Intersex is an umbrella term for people whose sex traits, hormonal differences, chromosomal differences, or anatomy (such as external or internal reproductive organs) differ from the typical binary notions of a male or female body. A individual's intersex traits may include one or multiple differences of aforementioned types. These differences can be noticed at birth or later in life.[1][2]
Etymology
The term "intersex" is comprised of "inter-", meaning "between", and "-sex". The term was coined in 1917 by geneticist Richard Goldschmidt,[3] but it did not gain popularity until used by biologist Anne Fausto-Sterling in 1993.[4]
Community
The word intersex also invokes a community. Intersex people are diverse, coming from all socioeconomic backgrounds, races, ethnicities, genders and orientations, faiths, and political ideologies. We are united by
1. our experiences living with variations in our sex traits,
2. the belief that these differences are a natural part of human diversity,
3. the idea that people deserve their own choices about their own bodies.
Between 0.05% and 1.7% of the population is born with intersex traits.[2] It is a decentralized community of people with very different characteristics or backgrounds.
Intersex individuals may have any gender identity, including man, woman, non-binary, intersex woman, intersex man and other.[5] Each intersex person has a unique relationship to their gender, assigned gender at birth, the gender they were raised as, and how that relates to their experience being intersex.
The intersex community sometimes uses the terms CAFAB/CAMAB – Coercively Assigned Female At Birth/Coercively Assigned Male At Birth,[6] due to the way intersex people are often assigned their birth. Often it happens by modifying genitals in pediatric surgery, which is not necessary and non-lifesaving, done when an individual cannot decide for themselves. Such procedures only serve making a person more stereotypically male or female. Children can later (as teens or adults) feel completely different about their gender or agree with the assignment, experiences vary.[1]
People with some variations of sex anatomy are intersex by definition, but not all identify as such. These variations are, but are not limited to:[1]
- Complete or partial androgen insensitivity
- Congenital adrenal hyperplasia
- Hypospadias
- Klinefelter's
- XY gonadal dysgenesis
History
Intersex people were known to exist as early as ancient history. Pliny the Elder wrote in his Natural History about "those who are born of both sexes, whom we call hermaphrodites, at one time androgyni". The term "hermaphrodite" is a slur and incorrect term to use for intersex individuals,[7] but it is known to have been used in history to describe them.
In medieval times in Europe, law often recognized intersex people, but required them to legally use the gender identity which stereotypical characteristics prevail in the person's appearance.[8][9] In some cultures, since early times there are systems that recognize the third gender. The Hijra recognize transgender and intersex citizens within the third gender category.[10]
In the second half of the 19th Century, surgeons in North America started offering cosmetic surgeries of genitals for those that did not meet the stereotypical "norm". However, most of these surgeries were performed on adults at their request. In the 20th Century, the practice evolved into operating on children. In the 1950s, Johns Hopkins University created a team that offered a "multidisciplinary" approach to intersex people, which in practice was one of the first steps into popularizing pediatric surgeries on intersex children "correcting" their genitals.[11]
The practice developed by Johns Hopkins University in the 50s was that a child's potential for a gender identity that was considered "normal" was best when their body, upbringing and mind were perfectly aligned. At the time, it was easier to modify genitals to stereotypical cis female genitals, so most intersex children were assigned female at birth and "corrected" to be cis female with surgery, hormonal therapy and psychology.[11]
The Johns Hopkins University practice was based on psychologist John Money's theory and work. Money researched intersex people and in 1953 he found that they enjoyed a lower rate of psychopathology than the general population. However, he later came to a conclusion that these people should function as either cis male or cis female, since early childhood. This conclusion had no basis in science, as it came from a famous case of forcibly assigning the wrong gender identity to a child: the "John/Joan case". David Reimer was born a cis male boy in 1965. A doctor accidentally burned off his penis when performing a circumcision on him, when the boy was 8 months old. Johns Hopkins University staff and Reimer's parents consulted and came to a conclusion that it will be easiest to raise the child as a cis female person. According to Money, it worked because the child seemed to be a "normal" girl and later woman. Many years later, David's parents told him the truth and it turned out that David Reimer never felt fully female.[11]
Until late 20th Century, being intersex still meant being forcefully assigned to cis male or cis female gender and not being fully recognized in North America and Europe. "Normalization surgery" for intersex children was standard practice. In 1993, biologist Anne Fausto-Sterling published articles in The Sciences and The New York Times and stated the fact that intersex exists.[4] Scientists and authors such as historian and bioethicist Alice Dreger, social psychologist Suzanne Kessler and aforementioned Anne Fausto-Sterling started publishing more works on the topic. Organizations such as ISNA or interACT were founded in the 90s and 2000s.[11]
Since 1993, the era of thorough medical research of intersexuality and advocacy for the intersex people has begun. More healthcare professionals started recognizing modern data and adjusting their standards to help intersex patients properly.[11] On the other hand, it took a decade more to start banning the harmful practice of "intersex surgery" on children. Malta became the first country to ban non-consensual normalization surgery on minors in 2015.[12] Chile passed legislation banning it in 2017.[13] California became the first US state to condemn nonconsensual surgeries on intersex children in 2018.[14]
According to medical consensus that is gaining more basis over time, intersex people's bodies are part of natural diversity and their characteristics appear less often than those seen in the majority, but they are as normal as bodies of the majority.[15][16][17][18][19]
Foremost, we advocate use of the terms "typical", "usual", or "most frequent" where it is more common to use the term "normal." When possible avoid expressions like maldeveloped or undeveloped, errors of development, defective genitals, abnormal, or mistakes of nature. Emphasize that all of these conditions are biologically understandable while they are statistically uncommon.
However, intersex people still face discrimination and misunderstanding in healthcare, often due to lack of updating one's knowledge as a healthcare professional, causing harm despite good intentions.[20]
In 2019, more than 50 intersex advocate organizations signed a joint statement in multiple languages that condemns the introduction of "disorders of sex development" language into the 11th Revision of the International Classification of Diseases (ICD-11). In the statement, organizations state that in some cases, the guidelines associated with ICD-11 codes require unnecessary surgeries or other procedures that are not lifesaving, often performed on children without their consent and are grounded in gender stereotypes. They call on the World Health Organization to reform their approach.[21]
Flag
The intersex flag was created by Morgan Carpenter from Organisation Intersex International Australia in July 2013. The organization aimed to create a symbol without pink and blue colors, which tend to be perceived as gendered. The circle symbolizes intersex people's wholeness, completeness and potentialities.[22]
Perceptions and Discrimination
Intersex people that have intersex anatomical traits often are forced into undergoing medical procedures due to stereotypical understanding of what "normal" is or limited understanding of gender. Such procedures are known as intersex surgeries or normalization surgeries, which are non-lifesaving. Most intersex surgeries without one's consent happen to children below 2 years old, after being offered to the child's parents. They include modifying genitals which do not need surgery to function or removing organs that produce sex hormones.[1]
Surgeries to change genital appearance may be described to parents by some health professionals as an emergency or necessity; some parents are never told about the risks of these surgeries and the fact that waiting is an option, or encouraged to meet intersex adults.[1][20]
United Nations considers intersex surgeries without one's consent human rights violations. The surgeries often result in complications, reduced sexual function, reduced fertility or worse emotional well-being.[1] There are studies that an estimate of 8.5-20% intersex people may experience gender dysphoria in regards to their assigned gender[23] and that intersex surgeries can cause mental suffering if done without consent.[2] Intersex organizations ask to let everyone decide about their own bodies and let them decide whether they want surgery or not.[1][24][25]
Adult intersex individuals can also face attempts to persuade them into undergoing surgery.[1]
Media
Literature
Film
- XXY - 2007
Television
- Lauren Cooper in Faking It is an intersex person; the character was written after consulting and working with multiple interACT members[26]
Music
Resources
- Intersex Support and Advocacy Groups
- interACT
- Organisation Intersex International
- Intersex Society of North America