Guest Post: What Makes You Who You Are?

By Anne Madeo

Anne Madeo is a genetic counselor who has worked for the National Institutes of Health for the past 11 years.  The views expressed here are her own and do not necessarily represent the views of the National Institutes of Health or the U.S. Department of Health and Human Services.

A few months ago, Bob Resta mused on clients’ responses to queries about ethnicity and what they tell us about the client. A recent conversation on the Nat’l. Society of Genetic Counselors’ listserv about ancestry testing and sex verification got me thinking about a similar issue in a different light.

What defines who we are on a fundamental level? Am I a woman because I wear dresses? Am I a woman because I have two X chromosomes? Am I woman simply because I say I am and that is how I feel on a gut level? Am I a woman if I have two X chromosomes and identify as a female, but I have a point mutation in a gene that increases testosterone production but not so much that in utero or postnatally I have male external genitalia? In the final question we might say that I am clearly female. But in the case of high-level performance athletics, my increased testosterone might provide such an advantage over women with typical human female hormone production that I shouldn’t be allowed to compete as a woman. In a recent decision, the International Amateur Athletic Federation (IAAF) side-stepped the issue of determining somebody’s sex and ruled that if a woman’s androgen levels are within the range of a typical male, she will not be allowed to compete as a woman in IAAF-regulated competitions. Should we should start testing athletes for mutations that predispose them to excel at sprinting and handicap the athletes that have these alleles to make the playing field even?

What about ethnicity or race? Am I Italian-American because I celebrate the Feast of the Seven Fishes on Christmas Eve? Am I Italian American because my paternal great grandparents immigrated here from Italy? Am I Italian-American because I say I am and it is how I’ve been raised and feel? Am I Italian-American because my DNA testing demonstrates that I’m a descendant of both Michelangelo and Leonardo da Vinci? I think most students of genetics would say that no, that last idea doesn’t make me Italian-American. We’re probably all distantly related to some famous individual or the other from the past. I could be Queen Victoria or Genghis Khan’s distant relative. (I doubt many people request testing to see if they’re related to Josef Stalin.)

So, can we use genetics to determine what racial or ethnic group we belong to? Although I usually assume that people with training in molecular or clinical genetics would say no, that’s clearly not always true. The postmodern interpretation of race is that it is a social construct. We determine our race and it is determined for us through family, societal and cultural cues. So, can I identify as Native American if my maternal great great grandmother was Native American and that’s the identity my family has always embraced? It seems that some would say yes, that if your experience is Native American and that is how you identify then you are Native American. But the extreme of the post-modern argument is that I, an individual with no known to me African heritage could claim that I am African-American simply because like most Americans I likely have some African ancestry. What say those who decry postmodernism? The extreme of the position that race and ethnicity are not culturally determined but the result of ancestry is the one-drop rule and the perception that light-skinned multi-racial individuals who identify as “white” are passing.

The obvious answer to all this is that who we are is determined by a complex mix of genetics, family, cultural and individual influences. Which still leaves us with the question—how do we decide ‘who’ or ‘what’ somebody is? Or, is that the right question to ask?


Filed under Guest Blogger

3 responses to “Guest Post: What Makes You Who You Are?

  1. Dave

    Excellent post. The clinical laboratory I work for categorizes all patient specimens from the America Southwest as Hispanic.

  2. Kara

    Earlier this week, when I asked my routine questions about a patient’s parental ancestries, she shrugged her shoulders. She said that she chooses “Other” when forced to select her ethnicity. It occurred to me that I do that too. In fact, it rubs me the wrong way that these stupid checkboxes try to pigeon-hole me into discrete categories that I don’t really fit into. And it is even worse for my kids! They are 25% Hispanic Caucasian (pure Neolithic Iberian), 25% Vietnamese, 50% non-Hispanic Northern European Caucasian mix, with a smattering of Ottawa Indian. If the US is a true melting pot of immigrants, how relevant is it (or will it be) on a genetic level to ask about maternal and paternal ancestry? To end my story, I didn’t push my patient to try to categorize herself. For the first time in eight years, I wrote “Other” on the top of her pedigree and just let it go.

  3. Sara

    Great piece. Italian-Canadians struggle with identity and acceptance especially here in Toronto since a recent wave of new Italian immigrants. The new Italians do not consider us Italian, or what they call “real Italian” and we have always identified ourselves in this way, granted the two are considerably divided in terms of cultural groupthink. I feel for individuals like my mother, born and raised in Italy, residing in Canada for the last 40+ years with a Canadian citizenship, assimilated and linguistically adjusted to her surroundings. Italians consider her Canadian, Canadians (of all ethnicities) acknowledge her roots/background and deem her Italian. I guess that would constitute an identity crisis? If you’re interested in the topic and would like to write for my magazine ( please contact me.

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