Ten Misconceptions about Intersex
By Curtis E. Hinkle
Founder, Organisation Intersex International
1. Intersex means that a person has both sets of genitalia.
This is probably one of the most common misconceptions about intersex. Intersex usually has nothing to do with the genitalia of the person, much less having two sets. There are intersex people with a penis and a vaginal opening. However, there are no documented cases of a person being born with fully developed male and female genitalia. The vast majority of intersex people have genitalia that look pretty typically male or female with a small minority having atypical genitalia. As a matter of fact, the quaint, pseudoscientific term “true hermaphrodite” can refer to a person with totally typical male or female genitalia.
2. 1 in 2000 infants is born intersex.
This is one of the most common statistics given. It would be more accurate to state simply that in hospitals with gender assignment teams, 1 in 2000 infants is born with genitalia that are so atypical that the attending physician requests the help of the specialists in the team to assign a sex. Most hospitals in the world have no gender assignment teams and most intersex people have typical genitalia. One should be careful to note that even in the majority of births with atypical genitalia, the doctor does not request any assistance from a gender assignment team even if one is available. Therefore, one can readily see that this figure gives the impression that intersex is very, very rare. It isn’t.
There are so many different ways of being intersexed that it is very hard to give a statistic at this time. A more accurate estimate is given by Sharon Preves who has researched the topic of intersex very thoroughly. According to Preves, “The frequency could be as high as four percent.”
3. Intersex is about homosexuality.
The underlying reasons for pathologizing intersex and suggesting treatments which are often barbaric most likely are a result of homophobia. However, there is nothing about intersex per se that would cause one to state that intersex and homosexuality are the same issue or that they are directly related. There quite possibly are links but the physiological reasons are not fully understood at this time.
What is important to understand is that many intersexed people do identify as gay or lesbian. At the same time, many intersex adults find the whole issue of homosexuality irrelevant to their perception of themselves. More and more intersex people are comfortable with an intersex gender identity which they feel is more accurate in describing how they perceive themselves. The socially constructed model of eroticism offered up by many cultures which divides people into homosexual and heterosexual erases their identity. Even bisexuality which has been reluctantly accepted further perpetuates the idea of only two genders by the use of the prefix “bi” which means “both.” Actual experience has led me to realize that there are people who are primarily attracted to androgynous people, to “masculine” women or “feminine” men. And most important of all, what is the opposite sex of an intersex person who clearly states they have an intersex identity?
4. Intersex is not about gender.
To many intersex people, gender is the main issue. In many countries around the world, there are no early surgeries to “treat” intersex bodies. These people’s main issues are often based on not being able to fit into either gender or growing up with a body incompatible with the gender in which they were raised.
The very theories used to support mutilating intersex bodies both surgically and hormonally are based on notions of gender which have been proved to be unreliable. According to the theories often espoused by followers of Dr. John Money, gender is merely the result of social factors. We have very reliable proof that this is not true. Many other factors are involved that are not simply social. The individual is the best source for determining their identity – not someone looking at them from the outside.
Intersex is not just about our bodies but also about how we perceive ourselves within those bodies and gender identity is a crucial part of everyone’s identity. To erase the importance of gender to the individual intersex person is to reduce that person to only the physical aspects of their body, neglecting the more important part of the equation, their own perception of that body and themselves, as opposed to how other’s perceive them.
5. Intersex is part of the transgender movement.
No. Whereas individuals who are intersexed might identify as transgender, the opposite is not true. Most people who are part of the transgender movement are not intersexed. To include intersex under the umbrella term “transgender,” overlooks our specific needs which often are medical reform, legal issues concerning which gender we are, health issues specific to intersexed bodies and more importantly, the fact that most intersexed people are not trans. Many are perfectly happy with being men or women and more and more of us are quite happy being simply intersex and find the notion of trans totally foreign to our identity because we are rejecting binary gender categories altogether and the prefix “trans,” just like the prefix “bi” mentioned earlier, keeps the binary well intact.
6. Only true hermaphrodites are real hermaphrodites.
This is as silly as saying there are true males and pseudomales. The whole idea of dividing intersexed people into true hermaphrodites and pseudohermaphrodites is just another desperate attempt to keep the arbitrary binary gender categories intact. According to this pseudoscientific terminology, only people with gonadal tissue of both “official” sexes are hermaphrodites. Choosing only testicles and ovaries as the indicator of one’s true sex has been totally dismissed by modern science. There are women born with no ovaries, men born with no testicles and their true sex as they perceive it is often clearly that of a man or a woman.
7. Transsexualism is not an intersex condition.
We don’t know. The definition for Transsexualism can lead one to think so because it is so intricately bound to the diagnosis of Gender Dysphoria that one is left with the impression that it is a mental disorder. The fact that many infants born intersexed reject their sex assigned at birth would cause a reasonable person to wonder if in fact all cases of Transsexualism are simply a mental phenomenon. Is the intersexed person merely delusional about their true sex? Should they just try harder and get over the “Gender Dysphoria?” I find it more likely that the medical personnel are the ones that are delusional in thinking that they can determine what sex an intersexed infant is without asking first. The Organisation Intersex International maintains that all persons born intersexed should have the right to speak for themselves and this includes those who were assigned the wrong sex. To view us through the lens of Gender Dysphoria simply silences us once again, making our problem a mental one and not a societal one. The delusion and mental pathology are in the society at large which feels the need to determine one’s true sex based on genitals and to stigmatize individuals who do not fit into neatly packaged gender stereotypes.
8. The intersex movement is an identity movement like other GLBT movements.
No. The Organisation Intersex International campaigns for full Human Rights for all people born intersexed and one of those rights should be the right to self-identify. The intersex movement should include us all whether we identify as a man, woman or simply intersex, and regardless of sexual orientation.
9. Most intersex people were assigned female.
From personal experience, I have not found this to be the case. Many intersexed infants assigned male are often overlooked and the parents are simply told there is some work necessary for proper urination or that a testicle has not descended, etc. When one reads about all the various ways of being intersexed, one realizes that an intersex person is just as likely to be assigned male as female.
10. Intersexuality is a condition which can be cured.
Intersex people have health problems just like everyone else. Mutilating our bodies is not a cure. It is simply barbaric. Being a male or a female is not in and of itself a health problem but there are health problems specific to females and males. This is also true of people born intersexed. To view intersex as a condition which can be cured only further justifies the barbaric medical practices we are often subjected to, such as mutilating surgeries, hormones which may be contrary to our own core identity and psychological treatments for not wishing to comply with the barbaric treatments.
Intersex rights are Human Rights and all people born with an intersex condition should have all the rights granted all other people. This is the mission of the Organisation Intersex International.
The Self is Infinitely More Than the Sum of Bodily Parts
"Same Sex" Marriage, Defining Male and Female, and
the Right of Intersex Persons to Be and to Marry
Jerry Falwell and his cadre of ill-informed homophobic marriage defenders are still at it. The premise of their "One Man and One Woman" Marriage Initiative (http://www.onemanonewoman.com/) has been endorsed by President Bush as an appropriate basis for an amendment to the United States Constitution. We should all welcome it, because medical challenges to such a law will prove, ultimately, the impossibility of using medical criteria to define a "man" or "woman." The many kinds of intersex persons who cannot fit any chromosomal or anatomical definition of male or female will have to have their constitutional rights upheld. The reality of such persons will never permit a simple chromosomal, gonadal or genital definition of male or female, man or woman.
By trying to force a legal medical definition of "man" and "woman' for marriage purposes, Falwell and his followers are in for a real shock from God and Mother Nature. Already the International Olympic Committee has entangled itself in a nightmarish legal mess by trying to define "male" and "female" for athletic competition legal purposes. The Committee had to stop genetic testing as a result of the surprising number of intersex persons who were being kept out of the Olympic Games because they could not pass the Committee's "sex" testing.
The reality of life on Earth is infinitely more complex than the common misunderstanding of male or female so passionately espoused by persons like Mr. Falwell and the promoters of the marriage amendment. Hoping to influence what they see as the moral decline of our nation, these marriage defenders base their case on a belief in human sexual dimorphism that has no grounding in objective reality. Neither is their misunderstanding Biblically based: you will find no mention of sex chromosomes or mixed-sex gonads anywhere in the Bible. The Falwellian idea of male and female is one based on out-dated 19th-century and early 20th-century science, an era when scientists assumed that animals and humans came in only two models, with only two kinds and expressions of sex chromosomes, an era when XY=male and XX=female. Modern science knows that this is simply not true.
Consequently, the key to the ultimate defeat of this misguided marriage-protection legislation is the fact that no purely biological definition of male or female will ever suffice. Chromosomes cannot be used to legally define every human because not all humans are merely XX or XY. Some are chromosomally XXY, XO or Mosaic. The astounding fact is that Mosaic persons can test XX, XY, XXY, XO (or something else) in various parts of their bodies. Further complicating the human mix are naturally sex-reversed people, who may possess XX chromosomes with male anatomy, or XY chromosomes with female anatomy.
Neither can gonads (ovaries or testes) or other reproductive parts be used to define every person's sex, because some otherwise "normal" men have a uterus (Persistent Mullerian Duct Syndrome) and some intersex chromosomal "women" have a functional penis and testes. Thus there are completely "sex-reversed" (this is the medical term) individuals whose physical appearance, including genitalia, is the opposite of their sex chromosomes, so that Complete-AIS XY "genetic males" may have female anatomy and function sexually just like normal XX women, while Complete-CAH XX "genetic females" may have external male anatomy, and live their entire lives as normal men.
Such naturally-occurring sex-reversed people have, traditionally, been sex-assigned and raised as their anatomical sex, not their so-called chromosomal or genetic sex. There are also men and women born without genitals, as well as intersex persons born with both a functional vagina and a functional phallus. Furthermore, some intersex people are so-called "true hermaphrodites" (a medical label that is being phased-out as offensive), possessing ovotestes, or both testicular and ovarian tissue in their mixed-sex gonads. Although most intersex persons are infertile, some can and do biologically parent children or successfully give birth. In 2001, when I was compiling a survey of the best and most recent research on sex differentiation and intersex conditions in vertebral species (including our own), I read a number of scientific reports on intersex and sex-reversed animals and humans who had fathered or given birth to healthy offspring. Yes, there are XY women who have given birth to normal children. So reproductively successful XY sex-reversed females are not limited to other species; fertile and infertile (with treatment) XY human females have given birth. [See terminal note.]
Increasing Intersexuality in All Species: Our Legal and Moral Responses
The feminization of all species due to environmental estrogen-mimicking compounds is a serious problem worldwide, called by some a crisis and an epidemic. In some badly polluted areas, the incidence of XY feminized intersex persons has doubled in the last twenty years. Since more and more people are born every day who cannot be sex-assigned according to traditional chromosomal differentiation, what will Mr. Falwell and his "man-woman" marriage crusaders want the legal establishment to do with these souls?
The increasing incidence of intersexuality means that such individuals will themselves need to challenge any simple dimorphic definitions of gender identity in order to secure their basic human rights. One wonders if more and more informed people in government, anticipating a legal nightmare on the legislative horizon, might try to block the passage of a federal marriage amendment. The institution of marriage cannot be "defended" by discriminating against a vast number of intersexed human beings.
So, let the ill-informed bring on this amendment, and then let science respond with the question: "How will we define "male" and "female"? I welcome the ensuing struggle, which will once and for all end the legal-medical tyranny of anatomical parts over people who do not fit neatly into our society's fantasy of a simple, sexually dimorphic species.
The proposed amendment is exactly what is needed to bring national and global attention to the scientific, medical and human rights questions that surround the issue of assigning gender identity. Simplistic definitions of male and female, or man and woman, are the fantasy of inexperienced and poorly educated people like Mr. Falwell. Such bigots would benefit from learning about the medical, legal, and pastoral needs of intersex and sex-reversed people and their families.
In the real world, humans come in a staggering variety of biological conditions that range from the standard-issue XX=female and XY=male, through an extremely complex continuum of intersex states, all the way to the naturally sex-reversed XX-male and XY-female. Increasingly, we humans exist in every state possible and viable between "normal" male and female and chromosomally sex-reversed male and female. In fact, estimates for various population groups range from 1 in 2000 to 1 in 100 for persons born with some atypical sex differentiation or intersex condition. The difference in these statistics is due to which conditions are included. When common female virilizing and male prenatal failure-to-masculinize conditions like hypospadias are included, the more accurate frequency of 1 in 100 intersexuality is statistically reflected.
Unfortunately, for psychological reasons, common "mildly" intersex conditions like hypospadias and phallic clitoral size are not usually included in intersex statistics. Thus denial operates to obscure the actual frequency of these atypical conditions. Whichever statistics are used, we can see that a large number of people will not fit into any one-size-fits-all legal-medical definition. As I write this a furious medical ethics debate rages about how to "treat" and assign sex to the ever-larger number of intersex persons born every day. At some point this medical ethics problem and the legal issue of defining "man" and "woman" for marriage purposes will merge. When they do, a new era for human rights education and activism will begin.
Education about the medical-legal impossibility of defining male and female is the key to a human-rights-centered outcome in this politicized struggle. The sanctity of sacramental marriage (in any faith) cannot be preserved by denying the existence and basic human rights of part of the human race.
© 2004 Bhakti Ananda Goswami
Header © 2004 Mark McBeth, IDEA | MONGER ("Adam and Eve" by Albrecht Dürer)
For examinations of the issues raised in the foregoing discussion I recommend two online resources where readers will find millions of scientific journal citations, including hundreds of papers on intersex and sex-reversal in humans and other species:
For a copy of the Topical Index to my sex differentiation study, "Improving Medical and Pastoral Responses To The Needs Of Intersex Persons," please write to firstname.lastname@example.org
Why the intergender community is so important
to the intersex community?
by Curtis E. Hinkle
Often those of us who are intersex who also affirm our intergender identity are marginalized not only by society at large but by the intersex community itself. It is time that we take our rightful place at the table and articulate our own views about the importance of our presence. We must speak up and resist the erasure of our identity both within the intersex movement and elsewhere. Our inclusion in society is crucial to ending the underlying violent oppression that many different people face, not just the intersex community.
One objection that often comes from intersex activists is to dismiss those of us who are intergender as insignificant because we are a minority. First of all, how do they know this to be so? Simply looking at one’s small circle of intersex friends and extrapolating generalizations from that close-knit community is very misleading. There are many intersex people all over the world who do identify as intergender. I don’t accept the premise that those of us with intergender identities are a minority. But, what if it we were? Is that a reason to dismiss us and our issues? If so, then society is perfectly justified in dismissing intersex since the definition that most experts give for it makes it such a small category of people. So-called “specialists” have defined intersex in such a limited way in order to erase almost all ambiguity which does not confirm the binary categories for sex which have been constructed in our societies and this is the same reason people, even intersex activists, erase intergender. They are just as uncomfortable with ambiguous gender as society is with ambiguity of sex. But what is really ambiguous, an intergender identity or the definitions that we have used to define gender? For the same reason that intersex is viewed as ambiguous, the ambiguity of gender ascribed to the intergender individual is not in the person but within the faulty binary lens that others view us through.
Another disturbing reason why many activists and “experts” dismiss intergender is a direct result of their insistence on a very essentialist definition of intersex. They often appear to have a vested interest in excluding as many people as possible from their “special” class. This seems quite odd for such a marginalized group of people as the intersexed, but it is true. However, the threat to the intersex movement is not from the intergender community. It is from the very essentialist ideas about intersex that many activists perpetuate based on faulty biological and pathological definitions which not only erase our existence by being so limited but also justify the elimination of any further “ambiguity” and intersex altogether.
No one has a problem with the idea that most people with female gender identities are of female sex and do not contest this. Is it not a rational assumption that most people with intergender identities are in fact intersex (i.e. of intermediate sex)? I think so. Should I require some medical proof that they are intersex? That is absurd. I would never ask a female or male to provide medical proof that they were a woman or a man. What would be the point? Male, female and intersex are not discreet categories. There is no clear way to determine where one category ends and the other begins. Why not let the person tell me who and what they are? I think they would most likely be more accurate than some outside expert who most likely views intersex as a rare pathology as most medical experts do – a view which is not scientific and which geneticists would not accept.
If we are ever going to expand our community and our visibility, the intergender community is essential. There is no way to exist socially without a gender. Gender is about how we perceive ourselves in relation to others within a social context. In other words, it is our most basic interpretation of where we fit based on our own core feelings and identity. To minimize intergender is one of the most effective methods for erasing intersex because it perpetuates the blindness and intolerance which is one of the main justifications for intersex genital mutilation and other pathological views of intersex.. Would it not be healthier for society to deal with the actual variations within the human population rather than to continue passing laws, making medical decisions and other intrusive forays into our private lives in order to enforce norms that most people really can’t meet? I think it would be and in so doing, we would be further deconstructing the binary construct of sex which is at the root of the binary gender expectations.
Another important contribution that intergender activists bring to intersex activism is their insistence on being viewed as whole people, not just bodies. They force us to take our focus from the body and away from an essentialist idea of who we are to the more basic idea of how we actually perceive ourselves and where we fit. For intersex activists to stay focused primarily on the body and our trauma without incorporating the needs of the actual individual in that body and his/her gender identity serves little purpose in the long run because we are seeking to be an integral part of humanity. One cannot be deemed human and intersex legally. To exist as a human legally, you must be categorized as male or female. By listening to intergender voices, we begin to understand the frustration of being silenced and mutilated psychologically and emotionally within this binary system. We have to be allowed to speak for ourselves and insist that not only does intersex exist but that it is the sex of a large part of humanity and moreover that many people are realizing this on their own, i.e. that they are not simply male or female but intergender. Their solidarity with us will help us eliminate a lot of the stigma associated with being intersex.
This is probably the most significant contribution of intergender activists. We clearly force society to deal with the fact that intersex bodies are not just mutilated but our identities are often mutilated too. This is something that many people can understand because it is obvious to a large segment of the humanity that the current social construct of sex and gender as a binary is oppressive and mutilating to their self actualization as fully functioning members of society. This increases our visibility and the solidarity from others that we so need for our very survival. Most people can see that gender stereotypes are harmful and this is something that affects not just intersex people. We welcome our closest allies who are intergender to join us. They understand our erasure, the silence that has been imposed on us. If everyone is just a man and a woman with male and female identities, then what is the purpose of intersex activism really? What do we have to offer society if we just stop a few medical treatments and disappear once again while society continues to forcefully categorize us and insist that we meet norms that are unrealistic and unnatural, while using violence and sexist propaganda to maintain this inhumane system?