The need to present new conceptions of gender and sex is paramount for transexual activists and theorists. The hegemonic acceptance of the sex dichotomy has had inadvertent, negative effects on trans people who identify beyond categories of man and woman. Feminist scholars, progressive thinkers, and even those within the transgender community often fall short of critically examining the very meaning of sex in gender theory. Feminist theorizing within a sex-gender distinction led to a necessary interrogation of male/female categories, but this distinction has also paved the way for a medicalization of trans people as dysmorphic and impaired. As such, there remains little room for medical, psychological, and legal institutions to recognize identity categories that fall outside of these established domains, thereby producing a disjunction between the lived realities of trans people and academic theory. Sex, if perceived as merely man and woman, re-produces sexual difference even if those boundaries are transgressed through gender.