23andMe’s CEO and Co-founder Anne Wojcicki rang the opening bell on<a href="https://www.nasdaq.com/"> Nasdaq</a> Thursday morning, celebrating our first day as a publicly-traded company.
Anne took a moment during the virtual bell-ringing ceremony to thank customers, employees, and investors for their support. From the company’s founding in 2006, 23andMe (Nasdaq: ME)&nbsp; hasn’t wavered from its mission to help people access, understand and benefit from the human genome. Now more than ever, the time is ripe for 23andMe to change how people engage in their health, and to improve how new genetic research and drug discovery are done.
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="683" src="https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-1024x683.jpg" alt="" class="wp-image-28989" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-1024x683.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-300x200.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-768x512.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-880x587.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/06/mo-06172112-1180x787.jpg 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
Below is a version of the remarks Anne shared during the ceremony:
In 2005 I was working on Wall Street investing in health care when I had a call with a genetic researcher. I asked him about the state of genetics research and he said, “The excitement is palpable. Everything is going to change. We are going to understand the human genetic code.”
The sense of excitement that I felt in that conversation in 2005 remains with me today. We are unlocking one of the most exciting human mysteries. This simple code &#8211; A C G and T &#8211; has built this incredible world, all this diversity. It is truly amazing. 

I want to thank our customers &#8211; all 11M of you. It has been a journey! Together we have shown the world that you are capable of getting YOUR genetic information and learning about your <a href="https://www.23andme.com/dna-health-ancestry" target="_blank" rel="noopener">health and ancestry</a> &#8211; all without the supervision of a medical professional. You are far more capable of understanding science or taking charge of your health than the world believes. I want to thank you for believing in 23andMe and trusting us to unlock your DNA. We are committed to being your advocate and to always providing you transparency and choice with how your DNA is used. We will always make decisions based on what is best for you.
23andMe was founded in 2006 with a passion and love for genetics and a desire to empower individuals to be in control of their health. I was surrounded by incredible co-workers then and I am lucky to have been surrounded by incredible people ever since. As I think about how we have gotten to this day, I want to thank everyone who has ever worked at 23andMe. We have an incredible Gene Pool. It is a true honor to have so many talented people working on this dream and making today happen. I have my moments where I sometimes just sit back and marvel &#8211; you are all SO good. So thanks to all of you. 

I also want to thank my investors and my board. You have stuck with me through hard times and good times. You have provided incredible insights and support. This has not been easy but the work we are doing genuinely changes the world. Thank you for helping us get to this moment &#8211; this is just the beginning of our story.
Lastly, I want to conclude with where we are going. 23andMe is more than just a genetics company. We are an activist brand that is approaching health care and drug discovery with the individual at the center, as our partner. We are going to continue pioneering a consumer-centered personalized health care world. We are going to show that drug discovery can be more efficient when you start with a human genetic insight. Over the past 15 years our mission has never wavered: to help people access, understand and benefit from the human genome. In the next phase of the company, I want to show all of you that you are benefiting from the human genome by actually living a longer, healthier life.&nbsp; 

I want to end with a quote from one of my colleagues when I asked him why he has stayed at the company for over a decade. He responded with a quizzical look: “If we don’t do this work, no one will.”&nbsp;&nbsp; 

Thank you to everyone. What we do is important. You are changing the world.&nbsp;
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&nbsp;&nbsp;

23andMe Blog

23andMe Blog Team

Ringing in 23andMe’s Next Chapter

<figure class="wp-block-image alignright size-full is-resized"><img loading="lazy" decoding="async" src="http://35.88.189.111/wp-content/uploads/2021/06/FB_IMG_1623439632505.jpg" alt="" class="wp-image-28957" width="480" height="479" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505.jpg 640w, https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505-300x300.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505-271x271.jpg 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505-372x372.jpg 372w, https://blogcms.23andme.com/wp-content/uploads/2021/06/FB_IMG_1623439632505-574x574.jpg 574w" sizes="auto, (max-width: 480px) 100vw, 480px" /><figcaption class="wp-element-caption">Stephanie McKenna</figcaption></figure>



Tom Chaney was the kind of cop who was married to his job. During his more than two decades in law enforcement, he&#8217;d grab shifts on holidays, fill in for other officers to work Christmas, or New Year&#8217;s Eve, or Thanksgiving.&nbsp;



&#8220;I was single and didn&#8217;t have any kids, so I figured I might as well,&#8221; Tom said. &#8220;Holidays were never really a big deal for me.&#8221;



Earlier this year, due in part to 23andMe and a call from a woman he&#8217;d never heard of before, Tom&#8217;s perceptions about kids, holidays, and Father&#8217;s Day in particular shifted, dramatically.&nbsp;



The call came from Stephanie McKenna, a 34-year-old operations assistant at the Museum of American Art in Arkansas. She stunned him with some news. Stephanie thought she might be his daughter.



Once they determined this wasn&#8217;t just a wild guess but an actual DNA match, the first thing Tom said to Stephanie was:



&#8220;I&#8217;m sorry, I didn&#8217;t know.&#8221;



<h6 class="wp-block-heading" id="h-decades-of-searching">Decades of Searching</h6>



For Stephanie, it was a good sign. She&#8217;d feared rejection.



When at 16, she&#8217;d reached out to her biological mother, it had been a harrowing experience. Her birth mom didn&#8217;t reject her; she simply wasn&#8217;t interested in establishing a relationship. But that disappointment and hurt didn&#8217;t prevent Stephanie from looking for her birth father.



Stephanie was an adoptee with loving and supportive parents, but she still wanted to know more about her origins. It took receiving 23andMe as a Christmas gift — that Stephanie got from her mom and dad — to connect her to Tom, or more precisely to Tom&#8217;s dad, Tom Sr. Both Stephanie and Tom Sr. had opted into <a href="https://www.23andme.com/dna-ancestry" target="_blank" rel="noopener">DNA Relatives</a>. After making that connection, she then quickly connected to Tom himself.



<figure class="wp-block-image alignright size-large is-resized"><img loading="lazy" decoding="async" src="http://35.88.189.111/wp-content/uploads/2021/06/IMG_20210314_152309065-1024x768.jpg" alt="" class="wp-image-28947" width="512" height="384" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/IMG_20210314_152309065-1024x768.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/06/IMG_20210314_152309065-300x225.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/IMG_20210314_152309065-768x576.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/06/IMG_20210314_152309065-880x660.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/06/IMG_20210314_152309065-1180x885.jpg 1180w" sizes="auto, (max-width: 512px) 100vw, 512px" /><figcaption class="wp-element-caption"> Tom Chaney early in his career as a police officer. </figcaption></figure>



&#8220;It was a meeting 34 years in the making,&#8221; she said.



First, through a series of phone calls and then video calls over Zoom and texts, the two got to know each other.



Tom didn&#8217;t know he&#8217;d had a child. He and Stephanie&#8217;s birth mom dated for a few weeks while they both were stationed in Alaska. Tom was in the Marines, and Stephanie&#8217;s birth mom was in the Navy. The relationship was brief, and then Tom shipped off to another billet in Hawaii. At the same time, Stephanie&#8217;s birth mom wound up on a base in Virginia. Tom never even knew she&#8217;d been the pregnant.&nbsp;



<h6 class="wp-block-heading" id="h-a-first-meeting">A First Meeting</h6>



Finding out he now had a daughter pushed Tom to learn more about Stephanie and do his best to establish a relationship. After all the calls, texts, and Zoom chats, Stephanie&nbsp; came to Arizona in early June to visit him. The first time Tom greeted her at the airport he was wearing his Marine Corps t-shirt and holding a sign that read:&nbsp;&nbsp;



&#8220;Stephanie, here is your father.&#8221;



A flood of emotion, tears, and laughter came out of them as they embraced for the first time.&nbsp;



When he and his wife, Krissy, brought Stephanie home, there was a sign that read:&nbsp;



&#8220;It&#8217;s a girl.&#8221; 



<figure class="wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio"><div class="wp-block-embed__wrapper">
<iframe loading="lazy" title="Tom and Stephanie" width="500" height="281" src="https://www.youtube.com/embed/3_DIyb5Mu74?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe>
</div></figure>



<h6 class="wp-block-heading" id="h-getting-to-know-each-other">Getting to Know Each Other</h6>



What followed was a visit to get to know each other. Tom introduced Stephanie to his family and friends. The two shared old photos of themselves. They did everything they could to go from being strangers to being a daughter and a father.&nbsp;



&#8220;It&#8217;s uncanny how many things we share in common,&#8221; Stephanie said.



From mannerisms to personalities to even the kinds of things they each find humorous.&nbsp;



&#8220;Even the way we talk, there&#8217;s a similar cadence and similar facial expressions,&#8221; she said.&nbsp;



Meeting him helped explain some of her own characteristics. Like her, Tom was an extrovert, someone who seemed to thrive with many people around him. And there were little things that were similar too, like Tom&#8217;s involvement with a motorcycle club for retired police officers. Stephanie is involved in a horse riding club on the side.&nbsp;&nbsp;



Ironically perhaps, is that the two also shared something else in common. Neither Tom nor Stephanie wanted to have kids. Stephanie said it&#8217;s just not something she&#8217;s focused on right now.



<figure class="wp-block-image alignright size-full is-resized"><img loading="lazy" decoding="async" src="http://35.88.189.111/wp-content/uploads/2021/06/rsSNs.jpeg" alt="" class="wp-image-28948" width="512" height="384" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/rsSNs.jpeg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/06/rsSNs-300x225.jpeg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/rsSNs-768x576.jpeg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/06/rsSNs-880x660.jpeg 880w" sizes="auto, (max-width: 512px) 100vw, 512px" /><figcaption class="wp-element-caption">Stephanie visiting Tom at his home in Arizona.</figcaption></figure>



<h6 class="wp-block-heading" id="h-a-bigger-family">A Bigger Family</h6>



For Tom, it was his focus on his work. Something he&#8217;d picked up from his father. Like Tom, his dad had been a Marine first, and then a career police officer, and Tom followed in his dad&#8217;s footsteps in all ways but one. The one exception was that he never wanted a family.



&#8220;I didn&#8217;t want to put a kid through that,&#8221; he said.



That&#8217;s why he never had kids. He was fine with the decision, or at least he thought he was.&nbsp;



But in sharing the time with Stephanie over a few days in early June and looking at old photos of when she was a little girl, Tom felt a pang of regret. It&#8217;s hard for him to even talk about without getting emotional about everything that he missed out on. On the eve of her visit, he couldn&#8217;t sleep. When they looked at old photos of her growing up, he felt that tug of emotion even more.



&#8220;It&#8217;s all those things that I missed, that I wasn&#8217;t there for and couldn&#8217;t share with her,&#8221; he said. &#8220;That hurts inside, but it&#8217;s in the past, and now I want to make the most of it.&#8221;



So does Stephanie. He&#8217;s coming to visit her and her family in a few months.



&#8220;They (her parents) are so awesome. They want to share this with me and see it more like bringing someone else into the family,&#8221; she said.



Father&#8217;s Day will take on a new meaning this year, but more importantly, it&#8217;s part of this new chapter in Tom’s life.



&#8220;I&#8217;ve got 34 years to catch up on,&#8221; he said.

A Father and Daughter Meet for the First Time

23andMe joined over 100 other companies, to stand up for equity and against state legislation that discriminates against the LGBTQ+ community. <a href="https://www.hrc.org/resources/business-statement-on-anti-lgbtq-state-legislation">The Human Rights Campaign</a> released a statement condemning this harmful state legislation for companies to sign. <a href="https://www.aclu.org/legislation-affecting-lgbt-rights-across-country">The legislation</a> efforts in question bar transgender people from participating in sports, having their gender identity reflected on IDs, and receiving necessary healthcare. <a href="https://www.aclu.org/legislation-affecting-lgbt-rights-across-country">Other bills</a> limit LGBTQ+ couples from starting a family via adoption or foster care.
“Pride month is a time to celebrate the love that’s in all our DNA, regardless of someone’s sexual orientation or gender identity. But even though we are all 99.5 percent genetically identical, we still aren’t treated 100 percent equally,” wrote Jey McCreight, PhD, Science Communication Sr. Program Manager at 23andMe.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="536" src="https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-1024x536.png" alt="" class="wp-image-28959" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-1024x536.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-880x461.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image-1180x618.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/06/equality-image.png 1600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
23andMe has set specific objectives related to diversity, equity, and inclusion focused on building a more inclusive and accessible product for everyone, including the LGBTQ+ community. Customer reports separate biological sex from gender identity. In addition, the research team is examining how genetics can impact gender identity and <a href="https://blog.23andme.com/23andme-research/sexual-behavior-not-meaningfully-predicted-by-genetics-new-study-finds/">same-sex sexual behavior</a>. Customer surveys always use inclusive language. This strong support of the LGBTQ+ community is not only drawn from the company value of “we’re in this together,” but the value of trusting science.
“People who fear or distrust trans people often use ‘biology’ as a justification for attacking this community. But the reality is that the biology of sex and gender is more complicated than a simple binary,” explained Dr. McCreight. “Regardless of what science says, everyone should still treat trans people with respect because it’s just the right thing to do. But if you want to claim you ‘trust the science’ in order to attack trans people, then sorry – the science says that trans rights are human rights.”
As a company committed to uplifting LGBTQ+<a href="https://www.23andme.com/diversity-equity-inclusion"> employees</a> and customers and leading with science, 23andMe signed the Human Rights Campaign’s business statement this June in opposition to these unjust anti-LGBTQ+ state laws.
The statement reads: 
The companies joining this statement do business, create jobs, and serve customers throughout the United States. Our businesses strongly embrace diversity and inclusion because we want everyone who works for us or does business with us to feel included and welcomed as their true, authentic selves. Fairness, equal treatment, and opportunity are central to our corporate values because we care about our employees and the customers we serve. What’s more, these values also matter to our bottom lines. Inclusive business practices lead to more productive and engaged employees, increased customer satisfaction; and, ultimately, improved competitiveness and financial performance.
We are deeply concerned by the bills being introduced in state houses across the country that single out LGBTQ individuals &#8211; many specifically targeting transgender youth &#8211; for exclusion or differential treatment. Laws that would affect access to medical care for transgender people, parental rights, social and family services, student sports, or access to public facilities such as restrooms, unnecessarily and uncharitably single out already marginalized groups for additional disadvantage. They seek to put the authority of state government behind discrimination and promote mistreatment of a targeted LBGTQ population.
These bills would harm our team members and their families, stripping them of opportunities and making them feel unwelcome and at risk in their own communities. As such, it can be exceedingly difficult for us to recruit the most qualified candidates for jobs in states that pursue such laws, and these measures can place substantial burdens on the families of our employees who already reside in these states. Legislation promoting discrimination directly affects our businesses, whether or not it occurs in the workplace.
As we make complex decisions about where to invest and grow, these issues can influence our decisions. America’s business community has consistently communicated to lawmakers at every level that such laws have a negative effect on our employees, our customers, our competitiveness, and state and national economies.
As business leaders dedicated to equal treatment, respect, and opportunity for all &#8211; as well as to improving the financial and investment climate across the country &#8211; we call for public leaders to abandon or oppose efforts to enact this type of discriminatory legislation and ensure fairness for all Americans.
To learn more about these proposed bills and take a stand alongside 23andMe, visit the <a href="https://www.hrc.org/campaigns/the-state-legislative-attack-on-lgbtq-people">Human Rights Campaign site.</a>

23andMe Signs Business Statement on Anti-LGBTQ+ State Laws

Researchers at Kaiser Permanente identified dozens of new genetic associations for increased risk of age-related cataracts, one of the leading causes of blindness worldwide.
The study, published in the journal <a href="https://www.nature.com/articles/s41467-021-23873-8?utm_source=feedburner&#038;utm_medium=feed&#038;utm_campaign=Feed%3A+ncomms%2Frss%2Fcurrent+%28Nature+Communications+-+current%29">Nature Communications,</a> also identified genetic associations that are specific to the risk of cataracts for women. The condition is more common among women and this specific association may help explain why.
<h6>Large Study</h6>
The large size of the study, which included data from more than 3.5 million individuals, helped researchers identify many more genetic associations than previously known. This study identified more than 54 genetic associations in dozens of genes, including some that are involved in the development of the lens within our eyes.
While genetics explains some of the risks for developing cataracts, environment, and lifestyle can also play a role. Smoking, eye injuries, and certain medications, for instance, all can increase the risk of developing cataracts. Cataracts tend to develop as we age. Some estimates are that<a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts"> more than half of those over 80</a> have cataracts or have had surgery to remove them.  Cataracts are characterized by a clouding of the lens that can cause blurry vision, a loss of the vividness of color, or the ability to see at night. In more serious cases, cataracts can lead to blindness.
<h6>Deeper Understanding</h6>
By understanding the associated genes, it can also help identify those at higher risk for the condition. This could allow for earlier treatment, said the author of the paper Hélène Choquet, Ph.D., a research scientist at the Kaiser Permanente Division of Research. 
“This is the first step, and we can use this information along with other factors to build predictive models to identify people more likely to develop cataracts,” Choquet said. “If we can screen people before they develop a disease that would help them and their doctors to quickly identify when a cataract is forming.” 
Thought to be the largest genetic study of cataracts ever the research included data from more than half a million people drawn from Kaiser Permanente, the UK Biobank, which included about 67,000 with cataracts. The researchers then replicated their findings by using data from more than 3 million, including more than 340,000 with cataracts, from 23andMe who consented to participate in research.
<h6>Better Representation</h6>
The large study also included data from people of non-European ancestry, which are underrepresented in genetic research. In this case, 37 of the new genetic associations cut across different ancestries. In addition two of the associations were found in just women.
The data came from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. This cohort includes a group of more than 100,000 Kaiser Permanente Northern California members who volunteered their genetic and medical information for research. GERA is part of the Kaiser Permanente Research Program on Genes, Environment, and Health, which is itself part of the Kaiser Permanente Research Bank. Researchers also used data from the UK Biobank. The UK Biobank contains <a href="https://www.23andme.com/dna-health-ancestry" target="_blank" rel="noopener">genetic and health information</a> from about a half-million residents of the United Kingdom. The replication study used data from more than 3 million 23andMe customers who consented to participate in research.
The researchers also looked at the genes identified through this study and analyzed their function in a database with information on how these same genes express themselves in mice. That analysis confirmed that many of the genetic associations identified in the study were also seen in data on gene expression in mouse eye lens tissue.
“If the gene is expressed in the tissue that means it could have a direct relationship to the development of a cataract, which is caused by crystallization of the lens,” Choquet said.
Funding for the study came from several sources including the National Institutes of Health and in particular the National Eye Institute. 
&nbsp;

New Research Offers Insights into Cataracts

By Jey McCreight, PhD, Science Communication Sr. Program Manager
Pride month is a chance to celebrate the LGBTQ+ community, which is important here at 23andMe where part of our job is understanding and celebrating human diversity. But we should not forget that Pride started as a protest for LGBTQ+ rights, and despite the progress we have made, there is still work ahead.
The last year during this pandemic has been a stressful time for all of us, but even more so for transgender people, especially during the last six months as cultural conversations have shifted to put trans rights at risk. In fact, 2021 has already become the worst year in recent history for <a href="https://www.hrc.org/press-releases/2021-officially-becomes-worst-year-in-recent-history-for-lgbtq-state-legislative-attacks-as-unprecedented-number-of-states-enact-record-shattering-number-of-anti-lgbtq-measures-into-law">anti-LGBTQ legislation in the US</a>. There have been more than 250 anti-LGBTQ bills introduced in state legislatures, and seventeen of those have already been enacted into law. These bills disproportionately target transgender people, especially youth. This year is also <a href="https://www.hrc.org/resources/fatal-violence-against-the-transgender-and-gender-non-conforming-community-in-2021">on track to become the most violent, fatal year</a> for the trans and gender non-conforming community.
Why are we bringing this up? Because these attacks and this legislation have real implications for the health and wellbeing for trans people. For us here at 23andMe, where science is at our core, it’s particularly painful to see some of these legislative efforts pushed under the rallying cry of “trust the science.” As a health company, we feel compelled to speak up about what the science actually says.
People who fear or distrust trans people often use “biology” as a justification for attacking this community. But the reality is that the biology of sex and gender is more complicated than a simple binary. The science shows us that sex itself is <a href="https://blog.23andme.com/23andme-research/how-was-your-sex-determined-it-might-be-a-lot-more-complicated-than-you-think/">not binary, but rather bimoda</a>l, with a range of diversity between the categories of male or female. Scientific research also <a href="https://blog.23andme.com/23andme-and-you/genetics-101/celebrating-pride-month-a-spotlight-on-sex-and-gender/">supports the existence of trans and non-binary gender identities</a> as a natural part of human diversity that have existed throughout history. 
But it is not enough to simply say “trans people exist.” Science also shows that trans people who are accepted and affirmed have better health outcomes and quality of life. 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="614" src="https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-1024x614.png" alt="" class="wp-image-28914" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-1024x614.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-300x180.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-768x461.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-880x528.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq-1180x708.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/05/lgbtq.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Supporting Social Transition</h6>
<div style="float: right; text-align: justified; width: 300px; background-color: #eee; padding: 15px; margin-left: 10px;">
Terms
Non-binary is an umbrella term to describe gender identities that cannot be described as entirely “male” or “female” (e.g. agender, androgyne, genderfluid, genderqueer, and more.)
Some non-binary people consider themselves to be transgender, while others do not.
</div>
The most well-established treatment protocol for gender dysphoria is social transition, which involves adopting a new name, using different pronouns, changing hair and clothing, and using public spaces associated with one’s gender identity. For trans youth in particular, studies have shown that <a href="https://pediatrics.aappublications.org/content/134/4/696?ijkey=61ee57685e1e08e366a9f122ecec4242d0864f87&#038;keytype2=tf_ipsecsha">having supportive family members</a> is associated with better mental and physical health. Trans adolescents who receive gender affirmation <a href="https://pubmed.ncbi.nlm.nih.gov/21587245/">have better academic success, relationship building, and future-orientated planning.</a> Simply <a href="https://news.utexas.edu/2018/03/30/name-use-matters-for-transgender-youths-mental-health/">using a trans youth’s chosen name</a> and <a href="https://www.thetrevorproject.org/2020/07/29/research-brief-pronouns-usage-among-lgbtq-youth/">respecting their pronouns</a> significantly reduces their risk of depression and suicide.
Social transition also includes allowing trans individuals to play on sports teams that match their gender identity. Despite the wave of legislation attempting to ban trans youth from participating in sports, <a href="https://www.scientificamerican.com/article/trans-girls-belong-on-girls-sports-teams/">there is no scientific evidence</a> that trans girls have inherent advantages over cis girls in sports that justify blanket bans.
<h6>Bathroom Access</h6>
<a href="https://www.ama-assn.org/delivering-care/population-care/advocating-lgbtq-community">Medical experts</a> also support allowing trans people to use bathrooms and other single-sex spaces that are in accordance with one’s gender identity. Laws that seek to force trans individuals to use a restroom that does not correspond with their gender identity increases the risk for trans people to experience harassment and violent assault. <a href="https://static1.squarespace.com/static/54f76238e4b03766696d8f4c/t/5782a8d9197aeaa57b589608/1468180715744/USTS-Preliminary-Findings-July-2016-2.pdf">Trans people often avoid public restrooms</a> because of fear of confrontation or worse, which can lead to higher rates of dehydration, kidney issues, and urinary tract infections.
<h6>Gender-affirming health care</h6>
<a href="https://www.ama-assn.org/delivering-care/population-care/advocating-lgbtq-community">The American Medical Association</a> supports gender-affirming health care, such as hormones and surgery, as receiving such care has been shown to dramatically reduce rates of suicide attempts, depression and anxiety, and substance abuse. Studies by the <a href="https://pediatrics.aappublications.org/content/145/2/e20191725">American Academy of Pediatrics</a>, Cornell University, and other institutions have found that pubertal suppression treatment for trans youth was associated with lower odds of suicidal thoughts. Despite <a href="https://jamanetwork.com/journals/jama/fullarticle/2780517">most mainstream medical associations opposing legislation</a> that limits gender affirming medical care for trans youth, this health care <a href="https://www.nbcnews.com/feature/nbc-out/arkansas-passes-bill-ban-gender-affirming-care-trans-youth-n1262412">has already been banned in the state of Arkansas</a>.
<div style="float: right; text-align: justified; width: 300px; background-color: #eee; padding: 15px; margin-left: 10px;">
Medical Opinion
The following medical associations oppose legislation that limits gender-affirming medical care for trans youth:
• American Medical Association
• American College of Physicians
• American Academy of Family Physicians
• American College of Obstetricians and Gynecologists
• American Osteopathic Association
• American Psychiatric Association
• American Academy of Pediatrics
• American Academy of Child and Adolescent Psychiatry
• The Endocrine Society
• The Pediatric Endocrine Society
• World Professional Association for Transgender Health
• US Professional Association for Trangender Health.
&nbsp;
</div>
<h6>Mental health</h6>
To be clear, there is no evidence that increased risk for mental illness among trans people is due to being transgender. The American Psychological Association and American Psychiatric Association have both firmly stated that <a href="https://pediatrics.aappublications.org/content/142/4/e20182162">this increased risk stems from stigma, social rejection, discrimination, and limited availability of gender-affirming health care services.</a>
<h6>What 23andMe is Doing in Product</h6>
To put it succinctly, there is no debate among the medical and scientific communities when it comes to accepting and affirming the gender identities of trans people.
This is why we have spent the last year working to improve our product experience for trans and non-binary customers. This has included research on best practices recommended by LGBTQ organizations, conducting focus groups with trans customers, and consulting trans employees. When these improvements go live later this year, customers will be able to input both their sex assigned at birth and their gender during kit registration and will be able to select the relationship labels (e.g. father, uncle, brother) that best reflect their gender identity, including gender-neutral options. The option to use gender-neutral pronouns is also available to cisgender customers who may want their gender anonymous for privacy reasons. 
This is only the first step in an overall commitment to improving our offerings for trans customers. As more research becomes available, for example on how hormone replacement therapy may affect risk estimates, we hope to keep improving our reports so they are more relevant for trans customers.
<h6>A Personal Conclusion</h6>
It’s easy to read a blog post on a company site and think it’s some detached statement. But I myself am a non-binary trans person. I’m hesitant to say this because I worry that some readers will no longer trust the scientific content of this post, despite my Ph.D. or my role leading 23andMe’s Science Communication program.
That fear of turning most of society against me is why I, like so many other trans people, stayed in the closet for so long. I was terrified that coming out would ruin my career, lose my family and friends, and put me at risk of violence. That fear directly came from the media I watched growing up, which cast trans people as monsters to be feared, pitied, or ridiculed. 
But a cultural shift is clearly happening. I finally found resources and language to describe how I’ve always felt, and to realize there were other people out there like me. I met trans people in real life and saw more role models in the media that showed me that, frankly, there is nothing wrong with being trans. 
I feel lucky to work at a place where I felt comfortable enough to publicly transition without losing my job or the respect of my colleagues. Being able to have that job security, which most trans people do not, enabled me to finally be myself completely openly, including to my closest family and friends. 
Do coworkers and family still occasionally mess up my pronouns? Yes. But overall I’ve been privileged by how supportive everyone has been. I can tell they’re making an effort to do better and to learn why affirming my gender matters so much to me because they care about my health and happiness. That willingness to learn sets them apart from transphobes who refuse to listen to scientists, doctors, and most importantly, trans people themselves.
But not every trans person is as privileged as I am. Many think trans people only care about pronouns, but from legislative attacks to literal violent attacks, it is a dangerous time to be trans. Trans people of color in particular are disproportionately affected by violence, discrimination, and lack of health care. Trans youth are already having life-saving gender-affirming health care made illegal, despite medical consensus supporting that care. I wish I would have had the support and science to not go through the wrong puberty, and it breaks my heart to watch kids have that taken away.
The least I can do from my position of privilege is to speak up. Regardless of what science says, everyone should still treat trans people with respect because it’s just the right thing to do. But if you want to claim you “trust the science” in order to attack trans people, then sorry &#8211; the science says that trans rights are human rights.

Trust the Science by Supporting Trans Health Care

Researchers at 23andMe have identified a new <a href="https://www.23andme.com/dna-health-ancestry" target="_blank" rel="noopener">genetic variant</a> associated with COVID-19 induced loss of smell and taste.
The findings, published in a preprint released on <a href="https://www.medrxiv.org/content/10.1101/2021.05.28.21257993v1">medRxiv</a>, note that the genetic variant is near two olfactory genes.  Loss of smell and, or taste — also called anosmia — is a hallmark symptom of COVID-19. It is often the earliest indication of infection, and in some cases, the only symptom. An individual with one copy of the variant is about 11.5 percent more likely to lose their sense of smell or taste if infected compared to someone with zero copies.
<h6>23andMe COVID-19 Study</h6>
The research adds another piece to the COVID-19 puzzle, and it builds on the work already done by 23andMe over the last year that includes new findings around <a href="https://blog.23andme.com/23andme-research/23andme-covid-study-published/">the role blood type plays </a>in severity and susceptibility to the virus. This piece of the puzzle is intriguing because the novel coronavirus SARS-CoV-2 first enters the body and accumulates in olfactory support cells. The findings may offer researchers important insights into the <a href="https://www.23andme.com/dna-health-ancestry" target="_blank" rel="noopener">biological pathway for infection</a>.
For these findings, the researchers again used data from more than one million people who consented to participate in 23andMe’s <a href="https://you.23andme.com/covid19-study/">COVID-19 Study</a>.  By examining the differences in the genome between COVID-19 cases who did and did not experience loss of taste or smell, our scientists identified an association on chromosome 4 near the olfactory genes UGT2A1 and UGT2A2 (Figure 1 and Figure 2a). 
<div id="attachment_28919" style="width: 890px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28919" class="size-larger wp-image-28919" src="http://35.88.189.111/wp-content/uploads/2021/05/ugt2a1-2-880x451.png" alt="A Manhattan plot showing a strong association in the genes UGT2a1/2" width="880" height="451" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2-880x451.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2-300x154.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2-768x394.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2-1024x525.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2-1180x605.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/05/ugt2a1-2.png 1494w" sizes="auto, (max-width: 880px) 100vw, 880px" />Figure 1. Manhattan plot of loss of smell vs. no loss of smell among those with a positive SARS-CoV-2 test.</div>
<h6>Relevant for All Ethnicities</h6>
The scientists ran separate genome-wide association studies for individuals of European, Latino, African American, East Asian, and South Asian ancestries, and then combined the data via a meta-analysis. The researchers evaluated the effect of the top-associated single nucleotide polymorphism (SNP) in the different ancestral populations (Figure 2).
<div id="attachment_28918" style="width: 522px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28918" class="size-full wp-image-28918" src="http://35.88.189.111/wp-content/uploads/2021/05/COVID-smell-snp-plot.png" alt="" width="512" height="398" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/COVID-smell-snp-plot.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/05/COVID-smell-snp-plot-300x233.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" />Figure 2a. Regional plot of the association detected in the vicinity of UGT2A1/2. </div>
<div id="attachment_28917" style="width: 522px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28917" class="size-full wp-image-28917" src="http://35.88.189.111/wp-content/uploads/2021/05/Covid-smell-p-values.png" alt="" width="512" height="315" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/Covid-smell-p-values.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Covid-smell-p-values-300x185.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /> Figure 2b. Population effect sizes and 95% confidence intervals.</div>
Those results show no evidence of a difference in the SNP effect between populations, although there is limited power to detect associations in the non-European populations. Nonetheless, the frequency of the risk allele does differ somewhat by population. It is most commonly observed in individuals of European ancestry (37 percent) and least commonly observed in individuals of East Asian ancestry (19 percent) (Table 1).
<table>
<tbody>
<tr>
<td>Population</td>
<td>Variant frequency</td>
</tr>
<tr>
<td>Europe</td>
<td>37%</td>
</tr>
<tr>
<td>South Asian</td>
<td>32%</td>
</tr>
<tr>
<td>African American</td>
<td>31%</td>
</tr>
<tr>
<td>Latino</td>
<td>30%</td>
</tr>
<tr>
<td>East Asian</td>
<td>19%</td>
</tr>
</tbody>
</table>
Table 1. Allele frequencies by population or rs7688383
<h6>Among the Most Common Symptoms</h6>
Early in the outbreak, the loss of smell and taste was recognized as a means to distinguish between patients with COVID-19 and those with simple colds or flu. That is, if you felt sick and had a loss of smell or taste, you were much more likely to have COVID-19 than another respiratory infection (<a href="https://www.nature.com/articles/s41591-020-0916-2">1</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386529.1/">2</a>).
In the 23andMe COVID-19 study, two-thirds (68 percent) of those who tested positive for the virus reported loss of smell or taste, compared to just 17 percent of those who tested negative (Figure 3). Furthermore, in a model adjusted for other symptoms, age, and sex, the loss of smell or taste carried a seven-fold increased likelihood of testing positive for SARS-CoV-2 among those reporting illness.
<div id="attachment_28916" style="width: 522px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28916" class="size-full wp-image-28916" src="http://35.88.189.111/wp-content/uploads/2021/05/COVID-symptoms.png" alt="" width="512" height="316" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/COVID-symptoms.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/05/COVID-symptoms-300x185.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" />Figure 3. Frequency of symptoms reported among respondents with a cold or flu-like illness who did and did not have a positive SARS-CoV-2 result in the 23andMe study, ordered by percentage difference.</div>
<h6>Looking by Age</h6>
When the researchers looked at the symptoms by age, they found that among younger people with COVID-19 the loss of smell and taste was more common. Among those aged 26-35, 73 percent reported loss of smell, whereas only 43 percent reported loss of smell in those 85 or older (Figure 4). When the researchers looked at differences between men and women they found that women were more likely than men to report loss of smell or taste (72 percent  vs. 61 percent). While it is known that age is associated with lower sensitivity to smell, these findings held up when adjusted for self-reported ability to smell in advance of infection with SARS-CoV-2.
<div id="attachment_28915" style="width: 890px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28915" class="size-larger wp-image-28915" src="http://35.88.189.111/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-880x545.png" alt="" width="880" height="545" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-880x545.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-300x186.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-768x476.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-1024x634.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age-1180x731.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/05/Loss-of-Smell-by-Age.png 1544w" sizes="auto, (max-width: 880px) 100vw, 880px" />Figure 4. COVID-19 related loss of smell by age group</div>
<h6>More About the Genetic Association</h6>
Little is known about what the genetic variant (rs7688383) does, or how it impacts the likelihood of losing your smell or taste during infection with SARS-CoV-2. But the olfactory genes UGT2A1/2 are part of a family of enzymes called uridine diphosphate glycosyltransferases and are expressed in the olfactory epithelium and metabolize odorant compounds. In the 23andMe database, both of these genes are related to such things as <a href="https://blog.23andme.com/23andme-research/genes-scream-for-ice-cream/">ice-cream</a> taste preference and ability to smell as measured by a self-reported five-point scale ranging from very poor to very good.
Recent evidence suggests that SARS-CoV-2 enters and accumulates in olfactory support cells, which abundantly express the viral entry proteins ACE2 and TMPRSS2 (<a href="https://advances.sciencemag.org/content/6/31/eabc5801">3</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241737/">4</a>). It has been proposed that olfactory sensation is impaired when these essential functions are disrupted, causing olfactory receptor neuron cilial impairment (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488171/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488171/">5</a>). Given their localization and essential function in the metabolization and detoxification of compounds in the olfactory epithelium, the genes identified here, UGT2A1/2, may play a role in the physiology of infected cells and the resulting changes to the cilia that contribute to our ability to smell.
Many thanks to the over 1 million research participants who answered our questionnaire and made this research possible. 
*The 23andMe COVID-19 research team includes: Adam Auton, Adrian Chubb, Alison Fitch, Alison Kung, Amanda Altman, Andy Kill, Anjali Shastri, Antony Symons, Catherine Weldon, Chelsea Ye, Daniella Coker, Janie Shelton, Jason Tan, Jeff Pollard, Jey McCreight, Jess Bielenberg, John Matthews, Johnny Lee, Lindsey Tran, Maya Lowe, Michelle Agee, Monica Royce, Nate Tang, Pooja Gandhi, Raffaello d’Amore, Ruth Tennen, Scott Dvorak, Scott Hadly, Stella Aslibekyan, Sungmin Park, Taylor Morrow, Teresa Filshtein Sonmez, Trung Le, and Yiwen Zheng. 
[/vc_column_text][/vc_column][/vc_row]

A logo for 23andMe's COVID-19 Research Study

Scientists Find Genetic Link to Loss of Smell Among COVID-19 Patients

By Samantha Ancona Esselmann, Ph.D., and Chelsea Robertson, Ph.D.*
Editor’s note: A version of this post originally appeared earlier this year in our premium content for <a href="https://www.23andme.com/membership" target="_blank" rel="noopener">23andMe+</a> members. We are reposting it on 23andMe&#8217;s blog for Pride Month. In this article, the term “sex” is used in a developmental and biological sense. This article does not focus on sexual orientation or gender identity, which were addressed in a <a href="https://blog.23andme.com/23andme-and-you/genetics-101/celebrating-pride-month-a-spotlight-on-sex-and-gender/">previous blog post</a>.  
A shallow understanding of the mechanisms that determine biological sex might lead one to suppose that sexual development is a simple matter of reading the same recipe and always ending up with the same cookie. It’s not.
We are astonishingly complex bags of organic and inorganic chemicals that defy entropy until we die. You can change the recipe and end up with the same cookie, or follow the same recipe and end up with a completely different cookie. (And, if baking were easy, we wouldn’t have just finished the 10th season of the “Great British Baking Show.”) 
Infinitely more complicated than baking a 20-layer Schichttorte are the biological processes that determine your sex. Your sex, like Schichttorte, has a lot of layers. <img loading="lazy" decoding="async" class="alignright size-medium wp-image-28892" src="https://blog-api.23andme.com/wp-content/uploads/2021/05/cookbook-2-251x300.png" alt="" width="251" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2-251x300.png 251w, https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2-768x920.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2-855x1024.png 855w, https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2-735x880.png 735w, https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2-985x1180.png 985w, https://blogcms.23andme.com/wp-content/uploads/2021/05/cookbook-2.png 1336w" sizes="auto, (max-width: 251px) 100vw, 251px" />
At the bottom, there’s your chromosomal and genetic sex. There are also sex organs, hormones, and secondary sex characteristics — like beards and breasts. Then, of course, there’s your biggest sex organ, your brain, wherein an incomprehensibly large ensemble of neurons shout, whisper, and sing a symphony of sexual identity that is wholly unique to you.
And while all those layers can be consistent with a binary definition of sex, sex is not binary: Any one of the layers can be swapped out for a different color or texture, or taste. Humans can be intersex.
In a recent 23andMe<a href="https://blog.23andme.com/23andme-and-you/genetics-101/celebrating-pride-month-a-spotlight-on-sex-and-gender/"> blog post</a> about sex and gender, Dr. Jey McCreight explained, “at least one in 1,500 births are intersex, meaning that a person’s anatomy and/or their chromosomes can’t be classified as typically male or female. This is a conservative estimate, as many people do not realize they are intersex until later in life. Some never find out.”
Let’s start at the very beginning.
<h6>The sex gene</h6>
During the first few <a href="https://www.ncbi.nlm.nih.gov/books/NBK279001/">weeks</a> of your life, you were an androgynous mass of cells. In form and face neither male nor female nor even recognizably human, you followed an age-old sequence of gestational milestones, starting with important ones like, “Grow heart!”

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="977" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-977x1024.png" alt="" class="wp-image-28890" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-977x1024.png 977w, https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-286x300.png 286w, https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-768x805.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-840x880.png 840w, https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution-1126x1180.png 1126w, https://blogcms.23andme.com/wp-content/uploads/2021/05/embryos-with-attribution.png 1336w" sizes="auto, (max-width: 977px) 100vw, 977px" /></figure>
 
As you bobbed and rolled, tethered to life by a spongy tube full of filtered blood, the cells of your primordial gonads still existed in a bi-potential state, meaning they possessed the power to develop and multiply into either ovaries or testes.
Which path these cells eventually followed depended on either the absence or the activation of a gene located on the Y chromosome. That gene is called SRY, or the Sex-determining Region on the Y chromosome&#8230; a very un-sexy name for the “sex gene.”

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="216" src="https://blogcms.23andme.com/wp-content/uploads/2021/05/sex-chromosome.png" alt="" class="wp-image-28891" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/05/sex-chromosome.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/05/sex-chromosome-300x127.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
In the absence of SRY activation, the default human embryo is female. But, turn on that switch and, like a soupy Rube-Goldberg machine, a fractal cascade of carefully orchestrated chemical events is initiated, knocking that developing embryo onto a “male” path. This path is not simply a matter of making all the male bits. It also requires a manual override of ovarian development — an active silencing of the default human protocol.
Needless to say, there’s a vas deferens between these two paths.
<h6>Chromosomes and sex</h6>
Through services like 23andMe, people may learn that their chromosomal sex doesn’t match the sex they were assigned at birth. We all fall on slightly different points along a spectrum between typical biological female and typical biological male, but most of us go through life without ever knowing the exact complement of chromosomes in our cells.
You need at least one X chromosome to survive past the tumultuous early days of embryonic development. But beyond this most basic requirement, there’s a lot of wiggle room in the pantheon of chromosomal sex.
Generally, people with no Y chromosome appear biologically female, while people with at least one Y chromosome appear male: Most females are XX, and most males are XY. But there are other combinations too, such as XXX, XXY, XYY, XYYY, XXXY, XXXX, X (also known as XO), and mosaic XY/X or XX/X individuals, whose unusual karyotypes arose from a failure of sex chromosomes to end up in the right place during cell division. (A karyotype is the number and appearance of your chromosomes under a microscope.)
But, your sex isn’t only about which sex chromosomes you have.
<h6>More on chromosomes: Why it’s not all about the Y</h6>
Over tens of millions of years, the Y chromosome’s role in humans has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120474/">atrophied</a> to one of ferrying a few genes across the generations to enable us to reproduce sexually.
But, it’s possible to have a Y chromosome and be genetically female, hormonally female, and physically female (meaning you have a Y chromosome but lack a functioning SRY gene). It’s also possible to lack a Y chromosome and be genetically, hormonally, and physically male.
These situations typically arise in a father’s sex cells when there’s a mutation in the SRY gene, or when SRY jumps from a Y chromosome onto an X inside a sex cell — rendering the former almost completely vestigial and conferring the power of sex determination on the latter.
When an SRY-deficient Y chromosome is passed on, the sexual development of the XY fetus <a href="https://www.ncbi.nlm.nih.gov/books/NBK279001/">can</a> follow a similar path to that of a fetus without a Y chromosome. The other side of the same coin can mean that there are XX males who inherited an SRY gene on an X chromosome. There’s even <a href="https://academic.oup.com/molehr/article/12/5/341/1005702">a report</a> of a male with two X chromosomes who lacks the SRY gene, and scientists speculate that mutations in other genes related to sexual development can also promote masculinization. 
And, well, biological sex doesn’t exactly get less complicated from here.
Beyond SRY, sex determination and development also depend on a flurry of hormones that help direct and monitor the progress of the human build, from gestation to adulthood.
<h6>Hormones</h6>
Hormone signaling in the womb affected the progress of your sexual development and, in particular, the shape and formation of your external genitalia — the appearance of which had a big impact on the sex you were assigned at birth.
The assignment of a baby’s biological sex is rarely called into question when the infant&#8217;s genitalia appear “normal” or as expected. But by this point, you can probably guess, biological sex is not as simple as what’s visible in your nether regions.
Certain genetic variants affecting hormone production and signaling can have dramatic effects on the formation of genitalia in the womb. So while you can be XY or XX or X (XO), or any other combination, small changes in hormone production and signaling can push you in different directions along the spectrum of biological sex traits, much like how small changes in humidity or temperature can change the rise of your bake.
Got a variant that boosts your testosterone levels? Might not be noticeable if you are a male (XY) embryo, but XX females with a variant like this may have genitalia at birth that do not appear particularly male or female.
Got a variant that changes the way testosterone transmits signals to the cell? If you&#8217;re a female (XX) embryo you might not have any noticeable signs or symptoms at birth. But if you&#8217;re a male (XY)  embryo, your genitalia may appear more ambiguous.
What about when babies are born with the expected external genitalia, but nevertheless have differences in hormone production and signaling? Sometimes hormonal differences go largely unnoticed until the early teenage years when your hormones return to center stage in Act 2 of your sexual development — puberty.
Got a genetic variant that inhibits the production of testosterone? If you are a male (XY) embryo, it&#8217;s possible that your genitalia could appear female at birth. You could be raised as a female for over a decade, then puberty hits and your body doesn&#8217;t do the normal female puberty thing. Instead, you notice increased muscle mass, some facial hair, and a deeper voice.
So you can be XY, insensitive to the effects of testosterone in the womb, born with female genitalia, then go on to develop male secondary sex characteristics later in life.
Are the lines encircling the concepts of biological sex beginning to blur?
Let&#8217;s recap.
You can be chromosomally and genetically male or female, but depending on your particular hormone production and signaling systems, you might end up somewhere else on the spectrum of biological sex.
Hormonally and physically, you can be somewhere in between male and female.
<h6>So why does this matter?</h6>
Imagine, for a moment, how boring life would be if every baguette came out of the oven the same, or if every birthday cake had the same frosting, or the same filling. The more we understand about the textured, richly flavored layers of sexual development, the better equipped we are to mobilize empathy for others and their diverse experiences.
*Both Samantha and Chelsea are 23andMe Product Scientists, and both hold doctorates in neuroscience.
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<ol>
<li aria-level="1"><a href="https://www.ncbi.nlm.nih.gov/books/NBK279001/">Rey R, Josso N, Racine C. Sexual Differentiation. [Updated 2020 May 27]. In: Feingold KR, Anawalt B, Boyce A, et al., editors.</a></li>
<li aria-level="1">McCreight, J. 2020. “<a href="https://blog.23andme.com/23andme-and-you/genetics-101/celebrating-pride-month-a-spotlight-on-sex-and-gender/">Celebrating Pride Month, a Spotlight on Sex and Gender.</a>” 23andMe blog.</li>
<li aria-level="1">Bachtrog D. (2013). &#8220;Y-chromosome evolution: emerging insights into processes of Y-chromosome degeneration.&#8221; Nat Rev Genet. 14(2):113-24. https://pubmed.ncbi.nlm.nih.gov/23329112/</li>
<li aria-level="1">The Y chromosome is disappearing – so what will happen to men? by Darren Griffin, The Conversation. Retrieved October 25, 2020, from <a href="https://phys.org/news/2018-01-chromosome-men.html">https://phys.org/news/2018-01-chromosome-men.html</a></li>
<li aria-level="1">Montañez A. (2017). &#8220;Beyond XX and XY.&#8221; Sci Am. 317(3):50-51. https://pubmed.ncbi.nlm.nih.gov/28813372/</li>
<li aria-level="1">Gomez-Lobo V et al. (2016). &#8220;Disorders of Sexual Development in Adult Women.&#8221; Obstet Gynecol. 128(5):1162-1173. https://pubmed.ncbi.nlm.nih.gov/27741188/</li>
<li aria-level="1">Ha NQ et al. (2014). &#8220;Hurdling over sex? Sport, science,nd equity.&#8221; Arch Sex Behav. 43(6):1035-42. https://pubmed.ncbi.nlm.nih.gov/25085349/</li>
<li aria-level="1">MedlinePlus (2019, Aug 7). “Intersex.” Retrieved October 31, 2020, from https://medlineplus.gov/ency/article/001669.htm</li>
<li aria-level="1">MedlinePlus (2010, Feb 1) “CYP21A2 gene: Health Conditions Related to Genetic Changes.”  Retrieved October 31, 2020, from https://medlineplus.gov/genetics/gene/cyp21a2/#conditions.</li>
<li aria-level="1">MedlinePlus (2018, Sept 1)“Congenital adrenal hyperplasia due to 11-beta-hydroxylase deficiency.” Retrieved October 31, 2020, from https://medlineplus.gov/genetics/condition/congenital-adrenal-hyperplasia-due-to-11-beta-hydroxylase-deficiency/</li>
<li aria-level="1">Ohnesorg T et al. (2014). &#8220;The genetics of disorders of sex development in humans.&#8221; Sex Dev. 8(5):262-72. https://pubmed.ncbi.nlm.nih.gov/24504012/</li>
</ol>

How was your sex determined? It might be a lot more complicated than you think

A massive new genome-wide association study led by the U.S. Department of Veteran Affairs is shedding new light on the genetic underpinnings of major depression.
More than 16 million Americans are affected by depression each year, and nearly 6 million Americans suffer from bipolar, according to the National Institutes of Health. However, current treatment options do not always work for people living with these conditions, and researchers hope that new insights into the condition&#8217;s genetics could help diagnose and treat it.
<h2>Million Veterans</h2>
For this study, scientists at Yale and the University of California, San Diego, used data from 1.2 million people to identify 178 genetic variants linked to depression.
The study, published in the journal <a href="https://www.nature.com/articles/s41593-021-00860-2">Nature Neuroscience</a>, included data from the Million Veteran’s Project, the UK Biobank, FinnGen, and from 23andMe customers who consented to participate in research. After the initial study, the researchers cross-checked their findings using an entirely separate cohort from 23andMe that included data from 1.3 million customers who consented to participate in research.
“What is most heartening is that we could replicate our findings in independent data sets,” said Daniel Levey, an associate research scientist in the Yale Department of Psychiatry and co-lead author. “Replication is a hallmark of good science, and this paper points to just how reliable and stable results from GWAS studies are becoming.”
<h2>Brain Development</h2>
A number of the genetic variants identified are giving researchers deeper insight into the underlying biology of depression. Researchers point to variants in or near the gene NEGR1, a neural growth regulator active in the hypothalamus, an area of the brain previously linked to depression.
That confirms research done by the late Yale neuroscientist Ronald Duman on the role of neurotrophic factors in depression, Levey said.
“It’s really striking when completely different kinds of research converge on similar biology, and that’s what’s happening here,” he said.
The size and breadth of the study will also help scientists create models to calculate risk — known as polygenic risk scores — to better estimate the risk of developing major depression or other related psychiatric disorders such as post-traumatic stress disorder and anxiety. Beyond estimating the risk, the hope is that new genetic insights will help in identifying better ways to treat depression and related conditions.
“One of the real goals of the research is bringing forward new ways to treat people suffering from depression,” said co-senior author Dr. Murray Stein, staff psychiatrist at the V.A. San Diego Healthcare System and Distinguished Professor of Psychiatry and Public Health at UCSD.

Study Offers More Insights into the Genetics of Depression

Over the last year, since the tragic murder of George Floyd, 23andMe has taken a number of steps to improve our approach in building a more diverse, equitable, and inclusive workplace. We identified four focus areas that we’ve been making progress on over the past year, including:
<ol>
<li aria-level="1">Hiring: Attract and hire top, diverse talent.&nbsp;</li>
<li aria-level="1">Employee Experience: Cultivate an inclusive environment that authentically celebrates our shared genome and unique differences.&nbsp;</li>
<li aria-level="1">Product &amp; Research: Use our product to build and sustain Diversity, Equity, and Inclusion (DEI) in every customer and community interaction.</li>
<li aria-level="1">Community Impact: Use our relationships to build diverse, equitable, and inclusive communities.</li>
</ol>
We have committed to holding ourselves accountable, while also rallying others to take action and be part of shaping a better future. To aid in these efforts, our CEO and co-founder Anne Wojcicki recently joined the<a href="https://www.ceoaction.com/"> CEO Action for Diversity &amp; Inclusion™</a> pledge to collaborate with other organizations in order to further our DEI efforts. The coalition, which now includes more than 1,600 CEOs across 85 industries, is the largest CEO-driven business commitment to advance diversity and inclusion within the workplace.
“Creating a more inclusive work environment and product is a lifelong journey that will require continuous input and feedback,” Anne said. “Joining this pledge will allow us to collaborate and learn from other organizations so that we can all build more diverse, equitable, and inclusive workplaces and products.”
The pledge centers around four main commitments that align with 23andMe’s commitments to DEI. They include:
<ul>
<li aria-level="1">Cultivate trusting workplaces that can have complex, and sometimes difficult, conversations.</li>
<li aria-level="1">Implement and/or expand unconscious bias education.</li>
<li aria-level="1">Share best—and unsuccessful—practices.&nbsp;</li>
<li aria-level="1">Create and share strategic inclusion and diversity plans with the board of directors (or equivalent governing bodies).</li>
</ul>
23andMe has already begun working on each of these four commitments, but this pledge offers another opportunity to hold ourselves accountable. We also hope that it will help encourage other companies to make similar moves toward creating more diverse, equitable, and inclusive workplaces.
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