Alice, from Holland, has Androgen Insensitivity Syndrome (AIS)
Alice has XY chromosomes, which is the norm for males, as opposed to XX for females. When she was 17, Alice went to the doctor to find out why she still hadn't got her first period. He sent her on to a hospital for a test. As the test was being administered, she saw the technician frown; he said that the machine didn't seem to be working, and they had better move to another room and try another machine. Again, there seemed to be something wrong.
The technician left the room to call a doctor. The doctor looked at the machine, frowned too, and then did an internal check up. What he found was nothing. In Alice's body, he found no womb, no uterus, no ovaries. Nothing. It was only then that Alice discovered she had AIS. Although she has XY chromosomes, being insensitive to testosterone, she developed in a female direction. Complete AIS means that the person will look absolutely female from the outside. However AIS is only one of about 75 different intersex conditions.
What is intersex?
Intersex people are born with external genitalia, internal reproductive organs, and/or endocrine system that are different from most other people. There is no single "intersex body"; it encompasses a wide variety of conditions that do not have anything in common except that they are deemed "abnormal" by the society. What makes intersex people similar is their experiences of medicalization, not biology. Intersex is not an identity. While some intersex people do reclaim it as part of their identity, it is not a freely chosen category of gender - it can only be reclaimed. Most intersex people identify as men or women, just like everybody else.
Are intersex conditions harmful?
In general, intersex conditions do not cause the person to feel sick or in pain. However, some intersex conditions are associated with serious health issues, which need to be treated medically. Surgically "correcting" the appearance of intersex genitals will not change these underlying medical needs.
How common are intersex conditions?
No one knows exactly how many children are born with intersex conditions because of the secrecy and deception surrounding it, and also because there are no concrete boundaries to the definition of "intersex." It is nonetheless estimated that about one in 2,000 children are born visibly intersex, prompting early intervention. It is estimated that approximately 30 babies are born each year in New Zealand with indeterminate sexual organs.
Can't they just do a test to find out babies' true sex?
Medicine cannot determine the baby's "true sex." For example, chromosomes do not necessarily dictate one's gender identity, as it is obvious from the fact that most people born with androgen insensitivity syndrome live as women despite their XY chromosomes. In other words: science can measure how large a clitoris is, but cannot conclude how large or small it needs to be. That is a social determination.
How do we know the correct gender of a child with an intersex condition?
In most cases the decision is made by parents and doctors when the child is an infant, based on their best prediction, and this is followed by repeated genital surgery, ongoing hormonal and psychological treatment, and socialisation in the assigned gender. The extent to which such intervention is necessary for the child's physical and mental health, or whether it is both physiologically and psychologically harmful, remains a contentious issue. It is however recommended that the child be assigned a gender, and allowed to determine for himself or herself once he or she is old enough to do so. Irreversible surgeries on infants should be avoided in order to give them the widest range of choices when they are older. Performing surgeries will not eliminate the possibility that our prediction is wrong.
What is the correct pronoun for intersex people?
Pronouns should not be based on the shape of one's genitalia, but on what the person prefers to be called. For children too young to communicate what her/his preference is, go with the gender assignment parents and doctor agreed on based on their best prediction. Do not call intersex children "it": that is dehumanizing.
Are there five sexes?
The notion of "five sexes" was popularized by Anne Fausto-Sterling's article "The Five Sexes: Why Male and Female Are Not Enough" published in 1993. In this largely tongue-in-cheek piece, she wrote that three subcategories among "intersex" should be considered as three additional sexes aside from male and female. Unfortunately, the "five sexes" theory does not help people with intersex conditions. Fausto-Sterling later wrote in "Sexing the Body" (2000) that she was "no longer advocating" these categories, "even tongue-in-cheek".
Are intersex people "third gender"?
Many people with intersex conditions identify solidly as a man or as a woman, like many non-intersex people. There are some who identify as a member of an alternative gender, like some non-intersex people. While everyone has a right to define his or her own identities, people with intersex conditions should not be expected to be gender-transgressive just because of their condition.
Is intersex part of the trans community?
While some people with intersex conditions also identify as trans, intersex people as a group have a unique set of needs and priorities beyond those shared with trans people. Too often, these unique needs are made invisible or secondary when "intersex" becomes a subcategory of "transgender". For example, people who discuss about intersex in the context of transgender often stress the risk of assigning a "wrong" gender as an argument against intersex genital mutilation, which overlooks the fact that intersex medical treatment is painful and traumatic whether or not one's gender identity happens to match her or his assigned gender. It is for this reason that intersex people prefer to have "intersex" spelled out explicitly rather than have it included in the "transgender" umbrella.
What is the difference between "hermaphrodite" and "intersex"?
In biology, "hermaphrodite" means an organism that has both male and female sets of reproductive organs (like snails and earthworms). In humans, there are no actual hermaphrodites in this sense, although doctors have called people with intersex conditions hermaphrodites because intersex bodies do not neatly conform to what doctors define as the "normal" male or female bodies. The word "hermaphrodite" is misleading, mythologizing, and stigmatizing. Although some intersex activists do reclaim and use this term to describe themselves, it is not an appropriate term to refer to intersex people in general. In short, snails are the hermaphrodites; humans are not. Also, please avoid using the word "intersexual" as a noun; it is preferable to say, "intersex people" or "people with intersex conditions/experiences."
“Gender is really outdated. You might say that we're very much wired as a society to believe that there's only 2 answers ... gender isn't just male or female. There's a plethora of options between, why do we have to stick with one or the other? It's not a yes/no binary question. It's like asking someone from Canada, "Do you live in Montreal or Quebec?" with absolutely no expectation of any other answer - it's completely ridiculous.”
DannyR, Trysha E'Layne Kaneko
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