Normativity in Sex Anatomy

“Shhhhh! They are called “private parts” for a reason!”

Everyone has genitals so we shouldn’t be ashamed to talk about them. Despite the two “standard” versions of a penis and vulva/vagina prevalent in textbooks, they come in all shapes, sizes, and colors; they also change over time! These limited and oft repeated images erase the existence of trans and intersex people and reinforce the gender/sex binary. Limited representation has real consequences. Medical illustration has historically promoted that beauty is health and vice versa. And that is harmful for all.

It is critical to expand the representation of natural human variation, depict trans and intersex people erased from medical education, and dismantle the scientifically disproved notion of two genders/sexes. The binary is a recent construction but assumptions about sex differences are nothing new. For many centuries, the scientific consensus was that all humans possess the same fundamental reproductive structures, just in different arrangements. Sex was contiguous along a spectrum: the vagina was merely an inverted penis, as depicted in this image by da Vinci. Medical imagery (historically created by privileged, white men) has always played a role in upholding biased misconceptions about sex differences.

Why does this matter? In medicine, what makes someone sick or well is having a disorder or disease, defined as any difference from the expected norm. By asserting that females are inherently different from males (the norm), anyone other than a cisgender male is essentially treated as having a medical condition. If difference makes disease, than anyone outside of the “standard human” could be pathologized. So, virtually everyone.

To paraphrase Anne Fausto-Sterling, the understanding of the biology of sex and gender has undoubtedly been shaped by the culture that produced it. So it is no surprise that one result of the Scientific Revolution was so-called “biological proof” of fundamental dissimilarities based on sex, race, and other physical characteristics that could be exploited to preserve the social hierarchy. By having “evidence” claiming of innate differences defining “superior” and “inferior” groups, Western societies were able to disenfranchise many and justify patriarchy, capitalism, colonialism, and white supremacy. Men and women were now considered opposites with natural, complementary roles in life, cementing socially-applied gender roles to biological characteristics of sex. And thus, females and males went from essentially the same but different to entirely dissimilar with some commonalities.

Not much has changed since. The vast majority of medical textbooks in the US, UK, and Canada nearly-exclusively depict white, tall, thin, able-bodied, cisgender males with People of Color and females being represented by small insets, if at all. This fails to represent over 85% of the entire population accurately — including most white males! The lack of representation of those assigned female at birth extends far beyond medical illustration, as female humans, lab animals, and even cells are routinely left out of scientific testing.

When females are depicted in medical illustration, what do you typically see? The same Eurocentric beauty standards and sexy poses you see in magazines. These images highlight  symmetrical breasts, wide hips, small hands and feet, narrow waists, short stature, etc. Such characteristics tend to be more pronounced when the female figure is depicted next to a male, who is typically hypermasculinized. 

Some examples of normativity in sex anatomy include: 

  • Genitals tend to be drawn in shades of pink
  • Diminutive and symmetrical labia with undersized or absent clitoris
  • Penises that are uncommonly large, straight, and circumcised yet scar-less.
  • Perfectly hemispherical, symmetrical, small, perky breasts with erect nipples
  • Absence or merely decorative application of wispy pubic hair
  • Erasure of intersex and transgender bodies, anatomy, and sexual functioning 


  • “Pink” genitals represent a minority of the population and it not representative of most skin tones; all genitals have areas that are darker
  • More than 50% of people with labia have inner lips that extend below the outer ones; it’s common for one labial lip to be longer/larger than the other
  • The average flaccid penis length is 3.61 inches
  • It is very common for penises to have a curvature/bend when erect, as well as vary in thickness 
  • Circumcision is extremely common in the West, especially the U.S., but medical illustrations rarely depict the surgical scarring
  • Breasts, nipples, and areolas are all unique and rarely symmetrical (the left breast tends to be larger); breasts/chests have many shapes and sizes 
  • Most bodies produce pubic hair after puberty; it can range from centralized to the mons pubis to the perineum but often extends outwards towards the thighs, belly button, buttocks, etc. 
  • Intersex people whose genitals may not easily be categorized as male/female-typical are as common as redheads yet rarely depicted 
  • Transgender people, who rely on the medical system for basic identity expression, often have to teach providers about trans care because of a lack of education

Despite many kinds of humans with all kinds of sex and reproductive anatomy, even those with “typical” penises and vulvas/vaginae, medical illustration rigidly depicts two standard images, as they have for centuries. What harm do you think that causes? 

Genital variety illustration
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*Note, use of “female” and “male” refers to one’s sex assigned at birth; these terms include those who are cis, trans, non-binary, and intersex


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