait, gestures, and related features. In this regard, Ibn ʿAbd al-­Barr’s definition of mukhannath represents a departure from the norm.” Now taking all of this into account, my question would be okay, there's a disagreement, or Ibn ʿAbd al-Barr added more criteria in comparison to other jurists. So my question is, on what basis are these rules made or these criteria made? You know, this ikhtilaaf (disagreement), why does it exist, and how do we reconcile it as lay men or women trying to understand this topic? 

Mobeen  1:10:41
Yes, so I'd say just that the rules aren't so much made as they are attempts to interpret the relevant ahadeeth of the Prophet (PBUH) and the verses of the Qur’an, and so what we have in the story of Hīt is a particular story that tells us about an individual, his interactions with women, and what transpired as a result of him violating the private trust that he had when he was within their company. What the scholars have done from that is that they have extrapolated a variety of rulings that help us understand why he was permitted to be in their company and why other people who have the same profile may have the same permission or may not have the same permission. And as you noted, it really ties back into the verse of “ghayr ulī ’l-­irba min ar-rijaal” (غير أولي الإربة من الرجال), do they have sexual desire for women or not. There are a minority of scholars, specifically amongst the Shafi’ites, I believe it's the standard position in the madhhab, where a mukhannath, as a general default rule, would not be permitted to remain in the private company of women, simply because he is an unambiguous male, and he can get married to women, right? Like he could presumably or potentially get married at times. And so, the other schools, likewise, would not prohibit that man from getting married to these women. However, the point here is simply that what they're doing is that they are reflecting the actions and the decisions of the Prophet (PBUH) as judgments and rulings that are applicable to the Muslim community at large. That's really what's going on. In terms of the ikhtilaaf, like I said, that's really the main area where we see some ikhtilaaf with the mukhannath himself, and so that's out there. 

Waheed  1:12:27
Okay, and when it comes to “mindset”, because he added the issue of “mindset”, and this kind of brings up the question of whether this has anything to do with the modern-day transgenderism or gender dysphoria? Can we consider it, let's say, [the case of] legitimate individuals who are really struggling with their gender identity and have gender dysphoria, would this apply here, given that Ibn ʿAbd al-Barr kind of focused on that “mindset”? 

Mobeen  1:12:52
He didn't focus, he mentioned it certainly; he catalogued it across or chronicled it alongside other specifically feminine characteristics and traits. In some ways, I don't know, because there isn't a deeper treatment of that particular aspect of what he discussed. Had he expanded on that or elaborated on it more, it's quite possible that he did recognize something of what it meant to have a female mindset. In some ways, that's a difficult conception for most people and what he might have intended by that, I would hesitate to say that his intention behind using that directly parallels to how we might think of that as well. 

Waheed  1:13:33
Right. And again, the mukhannathūn that are mentioned here are those who are congenital mukhannathūn, not the ones who deliberately adopt the cross-gender characteristics, but rather those who have the congenital affectations.  

Mobeen  1:13:47
Correct. 

Waheed  1:13:48
So, the question here would be (I'm guessing the answer's no): If someone has exclusive same-sex attractions and maintains the privacy (i.e. assuming that he is allowed to enter the company of women, and he keeps the privacy, he doesn't share anything outside), would this be acceptable? Because this is a kind of a question that I got, more or less, given that people confuse the mukhannath with someone who has same-sex attractions. How would you answer that? 

Mobeen  1:14:23
Well, independent of the mukhannath, you do have the category “ghayr ulī ’l-­irba min ar-rijaal” (غير أولي الإربة من الرجال), so men who don't have sexual attraction for women. If someone with exclusive SSA who has no sexual attraction towards women, theoretically, he would fall into that category. In terms of permitting or not permitting, I'd say that such a person should consult a scholar. I think, as a general rule, it's probably something that's not advisable, only because, number one, it's not something that a person necessarily wants to just reveal to other people about, you know, “I'm with the women because I don't have sexual desire for them.” Given the likelihood of confusion and scandal that's going to ensue, I would say it's probably something that is, even for a mukhannath today that has no sexual desire for women, I would think it to be something that would be a very, very rare exception, as opposed to something that would just be generally acted upon, even if the permission and permissibility is there. And Allah knows best. I just see it very difficult to functionally carry out, given all of the conditions that have to be adhered to firstly, and then, secondly, the possibility, perhaps even likelihood of scandal given the types of confidences that are maintained in private spaces, and then just the questions that it'll inspire. So that's my general sense. But that's more of just a sociological analysis as opposed to sort of a hard fiqhi answer. 

Waheed  1:15:58
Yeah. Right. In the description that I read out from Ibn ʿAbd al-Barr’s citation, there's an assumption that he makes that a man “who lacks desire for women” is effeminate. But that's not the case as we know, because we also know that there are a lot of effeminate men who have desires for women who may even be completely “straight”, and then there are a lot of men who lack desire for women who are quite masculine. So, is this a kind of generalization or lack of understanding on his behalf, or how would you characterize that? 

Mobeen  1:16:32
No, I think Ibn ʿAbd al-Barr (may Allah have mercy on his soul) is simply trying to make a distinction between al-mukhannath al-khilqī who would be permitted to remain in women's company and one that would not, and he's making that distinction using the terminology of mu’annath, and he's saying that the mu’annath is someone who does not possess the sexual desire, whereas the other one does. So he is, in fact, trying to parse between various situations where you may have someone who has various degrees and levels of effeminacy, and the question may come up as to whether or not such a man can remain in the private company of women. To your point, simply being an effeminate man does not mean that he has no sexual desire for women at all. How we regard effeminacy, certainly in our time today, is a much broader dialogue around how a person acts or behaves or what their special interests are, and hobbies and things like that, as opposed to here where the fundamental or underlying criteria for the mukhannath is primarily mannerisms that are outside of the person's control, they're things that are congenital. As opposed to what they like to do for fun or who they hang out with, and things like that. I mean, those don't seem to be deeper, relevant discussions when the category of the mukhannath comes up at all. 

There's no discussion of the mukhannath, you know, does he like to wrestle or not, you know, these types of things aren't brought up, right? You don't see any of that, it's almost as if what's relevant for us are these specific mannerisms, and are those mannerisms paired with a lack of sexual desire for women? If so, this permission is there, simply because Allah subhanahu wa ta’ala permitted it and the Prophet (PBUH) permitted it, and so who are we to make it impermissible? As I said, you know, there is a question whether or not they would be advisable for various situations today, and that's something that I think, as a general rule, should be approached with a lot of care and hesitancy, and I think, as a general rule, it should probably be something that's avoided, simply because of the possible entailments of what will happen if it's acted upon or incorporated or simply done. As a rule, I'd say that people should consult with scholars before doing anything like it. 

Waheed  1:19:05
Absolutely. And then, I've seen this a lot, whether it's in written media or in videos also, that a lot of the “progressive Muslims” would use the story of Hīt to kind of argue that the Prophet (PBUH) saw nothing wrong with being gender nonconforming and only evicted Hīt because he abused his status for immoral reasons. Some even say that Hīt himself and other mukhannathūn were trans, and that this is evidence for trans people being “valid” in Islam. Now, obviously, given everything that you have said about al-mukhannath al-khilqī vs. al-mukhannath ghayr al-khilqī, it is clear where we stand on this issue, but what would you like to add? 

Mobeen  1:19:47
Yeah, I mean, we have no evidence that he was looked at as anything other than a man, right? He's not dressing like a woman. Certainly he’s spending time in women's private assemblies, but that's effectively it, insofar as we're seeing certain permissions being granted that are exceptional. But beyond that, I mean, that's it. And so, I think there's a pretty large gap between the situation of Hīt and what we're looking at today with transgenderism. So I think there's a bit of a category error between those two as well. Again, Hīt, before he revealed the characteristics of the woman in question, he was not looked at as a sinner, right? In fact, he was in company of women in the home of the Prophet (PBUH), and so the Prophet (PBUH) provided him with that permission. We're talking about someone who was not… There's no record of him prior to that act having been looked at as a presumptively bad individual, and so, I think that that's a reminder for us as well, right? That individuals are struggling with different things, and some of those things are, in fact, congenital, that we don’t rush to judgment simply based on what we might assume to be negative, wrong or immoral, but actually ground our evaluative criteria for morality in a morality based on Revelation, and then respond in a way that is both proportional, reasonable, and that is geared towards trying to return those people to a life of faith and piety. 

Waheed  1:21:32
Ameen. Barak Allah feek. A few more questions: So, with regards to the congenital mukhannath, if we go back to al-mukhannath al-khilqī, the sexual interest may be directed towards members of the same sex in some cases, and then, in explaining the hadith of Hīt, you mentioned Ibn al­-Jawzī who writes that, concerning the congenital mukhannath, and I’m quoting him, “It is said [that they are from] ‘those who possess no sexual desire (ghayr ulī ’l-­irba),’ meaning, need for women”—precluding sexual desire for women, but not necessarily for men. So, what this gives us an idea of is that there was an early differentiation between one's gender and sexual orientation. Or, rather, if we don't want to use sexual orientation as a term, we can say that one’s sexual desire versus gender, there was a differentiation between them, we would say normatively that they would be in line, but in some cases, it was recognized that they may not be in line. So, what would be the rulings in this case? Because a lot of people say, “Okay, well, this was recognized, then it was okay!” But I kind of want to hear explicitly from you, what are the legal rulings in such a case? 

Mobeen  1:22:43
In such a case like would that person be permitted to have or act on same sex behaviors? No, I mean, obviously the ahkaam (rulings) and the hukm (ruling) of same-sex behavior is pretty clear. I mean, what we're talking about here – and I think this is where it shows up in the article - is that, okay, if you have someone who has these non-conforming congenital behaviors, was there ever a correspondence between those behaviors and their presumptive sexual attractions, insofar as was there a larger, for lack of a better term, stereotype or personality profile that scholars developed for such a person, or that even socially took form? And what we find, in general, is that it did not. At certain points in time, historically, it did. When exactly? We're not sure. But the dominant use of the term mukhannath, in the tradition, is fairly static and stable over the years, that we're looking at this individual that has certain congenital behaviors that's outside of his/her control, and we're keeping things at that level without extrapolating more about the person or jumping to conclusions about what they must be like, and other aspects of their own being. 

I mean, they're not making larger generalizations or judgments, all they're doing is focusing on this discrete question, which has specific legal implications religiously on a handful of important questions. Certainly, the most important questions being, are they morally culpable for the specific behaviorisms and mannerisms that they are manifesting? And if they're not, then what else? What other questions come into this? And you have a little bit of discussion around that. But that's it. I mean, that's really the question. It's not really coming up in the sense of, you know, “Okay, now that we've sort of identified that this person has certain gender nonconforming behaviors, can we also look at this person through the prism of sexuality, for instance, and now try to craft for them some newfangled dispensations for them to have sexual expressions based on our generalized assumption of who they're sexually attracted to?” That just never occurred, it never took place at all. 

Waheed  1:25:19
Jazak Allah khair. And the last question is, for individuals who develop rapid-onset gender dysphoria, and we will talk more about this later, inshaAllah, do these individuals fall under the category of al-mukhannath ghayr al-khilqī (the non-congenital mukhannath)? Because their nonconformity to their gender is not necessarily congenital, it's acquired. But, in this case, what would be the ruling or the classification if they start to suddenly develop gender dysphoria and start to imitate the opposite gender, in the same way that a al-mukhannath al-khilqī would, if that makes sense? 

Mobeen  1:25:54
Yeah. So, obviously, as you know, the category of rapid-onset gender dysphoria itself is something that is contested. I think a lot of trans activists do not accept that category to begin with. Rapid-onset gender dysphoria is really talking about people who have no history of any gender dysphoria to speak of, but then suddenly manifest behaviors, characteristics, dress, and others, that correspond with the opposite gender, normatively or simply a non-binary gender, or something like that, right? That just comes up very rapidly out of the blue, and then after that, things begin rolling very, very aggressively and quickly. And so, you’ve got somebody who is, for all intents and purposes, what we refer to as cis to now somebody who is precipitously non-binary or trans. And so, definitely, not khilqi at all. The literature on rapid-onset gender dysphoria tends to attribute that particular genre of gender dysphoria to social contagion, and so factors like peer pressure and other social environmental circumstances that can contribute to the fomenting of that dysphoria in psychosocial anxiety, and so it's definitely not congenital.

I don't think even people who have or are undergoing gender dysphoria at that level would argue that they were born with this, I think it's very tough for them to say that, I don't even know that they'd say that they've had it for a long time, perhaps some of them would reflect what they're currently experiencing and thinking on to the past, it's quite possible that some of them would make that projection, although I don't think that. I think, if it existed, it was something that was certainly not apparent and obvious to the people who were closest to them for so many years. There's a lot of the attempt to make something a historical and longer phenomenon than it honestly often is. 

And so, when you talk about ruling and classification, in terms of their acting on it, obviously, we're talking about something that would be impermissible religiously, and so it would not be permissible for them to begin taking steps to transition, whether that transition is medically or socially, and they would be required to try and attenuate those dysphoric feelings. And a person that's dealing with something like that should, in fact, reach out and get help and find individuals around them in the support structure that can help them weather the storm a little bit and get to a place where they can be at peace with the way Allah subhanahu wa ta’ala created them. And Allah knows best.

Waheed  1:28:52
Now, in the remainder of the episode, inshaAllah, we're going to be exploring the topic of intersex from a medical perspective. The information that I will use in this section of the episode is taken from Appendix B of the article ““And the Male is Not Like the Female”: Sunni Islam and Gender Nonconformity (Part 2)”, which I helped co-author with Br. Mobeen, and Appendix B is dedicated to intersex persons where we talk about the phenotypic sex, psychosexual development, examples of intersex syndromes, as well as the clinical management, gender reassignment and medical/surgical interventions of intersex individuals. And, of course, I will add a link to the article in the episode description for you to check out, and if anyone is interested in learning more about intersex syndromes. I will also add links in the episode description, inshaAllah. 

So far, in this episode, we have explored with Br. Mobeen the fiqhi perspectives and the social perspectives with regards to gender atypical individuals. The first category that we talked about was the category of al-khunthā al-mushkil, or the ambiguous khunthā.  Now, with regards to the term khunthā, in general, this refers to individuals who have disorders of sexual development, or DSD for short, and they're also known as intersex. Intersex is a term that refers to individuals who are born with sex characteristics that do not fit within physiological definitions of male and female sex. In other words, they have variations in their genitalia, their sex hormones, and/or their chromosomes, and this leads to gender ambiguity. 

Of course, some intersex individuals are unambiguous, so not all khunthā are ambiguous khunthā, just like category one, which we discussed with Mobeen earlier in this episode. There is unambiguous khunthā where you can identify the individual as male or female. But of course, there is the ambiguous khunthā where you cannot really differentiate, you cannot really tell if the individual is male or female, there's gender ambiguity. In addition to that, it's necessary to kind of differentiate between intersex persons from transgender individuals: Transgender individuals experience gender dysphoria, and they have problems with the gender identity on account of subjective personal experience, whereas intersex individuals, their gender ambiguity or problems with gender identity maybe are objectively proven through medical examinations and tests, and they have an incongruence between their genetic sex (meaning their XX or XY chromosomes or any variation thereof) and the physical manifestations of that biological sex. So, in the remainder of this episode, inshaAllah, we will be expanding on the etiology and the manifestations of intersexuality and tie that into the discussion of gender dysphoria, inshaAllah, which we will discuss in the upcoming episodes. 

Now, it's very important to start this discussion by talking about the phenotypic sex. Medically speaking, how does our genetic sex or phenotypic sex arise? During fertilization, a lot of us know that the sperm adds either an X or a Y chromosome to the X chromosome that's already present in the ovum (female egg). Now, if the sperm is going to add an X chromosome to the X chromosome of the ovum, it's going to result in an embryo that is XX, which means a genetic female. Whereas if the sperm adds a Y chromosome to the X chromosome that's in the ovum, we're going to end up with an XY sex chromosome, or a genetic male. During embryogenesis, two sets of ducts develop that are going to give rise to the human reproductive system: one is known as the paramesonephric (or Müllerian) ducts, which eventually develop into the female internal reproductive organs - and by female internal reproductive organs, we mean the uterus, the fallopian tubes and the upper third of the vagina - and the mesonephric second set of ducts, the mesonephric (also known as the Wolffian) ducts eventually develop into male internal reproductive structures, which include the epididymis, vas deferens, seminal vesicles and ejaculatory ducts. Up until approximately the seventh week of gestation, primitive sexual organs are not distinguishable between males and females. These organs develop later into either testes or ovaries depending on the subsequent stages of embryogenesis. 

Female sexual development is the default development in humans, whereby the paramesonephric ducts develop and the mesonephric ducts degenerate. However, if the embryo is genetically male, what happens is that the Y chromosome, through something called the SRY gene (the testes-determining gene) that is present on the Y chromosome, it aids in the testes developmental process, suppressing the development of the paramesonephric ducts and stimulating the development of the mesonephric ducts. Hormones, such as testosterone, which are produced by specialized cells in the testes are necessary for the full development of internal and external male reproductive organs. By birth, the typical baby can be visually distinguished as male or female with internal and external sexual organs that are congruent with the child's genetic sex. 

Along the path of normal embryonic development, however, some problems can occur that impede this natural scenario. And these occurrences are what we refer to as the disorders of sexual development (DSD). These disorders can be chromosomal, meaning that some human embryos do not have the normal set of 46 chromosomes, i.e. some may have an extra or even a deficient number of sex chromosomes. Other disorders are not chromosomal, meaning that individuals have a normal set of 46 chromosomes, and, from a genetic perspective, they are unambiguously female (i.e. 46,XX) or unambiguously male (i.e. 46,XY). But due to issues with pathways of the sex hormones, discrepancies can arise, whereby the external genitalia do not match the genetic sex and the internal organs. As a result, some individuals can be genetically male, but they can be born with female or ambiguous external genitalia, or they can be genetically female but born with virilized (masculinized) or ambiguous external genitalia. Now, upon suspecting disorders of sexual development, physicians nowadays would order a series of tests that determine a person's genetic makeup, as well as the presence or absence of internal sex organs, so that they can arrive at a proper diagnosis whenever possible. 

John Money and his colleagues in 1955 proposed the concept of psychosexual development, and, as shown by animal experiments, sexual differentiation is not completed with the formation of the sex organs. Rather, the brain also undergoes sexual differentiation that is consistent with other characteristics of sex. This paradigm suggests that, in the example of males, androgens or male hormones either directly or via local conversion into estradiol, which is a female hormone, they organize the brain in early development, while pubertal hormones (at the time of puberty later on) would, and I'm quoting this from their paper, “further activate and reorganize the already organized brain, resulting in the expression of masculine behaviors.” Now, two peaks for testosterone, in mid pregnancy and during the first three months after birth, are thought to organize and entrench the neural circuits in the brain for the rest of a male individual's life. It seems that rising testosterone levels during puberty would activate and reorganize these pathways. 

Traditionally, psychosexual development has comprised three domains: 1. Gender identity, which means a sense of belonging to and identifying with one's gender and the people of the same gender, 2. Gender role behavior, meaning behaviors and traits that are designated by society as appropriate for males and females (the specifics of these are culturally and historically bound), and 3. Sexual orientation, which is a person's responsiveness to sexual stimuli, mainly the sex of those to whom one is sexually and/or romantically attracted. 

So, it can be seen that human sexual differentiation is a multi-dimensional and sequential process. Any perturbation that happens during this complex process of sexual differentiation that I've just described, can lead to a misalignment between the chromosomal, gonadal, and phenotypic sex, which is classically defined as disorders of sexual development, or DSDs. In individuals with DSD, the three components of psychosexual development that I've just mentioned (gender identity, gender role, and sexual orientation) may not always be concordant or aligned. As sexual differentiation of the reproductive organs takes place earlier in human development, and that's mainly in the first two months of pregnancy, this takes place earlier than sexual differentiation of the brain, which occurs in the second half of pregnancy. So these two processes may be influenced independently.

So in the case of the ambiguous genitalia at birth, the degree of masculinization of the genitals, this may not always reflect the degree of the masculinization of the brain. So, psychosexual development appears to be a complex and long-term process that's affected by brain structure, genetics, in-utero and postnatal hormones, as well as the environment and social and familial circumstances. Arguably, after ruling out intersex syndromes and biological factors that may have contributed to DSD, it becomes evident that a person's environment, including social and familial circumstances, they play a crucial role in appropriate psychosexual development, accounting for the majority of DSD cases with misaligned components of psychosexual development. 

Now, of course, there are so many intersex syndromes, but they are not very common in populations. I'm just going to mention a few of these intersex syndromes. The most common disorder of sexual development is known as congenital adrenal hyperplasia, or CAH for short, and it consists of an autosomal recessive disorder that leads to deficiencies in key enzymes that are involved in the pathways of steroid hormone production in the adrenal glands. Depending on what role the enzyme plays and the severity of the block in its production, the disease presentation in affected individuals can vary. Many forms of CAH exist, and the most common of which is known as 21-hydroxylase deficiency, which may present during infancy as a salt-wasting adrenal crisis, or later during childhood as early, precocious puberty and virilized external genitalia in females, due to higher levels of circulating male sex hormones (androgens). Another form, for example, is 17-alpha-hydroxylase deficiency in which the production of sex hormones is impaired. Genetic females would therefore lack female secondary sexual characteristics at puberty, while genetic males will have ambiguous genitalia with undescended testicles and can therefore be confused for females. 

Another example of DSDs is androgen insensitivity syndrome, which is also known as testicular feminizing syndrome. This describes an X-linked genetic disorder that occurs in genetic males, whereby a defect in the androgen receptor results in the body's not responding to testosterone in the way that it should, and this results in a variety of disease manifestations. There are different forms of androgen insensitivity syndrome - if it's a complete form, a genetic male appears as a typical female, with breast development and female external genitalia, and such individuals would live as females, they are unaware of their condition until they hit puberty and they fail to menstruate. Now if this androgen insensitivity syndrome is actually mild, then the genetic male would have normal male external genitalia, but normally this would be accompanied by infertility or maybe enlarged breasts or both. And finally, the partial form of androgen insensitivity syndrome is marked by a spectrum of under-virilized external male genitalia. And depending on the precise form of the syndrome, issues related to sex assignment, removal of the testes, for example, due to the risk of developing tumors if they're not removed, issues related to fertility and psychosocial outcomes must all be taken into account in the treatment process. 

Other examples of disorders of sexual development are, for example, Klinefelter syndrome, and this refers to a genetic male who has an extra X chromosome. So, this individual has 47 chromosomes with an added X, so that would be XXY for his sex chromosomes, and this occurs in around one in 600 male births, approximately 64% of which would remain undiagnosed throughout life. Typical characteristics would include a eunuchoid body shape with tall and long extremities, female hair distribution, enlarged breasts, and cognitive and developmental delays, as well as infertility. Another example of DSDs is Turner syndrome, which unlike Klinefelter syndrome, where a genetic male has an extra X chromosome, in Turner syndrome, we have a genetic female who lacks an X chromosome. So, this female would have 45 total chromosomes, and she would only have one X chromosome as the sex chromosome. And this syndrome occurs around one in 2,500 female births. Generally, those females with Turner syndrome have a short stature, short neck, broad chest and they are at a higher risk of developing cardiovascular, skeletal and autoimmune diseases. And almost all females with Turner syndrome are infertile.

And then the example that we gave earlier in this episode, hermaphrodites, nowadays, it's referred to as ovo-testicular disorder of sexual development, which is also known as true hermaphroditism, and this is a very rare congenital anomaly that's characterized by the presence of both testes and ovaries in the same individual. And, most commonly, the individual would be a genetic female (i.e. 46,XX). And, of course, there are many other conditions and syndromes that exist under the umbrella of DSD or that would make the individual “intersex”, but from the few examples that I've just given, one can appreciate that chromosomal or hormonal imbalances can often lead to a wide variety of physical presentations, where the regular definitions of male and female do not quite fit. 

Nowadays in newborns found to have virilized or ambiguous genitalia or any secondary physical signs or symptoms that are typical of patients with such disorders, a set of tests is usually ordered to reach an appropriate diagnosis. Procedures such as blood tests to check for circulating estrogens and androgens, karyotyping (which means observing the complete set of chromosomes in the individual to kind of determine any chromosomal abnormalities), and doing an abdominal-pelvic ultrasound are quick and easy tests that can serve as a starting point for further investigations. Of course, not all of these disorders are diagnosed at birth, as some of them may only manifest during adolescence. Whether at birth or later in life, gender uncertainty is quite unsettling, and it may result in psychosocial and familial problems. Factors that influence the determination or assignment of gender include the diagnosis itself, genital appearance, surgical options, fertility potentials, and the need for lifelong hormonal replacement therapy, as well as, of course, cultural, familial, and religious considerations. 

Sometimes the person's gender is quite obvious, as in the case of genetic females with congenital adrenal hyperplasia, for example, where more than 90% of patients would live as females in congruence with their biological gender. Biological males with complete androgen insensitivity syndrome, on the other hand, are usually assigned as females in infancy, and they will usually identify as females. In the case of true hermaphroditism, or the ovo-testicular disorder, issues to consider include fertility potential based on the differentiation and development of the genitalia, as well as the degree to which the genitalia are or can be made consistent with the chosen sex. Other than surgical interventions that are called for depending on the individual diagnosis, individuals may require hormonal therapy to induce puberty, including secondary sexual characteristics, pubertal growth spurts and optimal bone mineralization, as well as psychosocial support for psychosexual maturation. 

It has been suggested that gender dysphoria is, in a sense, a subset of DSD, one that is limited to the brain and without the involvement of the reproductive tract. According to DSM-5, and we will talk about this, inshaAllah, later, gender dysphoria is a condition that is characterized by a marked incongruence between one's experienced or expressed gender and one's biological sex, and this is associated with clinically significant distress or impairment in social, occupational or other important areas of functioning. The overlap between gender dysphoria and DSD lies in the possibility of experiencing discomfort and the discrepancy between one's sex as determined at birth and one's gender identity, which can eventually lead to a request for sex reassignment. 

The difference between DSD and gender dysphoria, however, lies in the consideration of biological sex indicators, meaning that the sex chromosomes, sex-determining genes, genitalia, systemic sex hormones during fetal development, puberty and adulthood, as well as secondary sexual characteristics. In gender dysphoria, all the biological Indicators point in the direction of one's biological sex, while one's gender identity points in the opposite direction. In DSD, the misalignment also involves these biological sex indicators. This distinction has also been emphasized in DSM-5. Gender identity problems and subsequent gender assignment may occur later in life in persons with DSD, the context of which is different from that of non-DSD individuals. The question of how gender assignment at birth should be decided in cases of individuals with the DSD so as to minimize the later development of gender dysphoria and gender change is very controversial and subject to ongoing debates in clinical management policymaking circles. 

Such gender identity problems are not universal, of course, and when they develop, they may not occur before adolescence or even adulthood. Female-to-male is more frequent than male-to-female gender change in DSD patients. Likewise, gender change is more common in syndromes with a relatively high androgen exposure, suggesting an indirect influence of androgens on gender identity development. Therefore, there are very marked variations between syndromes of DSD with respect to the prevalence of individuals who are not satisfied with their assigned gender and who eventually choose to undergo gender change. 

Waheed  1:49:47
And with this we have come to the end of today's episode which has been dedicated to the discussion of the fiqhi and the social perspectives related to gender atypical individuals as well as the khunthā or intersex individuals, in addition to medical perspectives on the latter category. In the next episode, inshaAllah, we will start the discussion on gender dysphoria and offer medical perspectives on that and start talking about the transgender movement as well. Until then, stay safe and healthy, this has been Mobeen Vaid and Waheed Jensen in “A Way Beyond the Rainbow”, assalamu alaikom warahmatullahi ta’ala wabarakatuh.

Episode Introduction
On al-Khunthā al-Mushkil (Ambiguous Khunthā) and Intersex
Does the Category of Khunthā Indicate a Third Gender?
On al-Mukhannath al-Khilqī (Congenital Mukhannath)
On Islam's Accommodation of Gender Atypical Individuals
On al-Mukhannath Ghayr al-Khilqī (Affected or Non-Congenital Mukhannath)
On Perceived Precedence to Hate Crimes
On Men Who Possess No Sexual Desire for Women
On Intersex Syndromes: Medical Perspectives
Ending Remarks