{"id":20943,"date":"2013-08-26T16:03:26","date_gmt":"2013-08-26T23:03:26","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?page_id=20943"},"modified":"2019-09-10T10:12:39","modified_gmt":"2019-09-10T17:12:39","slug":"intersex","status":"publish","type":"page","link":"https:\/\/www.goodtherapy.org\/blog\/intersex\/","title":{"rendered":"Intersex"},"content":{"rendered":"

\"ALike gender identity, physical sex characteristics do not always fit neatly into a male-female binary. One individual may have ambiguous genitalia (a small penis, fused labia, etc.). Another might possess organs that do not \u201cmatch\u201d their sex chromosomes (such as a person who has a vagina and labia but also has \u201cmale\u201d XY chromosomes). These people are often categorized as intersex<\/strong>.<\/p>\n

The term \u201cintersex\u201d can be used to describe both the conditions that cause sex differences and the people who have these conditions. Some individuals prefer to use the term \u201cdifferences in sexual development\u201d, or \u201cDSDs\u201d to avoid stigma. However, much of this population still describes themselves as \u201cintersex people,” so this page will use both terms interchangeably.<\/p>\n

WHAT INTERSEX IS AND ISN\u2019T<\/h2>\n

Depending on the criteria used, intersex conditions affect anywhere from 0.06% to 1.70% of the global population. Some intersex conditions cause medical problems or infertility. Yet many intersex children have no medical symptoms and grow up as healthy as anyone else.<\/p>\n

Intersex conditions are physical diagnoses, not psychiatric ones. According to a 2017 report by three former U.S. surgeons general, there is little evidence to suggest that growing up with atypical sex characteristics causes psychosocial distress. When intersex people do feel anxiety or shame, it is almost always a reaction to discrimination or stigma<\/a>, not the diagnosis itself.<\/p>\n

It is important to remember that a person\u2019s genitals do not determine their gender<\/a>. Biological sex is distinct from a person\u2019s social identity. Just because a person has ambiguous genitalia does not mean they see themselves as androgynous<\/a>. Most intersex individuals feel comfortable with the binary gender they are assigned at birth (typically the one that most closely matches their chromosomes).<\/p>\n

Some intersex people may feel more aligned with another gender and seek to transition as they age. However, the same is true for people without DSDs. If an intersex person undergoes a gender transition<\/a> later in life, that does not necessarily mean parents or doctors \u201cchose the wrong gender\u201d. It is impossible to predict any child\u2019s gender identity with 100% accuracy. The most parents can do is accept their children for who they are, even if that identity turns out different from their initial prediction.<\/p>\n

WHAT CAUSES DIFFERENCES IN SEXUAL DEVELOPMENT?<\/h2>\n

There are many different intersex conditions and thus many different reasons that DSDs occur.<\/p>\n

One common cause is a child\u2019s genes<\/a>. The 46th chromosome influences sex development. Typically, children with XX chromosomes grow up female and those with XY chromosomes grow up male. But some children have an extra sex chromosome (XXX or XXY), and others have one X chromosome by itself.<\/p>\n

Even when a child has typical pair of XX or XY chromosomes, mutations within the chromosomes themselves can affect sex development. For instance, a child may be missing a certain gene that determines the size of their penis. Sometimes these mutations are inherited. Other times they happen suddenly and by chance.<\/p>\n

In some cases, the mutation only affects sex development indirectly by altering how hormones<\/a> are produced in the body. This mutation may be observed at birth, or it may not become apparent until puberty. For instance, children with congenital adrenal hyperplasia (CAH) have bodies that make too many androgens. While their bodies may be conventionally female-looking in childhood, puberty can cause them to develop masculine features such as facial hair.<\/p>\n

On rare occasions, DSDs may occur after a child is exposed to hormones or chemicals in the womb. If a mother has tumors on her ovaries during pregnancy, the resulting hormone imbalance can influence a child\u2019s development. Some agricultural pesticides have also been implicated in DSDs.<\/p>\n

TYPES OF INTERSEX CONDITIONS<\/h2>\n

There are over 40 conditions which can lead to DSDs. They are often divided into four categories depending on a child\u2019s chromosome structure. (FYI, usually intersex literature classifies body parts as “male” or “female” with cisgender individuals in mind.)<\/em><\/p>\n

1. 46, XX Intersex<\/h3>\n

Typically, babies with XX chromosomes are assigned female. An XX intersex child will often have ovaries, fallopian tubes, and a uterus. But they could also develop fused labia and an enlarged clitoris, giving the external genitals a masculine appearance.<\/p>\n

2. 46, XY Intersex<\/h3>\n

Babies with XY chromosomes are usually assigned male. An XY intersex condition will cause the external genitals to grow incompletely or ambiguously. In some cases, the genitals will appear female but change to external male genitalia around puberty.<\/p>\n

3. Complex Intersex (also called Undetermined Intersex)<\/h3>\n

Complex intersex conditions are caused by unusual chromosome configurations, such as XXX or XXY. In general, these conditions don\u2019t cause a discrepancy between internal and external genitalia. However, they can influence sex hormone levels and overall sexual development.<\/p>\n

4. True Gonadal Intersex<\/h3>\n

People with a true gonadal intersex condition have both ovarian and testicular tissue. Some individuals may have one ovary and one testes. Others possess an organ called an ovotestis, which contains both ovarian and testicular tissue.<\/p>\n

GENITAL SURGERY<\/h2>\n

When an infant is born with a DSD, doctors often ask parents if they want to give the child genital surgery. In many cases, these surgeries are purely cosmetic and have no medical purpose. Medical staff may pressure the parents to pay for surgery right away, claiming that the child will suffer emotionally if the parents wait. Yet research suggests these surgeries tend to cause distress rather than prevent it.<\/p>\n

Many human rights groups strongly discourage these surgeries, as they dramatically alter a person\u2019s body without their informed consent<\/a>. Genital surgeries can have long-lasting consequences, including:<\/p>\n