People with Intersex Traits Transcend History and Cultures

Intersex is a broad categorization of people with anatomical, genetic, or hormonal variations that do not fit the typical “male” or “female” patterns. Policies aimed at proclaiming there are only two absolute genders leave out people who fall outside of the gender binary and more along a spectrum dependent on biological factors. 

“Intersex is an umbrella term that’s used to refer to people who, as a result of some underlying condition, may have bodies that may or may not develop in a way that we think of as atypical with regards to sex difference,” Catherine Clune-Taylor, assistant professor of gender and sexuality studies at Princeton University, told IFLScience. 

“There are at least 40 known different intersex conditions, and probably a lot more that we haven’t identified yet, all of which may or may not give rise to an atypical sex body.”

In other words, intersex represents bodies that defy traditional definitions of binary sex, placing these people – and many others unknowingly – somewhere along a gender spectrum. 

What is intersex? 

But because intersex is such a broad umbrella term for atypical biological traits associated with gender, estimating those figures depends widely on the dataset used by research. One in an estimated 2,000 births may experience some kind of atypical genitalia, though figures vary widely depending on the conditions included. Some estimates of more selective intersex traits put the figure at two in 10,000. 

“To understand intersex, you have to understand that it’s been almost a fluid definition, and the term doesn’t necessarily mean the same thing to every person,” said Dr Ilene Wong, urologist and author of the intersex-related book None of the Above, speaking to IFLScience.

Intersex is a biological condition where a child is born with either external genitalia, internal genitalia, or chromosomal or hormonal abnormalities that don’t fit into a normal definition of male or female.

For example, there are some intersex traits where the baby’s genitals appear to be characteristic of one gender at birth, but at puberty, they may not develop further. A child who appears as a typical biological girl may have a chromosomal makeup that causes both internal testes and an external vagina, meaning she will never get her period. 

“Intersex people are born with a mismatch between the chromosomes and their body forms,” said Wong, who adds that cultural norms often establish that sex is a “clean binary,” and that people are either male or female. 

Biological sex is a spectrum

In many cases, biological sex is a spectrum influenced by biological factors. Typically, females are born with XX chromosomes, while males are born XY – but there can even be genetic variations in this genetic makeup. 

“Characteristics that typically define sex include external genitalia, such as a penis or vagina, and internal reproductive organs like a uterus,” said Clune-Taylor. “But we also must look at the makeup of a person’s gametes, whether they have ovaries or testes – then again, some people have neither.” 

In some instances, intersex can be explained by fetal development. An embryo begins as female and at a certain point, begins generating testosterone, causing certain female structures to evolve into male ones. With some intersex people, these changes may make them appear to be one biological sex externally, but could have a different chromosomal makeup than their assigned gender at birth. 

As these children grow and come into puberty, this can result in changes to the bodies, such as a child developing breasts and appearing to be female, but lacking ovaries or a uterus and instead having undescended internal testes. 

One of the most common intersex traits is congenital adrenal hyperplasia, an exposure to excess testosterone levels in utero that can cause an XX (female) embryo to develop a clitorus that appears “analogous to the male penis.” 

“Intersex identity is a very personal identity often related to medical intervention, to social stigma and even a concealment of diagnoses,” said Wong. 

Throughout modern history, children born with intersex traits have experienced prejudice from the medical community, societal judgments, and forced procedures without consent. 

The idea of intersex traits is not a new concept

Historical records of people with intersex traits date back to ancient Greeks, and these individuals are recognized across cultures. North American indigenous groups refer to “Two-Spirit” people, those who were male, female, and sometimes intersex individuals. “Māhūs” are “third-gender people” in native Hawai’ian culture, and in Japan, “X-jendā” is a term for a person “taken to signify that one’s gender is neither female nor male.” 

Elizabeth Reis, author of Bodies in Doubt: An American History of Intersex, says that the intersex community has gained visibility primarily in the last 30 years. Until the 2000s, intersex wasn’t a well-known concept in mainstream culture. It wasn’t until author Jeffrey Eugenides published the Pulitzer-Prize-winning novel Middlesex, where the central character had an intersex trait, that the condition was popularized and the term more widely used.  

“One of the reasons why people were unfamiliar with intersex is because doctors have been surgically ‘correcting the traits’ of intersex people, which often involves altering their genitals, and we are reluctant to talk about that as a culture,” Reis told IFLScience. 

“Another reason had to do with the way that doctors guided families when a baby with intersex traits was born. Often, families were counseled not to talk about it, and some intersex people have said that the shame and secrecy that came out of that advice from the medical profession was just as bad, if not worse, than anything medical done to their bodies,” said Reis. 

In the 1950s, for example, infants and children were often given a “surgical repair” or “correction” so that their bodies would have “typical male or female anatomy.” A common misconception was that infants’ gender identity, how they would come to think of themselves as boys or girls, was malleable in the first years of life. 

“This is one of the reasons why people don’t know about intersex – because the doctors had told the parents not to say anything, and so people themselves grew up with this sense of shame and secrecy around it,” said Reis. 

“People with intersex used to be called ‘hermaphrodites,’ a pejorative term that conjures up mythical creatures as opposed to human beings,” said Reis. “Not only were people called  ‘hermaphrodites’ and their conditions ‘hermaphroditic,’ but historically many have had negative opinions about those whose bodies had intersex traits.” 

Current legislation threatens people with intersex traits

Today, intersex is sometimes referred to as a disorder of sex development, or DSD. This term, too, can be misconstrued as the use of “disorder” implies something is wrong with the condition, rather than being a natural variation, and that it must be “fixed.”

Sylvan Anthony, legal policy director of the nonprofit group interACT, told IFLScience that current legislation proposed to define gender is “resting on a limited, binary definition of sex.” 

Proposed legislation like US President Donald Trump’s executive order to define gender props a “false idea that sex and gender have to be the same thing determined by a person’s physical characteristics at birth,” said Anthony. 

“These definitions put forward fail to take account of the established facts of biology, such as intersex variation, and they just don’t account for the concept of variation and sex characteristics,” said Anthony. 

Intersex traits constitute a range of variations from sex stereotypes typically associated with male or female bodies. When beginning to focus on a person’s chromosomes or gametes, Anthony says this categorization will put some intersex people on one side of a binary line that may not be correct for them. 

“As you start trying to define or put parameters for eligibility or access around the definition of sex, and trying to use any sort of formula or physical characteristic or birth certificate to define a person’s sex, for purposes of law or policy, it’s going to sweep in intersex people, whether they’re mentioned or not,” said Anthony. 

If proposed legislation continues, Anthony says that there is not one uniform answer about how intersex people will be impacted because so much depends on a person’s particular circumstances and what is going to be known or apparent about them. 

Acknowledging and understanding intersex can save lives

Culturally, people who are intersex experience higher rates of isolation, leading to anxiety, depression, and death by suicide, according to the Center for American Progress.

It’s crucial to bring understanding and awareness to misinformation surrounding gender and biological sex to give a voice to those impacted and potentially provide life-saving interventions.