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Role of man-made chemicals minimal, diet maximal: Ibid.:1256 (table 20). Summary There is another level of ambiguity, or at least complexity, associated with both sex and gender. Some people are born with all of their biological variables consistent with traditional maleness or femaleness (XX, ovaries, uterus, vagina, or XY, testicles, prostate, penis), but have an internal sense of themselves or their gender identity that is inconsistent with their biological sex. These individuals are often so dissatisfied with their biological sex that they may want to alter it so that it will be consistent with their internal sense of themselves as male or female. Traditionally, these individuals have been referred to astranssexual in order to describe the change in biological sex that many of these individuals wanted and often accomplished through medical intervention (i.e., sex re-assignment surgery) to make their bodies, particularly their genitalia, consistent with their internal sense of themselves (Benjamin, 1966). More recently, a related word,transgender, has emerged. Originally, this word was used to describe people who were dissatisfied with their biological sex but who did not want to alter aspects of their bodies (e.g., via sex re-assignment surgery) (Kotula, 2002). The meaning of the termtransgender has recently expanded, and is now a kind of“umbrella” term. This term often describes both traditional transsexuals (i.e., those who want to change biological sex and perhaps have done so) and anyone who violates traditional “gender” boundaries but does not necessarily want to alter aspects of their biological sex. Put another way,transgender can refer to those whose identity does not conform to their biological sex or those whose identity does not match their“gender” assigned at birth (Ekins& King, 2004). So, aside from transsexual people, the transgendered category may include those who cross-dress (e.g., drag queens or transvestites) and those who identify as, for example,“bi-gendered” or “non-gendered.” It may also include the intersexual people mentioned above. Notably, there is often a “political” dimension to the termtransgender, or a transgendered identity (Feinberg, 1992). As we describe in chapter 7, (public) identities frequently emerge out of and serve political ends. this must happen if one is to use a prosthesis effectively. The artificial limb becomes part of one’s body, of one’s body image, as a cane in ablind man’s hand becomes an

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