Only through what is essentially force and potentially threats from trans people and SJWs. Even including intersex people/hermaphrodites, there's still only really male or female. bigender. Sex and gender have been used interchangeably as synonyms for many years. Eg. on many forms (job applications, doctors forms, bank documents, etc.) they typically ask about your sex OR your gender. Intersex people are fairly rare anyway only making up about 1% of the human population. though intersex people could technically identify as bigender (as they happen to have both male and female genitals...in some way) they typically identify as either male or female. Also, depending on how rich their parents are, they typically get a sex change shortly after they're born (most likely with in the first couple weeks) after the doctors study their chromosomes to determine which sex will best fit.