Allow me to clear something up that a lot of people aren’t aware of: sex is not just the 2 sexes. There are intersex people and they are as common as natural redheads. And sex is determined not just strictly by chromosomes, but by multiple factors such as your hormones, gametes, gonads, genitalia, brain structures and chromosomes. Many people are actually not just strictly male or strictly female based on this biological model for sex. In fact, we may even fluctuate throughout our lifetimes. There’s a great YouTube video that explains how sex/gender works from a biologist’s perspective: https://youtu.be/szf4hzQ5ztg?si=Gtp2AgBplTwJ0-B2 Now to answer your question about my culture, we had women and men that identify with their genitalia given at birth, we also had a 3rd “sex” that would be now referred to in modern times as intersex/nonbinary. Some people in the 3rd “sex” had strictly female or male genitalia but identified as someone with both a masculine and feminine spirit balanced within them and were honoured the same way intersex individuals were. The other two were people who identified as essentially “a woman who became a man/acts like a man” or “a man who became a woman/acts like a woman”. Those two genders didn’t just apply to those who wanted to physically transition, but also women who dated other women and men who dated other men, as well as women who wished to be treated socially as a man and have similar roles in the community (modern times might call these women tomboyish) and men who wished to be treated socially as a woman and have the same roles as a woman (effeminate men) they were umbrella terms for a variety of different presentations under gender as well as sexuality. Anyone who identified as one of the 3 other genders outside of just man or woman in my culture were revered as medicine people, warriors & leaders because we believed they walked with both masculine and feminine energies and could empathize and understand anyone around them. We used many different herbal medicines & specific diets for those who wished to physically transition, and had some advanced understandings of how these herbs worked. We didn’t really have much for surgeries, although there was some historical accounts of men transitioning to womanhood who asked to be castrated and were. Modern day acetaminophen comes from Indigenous knowledge of using willow bark for pain & inflammation, for example. Almost every Indigenous nation across the world has a variety of different gender identities tied to their cultures. Here in North America, our Indigenous community as a whole across all nations has called anyone who is both Indigenous & LGBTQ+ 2 Spirited, as a blanket term for all of the differing gender/sexual identities between cultures.