Intersex is an umbrella term for various people who are born with or develop sex characteristics that differ from the binary notions of a "male" or "female" body. These differences are called variations, and may involve one's hormones, chromosomes, external and internal reproductive organs, or secondary sex characteristics. An individual's intersex traits may include variations in one or multiple of the aforementioned types. These differences can be noticed at birth or later in life.[1][2]
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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.
According to the ISNA it is estimated that as many as 1.7% of individuals are born with intersex traits, however, there have been unreported or undiagnosed cases of intersex. Additionally, many people may be unaware of their intersex traits unless they receive genetic testing. Intersex people are not as uncommon as once believed, they have just been invisible until recent years.[5][6] Intersex individuals may have any gender identity or gender expression.[7]
Some examples of variations are:[1]
- Complete or partial androgen insensitivity
- Congenital adrenal hyperplasia
- Hypospadias
- Klinefelter's
- XY gonadal dysgenesis
After years of activist efforts, members of the hijra community in India gained legal recognition in 2014 as part of a third gender category. Aspects of the hijra identity can include wearing clothing and cosmetics that are considered feminine. Some intersex people are part of the hijra community.[8]
Coercive gender assignments
Intersex people often are forced and coerced into undergoing surgery or hormone replacement due to binarist views of gender and sex. The surgeries are known as intersex genital mutilation (IGM), intersex surgeries, or normalization surgeries. These surgeries often happen to children below 2 years old, however they happen to older children, teens, and adults as well. They include altering genitals which do not need surgery to function or removing organs that produce sex hormones.[1] They may be described to parents and patients by health professionals as an emergency or necessity; many parents and patients are never fully informed on the negative health effects, or given resources and insight from intersex people.[1][9] The United Nations has stated these are human rights violations.[10] 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[11] and that these actions can cause mental suffering.[2] Due to this and the prevalence of nonconsensual medical intervention, the fight for the bodily autonomy of intersex people is a main objective of intersex organizations and activists.[12][13]
Some intersex people use the terms CAFAB/CAMAB – Coercively Assigned Female At Birth/Coercively Assigned Male At Birth - [14] due to being subjected to nonconsensual, unnecessary surgery. However, the terms are not exclusively used in this manner. A variety of experiences and relationships with assigned gender exists within these labels. The terminology is used by trans and cis intersex people alike.[1]
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 1950s, Johns Hopkins University instead began a practice of performing pediatric surgeries on intersex children without consent. The practice was developed by psychologist John Money, who ignored evidence he himself had collected in 1953 that showed intersex adults had relatively low rates of psychopathology. He decided intersex children would best develop into what he defined as "normal" through surgically imposing a "male" or "female" body in early childhood, along with hormone treatments and being raised based on their coercive assignment. Surgeons "corrected" intersex children's bodies by surgically altering their genitals into either stereotypically male or female. Because surgeons considered it more difficult to perform operations that made a child "male", most intersex children were forcibly assigned female through the procedures. The children could not give consent, and their parents often were not consulted.[15]
Money based his theory about intersex children based on the infamous "John/Joan case" involving David Reimer, who was assigned male at birth in 1965 and was not intersex. When Reimer was eight months old, his genitals were damaged by the doctor performing a circumcision on him. Johns Hopkins University staff and Reimer's parents consulted and came to a conclusion that it would be easiest for them to raise their child as female. Money declared it had worked; he believed Reimer developed into a "normal" girl and later woman from Money's perspective. However, when Reimer's parents told him the truth many years later, it turned out that David Reimer had never felt fully female.[15]
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.[15]
Medical advocacy
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.[15] 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.[16] Chile passed legislation banning it in 2017.[17] California became the first US state to condemn nonconsensual surgeries on intersex children in 2018.[18]
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.[19]
Flag
The intersex flag was created by Morgan Carpenter from Intersex Human Rights Australia (IHRA, previously Organisation Intersex International Australia or OII Australia) in July 2013. The organization aimed to create a symbol that was unique - one that did not seem derivative of existing flags, and without pink and blue colors (which tend to be perceived as gendered). In Carpenter's words, the circle was chosen because it "is unbroken and unornamented, symbolising wholeness and completeness, and our potentialities. We are still fighting for bodily autonomy and genital integrity, and this symbolises the right to be who and how we want to be."[20]
Perceptions and discrimination
From a medical perspective, the growing consensus among health care professionals is that intersex characteristics are part of natural human diversity.[21][22][23][24] However, intersex people still face discrimination and misunderstanding in healthcare, often due to healthcare professionals failing to update their knowledge and causing harm regardless of their intentions.[9]
Controversy
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| This section uses a word that is now recognized as a slur against intersex people in order to describe its historic usage. Reader discretion is advised or skip to the next section. |
Modern scientific understandings of intersex traits have proven that none of the forms of hermaphroditism found in other species apply to humans.[25] While many animal species are described scientifically as "hermaphrodites",[26] using the term to describe intersex humans is considered a slur in the English language.[25]
Adding the I
The movement to include the letter "I" for "intersex" in the acronym LGBTQIA+ is one that is met with both support and hesitance from the intersex communities.[27][28] One popular supporting factor to include the "I" in the LGBT movement is the direct similarities to erasure that the queer community has been historically treated both societally and in psychiatry. In addition, Western medicine and surgical treatments is heavily motivated by homophobia, transphobia, misogyny, and sexism - all of which are also experienced by those wanting to transition.[27] Both communities still fight for the right to not have their bodies 'rectified' or be 'fixed'.[28]
The criticism for the adding the "I" is a fear that the inclusion gives the impression that intersex is inherently queer, or implies that intersex individuals are lesbian, gay, bisexual, and/or transgender or another queer label.[27] This argument stems from the false premise that intersex falls under the umbrella term of transgender, despite the two not being related in that capacity. Additionally, intersex refers to biological features and is not a gender identity, which is another common motivator for the exclusion of the "I".[28][29]
While some intersex people do identify as one or more of the LGBTQIA+ identities, there is a concern that the association with LGBT may drive away parents of intersex children who seek out information. Another critique is the conflation between LGBT and intersex, as being combined with LGBT may make it harder for intersex people to gain visibility on their own. Searching the terms "LGBTI" brings an overwhelming about of resources for LGBT-specific issues, with little to mention of issues pertaining to intersex people. Another concern is the inclusion of the "I" being used only for tokenism and not actually furthering the development of research or resources for the intersex community.[27]
Media
Literature
- None of the Above by I.W. Gregorio - 2015
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[30]
Music
- Raven van Dorst is an intersex rock artist from the Netherlands.
Resources
- Intersex Support and Advocacy Groups
- interACT
- Intersex Human Rights International
- Organisation Intersex International
- Intersex Society of North America