On Jan. 20, 2025, President Donald Trump signed Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which directed government agencies to replace the term “gender” with “sex” in all federal documents and to recognize only two biological sexes, male and female, as determined at conception.
In February 2026, Kansas Senate Bill 244 was enacted into law over the governor’s veto. This law defines gender as the biological sex at birth and mandates sex-defined restrooms in public buildings while suddenly and summarily invalidating state-issued drivers licenses and birth certificates that do not match a person’s assigned sex at birth.
In June 2026, newly elected president of the Southern Baptist Convention Willie Rice declared gender is biologically determined and unchangeable.
A church near my home recently posted this slogan on their electronic marquee: “Male=Male, Female=Female.”
“So many opinions, so much ignorance.”
So many opinions, so much ignorance. At least Willie Rice, like Balaam’s ass, spoke the truth, but neither of them understood what they were saying. I will present the case that sexuality in the broadest sense is not dualistic but is a spectrum of biological events, variable and immutable. At the end, I will offer a theological interpretation of the science and a warning.
Definitions
Sex is regulated by chromosomes, genes, hormones and hormone receptors, which in turn regulate external and internal reproductive anatomy. For millennia, sex was defined by external reproductive anatomy. Only in the early 20th century did we begin to understand the processes that led to the anatomy. External reproductive anatomy is still the basis for what goes on our birth certificates.
Gender is the sense of who we are. That sense is present from the earliest stages of thinking, in parallel with our developing understanding of what society and culture expect of males and females. In most instances, sense of self is concordant with societal and cultural expectations. But some children strongly feel they are in the wrong body from an early age, long before they can fully understand the expectations of society and culture.
Sexual orientation is distinct from sex and gender. It is about who you are attracted to. As with gender, many individuals who feel same-sex attraction have felt that way since before they knew how society expected them to feel.
Same-sex behavior and preference have been observed in mammals and birds, but lifelong or exclusive same-sex orientation is rare in nonhumans. Gender identity, which involves higher cognitive capacity and language, seems to be exclusive to humans. Contrary to the president’s assertion, I do not think anyone has tried to “make” a transgender mouse. As hard as it is to get a federal research grant, I cannot imagine such a grant was ever funded. I suspect he saw the term “transgenic” and thought it was transgender. Transgenic mice are genetically modified to express human genes and are valuable for the study of human diseases, but not for gender or sexual orientation, at least at the present state of the science.
The science of sexual development
It is a long path from sperm and egg to a newborn baby. The father’s sperm contributes either an X or a Y chromosome; the mother’s egg contributes an X chromosome. Thus, the father determines the chromosomal sex of the child — XX is a female, XY is a male.
But not always.
At about 6 weeks of gestation, hormones and their receptors, regulated by genes on the X and/or Y chromosomes, begin the process of sex differentiation. Most of the time, there is concordance among chromosomes, genes, hormones, receptors, anatomy, gender (sense of self), who we love and societal and cultural expectations. But biology is complex and variations happen. And contrary to what the president said, sex is not determined at conception, as we shall see.
Since the mid 20th century, we have learned of several dozen syndromes in which there is discordance between anatomy and the preceding genetically driven events. I cite a few examples for demonstration:
- Swyer syndrome. These individuals look and feel like women, have female external genitalia and a uterus, but have male genes (XY), no testes or ovaries and no estrogen or testosterone production. They cannot reproduce. The responsible genetic variation is a nonfunctional male sex determining gene, SRY, carried by the Y (male) chromosome.
- Androgen insensitivity syndrome, formerly called testicular feminization syndrome. These people look and feel like women and have male genes, like those with Swyer syndrome. They differ from Swyer syndrome in that they have testes, often undescended, but the tissues destined to become external and internal sex organs cannot respond to testosterone, the hormonal driver of male development, because of a variant receptor for the hormone. It is the absence of testosterone effect that determines female reproductive anatomy.
- de la Chapelle syndrome, also called XX male syndrome. They have a male body, as the name implies, but female chromosomes. The variant expression is caused by translocation of the SRY gene from the Y chromosome to the X chromosome during sperm formation.
The above conditions and the several dozen other examples of discordance between genetics and anatomy are classified as intersex conditions or Differences in Sex Development (DSD). They are the exceptions that test the rule in the science of sex development, and the rule has been found wanting. Furthermore, within each syndrome there seems to be a spectrum of expression, ranging from minor discordance resulting in ambiguous anatomy, to complete discordance between genes and external anatomy.
The science of gender and sexual orientation
In contrast to the science of sexual development, the factors that regulate gender and sexual orientation are not as well identified or understood. A person’s gender and sexual orientation, whether concordant or discordant with their genes and hormones, develop at a very early age, starting in the uterus.
“A person’s gender and sexual orientation develop at a very early age, starting in the uterus.”
For example, evidence exists that gender identity and sexual orientation are pushed toward the masculine by prenatal exposure to testosterone and toward feminine in its absence. Development of gender and sexual orientation continues after birth, in parallel with the child’s understanding of the expectations of society and culture.
It is not at all farfetched to think biology is involved in development of gender and sexual orientation, in view of the known processes and their variations in sex development. In fact, to suggest that any neural processes are not biologically regulated or subject to variation in expression is nonsense. I do not deny the influence of society and culture, but those factors are not deterministic.
Theological reflection
People who exhibit differences of sex development, different gender expression or different sexual orientation are human beings created in God’s own image. They exhibit biological variation, not disease or deviancy. They are not sick. They are not mentally ill. They are not abnormal. They are not our enemies. They are sinful only in the way that all of us are sinful.
They are the way they are because of biology, just as we heterosexual and cisgendered people are, and sin is not caused by biology.
“I don’t know how to apply those passages except through the lens of radical love taught by Jesus.”
I am not suggesting the Bible’s clobber passages must be ignored. I am suggesting they be interpreted and applied with the same hermeneutic applied to passages about stoning adulterers and justifying slavery. I confess, I don’t know how to apply those passages except through the lens of radical love taught by Jesus.
Certainty is not possible in science. Scientific truth is valid only until a better truth is found. What I have written about sex differentiation will be refined, but there is sufficient evidence that the basic facts will not be overturned.
Likewise, religious dogma is subject to progressive revelation and understanding. Once it was plausible to think the sun and the stars revolved around the earth. It was something people could see with their own eyes. Yet Galileo was almost burned at the stake because his research had correctly shown that the earth revolved around the sun, rather than supporting the church’s official position, which was based on a faulty interpretation of scripture and simplistic observation.
Our Southern Baptist forebears broke fellowship with their fellow Baptists because they insisted that the Bible sanctioned slavery and Southern Baptists have apologized for that. The same is true for our attitudes about sex, gender and sexual orientation; there is more than meets the eye.
Followers of Jesus do not have to understand the science, but we are obligated to follow the teachings of Jesus, no matter what. As for me, in that great gettin’ up mornin’ when I bow before God, I would rather have erred on the side of love than on the side of inerrant interpretation of Scripture.
In the final analysis, both Willie Rice and Balaam’s ass spoke truth. Neither understood what they were saying, but Balaam’s ass spoke for God. Willie Rice does not. And the president was just flat out wrong.
Charles Packman
Charles Packman is a retired physician, a hematologist by specialty, who worked in two academic institutions over a 50-year career, University of Rochester and then Atrium Health in Charlotte, N.C. He was a scientist and educator of medical students, PhD students and post-graduates, then a clinician caring for uninsured blood and cancer patients and an educator of residents and fellows. He has been a member of St. John’s Baptist Church in Charlotte for 28 years.