The recent release of the Vanity Fair cover featuring Caitlyn Jenner, formerly known as Bruce, has sparked controversy once again. So is gender identification based on physical or psychological factors? The debate is endless in which both sides may argue their points to discourage the other.

Unlike so many other phenomenons, a clear line between clinical physiology and one’s inner psychology cannot define gender identification and sexual orientation. The insular cortex, located within the lateral sulcus, is the area of the brain thought to be responsible for our sense of inner self, identification, and introversion. Consciousness can embody the idea of self as well as emotions. It is also linked to the regulation of the body’s homeostasis. Very different than “consciousness,” output from insular cortex has great implications in chronic disease such as chronic pain as well as the internal image we create of how well we feel.

The human body is anatomically programmed to respond to either X or Y, female or male, from day one. Science and medicine identify sex in one of two possibilities: male or female. This becomes defined at a molecular level when chromosomes start duplicating and the labels of 46,XX and 46,XY are assigned. Each Y chromosome contains the SRY gene that signals the body to cascade into anatomical development of male or female. The original separation of male and female begins at conception, at the very moment when sperm, which carries either an X or Y chromosome, has fertilized the ovum. Influences of hormones on the temporal lobe are essential in utero and up to the first few years of life to complete this process.

Human anatomical composition, defined by primary and secondary sexual characteristic development, strongly influences gender identification as well. The start of puberty and development of secondary sexual characteristics (those seen to the naked eye such as breasts and pubic hair) begins with a surge of GnRH, gonadotropin releasing hormone, from the hypothalamus.

The visualization of these sexual characteristics helps one identify a gender due to clear-cut definitions such as women having breasts and males having chest hair. It is important to define visualization as what the human eyes physically see in the mirror or as others see us. Internal visualization is an individual’s independent perception of self for which the brain region known as the insular cortex is thought to be responsible for. Hormonal influences are responsible for anatomical changes to our bodies, as well as certain behavioral changes. Libido is a primary example of sexual behavior influenced by hormone level regulation of the hypothalamus.

Human beings are empathetic to other people’s plights in cases of divorce, war, hunger, and other life situations. However, it becomes more difficult to be empathetic when one does not have the education for a social issue. We, as humans, feel uncomfortable when we do not comprehend the complexity of a situation. The transitional identification from one sex to another is an outlying experience. Gender identification is a journey that requires looking beyond the box as mentioned by Tania Israel, Ph.D. during a TEDxUCLA talk. Dr. Israel described sexuality in a very profound way giving the nickname, “pisexuality”. “Pisexuality” derives from the mathematical concept of “pi”. It was described as the infinite possibilities of sexuality on the spectrum. Ironically, mathematicians also described it as “irrational.”

The choice of sexuality and gender identification as a matter of personal choice, and influenced by cognitive development as opposed to anatomical pre-distinction is a vast and critical subject to study.The profound ignorance of gender on a spectrum needs to be embraced for a societal shift. Before one can judge any individual on their decisions of gender identification we must educate ourselves on the awareness of the gender spectrum.