Tuesday, August 5, 2014

Cis Gender, Trans Gender, and Intersex

Today, the Intersex & the City blog asks, "Is it impossible for intersex people to be cisgender because it is impossible in society to live completely as in intersex person with no male or female legal checkbox?"

In my experience, what you find when speaking with intersex people about this is an interesting split based upon gender identity. Intersex people who do not identify with the binary sex they were coercively assigned at birth tend to see all intersex people as forced to live trans lives. Intersex people who do identify with the binary sex label they were given at birth instead generally see themselves as cis people, and only frame as trans gender those intersex people who gender transition or who assert a nonbinary gender identity.

Personally, as an intersex gender transitioner, I fall into the camp that does not view intersex people living in our society as cis gender, even if their gender identity matches their assigned sex. Intersex children are born neither male nor female, but are forced into a binary sex category by a contemporary social ideology that says this is mandatory. Many are then subjected to infant sex assignment surgery to try to make their bodies conform to their assigned sex. What is that other than a forced sex change? Just because a person grows up to identify with the sex they were assigned at birth does not mean they will feel surgeries they were subjected to were appropriate. Loss of potential fertility and loss of capacity for sexual sensation are prices that they may not consider worth the result of a somewhat-more-sex-conforming body--note that many people who gender transition by choice choose not to get genital surgery. Thus, I believe, framing medical interventions into the reproductive organs and genitals of intersex people as trans interventions, not "corrections," is important, as it will force doctors to give us agency over what is done to our bodies, and prevent them from removing the very sexual features we may most identify with.

The problem with my framework politically is that a majority of intersex people today do live in their assigned binary sexes, growing up as we do in a society in which that is the norm. The percentage of us who mature to gender transition or assert a nonbinary gender identity is much higher than is the case for nonintersex people, although we don't know the exact degree of the difference because doctors are emphatically not collecting data on us, their sex-assignment "failures." Still, a majority do live their lives in their assigned sexes (often completely in the closet about being born sex-variant, as doctors have urged parents to train their children to be). And most such people do not identify at all as "forced to live a transgender life."  That is, they identify as cis gender.

If someone says, "I was assigned female (or male) at birth, and I identify as female (or male)," then we usually call such a person cis gender. So intersex people who understand themselves as cis gender have a very valid basis for framing themselves that way. Certainly this is the way the medical field treats the situation, in claiming to assign us to what they used to call our "true" sex, and now call our "best" sex. Doctors view themselves not as imposing sex changes upon unconsenting infants, but as revealing our "real" binary (cis) sex.

I feel that understanding all intersex people who have been assigned a binary sex (which, in the US today, is all of us) as trans is useful, because it gives us a way to oppose unconsented-to infant genital surgeries. I view those intersex people who are happy in their assigned sexes as no different from people who are not intersex, but gender transition by choice and are happy as a result.

At the same time, I don't feel I have a right to tell an intersex person who identifies as cis gender that they can't do that.  After all, as trans gender advocates note, every person is coercively assigned to a binary sex at birth. A person who grows up to identify as genderqueer, or with the binary sex they were not assigned, is forced to struggle with medical and legal and social forces to have their identity recognized, whether sex variant by birth or born with a body considered normative.  So, viewing all cis people as coercively assigned to the sex with which they identify makes calling intersex people who identify with the sex they were assigned "cis gender" reasonable, from a trans-affirming perspective.  (Of course, many people are not trans-affirming, and transphobia can motivate rejection of being labeled trans gender.  But I do not believe it is either charitable or necessary to assume that an intersex person who identifies with their birth-assigned sex and rejects being labeled as trans is motivated by bigotry.)

I just feel that labeling anyone who is medically altered to change the sex characteristics of their body as trans makes the most sense, and is useful from an advocacy standpoint.


I've done some additional thinking about this topic, and would like to have people consider approaching gender identity in intersex people by acknowledging that we can never address intersex experience well through binary terminology.  What we may really need to do is to introduce another term.

what I would suggest doing is adding to the terms "cis" and "trans" another term often used in scientific terminology.  In chemistry, which gives us the language of cis and trans isomers, there are chemicals based upon a ring structure, called arene rings. When a chemical substitution is made in the same place on the ring, this is referred to as "ipso" substitution.

If we were to add the term "ipso gender" to trans and cis gender, we could perhaps describe intersex experience more accurately. A cis gender intersex person would be one with an intermediate gender identity, since that "matches" their birth sex. An ipso gender intersex person would identify with the binary sex they were medically assigned (the social sex substituted for their intersex birth status being the same as their identified sex). And a trans gender intersex person would be one who identifies with the binary sex other than the one they were assigned by doctors.

This terminology solution is not without its drawbacks. Usually people who are genderqueer in identity are considered to fall under the trans umbrella, but in the case of intersex people, they'd fall under the cis heading, which could prove confusing. But it's also possible that confusion would itself prove productive.

It's certainly worth considering.


  1. Another really cool article.

    I had one coerced gender "corrective" surgery as an infant, but refused the second when I was 10 years old (with the support of my parents.)

    My best guess-- and it's only a guess, but a pretty well-informed one-- is that the first surgery was more of a functional one and the second one would have been almost entirely cosmetic, though it could certainly be argued that the first one was also cosmetic. The first surgery probably served multiple purposes, but the primary one was functional.

    The second, cosmetic one was probably far more risky, and I am really glad my parents had the good sense to back my decision. I had one complication from the first surgery, but it was extremely minor, resolved with an exploratory in my 20s.

    I have resolved this dilemma for myself by identifying, most simply, as intersex-- or sometimes, as an intersex man. When asked for more detail, I might identify as gender queer, gender variant, or intersex male. I do not accept an entirely male identity; I consider myself something like 88% male and 12% female. That's what I feel like, anyway.

    I suppose I could consider identifying as trans, and I understand your thinking on this.

    But it may take me a while to get that sorted out-- I'm kind of exhausted. It took me about half a century to come out as Intersex!


  2. I tried to post this comment on INTERSEX and the CITY. My brother and myself share "Catalzt"s experience in that we were both gender assigned at birth with an identical follow-up operation at age ten. In addition I have known three others who were gender-assigned and two who were allowed to choose their gender as pre-teens (progressive for 1970!). In addition I have known five other intersex persons and one other who was gay, and believed by me to be intersex, but without any confirmation in fact. Oddly, only one of these persons (and my brother) was known to me within the time I knew myself to be intersex and he is the only one I am likely to have future contact with (at least three have died). All of these persons, except for the gay boy (who may or may not be intersex) live within their assigned gender. however, as you suggest, all of these persons except two have individual behaviors and mannerisms that more typically belong to the opposite gender. My own situation is one of working in a service shop as an office type where office types are usually female and road-techs are always male (I do some outside tech work), Nine of the ten of us know I am intersex, although one pretends not to know. As near as I can tell, none of these persons regard me as effeminate (at 57 I look more male every day), yet all of them are amused (and remark on it) when a situation occurs where I will always (and predictably) behave in a feminine/female manner. So I am in agreement that even the most gender consistent intersex person will usually not fit neatly and entirely within the box provided. Now an aside on the subject of not fitting into boxes: on my birth certificate all of the boxes have perfectly centered in the box "X" except for the gender box, which is clearly not even the same typewriter. There is no name on it. At the bottom there is a note adding a name two months later. My mother informed me when I was 32. By the way, please see my comment on the April article about gender policing in sports. At the some risk I present a brief case on why I believe Babe Ruth to have had Klinefelter syndrome. - Tupungato.

    1. Like Peter Falk's COLUMBO, I always come back with a post-script. Reviewing my comment, I realized how insane it sounds. The explanation is that Congenital Adrenal Hyperplasia runs in my family. We have been marrying our cousins for over a thousand years (no one else will have us). So intersex conditions are common and casual (no big deal). - Tupungato.

  3. I would like to know about other variations. Such as having mastoid bone protrusions and brow ridge but being labeled as female, and identifying as male transgender.

    David is my name, but my school chose to use my birthname in my Gmail. :(

  4. I'm not sure what you mean by 'mastoid protrusion'? My college training is in Anthropology. One delightful characteristic I have observed in studying faces is how many actors/actresses have features which more typically belong to the opposite gender. The atypical face can be a powerful asset. Sean Bean (Boromir of LOTR) has the brow ridge below the eyebrow which is a female characteristic. I believe this gives him a rakish appearance. Sean Connery has a prefrontal cortex swelling on his forehead which sometimes reflects light (if the makeup artist has not been alert). In most populations this is a female characteristic, but is really very common among Russians and border-Scots (they are closely related). This may soften his otherwise hard edges. Glen Close has a somewhat harsh, even mannish face, which adds authority to many of her portrayals (I will often say that gender dimorphism is thin in some populations and I am part border-Scot myself). The point is none of these people are intersex, but they are part of a continuum spectrum, as in a rainbow, that illustrates the fallacy of gender as a binary. My interest in this began with learning the visual differences between male and female. It was years later that I learned the family oddities were called "intersex", that I was such, and there were related consequences other than some cosmetic corrections. I always try to say something intelligent, but I present the previous sentence as evidence of how slow (and stupid) I can be to see the obvious. It is because I was not conditioned to think beyond the binary. So when a person has characteristics of the opposite gender it challenges our binary concept. It also blurs our ability to be recognized as "intersex" as we can get lost in the various degrees that are still regarded as normal variation. If we want to be invisible, this is a good thing. Once I was at a hot dog restaurant when an older man whom I had met recently sat down and said "You should get a genetic test". I answered "And what would I be testing for?" He explained how he was "intersex" with Klinefelter's syndrome and how much I looked the same. I had never heard the "intersex" before. After years of study I related to him what I knew to be facts about my condition (a male-feminizing version of CAH). He said I was delusional. I have observed a common event among the "intersex". That is many will know more about THEIR condition than most doctors. When confronted by something that does not match their limited experience they reject it as some variety of error. So it is good to learn the basics of the 36+/- varieties that make us a family. Remember that the medical profession remains one of the great wellsprings of misinformation. - Tupungato.

  5. This comment has been removed by a blog administrator.


  6. Cis, white, christian, male, living along the west coast if that matters, which i don't think it should.

    First I would like to ask you about (middle-aged, middle-income, non-disabled, white)male privilege. It is a concept I am familiar with only by testimony and perhaps some observation, but not one which I have any recollection of being guilty of enforcing, or enjoying.

    I know what you are thinking. "Of course you don't observe it; your mind has no benefit to observing it," or perhaps just "This person is a sociopath," but I have taken the time to read (and learn from) your blog, so I hope you have time to hear me out.

    When I introspect all the major points in my lifetime. School, job interviews, or even common points, like straightening out billing errors (which seems to be becoming a rite of passage for any adult in the first world), I found that while my appearance and title may have had some effect on the outcome, far more potent results came from stance, body language, and words.

    While I empathize with cracking voices (having been a preteen trying to sound manly once) is there some physical or mental inhibition for a female or intersex person from assuming an assertive stance, posture, and tone?

    I can tell you from experience, that a slouch, stammer, and an infirm stance ("maybe I don't deserve this job, i don't know....") is too heavy a disadvantage to be carried by this "male privilege" force, so would it not also stand to reason that having assertiveness and confidence on your side is not only stronger than privilege, but also has the potential to make that privilege inconsequential?

    I'm not so sheltered to suggest racism or sexism or cissexism is non-existent. But, tagging and swearing by a concept like "male privilege" instead of taking action to dissipate it's power is like a climate-change researcher who doesn't recycle.

    Second, (if you're still reading) I'd like to suggest that your rejection by your students is less based on their religion, upbringing, and identity, and more based on a notion that their youth of mind grants them pride in opinions that they feel don't need testing.

    A person of respectable academic prowess (as you yourself appear to be) knows that even if an opinion is convenient, adopting it without its being tested, ESPECIALLY if it's a strong opinion, is irresponsible.

    But let's be a 19 yo student here for a moment. Testing opinions takes WORK. And screw that.

    So, while I've come to reject the notion that "boys will be boys" I think short of an evolutionary leap, "kids will be kids." And, if you've managed to maintain eye-rolling vigilance, I encourage you to keep it up.

    I wish you luck in your newly aligned body, and specifically solidity of your career. While I may not wholly believe that what you have to teach is the naked truth, I think it is a closer truth than many adults enjoy today, and I hope the adults of tomorrow are smarter than me.

    GE 3S

  7. Great article!
    What I'd like to take a closer look at is the cis/ipso/trans thing. I recently read a blog post by a transwoman about the "biological sex" and she stated that it is based on the binary system created by society. Accordingly, cis doesn't mean "born in the right body" but "identifying with the gender one is assigned to". That in mind my thought would be if for intersex people, cis and ipso should be the other way around: cis for those who identify with the assigned binary gender and ipso for the intermediate gender (maybe I'm lacking knowledge in Chemistry, but I read that "ipso" means "self").

    Any other thoughts on that?
    Or am I confusing things now?
    Would be very grateful for a reply!