Because of intersex people, I imagine. Did you know females can grow up with penises and males can grow up with inverted genitals? Then, when they hit puberty, the correct hormones start producing in their brains, which physically change their bodies to the other sex. A very bizarre process that probably causes a lot of trauma, but it happens.
There are a lot of variations that aren’t common but definitely come into play. An estimated roughly 1% of the population is non-binary.
One example is that someone can have XX chromosomes and have testes and/or a penis. Another is that a woman can have XY chromosomes, have a uterus, vagina, vulva, breasts, everything “typical” of a woman but instead of ovaries can have testes.
OP, it is probably addressing that sex hormones also play a role. Physical sex is partly genetic and partly hormonal. There are genes and then the expression of genes. For example, it turns out male pattern baldness is a misnomer: it is a genetic trait, but activated (allowed to be expressed as a phenotype) by androgens. There are primary and secondary sex characteristics for humans.
I share your confusion. Sex is determined by XX or XY chromosomes **by definition**.
This is from the ‘sex’ [Wiki page](https://en.wikipedia.org/wiki/Sex):
>Sex is genetically determined in most mammals by the XY sex-determination system, where male mammals carry an X and a Y chromosome (XY), whereas female mammals carry two X chromosomes (XX).
This is the definition of biological sex in mammals. How would knowing an individual’s XX or XY chromosomes would be insufficient to determine their biological sex when biological sex is literally defined by XX and XY chromosomes?
A [chemical element](https://en.wikipedia.org/wiki/Chemical_element) is defined by the number of protons in the nucleus. Asking a question “Discuss how knowing the number of protons in the nucleus of an atom is insufficient to determine what element this atom is.” Is exactly the same as the question above.
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People in the comments pointing out that this question refers to outliers like people who have 3 sex chromosomes like XXX or XXY.
However, if that’s the case. How does one determine the biological sex of people with 3 chromosomes? Or in other words what information is sufficient to determine one’s sex?
Sex development is determined by genes on the X and Y chromosomes. One of the most important ones is *SRY* on the Y chromosome. Having this gene makes the embrio develop testicles, which then produce hormones that lead to development of other masculine traits. If the *SRY* gene is nonfunctional, you can get an XY woman. If the *SRY* gene gets translocated to the X chromosome, you can get an XX man.
There are many other genes and organs involved that will determine the final phenotype.
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