Tuesday, April 28, 2009

Intersex 101

What is intersex?

OK, it's important that I get the basics out for blogreaders unfamiliar with intersex conditions. In our society, it’s common to think that all people are born either male or female. But the biological truth is that sex is a spectrum, not a binary. It’s typical for people to lie near the male or female ends of the spectrum, but many people are born with bodies closer to the middle. Sometimes this fact is immediately clear at birth, because a baby has intermediate genitals. Sometimes a person may look male or female on the outside, but have different internal organs than would usually be expected. And sometimes a person may have a body with typical female or male organs, but have chromosomes that do not match expectations.

How common is intersexuality?

About 1 in 1000 babies are classified at birth by doctors as intersex because their genitalia appear atypical. This is more babies than are born with Down’s Syndrome. Many more babies are diagnosed as having a "disorder of sex development" based on variant genitalia, yet not given an "official" intersex diagnosis. Other individuals are not diagnosed at birth, as their genitals appear fairly standard, but later are found to have an intersex condition. It is commonly estimated that 1 in 150 people has an intersex condition. Some find out because they encounter fertility problems, or have a medical scan done for some unrelated reason. Some people never know--do you know if your chromosomes are XX, XY, XXY, or some other variation?

What is the gender of an intersex person?

The way to tell the gender of an intersexed person is to ask them. Often intersex people identify as either male or female, because that is how contemporary Western society understands gender. Some of us do not identify as male or female, however. You can’t tell by looking at an intersex person’s body what their gender identity will be—different people with similar looking intermediate genitals will have different identities. Simply respect each individual’s sense of self.

What are central concerns for intersex people?

Our contemporary society frames being intersex as a disorder, and being endosex--having a body that matches expectations of binary sex--as necessary and good. Intersex status has been treated as a source of shame in the U.S., which means that most intersex people are in the closet about their status. We have been called “freaks” and “monsters,” have been treated as sexually titillating, have been excluded from international sporting competitions, and have been subjected to medical treatment without consent. Intersex people deserve to have their bodies, their gender identities, and their choices respected.

A major complaint of many intersex people is that they were subjected to childhood surgery that they are unhappy about. Every day in the U.S., dozens of babies are surgically altered to “correct” intermediate genitals to look more typically female or male. Doctors choose the sex they see as appropriate for the infant based on appearance or surgical ease—and often, their choice is wrong.  Furthermore, although doctors say they have gotten better at these surgeries over time, they often result in loss of genital sensation. I don't know about you, but I and many others would rather have sensitive genitals than somewhat-more-average-looking ones. Advocates for intersex people urge that no sex assignment or cosmetic surgery be performed on children. Instead, intersex children should be allowed to grow up to make their own decisions about what surgery, if any, they would like.


The decision about a sex of rearing for an intersex child is often rushed.  This is because families are only given a day or two to decide whether to put an "M" or "F" on the birth certificate.  What intersex advocates urge is that the requirement of listing a sex on the birth certificate be removed.  After all, in most states in the U.S. doctors used to be required to list a race on the birth certificate, but that requirement has been eliminated.  The reason given for listing a sex--that it would help to identify an infant who was lost or abducted--is very weak.  Footprints which are taken at birth are vastly more identifying, and in any case, the family can give authorities information about the sex, race, hair color and other information about what a child looks like without it being listed on a birth certificate.  So, removing the requirement of listing a binary sex of male or female on the birth certificate would not hurt anyone, and would give families of intersex children all the time they like to decide on a provisional sex of rearing.

Often, doctors and families try to keep chidren's intersex status a secret, even from the children themselves.  Knowing that there is something "wrong" with your body, but not what that is, is confusing.  Knowing that your body is sex-variant, and that this is something that must be kept a secret from others, leaves a person feeling ashamed and isolated.  Advocates ask that children be informed about their bodies in a nonstigmatizing way.  Having a body that is atypical can be seen as special--think of how our society celebrates having red hair, another atypical bodily status.  

Sometimes an intersex child may be happy living in an assigned sex, but then experience bodily changes at puberty that are atypical for that sex.  For example, an individual born with a typical-looking phallus but internal ovaries and a uterus will develop a menstrual period.  If that child is happy being raised as a boy, he may find this difficult to deal with.  In that chase, the child should be given access to hormonal treatments to prevent menstruation and promote a typical male puberty.  If he wishes it, he should be given surgery to remove his ovaries.  The decision should be his, and if he is comfortable leaving his body unaltered, that should be the course of action, and he should be supported in his embracing of his sex-variant body.

Intersex people may suffer from gender dysphoria if they were assigned by doctors to a sex but do not identify with it. If so, they should be assisted in securing hormonal and/or surgical treatment so that they can transition to the sex that is the same as their gender identity, if that is what they wish.

Intersex people and their families may also need supportive therapy. When a mother gives birth to an intersex baby, the family may be thrown into distress. It is especially important that the family receive support so that hasty decisions about “normalizing” surgery are not made. Adults who discover that they are intersex may also be thrown into an identity crisis and need support. And since all intersex people have to face lack of understanding and pressure to hide our sex status, many of us need access to counseling.

There is a myth that intersex people are almost always infertile.
Sadly, many of us are infertile not because of how we were born, but because of surgical intervention in infancy. In fact, intersex people can have children (I did it. . .), but we may need fertility treatment and supportive medical assistance during pregnancy and birth.

What are some common types of intersexuality?

There are many conditions that lead to intersex status. I have no interest in getting overly clinical and showing the sort of medical photographs of dehumanized children with their genitals exposed that are so common in discussions of intersex. We are people, not . . . bits for display. However, I'll do a quick run through of some of the diagnoses given to intersex people, with physical description, in the name of education.

People with Complete Androgen Insensitivity Syndrome usually have a clitoris, labia, and partial vagina, with testes internally. They develop breasts at puberty, but no periods. People with Partial Androgen Insensitivity Syndrome are born with intermediate genital appearance and internal testes.

People born with Congenital Adrenal Hyperplasia or CAH are born with a phallus of average or small size, an empty scrotum, a uterus, and ovaries. At puberty, people with CAH will develop breasts and get a period.

Hypospadias refers to a range of conditions in which a person has phallic tissue, but does not have the urethral opening at the tip. This can be a small displacement in an otherwise typical penis, or can occur with an intermediate genital appearance.

People who have Klinefelter Syndrome are born with XXY chromosomes. Individuals with Klinefelter’s usually have a penis and small testes, wide hips, small breasts, and are usually tall and long-limbed.

People who have ovotestes are diagnosed as "True Gonadal Intersex" by doctors. Ovotestes are gonads which combine ovarian and testicular elements. Those of us with ovotestes may also have an ovary or a testis, and may have a uterus and a menstrual period.

What can other people do to be allies for intersex folks?
There are plenty of things allies can do, and I'll post more about them later. But the single most important thing allies can do is to refuse to treat intersex status as something shameful and freakish. Allies can help educate people about the fact that intersex happens and is not some sort of medical emergency requiring cosmetic surgery on infant genitals. Only an intersex person can determine what hir gender is, and what surgery if any zie wants--doctors and parents can no more decide what gender a person will have than they can pick hir sexual orientation or taste in music. Educating people about this will help lead to a day when parents welcome an intersex baby as a happy rather than tragic addition to the family.

22 comments:

  1. Hi Luminis :)

    I posted a comment on a previous posting - but appeared as "anonymous" - logged in afterwards.
    Still a bit clumsy on the "connecting thing" and the handling of "the right procedures" online.
    Started my personal "connecting trip" just a few weeks ago...

    Anyway - your blog is now one of my favourites - you are doing an excellent job & I a learned a lot from your blog in the past few days.
    Thanks ! :)

    Kind regards,

    Mau.

    Flanders - Belgium.

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  2. I am a female with very small breasts and have stumbled across your page. I have a normal size areola as part of a small satsuma orange sized mass but no real breast tissue as such. I have never felt psychologically confused about my gender but wondered if I could have one of these conditions? There is many a time when I should by all rights have fallen pregnant and havn't. However I do have menstrual periods. Can you advise? Thank you Jo

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  3. I am writing a play called Heteronormativity and ran across your blog. I have been unsuccessful in documenting the "five a day" stat for the surgeries. Do you have a source for it? thanx bjm

    http://www.benjamingraber.com/

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  4. I can't find anything that looks like me. I'm sure I have something though. I get a period, and I am about a B cup. However, I have more outer stuff then I think is normal.. I've tried looking at anatomy photos and stuff and I think its where the clit is that's enlarged. Like a little dick, but really little. Like you can only tell a little bit when I'm in a swimsuit-however you can tell. And its obviously not camel toe. Does anyone know what's my issue?

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  5. This helped answer quite a few questions I had about intersex people... and I work very hard to be an informed ally. Thank you so very much for posting this!

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  6. My friend is a full hermaphrodite. She has both male & female organs which are fully functional. She has had at least 3 kids from her womb & another in the oven, & from her loins. Yes, she has both mothered & fathered babies if that makes it simpler. Technically in theory she can self impregnate but said it hurts to bend her penis that hard when it's erect. Her condition is also hereditary. How do I know? Her mother was 1, so is her cousin, (moms sisters kid) her 1st & 3rd children are normal girls, her 2nd is like her & so was the father to that 1. Her latest is the 1 she fathered with a woman & is also full hermaphrodite, & the one in her belly shows in the ultrasound to have ambiguous genitals. Hows that for an eye opener? Btw, I'm Frankierod on another site & a straight male.

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    1. Ok, cool, I just created an account. I'm the one who wrote this reply.

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  7. I just wanna know that is intersex condition people the hv baby.Can they relate a sexual life without changing them self,Im bit much confuse today about it
    plz tell me know.

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  8. Hi I am victim of primary amenorrhea. I have about 1 inch clit hangs out when not erected. I have small breast as well. I was diagnosed with small uterus of 4.6×2.5 cm along with both ovaries. No cyst was found. My doc did not say in detail but she prescribed me provera first I did not get period.again my doc prescribed me conjugate estrogen pills of 1.25 mg and I started my period. Am I intersex?? I dont have deepning voice and men type hair. I look typical girl and I am married now. I want to conceive. Can anyone tell me whats wrong with me?? Please help..

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  9. I love your readings. I am an anthropology student and students like intersex and transgender really excite me. Your reading along with many of othe works has enhanced my perspective.

    Thank you

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  10. hello everyone, i had a poor erection from birth, i noticed myself when i was 7years old. my penis is very small that its only use is to pass out urine. when i was 23, i tried to come close to women, my penis will not stand erect to make love. this has been my greatest problem until i met a man called Dr. EDIONWE. he assured to cast a spell on me for long penis and erection and high sperm count. it seems like a dream to me, i decided to give it a trial because this has been my greatest problem and medical attention have not been of help. it seems shock to me. i made love with the girl i have always dreamnt to be with and i intend to get her pregnant. i know its not easy to live in this condition so i cannot keep this miracle to myself. i urge everyone in similar condition to contact Dr. EDIONWE today via email edionwesolutiontemple@gmail.com. Any problem you are, he has a way of bringing solution to it. if mine is possible, then i can say nothing is possible. contact him today via email edionwesolutiontemple@gmail.com. there will be a miracle, and you will share testimony as i am doing now. feeling happy!!! grateful heart!!!

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  11. I am MOORE JULIET from Australia, I have been trying for 5years to get pregnant and needed help! i have Been going to the doctors but still nothing. The doctor said that me and my husband are fine and I don't know where else to turn, until one day my friend introduce me to this great spell caster who helped her to get back her lost husband back with love spell and also made her pregnant, So I decided to contact this spell caster Dr.Sam on his email after interaction with him he instructed me on what to do, after then i should have sex with the my husband or any man I love in this world, And i did so, within the next one months i went for a check up and my doctor confirmed that i am 2weeks pregnant of two babies. I am so happy!! if you also need help to get pregnant or need your ex back please contact him for help via email: miraclefertilitysolutiontemple@gmail.com or miraclefertilitysolutiontemple@yahoo.com or through his website: http://miraclefertilityso.wix.com/dr-sam You can also contact him through his mobile: +2348110496031. YOU CAN ALSO READ MY TESTIMONY ON MY BLOGGER LINK: http://moorejuliet.blogspot.com He is a good spell caster

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  12. My name is Frank Silver from uk, I am here to give my testimony about a doctor who helped me in my life. I was infected with HERPES SIMPLEX VIRUS in 2010, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the river side thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS and gave me his email, so i mail him. He told me all the things I need to do and also give me instructions to take, which I followed properly. Before I knew what is happening after two weeks the HERPES SIMPLEX VIRUS that was in my body got vanished . so if you are also heart broken and also need a help, you can also email him at ekpikuspellhomeofgrace@hotmail.com or ekpikuspellhomeofgrace@gmail.com THESE ARE THE THINGS Dr. Ekpiku. . HERPES . HIV/AIDS . CANCER

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  13. My name is Sly Nikki, i want to give thanks to DR.EVA for bringing back my ex Husband. No one could have ever made me believe that the letter I’m about to write would actually one day be written. I was the world’s biggest skeptic. I never believed in magic spells or anything like this, not until i came across DR. EVA through the help of a friend, that she (DR. EVA) has helped before, she made me understand that DR. EVA is a very dedicated, gifted, and talented person, that i am a witness to. Contacting Her to help me was one of the best things I have ever done in life. My love life was in shambles. I had been through two divorces and was on the brink of a third. I just couldn’t face another divorce, and I wanted to try harder to make our relationship work, but my husband didn’t seem to care. and he brake up with me again. I was confuse and do not no what to do again, so i had to get in contact with DR. EVA, She did a permanent love spell that made my husband come back to me. we are now very much happy with our self. DR. EVA make him to realize how much we love and need each other.This woman is for REAL and for good. She can also help you to fix your broken relationship. I had my husband back! It was like a miracle and we’re doing very, very well in our marriage. Contact email: evafertilityspelltemple@gmail.com or evafertilityspelltemple@yahoo.com or view through her website and Contact her there: http://evafertilityspellt.wix.com/evafertilityspell

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