Intersex

What is Intersex?

Intersex is an umbrella term used for individuals born with one or more traits that do not fit typical male or female patterns in chromosomes, sexual organs, hormones, or internal reproductive organs. Some features of these individuals may not align with the gender assigned at birth or may combine traditional male and female characteristics.

Intersex traits are often identified at birth, but differences may not always be evident. Therefore, they can be discovered during adolescence or adulthood through tests for other health issues. Rarely, the definition of intersex may be applied post-mortem.

Various terms related to intersex are used. These include terms like disorders of sex development or differences of sex development, although these terms are now rejected. The most commonly used term is intersex. The term hermaphrodite is not appropriate for humans, as a person cannot be fully male and fully female.

Types of Intersex

Intersex is generally divided into three categories:

46+XY

In this type, male chromosomes are present but there may be a lack, ambiguity, or female appearance of external genitalia. The testes may be normal, malformed, or absent, which can result from testosterone issues or other fetal development variations.

46+XX

This term refers to the condition where an individual has female chromosomes and ovaries but male external genitalia. This condition may be due to excessive testosterone exposure before birth.

Gonadal Intersex

This type involves a range of chromosomal variations affecting sex development. They do not cause discordance between internal and external genital organs but may involve potential issues with sex hormone levels and overall sexual development.

Complex or Undetermined Intersex

In these individuals, chromosomal structure can vary as described above. The mismatch between internal and external organs varies depending on the type of chromosomal disorder.

Causes of Intersex

Research has not definitively proven the cause of intersex. Some characteristics are thought to be inherited genetically. However, being intersex can arise from the following:

• Changes in the androgen hormone receptor gene
• Exposure to natural and synthetic hormones during embryo development
• Absence or malfunction of the sex-determining region Y gene
• Other genetic conditions causing abnormal hormone levels related to genital development

Symptoms of Intersex

In many cases of intersex, the external appearance of infants is indicative. Other potential symptoms include:

• Absence of typical ovaries or testes
• Having a different set of sex chromosomes
• Adolescence not progressing as expected
• Infertility

Diagnostic Criteria for Intersex

The condition of being intersex is usually diagnosed through physical examination. However, imaging methods may be required to detect the absence of internal reproductive organs in some cases. Additionally, chromosome tests may be needed to confirm the diagnosis.

Intersex Surgery

Intersex surgeries, aimed at altering genital anatomy to match the gender assigned at birth for individuals born with atypical sexual organs, were commonly performed at an early age in the past. The purpose of these surgeries was to help the child adapt to gender development and societal gender roles. However, there is a prevailing belief today that individuals should not be subjected to these surgeries without their consent.

In many countries, such surgical procedures are postponed until consent is obtained. This particularly aims to wait until children reach an age where they can make a more informed decision about their gender identity. When surgery is decided upon, procedures are performed considering the individual's health, physical characteristics, and preferences.

Risks of Intersex Surgery

Risks associated with intersex surgery include:

• Decreased sexual function
• Infertility
• Scarring
• Urinary incontinence
• Urinary tract infection

Additionally, if the surgery is performed for transitioning to a different gender than assigned, it can cause serious trauma, potentially leading to anxiety and depression.

Health Issues Associated with Being Intersex

Although intersex typically does not cause any health problems, there can be some health issues, albeit rare. These include:

• Bone issues
• Cancer
• Congenital adrenal hyperplasia or androgen insensitivity
• Absence of urethral opening
• Urethra opening on the wrong side of the penis
• Klinefelter syndrome
• Inadequate development of the uterus and vagina
• Underdeveloped sex glands