Intersex

Intersex is an umbrella term used to describe people whose physical sex characteristics fall outside the strict binary classifications of female or male  It is a common and naturally occurring biological variation in humans.

Physical sex is the set of biological and physiological attributes and characteristics associated with chromosomes and gene expression, hormones, and both the internal and external organs and anatomy related to sex and sexual reproduction.  Intersex is not a “third sex” but an acknowledgment of the spectrum of physical sex. Because sex exists on a spectrum, there are virtually infinite ways an individual can be intersex. 

People of any gender identity or sexual orientation can be intersex. Intersex is included in the queer community. In the extended abbreviation, the “I” in LGBTQIA2S+ represents Intersex people. However, not all intersex people consider themselves queer. 

Many sex characteristics and functions are not visible, therefore it is not always immediately apparent when someone is intersex. It is possible for someone to be intersex and not know it until later in life (e.g. when they go through puberty or try to reproduce) or live their whole life without discovering that they are intersex.

History and Stigma

The vocabulary used to define and describe intersex has changed over time. Previously, the taxonomical term “hermaphrodite” (i.e. an organism that has both male and female sex characteristics) was. In an attempt to refine the medical terminology, subdivisions were created to classify intersex as having true hermaphroditism – also known as ovotesticular syndrome – to describe someone with both ovarian and testicular tissue, and male or female pseudohermaphroditism to describe someone whose chromosomes and internal reproductive structures do not match with their external genitalia.

All of this nomenclature is no longer used in the context of intersex people on the grounds of it being inadequately descriptive as well as clinically problematic. Using the word “hermaphrodite” to describe an intersex person is considered offensive and reinforces the stigma surrounding the intersex experience. 

Physical Sex 

Human sex exists on a spectrum of expression from male to female sex. While many people lean towards one end of the spectrum in terms of their anatomically visible and physiological expression of biological sex, there is vast potential for variation of expression along the spectrum. When factors and their variations are considered, the functionally close estimate is that there are 7.4 billion possible sex expressions. It is estimated that roughly 1.7% of the population is born intersex, statistically similar to the number of people born with red hair.

There are many different ways an individual can be intersex. Some intersex people have genitalia or internal sex organs that do not fall into the typical classifications of male or female. Other intersex people have combinations of chromosomes that are different than XY ( usually associated with male) and XX (usually associated with female), like XXY. And some people are born with external genitals that fall into the typical male/female categories, but their internal organs or hormones don’t.

Assigning Sex at Birth

Legally, all babies are assigned a sex and gender at birth based on their external or visible genital anatomy, or their chromosomes. Babies with a visible vulva or XX chromosome pairing are typically labeled as female, while babies with a visible penis or XY chromosome pairing are typically labeled as male. 

However, neither genitalia nor chromosomes alone can determine the sex of the baby. There are many ways sex factors vary to prove how limited this binary classification method based on observations made at birth is. For example, people with XY chromosomes can have a visible vulva, functional ovaries and reproduce. Some people can have an extra chromosome while people with XX chromosomes may have testicular tissue and a visible penis. Others still may be born with what is referred to as mosaic genetics, which means that some of their cells express XX chromosomes while other cells in their body have XY chromosomes. 

When a baby is born visibly intersex, the doctors and/or parents will often make a decision regarding the assigned sex and raise the child based on the gender norms associated with the assigned sex. However, someone might be identified as intersex from immediately birth.

Forcing Sex Assignment

It is not uncommon for genital mutilation surgery to be performed on the baby for it to conform more to the physical expectations of the assigned sex. Hormone therapy may be administered to the intersex person through childhood and/or adolescence with the same goal of sex confirmation in mind. 

It is important to note that being intersex is not a medical emergency that requires correction for the health of the baby. These surgeries and treatments are not medically necessary and are administered in an attempt to force the child to conform to their assigned sex. 

This forced sex and gender assignment can cause long-term and irreversible damage to the intersex person’s body and psychology throughout their life. Manipulating sex expression or ignoring the internal functions of an intersex can also affect the quality and effectiveness of treatments they receive for other health conditions. For example, if someone is treated based on what they look like rather than their physiological defaults, pharmaceutical treatments could be ineffective. The pressure to conform to social expectations over the reality of one’s lived experience can also severely affect one’s mental health.

Sex vs Gender

Under the heteronormative binary system currently influencing both sex and gender, the two words are often conflated and used interchangeably. However, they are two distinct terms and concepts.

While sex refers to the set of physical and physiological characteristics associated with reproduction, gender is the set of socially constructed and enforced norms and expectations regarding the characteristics, outward appearance, behaviors, and professional and interpersonal roles. These norms are constantly in flux, based on a given society’s values and dominant social frameworks of a given time.

In contemporary Western society, gender norms exist predominantly within a heteronormative binary which continues to enforce a strict and static male-female dichotomy. However, gender identity exists on a spectrum, can change over time, and is not decided by one’s biological sex expression. While a legal gender is assigned at birth, sex characteristics can not determine one’s gender identity.

Just as sex and gender are different, intersex is not the same as transgender. Someone can be either intersex or transgender, or both, but they are not at all synonymous or interchangeable terms.