Hearing on SJR13 -- Proposes to amend the Nevada Constitution by repealing the limitation on the recognition of marriage.

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1 Written statement of Lauren A. Scott- Executive Director Equality Nevada Freeport Blvd, #107 Sparks, Nevada Testimony and Statement for the Record of Hearing on SJR13 -- Proposes to amend the Nevada Constitution by repealing the limitation on the recognition of marriage. Before the Nevada Senate Committee on Legislative Operations and Elections Nevada Legislative Building, State Capital March 26, 2013 Chairwoman Spearman and Members of the Senate Legislative Operations and Elections Committee. I am the Executive Director of Equality Nevada, which is an organization dedicated to improving the lives of lesbian, gay, bisexual, transgender (LGBT), intersex and genderqueer individuals and their families by advocating for equal rights and ensuring individuals are treated equally under the law. I am also a governor appointed member of the Nevada Equal Rights Commission (NERC), however I am not representing the board, staff or the interests of NERC in these regards. I would like to personally ask for your support for S.J.R.13, which would amend the Nevada Constitution by repealing the limitation on the recognition of marriage. I have included a detailed presentation entitled A Male and a Female Person for your consideration which discusses human sex variation and its impact on the concept of same sex marriage. Thank you.

2 A Male and a Female Person Presented for the Record of Hearing on SJR13 - Proposes to amend the Nevada Constitution to repeal the limitation on the recognition of marriage Before the Nevada Senate Committee on Legislative Operations and Elections Nevada Legislative Building, State Capital Lauren A. Scott Executive Director Equality Nevada March 26, 2013 Slide 1 Q 2

3 Copyright and Disclaimer Notice This presentation may contain copyrighted material, the use of which has not always been specifically authorized by the copyright owner. This material is being made available in an effort to advance understanding of environmental, political, human rights, economic, democratic, scientific and social justice issues, etc. This constitutes a 'fair use' of any copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this presentation is being distributed without profit to those who have expressed an interest in receiving the included information for educational purposes. Original copyright and ownership remains with all original copyright holders, photographers or authors. Slide 2 Q 3

4 Sex and Marriage The concept of sex is simple and two dimensional. Slide 3 Q 4

5 Sex and Marriage In 2000, a ballot initiative to define that only a marriage between a male and female person shall be recognized and given effect in this state is placed on the Nevada 2000 ballot and approved by voters. Nevada requires constitutional initiatives to be approved at two successive general elections. In 2002, the required petition signatures were obtained and the measure was placed on the 2002 ballot and the initiative was approved by voters in 2002 by a margin of 66% (Yes) to 33% (No). Slide 4 Q 5

6 Defining Sex How do we define a male and a female person? - The configuration of external genitalia - The production of sperm or eggs - Sex chromosomes - 46XX or 46XY XY Slide 5 Q 6

7 Defining Sex Almost all humans have 23 pairs of chromosomes (46) Slide 6 Q 7

8 Defining Sex One pair is referred to as the sex chromosomes Slide 7 Q 8

9 Defining Sex Normal primary and secondary sex characteristics Male Female External genitalia Penis Vagina Chromosomes 46 XY 46 XX Means of reproduction Sperm Egg Gonads Testicles Ovaries Major hormonal influence Testosterone Estrogen Secondary sex characteristics Facial hair Breasts Gender identity and behaviors Masculine Feminine Slide 8 Q 9

10 Intersex - What is intersex and who is intersex? - Typically involves indeterminate genitalia or mixed biological sexual characteristics - Usually the result of natural genetic or hormonal variability, affecting fetal development Slide 9 Q 10

11 Intersex - Many different sex chromosome arrangements have been documented - XYY (1:1,000 boys) - XXX (Triple X syndrome; 1:1,000 girls) - XO (Turner syndrome; 1:2,500 girls) Dr. Edward R. Friedlander XYY karyotype Slide 10 Q 11

12 Intersex - An XO karyotype lacks an entire sex chromosome. Slide 11 Q 12

13 Normal sexual development is a complex process Slide 12 Q 13

14 Physical genitalia are initially undifferentiated. Slide 13 Q 14

15 Sex and genitalia are influenced by genes and hormones. Chromosomes and genes only suggest what you could be. Hormones ultimately determine who and what you are. Slide 14 Q 15

16 Genetic issues affecting sexual development - Klinefelter s syndrome (47XXY) - Androgen insensitivity syndrome (AIS) - 5-alpha-reductase deficiency (5-ARD) - Congenital adrenal hyperplasia (CAH) - Polycystic ovary syndrome (POS) - Müllerian agenesis (MRKH) - Tetragametic Chimeras (Genetic Mosaicism) Slide 15 Q 16

17 Klinefelter s syndrome (47XXY) - Occurrence is 1 in 1,000 males - Male sex organs are underdeveloped - Typically considered and raised as male - Usually infertile; spermatogenesis is reduced - Testosterone is administered at puberty Slide 16 Q 17

18 Klinefelter s syndrome (47XXY) - XXY was a 2007 film about the emotional struggles of an intersex teenager - Critics' Week grand prize at 2007 Cannes film festival Slide 17 Q 18

19 Androgen Insensitivity Syndrome (AIS) - Conceived as a 46XY male - Genetic defect results in inability to respond to androgens (testosterone) - External genitalia has a female appearance - Occurrence of complete AIS is 1 in 20,000 male births Slide 18 Q 19

20 Complete androgen insensitivity syndrome (AIS) Slide 19 Q 20

21 Excess testosterone is converted to estradiol, resulting in female secondary sex characteristics. The enzyme Aromatase can convert Testosterone into Estradiol Slide 20 Q 21

22 Androgen insensitivity syndrome (AIS) - No ovaries or uterus present - Underdeveloped gonads are usually removed - Usually considered women and raised as female - Is this a third sex? Slide 21 Q 22

23 Partial or incomplete AIS (PAIS) - Underdeveloped penis may resemble a large clitoris - Vaginal opening may not be fully closed without surgery - Gynecomastia (male breast tissues) is common - Azoospermia is common Sexual Diversity Slide 22 Q 23

24 5-alpha-reductase deficiency (5-ARD) - Conceived as a 46XY male - Genetic defect results in inability to produce DHT - External genitalia has a female appearance - Masculization occurs during puberty upon exposure to testosterone - Incidence higher in the Dominican Republic (1:90), Papua New Guinea, Turkey, and Egypt. Slide 23 Q 24

25 Congenital adrenal hyperplasia (CAH) - Conceived as 46XX female - Female fetus releases a steroid hormone - External genitalia are masculinized - Some variations can cause physical defects Slide 24 Q 25

26 Congenital adrenal hyperplasia (CAH) Sexual Diversity Slide 25 Q 26

27 Polycystic ovary syndrome (POS) - Conceived as a 46XX female - Blood levels of androgens (male hormones) of the mother, including androstenedione and testosterone are be elevated. - Females exposed to androgen excess in utero or during early life typically show masculinized and defeminized behavior, ovulatory dysfunction and virilized genitalia based upon the timing of exposure. Slide 26 Q 27

28 Müllerian agenesis Sexual Diversity - Mayer Rokitansky Kuster Hauser (MRKH) Syndrome - Conceived as a 46XX female - External genitalia has a female appearance - No fallopian tubes or uterus present, vagina may be very shallow and other abnormalities may exist. - The estimated prevalence is 1:5000 women Slide 27 Q 28

29 Tetragametic Chimeras - Results from the fusion of two fertilized eggs - Individual is composed of two unique sets of DNA Sexual Diversity Slide 28 Q 29

30 Tetragametic Chimeras (Genetic Mosaicism) Slide 29 Q 30

31 Tetragametic Chimeras (Genetic Mosaicism) Blaschko patterns indicating genetic mosaicism Slide 30 Q 31

32 Tetragametic Chimeras (Genetic Mosaicism) - Zygote DNA could be both male (XY) and female (XX) - Gene expression could result in true hermaphrodite - Complex medical and legal issues + Organ donor matching errors + Forensic analysis errors Slide 31 Q 32

33 Normalized sexual developmental characteristics Male Female External genitalia Penis Vagina Chromosomes 46 XY 46 XX Means of reproduction Sperm Egg Gonads Testicles Ovaries Major hormonal influence Testosterone Estrogen Secondary sex characteristics Facial hair Breasts Gender identity and behaviors Masculine Feminine Slide 32 Q 33

34 Case Studies Slide 33 Q 34

35 Case Study - Katie Baratz Diagnosed with complete androgen insensitivity syndrome (AIS) at 6 yrs Has XY (male) chromosomes Genetically insensitive to testosterone and androgens Did not develop a penis or external testes Slide 34 Q 35

36 Case Study - Katie Baratz Externally appears female presenting a shallow vagina Never developed a uterus or fallopian tubes thus infertile Appeared on Oprah to raise awareness of AIS Slide 35 Q 36

37 Case Study Caster Semenya Competed in the 2009 World Championships as a woman Genitals have a female appearance IAAF performed gender test In the 1996 Olympics, eight woman had male sex chromosomes. Seven of these eight women had Androgen Insensitivity Syndrome. Slide 36 Q 37

38 Question If a person with Klinefelter's syndrome (XXY) marries a person with Androgen Insensitivity Syndrome (AIS), is it a same sex marriage? Slide 37 Q 38

39 Question If a person with Klinefelter's syndrome (XXY) marries a person with Androgen Insensitivity Syndrome (AIS), is it a same sex marriage? -- Persons with XXY sex chromosomes are often undervirilized but are raised as male. They would have a M gender marker but would probably be infertile (no spermatogenesis). Persons with AIS are often raised as female, even though they have no uterus or ovaries and have XY (male) sex chromosomes. They would have a F gender marker but would incapable of bearing children. So what sex are they? Since marriage can only between a man and a woman, can they be married? Slide 38 Q 39

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