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An intro to intersex identities Part 1: Challenging the myth of binary sex

A 4 panel cartoon with 2 stick figures (A & B). A: So What are your sex chromosomes? B: I don't know - most people haven't been genotyped? A: What I meant was, what genitals do you have? B: My sex chromosomes are irrelevant then - I could have any configuration of genital configuration. A:

Image by Jesse Nylund @turboburpo, shared with permission.

Creating inclusive spaces for intersex people involves interrogating our biases about bodies, deconstructing narratives about gender, and being aware that these communities have been historically silenced and erased (in a very literal sense). In order to explore how we can challenge ourselves and our communities to make space for intersex people and experiences, let’s first start with some basics.

Intersex 101

A person’s sex is made up of 5 characteristics that interplay with one another over a lifetime: Internal gonads, external genitalia, chromosomes, hormones, and secondary sex characteristics (i.e anything that happens during puberty). Intersex people have combinations of what are thought of as “male” and “female” biology. Intersex people may be born with external genitalia or internal gonads that do not fall within stereotypical definitions of “male” or “female.” In many instances, there may be no obvious indication that a person is intersex, with the blending of sex characteristics occurring only at the DNA and/or hormonal level. Diversity in sex and sexual development may express at birth, during puberty, during other hormonal shifts (like menopause), or they may never express.

One’s physical sex and pubescent future are generally determined first in an embryo by the interaction of X and Y chromosomes. The typical (and flawed) story we are told is that male embryos will have one X and one Y chromosome, while female embryos will have two X chromosomes. Embryonic sex development is pushed along further when tiny gonads can descend to become testicles if exposed to a testosterone bath, or stay put and develop into ovaries if testosterone is not present. Genital tissue in an embryo can develop into a penis if cued by testosterone, or grow into a clitoris if not.

With this knowledge, it’s clear that the diagrams used in sex-ed classes do a major disservice to the vast diversity of genital and reproductive shapes, sizes and configurations – any combination of which are natural and normal.

The myth of binary sex

While approximately 1.7% of the population is intersex (the same likelihood as being a redhead!), their physical traits continue to be pathologized and surgically “corrected,” usually without the informed consent of the intersex person themself. The vast majority of intersex surgeries are mostly concerned with cosmetics, not safety or function (the removal of “oversized” clitorises, redesigning penises to allow for standing-urination, or the removal of internal testes are just a few), and are driven by an attempt to preserve two binary sexes.

A measuring meter showing what qualifies genitals as "male" (i.e. longer than 1 inch) or "female" (i.e. under 3/8 of an inch(

Although some intersex people choose to undergo these procedures as consenting adults, the bulk of intersex surgeries occur during infancy or childhood. Often, doctors lead parents to believe that such surgeries will have a positive impact on their child’s social and psychological well-being, or that not intervening will create health problems for them in the future. In reality, it is often the surgeries themselves that are the cause of severe and irreversible physical harm and emotional distress.

Many times, people who received intersex surgeries as infants are not informed about them until adolescence or adulthood, and often are only made aware because the procedure has created unexpected health consequences for them. Coping with these consequences is now made much more difficult due to the attempted erasure of a person’s intersex identity and their body’s natural development being non-consensually tampered with.

Changing standards of practice in the medical community

In June, 2017, after decades of advocacy by intersex people and organizations, a group of US Surgeon Generals released an official recommendation that “children born with atypical genitalia should not have genitoplasty performed on them absent a need to ensure physical functioning.” The recommendation further states:

…We hope that professionals and parents who face this difficult decision will heed the growing consensus that the practice [of cosmetic infant genitoplasty] should stop.

Intersex stories, not surgeries

Listening to and sharing the experiences of intersex folks can be a great way to broaden understanding of what is possible for human biology and sexual development. Some awesome people to check out are Pigeon Pagonis, Emily QuinnHanne Gaby OdieleSean Saifa Wall, and Alice Alverez. Some of these folks are featured in the video below, but there are lots of other resources out there are well. Check out the Intersex Youth Advocacy GroupIntersex RoadshowIntersex Society of North America, and this AIS-DSD Support Group.

How we can do better for the intersex community

As awareness of gender identity increases, it is important raise consciousness about intersex realities at the same time. The common occurrence of intersex surgeries in childhood and infancy and the shame and silence that accompanies these experiences creates the social conditions for these indignities to be perpetuated by our medical system. Make time to seek out the stories of intersex folks, and make space for conversations that dismantle binaries, and make change within your sphere of influence whether that’s in your workplace, in your family, or simply within yourself.

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