The book has posed several questions about how self-determination is conceived, achieved, contested and materially lived through in (some) historical realities of sex/gender. My intention was not to answer all the questions posed, because we cannot securely retrieve them due to the productively fleeing, eluding, flowing, leaking and disappearing nature of sex/gender self-determination in complex assemblages developed vis-à-vis legal statutes, healthcare protocols and pedagogical cultures. I have instead tried to pose dilemmas, paradoxes and look at power games that assert forces within debates about sex/gender self-determination. Nonetheless, I have tried to draw out the singularities of trans, sex/gender expansive and intersex people and show how, in our examples, they connect to bioethics (in the form of research relations), biopolitics (in the forms of sex/gender assignments and the connected citizenship and policy frameworks), and the wider population (in their singularities). The one clear force that I wanted to highlight, even though this force is affected and affective differently in all these nomadic connections, is the birth designation made by physicians and recorded by parents. This led me to the questions: Is sex/gender assignment at birth fit for purpose? Do sex/gender assignments have a medical purpose? and What challenges can be levelled at the practice in light of human rights declarations surrounding the rights of people to their bodily integrity, autonomy and ‘self-determination’? I demonstrated that sex/gender assignment at birth is only ever a clumsy representation that cannot cope with those bodies that do not, will not, or indeed cannot be constrained within the parameters of those vague designations in use across the world. This form of sex/gender ‘recognition’, as we have seen, is on shaky ground in the areas of biology, law and personal desires. I suggest that, to paraphrase Braidotti (1994), we may want to displace established expectations about sex/gender essentialism and sex assignment at birth and blur them gracefully but firmly, and acknowledge the constantly nomadic interactions that we all have with our desires to self-determine our lives.