Queer Cafe

Video: What Does Intersex Mean?

Intersex: More Than a Diagnosis

APA: Answers to Intersex Questions

Info: Sex and Gender

Born Intersex: Mx. Anunnaki Ray Maquez

Blume (My Life Being Intersex): Interesting and Sexy

Human Rights Watch: Doctors Need Intersex Care Standards

Colorado Issues Intersex Birth Certificates

MedLine Plus: Intersex

Secret Intersex Documentary: Neither Male Nor Female

ABC News Report: Intersex Children

GLAAD: Debunking Intersex Myths

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

What is Endosex?

Endosex is a new term that means the opposite of intersex. It means non-intersex. It means that a person has innate physical sex characteristics that match what is expected for female or male bodies. Innate means that the person is born with these characteristics, including chromosomes, hormones, genitals and other anatomy.

Prior to the introduction of the term "endosex," a popular term was "dyadic." The term derives from the Latin word for two or pair. Some discussion has ensued as to the best term to use to refer to non-intersex people. Among the possible terms that were bandied about were perisex (peri means around) and mesosex (meso means in the middle). It was even suggested that intersex was between intrasex and extrasex.

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

How Many Trans and Intersex People Live in the US?

Biden Administration Committed to Protecting Intersex People's Rights
Not Everyone is Male or Female: Growing Controversy over Sex Designation
GLAAD: Debunking Intersex Myths
What the Intersex Community Wishes You Knew: We are OK the Way We Are

PBS Video: Growing Up Intersex

Intersex Advocacy: Past and Present

According to Intersex Activist and Educator Anunnaki Ray Marquez, "endosex' is the proper word to use to describe people who were not born intersex. Endosex is a way to describe sex characteristics that categorize as typical anatomical females or males. Endosex people can have any gender identity: man, woman, both, neither. Endosex people can be transgender, gender fluid, bi-gender, tri-gender, asexual, and all the many other ways to describe gender identity. Some people use the word “dyadic” instead of endosex. "Dyadic" is not typically preferred due to it reinforcing the binary male/female binary construct that does not exist if we are to include intersex people.

Endosex Male: Is the physiological sex that produces sperm. Most male mammals, including male humans, have one Y and one X chromosomes.

Endosex Female: Is the sex of an organism, or a part of an organism, that produces non-mobile ova (egg cells). Most female mammals, including most female humans, have two X chromosomes.

Altersex is a catch-all term consisting of “alter”, meant here as “different” or “another possibility,” and sex, referring to physiological primary and secondary sex characteristics. Altersex refers to possible sexes that are neither endosex nor intersex, in the cases of those who go through HRT or sexual reassignment surgery of some sort to change their sex. Altersex is a word that can be used for people who are not born intersex, who alter their sex to appear intersex.

Sex Redefined: The Idea of 2 Sexes Is Overly Simplistic

I Am Intersex: Supermodel Hoping To End Stigma
Born Intersex. Why Her Parents Let Her Grow Up Without Surgical Intervention
Intersex People are Challenging Gender-Normalizing Surgery
Irene Kuzemko: Everything I Was Told Was a Lie

Wikipedia: Intersex Defined

HRC: Understanding the Intersex Community

Intersex People

Christine Jorgensen - First Person to Undergo SRS

Mx. Anunnaki Ray Marquez - Activist, Educator, Writer

Mari Wrobi - Youth Advocate

Hanne Gaby Odiele - Belgian Fashion Model

Ana Roxanne - Musician

Santhi Soundarajan - Indian Athlete
Reuben Zellman - US Rabbi and Musician

Sara Kelly Keenan - Issued First Intersex Birth Certificate in US

Caroline Cossey - English Fashion Model
Cary Gabriel Costello - US Sociology Professor

Betsy Driver - Mayor of Flemington NJ, First Intersex US Elected Official
Florian-Ayala Fauna - American Musician and Music Producer
Sarah Gronert - German Tennis Player

River Gallo - Filmmaker

Eden Atwood - US Jazz Musician

Marissa Adams - Communications Coordinator at InterConnect Support Group
Carlett Brown Angianlee - US Navy Officer, First African American to Undergo SRS

Emily Quinn: What It's Like to be Intersex
TED Talk: Mx. Anunnaki Ray Maquez, Born Intersex

Alyssa Ball (The Intersex Witch): Interesting and Sexy

Understanding the Intersex Community
Massachusetts: Model for Intersex Rights

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Alyssa Ball - Educator, Activist

Pidgeon Pagonis - Author

Emily Quinn - Activist, Advocate

Jimmy Scott - Jazz Musician

Morgan Carpenter - Australian Activist, Created Modern Intersex Flag

Lisa Lee Dark - Welsh Opera Singer

Irene Kuzemko - Secretary of Organisation Intersex International Europe
Dora Ratjen - German Athlete

Alicia Roth Weigel - Activist
Jemma Redmond - Irish Biotechnologist and Innovator
Veronique Renard - Dutch Author and Artist

Dana Zzyym - US Navy Veteran

River Gallo - Film Director

Ana Roxanne - Musician

Dani Coyle - Artist, Photographer

Erik Schinegger - Alpine Skier
Jim Sinclair - Autism Rights Activist
Georgina Somerset - First Openly Intersex Person in the UK
Kimberly Zieselman - US Advocate, Attorney, and Executive Drector of InterACT

Tony Briffa - Australian Politician and Activist, World's First Out Intersex Mayor (Also: Current co-executive director of Intersex Human Rights Australia and Vice-President and former President of the Androgen Insensitivity Syndrome Support Group Australia)

Teen Vogue: Teens Who Discovered They Are Intersex

Sara Kelly Keenan: First Intersex Birth Certificate

Mx. Anunnaki Ray Marquez: Website

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

Emily Quinn: My Coming Out Story

Intersex Supermodel Hanne Gaby Odiele

Jazz Legend Little Jimmy Scott Is a Cornerstone of Black Intersex History
Ana Roxanne: Intersex Musician

Intersex Fashion Model Hanne Gabby Odiele

Not Everyone is Male or Female: Growing Controversy over Sex Designation

Fix your hearts... Not our parts

Check out your birth certificate and surely you'll see a designation for sex. When you were born, a doctor or clinician assigned you the "male" or "female" label based on a look at your genitalia. In the US, this has been standard practice for more than a century.

But sex designation is not as simple as a glance and then a check of one box or another. Instead, the overwhelming evidence shows that sex is not binary. To put it another way, the terms "male" and "female" don't fully capture the complex biological, anatomical and chromosomal variations that occur in the human body.

That's why calls are growing to remove sex designation from birth certificates, including a recent recommendation from the American Medical Association.

I am a professor of medicine who has worked extensively on lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA) issues. My co-author is a professor of gynecology who is deeply involved in the health of people who are trans and intersex.

Our research and clinical experience show that sex designation is not something to take for granted. For those who don't fit neatly into one of two categories (and there are millions) an inappropriate classification on a birth certificate can have consequences that last a lifetime.

Maria: I Happen to Like Girls, I Happen to be Intersex

Alyssa Ball: Vulnerability and Intimacy

California Denounces Corrective Surgery on Intersex Children

Out: Intersex Supermodel Hanne Gaby Odiele

HRC: Understanding the Intersex Community

The problems with sex designation

Variations in genital anatomy happen more frequently than you might think; they occur in 0.1 to 0.2% of births annually. In the US, that's about 4,000 to 8,000 babies each year.

Other sex traits don't necessarily help either. Doctors examining the reproductive organs can find people born with both a vagina and testes, and also those born without any gonads. And when evaluating an individual's estrogen and testosterone hormone levels, long defined as key determinants of female and male bodies, doctors find some people with vaginas still produce significant amounts of testosterone. Because of this, testosterone is not a great indicator for defining sex; higher amounts of testosterone do not necessarily make someone male.

Even karyotyping — a laboratory procedure used since the 1950s to evaluate an individual's number and type of chromosomes — doesn't tell the whole story. While we typically expect people to either have XX or XY pairs of sex chromosomes, many people have variations that do not fit either category. These include Turner syndrome, in which a person is born with a single X chromosome, and Kleinfelter syndrome, which occurs when a person is born with a combination of XXY chromosomes.

In short, human diversity has demonstrated that the binary categories of male and female are incomplete and inaccurate. Sex designation, rather than "two sizes fit all," is on a spectrum. Up to 1.7% of the US population (that's more than 5 million Americans) have an anatomy and physiology that present intersex traits.

Intersex People Don't Need to Be Fixed

Advocate: Intersex Myths and Misconceptions

InQueery: What Does Intersex Mean?

Emily Quinn: Androgen Insensitivity Syndrome

Info: Gender Queer

Wikipedia: Hermaphrodite

Blume (My Life Being Intersex): Interesting and Sexy

Binary designations can be damaging

Those with intersex traits who are assigned at birth to be female or male can experience medical care that harms them, both physically and psychologically.

Sometimes physicians perform surgeries to align bodies into binary categories. For example, those born with a larger than typical clitoris may have it reduced in size. But some who have this childhood surgery suffer as adults from pain and difficulty having sex.

Additionally, governments sometimes limit those with intersex traits from fully participating in society. For instance, in Australia, marriages have been annulled because governments have previously ruled that an intersex person (someone not seen to be "100% man" or "100% woman") cannot be legally married.

Private entities often do the same. The International Olympics Committee uses cutoffs of hormone levels to determine who plays in women's sports. As a result, some athletes have been barred from participation.

And for those with a gender identity that differs from the sex designation on a government document, discrimination, harassment or violence can result.

State governments have begun to acknowledge sex diversity. Some let gender-diverse people change their designation on birth certificates, although there are restrictions. Medicine too is changing. For example, some pediatric centers have stopped performing surgeries on newborns with differences in sex development. Still, society at large has been much slower to move beyond the use of strictly binary categories.

As clinicians, we strive to be accurate. The evidence shows that using male and female as the only options on birth certificates is not consistent with scientific reality. Evidence shows that removing this designation will tell new parents that it's not sex assignment that's most important at birth but rather the celebration of a healthy and happy baby.

[Source: Carl Streed Jr, Assistant Professor of Medicine, Boston University and Frances Grimstad, Assistant Professor of Gynecology, Harvard University; February 2022]

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Pidgeon Pagonis Reveals Long Held Secret: Nobody Needs to Know
For the Intersex Community: Every Body Exists on a Spectrum
Not Everyone is Male or Female : Growing Controversy over Sex Designation
What Does AMAB and AFAB Mean?

I am Intersex: Supermodel Hoping To End Stigma
Born Intersex. Why Her Parents Let Her Grow Up Without Surgical Intervention
How Common is Intersex?

Intersex Advocacy: Past and Present

Jazz Legend Little Jimmy Scott Is a Cornerstone of Black Intersex History
Massachusetts: Model for Intersex Rights

Cheryl Chase: Founder of Intersex Society of North America

Bo Laurent, better known by her pseudonym Cheryl Chase (born 1956), is an American intersex activist and the founder of the Intersex Society of North America. She began using the names Bo Laurent and Cheryl Chase simultaneously in the 1990s and changed her name legally from Bonnie Sullivan to Bo Laurent in 1995.

Chase had a "nervous breakdown" in her mid-30s. She said she once contemplated committing suicide "in front of the mutilating physician who had rendered her genitalia numb and scarred."

When she was 35 she badgered her mother for answers, and then embarked on a search for a fuller understanding of what she had learned. Chase contacted many academic researchers and people with personal experiences of intersex conditions.

In 1993 she founded the now-defunct Intersex Society of North America (ISNA) and asked for people to write to her under her new name, Cheryl Chase, which was the beginning of the movement to protect the human rights of people in the USA born with intersex conditions. ISNA was honored with the International Gay and Lesbian Human Rights Commission's 2000 Felipa de Souza Human Rights Award.

She is the creator of Hermaphrodites Speak! (1995), a 30-minute documentary film in which several intersex people discuss the psychological impact of their conditions, the medical treatment and parenting they received, and she is the editor of the journal Hermaphrodites with Attitude.
In 1998 Chase wrote an amicus brief for the Colombian constitutional court, which was then considering a ruling on surgery for a six-year-old boy with a micropenis. In 2004 Chase and the ISNA persuaded the San Francisco Human Rights Commission to hold hearings on medical procedures for intersex infants.

Her activism was a factor in the urology and endocrinology disciplines reopening of their consideration of intersex conditions. She advocates a more complex view of intersexuality: in particular that difficulties cannot be eliminated by early genital surgery.

Chase has written about being openly lesbian since her 20s. She married her partner of five years, Robin Mathias, in San Francisco in 2004. They live on a hobby farm in Sonoma and remarried in 2008.

Alyssa Ball (The Intersex Witch): Interesting and Sexy
How Many Trans and Intersex People Live in the US?

Biden Administration Committed to Protecting Intersex People's Rights
Not Everyone is Male or Female: Growing Controversy over Sex Designation
GLAAD: Debunking Intersex Myths

HRC: Understanding the Intersex Community

What the Intersex Community Wishes You Knew: We are OK the Way We Are

PBS Video: Growing Up Intersex

Intersex Advocacy: Past and Present

Sex Redefined: The Idea of 2 Sexes Is Overly Simplistic

Dana Zzyym: Intersex Activist

Dana Zzyym was born in 1958 with sex characteristics that are not typically male or female, but was raised a boy by their parents. As a result, Dana was forced to undergo several irreversible, painful, and medically unnecessary surgeries to conform to binary sex stereotypes. The surgeries failed immediately and traumatized Dana with permanent scarring and damage.

Dana Zzyym: Biographical Notes

Lambda Legal: Dana Zzyym Receives First 'X' on US Passport
Dana Zzyym Receives First US Passport With 'X' Gender Marker

Later into their adult life, Dana learned they were born with intersex traits and had been forced into an incorrect binary sex/gender category. As an Intersex and nonbinary person who advocated for human rights, Dana was invited to attend an International Intersex Forum in Mexico City, at which time they applied for a US passport. Dana’s application was denied by the US State Department because they could not truthfully select “M” or “F” in the sex field and their request to select another option such as “X” was rejected.

Denying Dana a passport would be depriving them access to any and all means of lawfully exiting the United States, so Dana fought back. They sued the US State Department for denying them a passport that accurately reflected their identity and made history by becoming the first US citizen to receive an official US passport with an “X” gender marker.

Pidgeon Pagonis Reveals Long Held Secret: Nobody Needs to Know
Intersex Advocacy: Past and Present

For the Intersex Community: Every Body Exists on a Spectrum

Gender Fender Bender: Mari Wrobi

Mari Wrobi: Intersex Youth Advocate

Intersex people are viewed as a biological fluke, a mistake. Certainly not an identity to be celebrated. Which is why most intersex people are never told that we’re intersex. Admitting that we’re intersex would mean identifying that there is a broader community of people with a shared or similar experience that would create a sense of pride, the creation of our own culture, and our mobilization against the injustices that intersex people face. So, the word intersex is left out of most of our stories – for months, years, even decades at a time. Given this stigma, most people will never understand the absolute relief that followed the discovery that I’m intersex.

The process started for me several years after I’d already come out as transgender. Rather than being concerned when I didn’t get my period, I was elated. It was as if my prayers had been answered. My stomach and legs being hairier than my brother was a personal achievement. My higher-than-average sex drive was the social expectation for a boy my age. I liked that I didn’t need to strain my voice for it to take on a naturally deeper tone. And I even remember making a secret trip to Target so that I could buy men’s razors to shave the thick hair growing on my face.

My body felt like a home to the identity that I was cultivating as a boy going through puberty. But I eventually came to understand that this puberty (during which I developed the ‘wrong’ secondary sex characteristics as a result of my body producing the ‘wrong’ primary sex hormones) was an intersex puberty that I simply didn’t have the knowledge or vocabulary to describe. The dysphoria and disconnect that I felt with my assigned sex at birth and the feeling that my body was more aligned with the other binary sex was a result of being intersex, not transgender.

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

I wouldn’t have even known if it weren’t for a conversation I accidentally started with my doctor. Normally “When was your last period?” was a question I shrugged off, but one day I answered it honestly instead. “I’ve never had my period.” Finding out that you’re intersex doesn’t happen in just one conversation, though. It’s not like finding out you have the flu where there are a few, quick and easily identifiable symptoms. No, finding out that you’re intersex happens over the course of hundreds of conversations with doctors, parents, partners, and online forums full of messages asking the same question that had crossed my mind once or twice. “I’m already 18, 19, 20, and I’ve never had my period. Am I okay?! Help!” But after enough bloodwork to feel like a pin cushion and enough Googling to finally find the word intersex, I started to understand why
I always felt so different. Why I never felt like a ‘normal girl’. Why I felt dysphoria with my assigned sex and with the gender I identified as. Why I didn’t feel like I had the ‘typical’ trans experience. I breathed a sigh of relief when I finally put two-and-two together. I am intersex. The thought made me feel like I was going to be alright after all.

A few studies have looked at the intersection between intersex and LGBTQ identities. One study from 2016 found that 52% of intersex people identify as ‘non-heterosexual’. Another study found that up to 40% of intersex people experience dysphoria and transition, compared to only 10% of the general population. And, when looking at the statistics of intersex youth specifically, 75% identify as LGBTQ. Needless to say, intersex people are very integrated into the LGBTQ community – whether the ‘I’ is included in the acronym or not. As someone who identifies as non-binary and bisexual, I initially expected a positive experience within my community. But the LGBTQ community has not always been the most welcome place for intersex people.

For instance, I was used to cisgender people asking me about my genitals or which bathroom I used, but I wasn’t prepared for this to come from trans people too. Most people, whether they’re cis or trans, harbor the incorrect assumption that all intersex people have ‘ambiguous’ genitals. Within the LGBTQ community, this ambiguity is viewed with jealousy and desire, to the point where trans people tell me that they wish they were intersex. But they don’t wish they were actually intersex, because that means medical trauma, social discrimination, and ignorance like this. They either want points for existing outside of the sex binary, or ‘ambiguous’ genitals to validate their non-binary gender or androgynous presentation.

Aside from fetishization, I’ve been referred to as a hermaphrodite (a slur used against intersex people) within the LGBTQ community. I’ve been told that intersex people make up such a small percentage of the population that we’re not worth including or discussing even though intersex people make up about 1 in 40 people, the same amount of people in the population with red hair. Further, it’s often assumed that all intersex people are non-binary and, for those of us who are, since our non-binary sex matches our non-binary gender, we’re actually cisgender.

Perhaps worst of all, intersex people are routinely left out of conversations that affect us too, such as discussions on bathroom bills, reproductive rights, non-binary gender markers, coercive gendering of infants, Title IX protections, and more.

Gender Fender Bender: Mari Wrobi

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

So, how can we make the LGBTQ community more welcome for intersex people? Easy. Use language that is inclusive of intersex experiences. Terms that are considered trans-inclusive such as ‘people with penises/vaginas’ or ‘biologically male/female’ actually exclude intersex people by focusing on the genitalia rather than its function. Instead, say what you mean. Say, ‘people who menstruate’, ‘people who can get pregnant/can get someone pregnant’, ‘people at risk of testicular cancer’, to include intersex people who can also do those things.

Recognize that all intersex people are different. Intersex people are just as diverse in our gender, expressions, presentations, and sexualities as non-intersex people. We can be cis or trans, straight or queer, masculine or feminine or both or neither. Don’t assume you know our identities based on the fact that we’re intersex alone.

Don’t use intersex people as ‘gotchas’. A common retort from people during transphobic arguments is ‘but if there are only two genders, then how do intersex people exist?’ Try to avoid this. Intersex people don’t exist solely to further your arguments, we are a diverse community with unique needs that deserve our own spotlight.

Don’t include us as an afterthought. At the end of the day, the debate about including the ‘I’ in the acronym is fought on both sides. But including one letter as a last-ditch effort to be inclusive doesn’t quite cut it. Unless you intend to make the community a safe, inclusive and affirming place for intersex people, then don’t simply add the ‘I’ for ally points. Do your part to stand up for intersex people and educate others on being the best intersex allies they can be before claiming inclusivity.

[Source: Mari Wrobe, Gay Times, Sept 2019]

Intersex People are Challenging Gender-Normalizing Surgery
GLAAD: Debunking Intersex Myths
What the Intersex Community Wishes You Knew: We are OK the Way We Are
Irene Kuzemko: Everything I Was Told Was a Lie
PBS Video: Growing Up Intersex

TED Talk: Mx.Anunnaki Ray Maquez, Born Intersex

Pidgeon Pagonis Reveals Long Held Secret: Nobody Needs to Know
Teen Vogue: Teens Who Discovered They Are Intersex
Alyssa Ball: Vulnerability and Intimacy

Intersex Facts

--Intersex is an umbrella term used to describe people who are born with biological variations in their sex characteristics that don’t fit female or male categories
--There is no one way to be intersex. An intersex person can have traits which affect their chromosomes, hormones, and/or internal and external genitalia.
--Being intersex occurs as a natural biological variation in as much as 1.7% of the population.
--Intersex people face medical violence. The medical system often views intersex people as something to be erased or corrected by forcing intersex bodies to undergo surgery or hormone therapy.
--Intersex people should be allowed autonomy over their bodies. They should not be forced to have surgery or hormone therapy in order to conform to a male or female gender.
--Surgery or hormone therapy can be okay if it’s your personal decision to give consent.
--Being intersex is not the same as being transgender.
--Some intersex characteristics are identified at birth, while other people may not discover they have intersex traits until later in life or never at all.

What Does AMAB and AFAB Mean?
Born Intersex. Why Her Parents Let Her Grow Up Without Surgical Intervention
Intersex People are Challenging Gender-Normalizing Surgery

Wikipedia: Intersex Defined

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Video: What Does Intersex Mean?

Intersex: More Than a Diagnosis

Blume (My Life Being Intersex): Interesting and Sexy
APA: Answers to Intersex Questions

Info: Sex and Gender

Understanding the Intersex Community

Anatomy and Intersex

Which variations of sexual anatomy count as intersex? In practice, different people have different answers to that question. That’s not surprising, because intersex isn’t a discreet or natural category.

What does this mean? Intersex is a socially constructed category that reflects real biological variation. To better explain this, we can liken the sex spectrum to the color spectrum. There’s no question that in nature there are different wavelengths that translate into colors most of us see as red, blue, orange, yellow. But the decision to distinguish, say, between orange and red-orange is made only when we need it (like when we’re asking for a particular paint color). Sometimes social necessity leads us to make color distinctions that otherwise would seem incorrect or irrational, as, for instance, when we call certain people “black” or “white” when they’re not especially black or white as we would otherwise use the terms.

In the same way, nature presents us with sex anatomy spectrums. Breasts, penises, clitorises, scrotums, labia, gonads (all of these vary in size and shape and morphology). So-called “sex” chromosomes can vary quite a bit, too. But in human cultures, sex categories get simplified into male, female, and sometimes intersex, in order to simplify social interactions, express what we know and feel, and maintain order.

Sara Kelly Keenan: First Intersex Birth Certificate

Mx. Anunnaki Ray Marquez: Website

For the Intersex Community: Every Body Exists on a Spectrum

Intersex Supermodel Hanne Gaby Odiele

Jazz Legend Little Jimmy Scott Is a Cornerstone of Black Intersex History

So nature doesn’t decide where the category of “male” ends and the category of “intersex” begins, or where the category of “intersex” ends and the category of “female” begins. Humans decide. Humans (today, typically doctors) decide how small a penis has to be, or how unusual a combination of parts has to be, before it counts as intersex. Humans decide whether a person with XXY chromosomes or XY chromosomes and androgen insensitivity will count as intersex.

Research conducted by the Intersex Society of North America finds that doctors’ opinions about what should count as “intersex” vary substantially. Some think you have to have “ambiguous genitalia” to count as intersex, even if your inside is mostly of one sex and your outside is mostly of another. Some think your brain has to be exposed to an unusual mix of hormones prenatally to count as intersex. So that even if you’re born with atypical genitalia, you’re not intersex unless your brain experienced atypical development. And some think you have to have both ovarian and testicular tissue to count as intersex.

Rather than trying to play a semantic game that never ends, the ISNA (Intersex Society of North America) takes a pragmatic approach to the question of who counts as intersex. They work to build a world free of shame, secrecy, and unwanted genital surgeries for anyone born with what someone believes to be non-standard sexual anatomy.

By the way, because some forms of intersex signal underlying metabolic concerns, a person who thinks she or he might be intersex should seek a diagnosis and find out if she or he needs professional healthcare.

GLAAD: Debunking Intersex Myths

For the Intersex Community: Every Body Exists on a Spectrum

Intersex Surgeries: Viginoplasty and Clitorectomy

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

Video: What Does Intersex Mean?

Androgen Insensitivity Syndrome Explained

Teen Vogue: Teens Who Discovered They Are Intersex

InQueery: What Does Intersex Mean?

Intersex Documentary: Neither Male Nor Female

Out: Intersex Supermodel Hanne Gaby Odiele

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Wikipedia: Intersex Defined

Info: Gender Expression

Intersex Surgeries: Gonadectomy

Video Talk: What is Intersex

Intersex: More Than a Diagnosis

APA: Answers to Intersex Questions

Emily Quinn: Intersex Experiences

Jazz Legend Little Jimmy Scott Is a Cornerstone of Black Intersex History
Intersex Human Rights Australia

Katie Talks to Oprah: Growing Up Intersex

Intersex People Talk: What It's Like to Be Intersex

Intersex Presentations

Intersex is an umbrella term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. For example, someone can be born with the appearance of being male (penis, scrotum), but have a functional female reproductive system inside.

There are many examples of how intersex can present itself, and here are some statistics from the Intersex Society of North America that describe the frequency of intersex births.

--Total number of people whose bodies differ from standard male or female -- One in 100 births
--Total number of people receiving surgery to “normalize” genital appearance -- One or two in 1,000 births

Examples:

--One in 1,666 births        --Not XX and not XY
--One in 1,000 births        --Klinefelter Syndrome (XXY)
--One in 13,000 births      --Androgen Insensitivity Syndrome
--One in 130,000 births     --Partial Androgen Insensitivity Syndrome
--One in 13,000 births       --Classical Congenital Adrenal Hyperplasia
--One in 6,000 births        --Vaginal Agenesis
--One in 83,000 births       --Ovotestes
--One in 150,000 births     --Complete Gonadal Dysgenesis
--One in 2,000 births        --Hypospadias (urethral opening in perineum or along penile shaft)
--One in 770 births           --Hypospadias (urethral opening between corona and tip of glans penis)

--One in 110,000 births --Idiopathic (no discernable medical cause)
--One in 66 individuals --Late onset adrenal hyperplasia

Also:

--Iatrogenic (caused by medical treatment, for instance progestin administered to pregnant mother)
--5 alpha reductase deficiency
--Mixed gonadal dysgenesis

[Source: Intersex Society of North America]

Mayo Clinic: Klinefelter Syndrome

Living with XXY: Spreading Positivity and Awareness

Famous People with Klinefelter Syndrome

This is Me with Klinefelter Syndrome
Celebrities with Klinefelter or Marfan Syndrome

Intersex Supermodel: Hanne Gaby Odiele

Top fashion model Hanne Gaby Odiele revealed that she is intersex, saying that she hopes speaking out will help break a taboo. She was born with undescended testicles, which were removed when she was 10 after doctors warned that they could cause cancer.

Intersex people are born with a mixture of male and female sex characteristics. According to the United Nations, the condition affects up to 1.7% of the world's population.

Ms Odiele, originally from Belgium, was born with androgen insensitivity syndrome (AIS). "It is very important to me in my life right now to break the taboo," she said in an interview. "At this point, in this day and age, it should be perfectly all right to talk about this."

Out: Intersex Supermodel Hanne Gaby Odiele

USA Today: Model Hanne Gaby Odiele Reveals She is Intersex

Vogue: Intersex Fashion Model Hanne Gaby Odiele

BBC: Model Hanne Gaby Odiele Reveals She is Intersex

Not Everyone is Male or Female : Growing Controversy over Sex Designation
I am Intersex: Supermodel Hoping To End Stigma
Born Intersex. Why Her Parents Let Her Grow Up Without Surgical Intervention

At 10, Ms Odiele had surgery to remove her testes. "I knew at one point after the surgery I could not have kids, I was not having my period. I knew something was wrong with me," she said. She had additional surgery at 18 to reconstruct her vagina. But she said the procedures caused her distress and she wanted to speak out in part to discourage other parents from putting their children through perhaps unnecessary surgery.

Ms Odiele's husband, John Swiatek, also a model, said he was "incredibly proud" of his wife for speaking out. "I am very impressed with her decision to advocate for intersex children in order to give them an opportunity to make up their own minds about their bodies, unlike the lack of options and information Hanne and her family (and many others) were given," he said.

Her decision to go public about her condition and become a "spokesperson and advocate for the intersex community" has been praised by the fashion magazine Vogue as "an act of enormous courage". "Odiele is exploring uncharted territory," it commented, "as it is impossible to identify even one well-known person in any field who is openly intersex."

Alyssa Ball (The Intersex Witch): Interesting and Sexy
Intersex People are Challenging Gender-Normalizing Surgery
GLAAD: Debunking Intersex Myths
What the Intersex Community Wishes You Knew: We are OK the Way We Are
Irene Kuzemko: Everything I Was Told Was a Lie
PBS Video: Growing Up Intersex

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Intersex Defined

According to the UN Office of the High Commissioner for Human Rights, intersex people are born with sex characteristics (including genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies. Intersex is an umbrella term used to describe a wide range of natural bodily variations. In some cases, intersex traits are visible at birth while in others, they are not apparent until puberty. Some chromosomal intersex variations may not be physically apparent at all.

Pidgeon Pagonis Reveals Long Held Secret: Nobody Needs to Know
The Way We Think About Biological Sex is Wrong

Sex Redefined: The Idea of 2 Sexes Is Overly Simplistic

Sara Kelly Keenan: First Intersex Birth Certificate

Advocate: Intersex Myths and Misconceptions

Pidgeon Pagonis Reveals Long Held Secret: Nobody Needs to Know
Intersex Advocacy: Past and Present

The Foreign Affairs Council of the Council of the European Union defined intersex in guidelines on the promotion of human rights in foreign affairs (2013) this way: "The term intersex covers bodily variations in regard to culturally established standards of maleness and femaleness, including variations at the level of chromosomes, gonads and genitals." A more medicalized definition describes biological sex as determined by five factors present at birth:

--number and type of sex chromosomes
--type of gonads (ovaries or testicles)
--sex hormones
--internal reproductive anatomy (uterus in females)
--external genitalia

People whose five characteristics are not either all typically male or all typically female at birth are intersex. Intersex traits are not always apparent at birth. Some babies may be born with ambiguous genitals, while others may have ambiguous internal organs (testes and ovaries). Others will not become aware that they are intersex unless they receive genetic testing, because it does not manifest in their phenotype.

For the Intersex Community: Every Body Exists on a Spectrum

Understanding the Intersex Community

Sex Assignment

The acronyms AFAB and AMAB refer to a person's natal sex, medical assignment, physical features, biological elements, and anatomical manifestations regarding sex.

AFAB - Assigned Female At Birth

AMAB - Assigned Male At Birth

DFAB - Designated Female At Birth

DMAB - Designated Male At Birth

CAFAB - Coercively Assigned Female At Birth

CAMAB - Coercively Assigned Male At Birth

UAAB - Un-Assigned At Birth, used where a person was not assigned male or female at birth

Sex assignment is the determination of an infant's sex at the time of birth. In the majority of births, a relative, midwife, nurse or physician inspects the genitalia when the baby is delivered, and sex and gender are assigned, without the expectation of ambiguity.

Sex assignment at birth usually aligns with a child's anatomical and biological sex. The number of births where the baby does not fit into strict definitions of male and female may be as high as 1.7%, of which 0.5% are due to visibly ambiguous genitals. Other reasons include atypical chromosomes, gonads, or hormones. These conditions are collectively called intersex or disorders of sex development, and may complicate sex assignment. Reinforcing sex assignments through surgical or hormonal interventions may violate the individual's human rights.

The act of assignment carries the implicit expectation that future gender identity will develop in alignment with the physical anatomy, assignment, and rearing. In the majority of cases, sex assignment matches the child's gender identity. If sex assignment and gender identity do not align, the person may be transgender or gender non-conforming. The sex assignment of an intersex individual may also contradict their future gender identity.

Wikipedia: Sex Assignment

Info: Gender Queer

Mari Wrobi: I Discovered I am Intersex When I Was 21 Years Old

Intersex Explained: Androgen Insensitivity

Intersex Documentary: Neither Male Nor Female

Human Rights Watch: Doctors Need Intersex Care Standards

Maria: I Happen to Like Girls, I Happen to be Intersex

Sara Kelly Keenan: First Intersex Birth Certificate

Video: The Way We Think About Biological Sex is Wrong

Teen Vogue: Teens Who Discovered They Are Intersex

InQueery: What Does Intersex Mean?

Info: Sex and Gender

Intersex People Talk: What It's Like to Be Intersex

Intersex People Don't Need to Be Fixed

MedLine Plus: Intersex

Advocate: Intersex Myths and Misconceptions

Video Talk: What is Intersex

Wikipedia: Hermaphrodite

Vogue: Intersex Fashion Model Hanne Gabby Odiele

PBS Video: Growing Up Intersex

Biological Combination

Some people are born with a mix of male and female biological traits that can make it hard for doctors to assign them a male or female sex. These people are intersex.

What does intersex mean? The intersex definition is a person is born with a combination of male and female biological characteristics, such as chromosomes or genitals, and that can make it difficult for doctors to assign their sex as distinctly male or female.

Being intersex is a naturally occurring variation in humans, and isn’t a medical problem. It’s also more common than most people realize. It’s hard to know exactly how many people are intersex, but estimates suggest that about 1 in 100 people born in the US is intersex.

There are many different intersex variations. Some intersex people have ambiguous genitalia or internal sex organs, such as a person with both ovarian and testicular tissues. Other intersex people have a combination of chromosomes that is different than XY (male) and XX (female), like XXY. And some people are born with what looks like totally male or totally female genitals, but their internal organs or hormones released during puberty don’t match.

If a person is born with intersex genitalia, they might be identified as intersex at birth. For people born with more clearly male or female external genitals, they might not know they’re intersex until later in life, like when they go through puberty. Sometimes a person can live their whole life without ever discovering that they’re intersex.

What happens when someone is born intersex? Awareness of intersex conditions is growing. In the past, when a baby was born intersex, doctors and the family would decide on a gender and raise the baby as that gender (either male or female). It was common for surgery to be done on the baby’s genitals and also for the child to be given male or female hormones as they went through puberty. But of course sometimes the gender they picked didn’t match the gender identity the young person grew up to have.

So today, more and more people believe unnecessary surgery and other medical interventions should be postponed until intersex people are old enough to decide for themselves what gender they identify with and what, if any, treatments they want.

If you have a child who is intersex, open conversation about gender is especially important throughout your child’s life, whether or not your child has gender-assignment surgery. It can help your child develop a healthy gender identity and body image.

[Source: Planned Parenthood]

Androgen Insensitivity Syndrome Explained

United Nations Adopts Historic First-Ever Resolution on Rights of Intersex People

Emily Quinn: Androgen Insensitivity Syndrome

ABC News Report: Intersex Children

Quigley Scale: Phenotypic Grading of Genitalia

MedLine Plus: Intersex

Intersex People Don't Need to Be Fixed

Katie Talks to Oprah: Growing Up Intersex

Wikipedia: Hermaphrodite

Info: Gender Expression

Video: The Way We Think About Biological Sex is Wrong

Vogue: Intersex Fashion Model Hanne Gabby Odiele

AIS: Androgen Insensitivity Syndrome

Klinefelter Syndrome

Klinefelter Syndrome (KS), also known as XXY male (or 47XXY), is a condition that occurs in men who have an extra X chromosome. They are typically referred to as genderless, intersex, or hermaphroditic. Klinefelter Sydrome is classified as a "Karyotype" variation.

The primary features are infertility and small testicles. Often, symptoms may be subtle and many people do not realize they are affected. The syndrome can affect different stages of physical, language, and social development. Sometimes, symptoms are more prominent and may include weaker muscles, greater height, poor coordination, less body hair, breast growth, and less interest in sex. Often it is only at puberty that these symptoms are noticed. Intelligence is usually normal. However, reading difficulties and problems with speech are more common.

The most common symptom is infertility. Boys may be taller than other boys their age, with more fat around the belly. After puberty, KS boys may have... Smaller testes and penis... Breast growth... Less facial and body hair... Reduced muscle tone... Narrower shoulders and wider hips... Weaker bones... Decreased sexual interest... Lower energy.

KS males may have learning or language problems. They may be quiet and shy and have trouble fitting in.

A genetic test can diagnose KS. There is no cure, but treatments are available. It is important to start treatment as early as possible. With treatment, most boys grow up to have normal lives. Treatments include testosterone replacement therapy and breast reduction surgery. If needed, physical, speech, language, and occupational therapy may also help. Other medical conditions that are closely related to Klinefelter Syndrome are Marfan Syndrome and Androgen Insensitivity Syndrome.

Mayo Clinic: Klinefelter Syndrome

Living with XXY: Spreading Positivity and Awareness

Famous People with Klinefelter Syndrome

This is Me with Klinefelter Syndrome
Celebrities with Klinefelter or Marfan Syndrome

Classification of Intersex Variations

There are four classifications of intersex variations: Karyotype, Gonads, Genitalia, Hormonal Milieu.

Karyotype

--Klinefelter Syndrome (XXY)

--Turner Syndrome (XO)

--Mosaicism (XX/XY)

Gonads

--Gonadal Dysgenesis (Swyer’s Syndrome)
--Ovotesticular Syndrome

Genitalia

--Mϋllerian Agenesis (MRKH)
--Hypospadias
--Penile Agenesis or Microphallus

Hormonal Milieu

--Androgen Insensitivity Syndrome (AIS)
--Congenital Adrenal Hyperplasia (CAH)
--5-Alpha Reductase Deficiency (5-ARD)

[Source: Dr. Katharine Baratz Dalke, Director of Office for Culturally Responsive Health Care Education, Asst Professor of Psychiatry & Behavioral Health, Penn State College of Medicine, March 2020]

Mayo Clinic: Klinefelter Syndrome

Living with XXY: Spreading Positivity and Awareness

Emily Quinn: Androgen Insensitivity Syndrome

Famous People with Klinefelter Syndrome

This is Me with Klinefelter Syndrome
Celebrities with Klinefelter or Marfan Syndrome

Intersex Vs. Hermaphrodite

There’s a lot of misconceptions about what it means to be intersex, and how intersex people differ from hermaphrodites.

Hermaphrodites are living things that have fully functioning sets of “male” AND “female” reproductive anatomy, either at the same time, or at different times during their life cycles. They include various species of plants, fish, mollusks, and other little beasties, but not humans. It’s biologically impossible for humans to have full, functional sets of “M” and “F” reproductive anatomy, so we aren’t hermaphrodites.

Intersex people, on the other hand, are those that have a mix of traits traditionally considered “male” or “female” (and sometimes, traits that are atypical for males or females) in the same body. For example, I have breasts and a vagina (“F” traits) and also have XY chromosomes and was born with testes (“M” traits). Some intersex people may also have traits such as ovotestes (gonads with both testicular and ovarian tissue), chromosome types like XXY, or a phalloclitoris that is sometimes described as a large clitoris or a small penis.

Here’s a scientific fact: The penis and the clitoris derive from the same developmental tissue, hence, the term phalloclitoris. The term “ambiguous genitalia” is often used here. In actuality, everyone’s genital form is just as real as everyone else’s, no one’s is “ambiguous.”

There’s a ton of variation in what our bodies look like and how they function. Think about the people you know and how different everyone’s body and build is, even though we all have bodies. It’s the same thing for intersex people. There is a variety of ways our bodies can look in terms of what traits we do and don’t have, what our bodies do and don’t do. Intersex is really an umbrella term for the many different, distinct ways bodies can be. Even within a form of intersex, there can be a lot of variation.

So, why do folks sometimes confuse intersex people with hermaphrodites? In short, because of history. Doctors applied this label to intersex people several centuries ago, and calling intersex folks “hermaphrodites” is really problematic for the following reasons:

GLAAD: Debunking Intersex Myths

Intersex Documentary: Neither Male Nor Female

Sex Redefined: The Idea of 2 Sexes Is Overly Simplistic