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?
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