I’ve been looking into this for education…came across the publication which sheds some light on the history of sex determination and the evolution of the knowledge back behind it, which really didn’t start until WW2. excerpt below.
https://journals.sagepub.com/doi/10.1177/0306312718757081
" The 2006 consensus statement includes ‘45,X (Turner syndrome and variants)’ and ‘47,XXY (Klinefelter syndrome and variants)’ as ‘Sex Chromosome DSD’. However, discussion about these variations is limited and estimates of intersex in the consensus statement are reserved for a statement that ‘genital anomalies occur in 1 in 4500 births’ (Hughes et al., 2006: 554). There is also no consensus in medicine as to the boundaries of the DSD classification system. Despite the ‘consensus’ to include Turner and Klinefelter’s syndromes in DSD, some medical professionals have suggested they be excluded (Aaronson and Aaronson, 2010; Wit et al., 2007), and that the features that anchor the DSD should necessarily be gonads, genitals and the assignment of gender as close to the moment of birth as possible. I will return to these points. Crucially, the DSD classification rests upon the choice to include these syndromes, a choice that, as Bowker and Star (1999) point out, is not merely conceptual, but also normative and ethical, and that has clear consequences for the people so classified.
Some individuals and organizations have been critical of the shift to DSD terminology; many organizations used the term ‘intersex’ to reframe variations in sex characteristics as a social issue, not a medical emergency. The term ‘disorder’ structures the classification around the normal and the abnormal – a fact implicitly recognized by medical professionals when they suggested using ‘differences’ or ‘variations’ (rather than ‘disorders’) of sex development when speaking with individuals and family members (Ahmed et el., 2011). At the World Professional Health Association for Transgender Health conference in 2016, representatives of a number of global intersex activist communities presented evidence of ongoing medical mistreatment of intersex individuals internationally. As part of a presentation, Miriam van der Have, co-chair of Organisation Intersex International Europe (OII-Europe) and chair of Nederlands Netwerk Intersekse/DSD suggested a shift in the definition of the term intersex. Her ‘post-medicine definition’ defines intersex as ‘the lived experience of the socio-cultural consequences of being born with a body that does not fit with normative social constructions of male and female’ (Van der Have, 2016; see also Van der Have, 2017; Van Heesch, 2016). This post-medicine (and by extension, post-DSD) definition, to which I will return, shifts the focus from individual bodily differences, whether at the level of genes, chromosomes, gonads or genitals, to the social context in which such classifications are made, and the ramifications that inclusion or exclusion from normative social classifications can have on individuals. There is a lack of consensus, inside and outside medicine, as to whether to use the DSD classification system, and if so, what to include and what the central features of the classification are. This is not a new phenomenon."