  Butler's account of gender aims to call into question the pre-existence of a group of individuals (i.e., women, females) prior to the enforcement of gender role. Instead, in Butler's view, biological sex is culturally instituted and in this sense “gender all along.” Prima facie this view seems counter-intuitive. One way to motivate it is to recognize that contrary to the natural attitude about sex (discussed above), human beings cannot always be neatly divided into male and female. Indeed, once we recognize various features which go into sex determination (chromosomal sex, gonadal sex, genital sex, etc.) we see that sex is not a single, unitary, easily-determined feature. Insofar as the natural attitude prevails, however, individuals act as if the natural attitude were true. Sex is now understood in terms of a particular attitude which shapes everyday social practices. And to the extent that such an attitude helps ground medical practices designed to surgically assign intersex infants to one sex or the other, it appears that sexual dimorphism is medically instituted. Insofar as bodies are made to conform to a particular cultural ideology about sex—an ideology which governs social practice—it makes some sense to say that biological sex itself is, to this degree, “culturally instituted.”