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Let me make this as clear as possible. If you are human and have have 2 X chromosomes in your somatic cells, you are female. If you are human and have have both an X and a Y chromosomes in your somatic cells, you are male. Barring any strange mutations, those are the only options, and they aren't really optional b/c like a Pokémon trainers name, they can't be changed later. Any mismatch of genetalia and gender is an it.

That's heart wrenching