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Intersex people are those born with any of several
sex characteristics Sexual characteristics are physical traits of an organism (typically of a sexually dimorphic organism) which are indicative of or resultant from biological sexual factors. These include both primary sex characteristics, such as gonads, and sec ...
, including
chromosome A chromosome is a package of DNA containing part or all of the genetic material of an organism. In most chromosomes, the very long thin DNA fibers are coated with nucleosome-forming packaging proteins; in eukaryotic cells, the most import ...
patterns,
gonad A gonad, sex gland, or reproductive gland is a Heterocrine gland, mixed gland and sex organ that produces the gametes and sex hormones of an organism. Female reproductive cells are egg cells, and male reproductive cells are sperm. The male gon ...
s, or
genital A sex organ, also known as a reproductive organ, is a part of an organism that is involved in sexual reproduction. Sex organs constitute the primary sex characteristics of an organism. Sex organs are responsible for producing and transporting ...
s that, according to the
Office of the United Nations High Commissioner for Human Rights The Office of the United Nations High Commissioner for Human Rights (OHCHR) is a department of the United Nations Secretariat that works to promote and protect human rights that are guaranteed under international law and stipulated in the Univers ...
, "do not fit typical binary notions of male or female bodies".
Sex assignment Sex assignment (also known as gender assignment) is the discernment of an infant's sex, typically made at birth based on an examination of the baby's external genitalia by a healthcare provider such as a midwife, nurse, or physician. In the v ...
at birth usually aligns with a child's external genitalia. The number of births with ambiguous genitals is in the range of 1:4,500–1:2,000 (0.02%–0.05%). Other conditions involve the development of atypical chromosomes, gonads, or hormones. The portion of the population that is intersex has been reported differently depending on which
definition of intersex Various criteria have been offered for the definition of intersex, including ambiguous genitalia, Sexual differentiation in humans, atypical genitalia, and differential sexual development. Ambiguous genitalia occurs in roughly 0.05% of all birt ...
is used and which conditions are included. Estimates range from 0.018% (one in 5,500 births) to 1.7%. The difference centers on whether conditions in which chromosomal sex matches a phenotypic sex which is clearly identifiable as male or female, such as
late onset congenital adrenal hyperplasia Late onset congenital adrenal hyperplasia (LOCAH), also known as nonclassic congenital adrenal hyperplasia (NCCAH or NCAH), is a milder form of congenital adrenal hyperplasia (CAH), a group of autosomal recessive disorders characterized by impair ...
(1.5 percentage points) and
Klinefelter syndrome Klinefelter syndrome (KS), also known as 47,XXY, is a chromosome anomaly where a male has an extra X chromosome. These complications commonly include infertility and small, poorly functioning testicles (if present). These symptoms are often n ...
, should be counted as intersex. Whether intersex or not, people may be assigned and raised as a girl or boy but then identify with another gender later in life, while most continue to identify with their assigned sex. Terms used to describe intersex people are contested, and change over time and place. Intersex people were previously referred to as "
hermaphrodite A hermaphrodite () is a sexually reproducing organism that produces both male and female gametes. Animal species in which individuals are either male or female are gonochoric, which is the opposite of hermaphroditic. The individuals of many ...
s" or "congenital
eunuch A eunuch ( , ) is a male who has been castration, castrated. Throughout history, castration often served a specific social function. The earliest records for intentional castration to produce eunuchs are from the Sumerian city of Lagash in the 2 ...
s". In the 19th and 20th centuries, some medical experts devised new
nomenclature Nomenclature (, ) is a system of names or terms, or the rules for forming these terms in a particular field of arts or sciences. (The theoretical field studying nomenclature is sometimes referred to as ''onymology'' or ''taxonymy'' ). The principl ...
in an attempt to classify the characteristics that they had observed, the first attempt to create a
taxonomic 280px, Generalized scheme of taxonomy Taxonomy is a practice and science concerned with classification or categorization. Typically, there are two parts to it: the development of an underlying scheme of classes (a taxonomy) and the allocation ...
classification system of intersex conditions. Intersex people were categorized as either having "
true hermaphroditism Ovotesticular syndrome (also known as ovotesticular disorder or OT-DSD) is a rare congenital condition where an individual is born with both ovarian and testicular tissue. It is one of the rarest disorders of sex development (DSDs), with only 50 ...
", "female
pseudohermaphroditism Pseudohermaphroditism is an outdated term for when an individual's gonads were mismatched with their internal reproductive system and/or external genitalia. The term was contrasted with "true hermaphroditism" (now known as ovotesticular syndrome), ...
", or "male pseudohermaphroditism". These terms are no longer used, and terms including the word "hermaphrodite" are considered to be misleading, stigmatizing, and scientifically specious in reference to humans. In biology, the term "hermaphrodite" is used to describe an organism that can produce both male and female
gamete A gamete ( ) is a Ploidy#Haploid and monoploid, haploid cell that fuses with another haploid cell during fertilization in organisms that Sexual reproduction, reproduce sexually. Gametes are an organism's reproductive cells, also referred to as s ...
s. Some people with intersex traits use the term "intersex", and some prefer other language. In clinical settings, the term "
disorders of sex development Disorders of sex development (DSDs), also known as differences in sex development, variations in sex characteristics (VSC), sexual anomalies, or sexual abnormalities, are congenital conditions affecting the reproductive system, in which developme ...
" (DSD) has been used since 2006, a shift in language considered controversial since its introduction. Intersex people face
stigmatization Stigma, originally referring to the visible marking of people considered inferior, has evolved to mean a negative perception or sense of disapproval that a society places on a group or individual based on certain characteristics such as their ...
and
discrimination Discrimination is the process of making unfair or prejudicial distinctions between people based on the groups, classes, or other categories to which they belong or are perceived to belong, such as race, gender, age, class, religion, or sex ...
from birth, or following the discovery of intersex traits at stages of development such as
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles i ...
. Intersex people may face
infanticide Infanticide (or infant homicide) is the intentional killing of infants or offspring. Infanticide was a widespread practice throughout human history that was mainly used to dispose of unwanted children, its main purpose being the prevention of re ...
, abandonment, and stigmatization from their families. Globally, some intersex infants and children, such as those with ambiguous outer genitalia, are surgically or
hormonally A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...
altered to create more socially acceptable sex characteristics. This is considered controversial, with no firm evidence of favorable outcomes.Submission 88 to the Australian Senate inquiry on the involuntary or coerced sterilisation of people with disabilities in Australia
, Australasian Paediatric Endocrine Group (APEG), 27 June 2013
Such treatments may involve sterilization. Adults, including elite female athletes, have also been subjects of such treatment. Increasingly, these issues are considered
human rights abuse Human rights are universally recognized moral principles or norms that establish standards of human behavior and are often protected by both national and international laws. These rights are considered inherent and inalienable, meaning t ...
s, with statements from internationalReport of the UN Special Rapporteur on Torture
, Office of the UN High Commissioner for Human Rights, February 2013.
Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement
,
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
, May 2014.
and national human rights and ethics institutions. Intersex organizations have also issued statements about human rights violations, including the 2013 Malta declaration of the third
International Intersex Forum The International Intersex Forum is an annual event organised, then later supported, by the International Lesbian, Gay, Bisexual, Trans and Intersex Association, ILGA and ILGA-Europe that and List of intersex organizations, organisations from mul ...
. In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention. In April 2015,
Malta Malta, officially the Republic of Malta, is an island country in Southern Europe located in the Mediterranean Sea, between Sicily and North Africa. It consists of an archipelago south of Italy, east of Tunisia, and north of Libya. The two ...
became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people.


Terminology

There is no clear consensus definition of intersex and no clear delineation of which specific conditions qualify an individual as intersex. The World Health Organization's
International Classification of Diseases The International Classification of Diseases (ICD) is a globally used medical classification that is used in epidemiology, health management and clinical diagnosis. The ICD is maintained by the World Health Organization (WHO), which is the dir ...
(ICD), the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
(DSM), and many
medical journal A medical journal is a peer-reviewed scientific journal that communicates medical information to physicians, other health professionals. Journals that cover many medical specialties are sometimes called general medical journals. History The first ...
s classify intersex traits or conditions among
disorders of sex development Disorders of sex development (DSDs), also known as differences in sex development, variations in sex characteristics (VSC), sexual anomalies, or sexual abnormalities, are congenital conditions affecting the reproductive system, in which developme ...
(DSD). A common adjective for people with disorders of sex development (DSD) is "intersex".


Etymology and definitions

In 1917,
Richard Goldschmidt Richard Benedict Goldschmidt (April 12, 1878 – April 24, 1958) was a German geneticist. He is considered the first to attempt to integrate genetics, development, and evolution. He pioneered understanding of reaction norms, genetic assimilatio ...
created the term "intersexuality" to refer to a variety of physical sex ambiguities. However, according to ''The SAGE Encyclopedia of
LGBTQ LGBTQ people are individuals who are lesbian, Gay men, gay, bisexual, transgender, queer, or questioning (sexuality and gender), questioning. Many variants of the initialism are used; LGBTQIA+ people incorporates intersex, Asexuality, asexual, ...
Studies'', it was not until Anne Fausto Sterling published her article "The Five Sexes: Why Male and Female Are Not Enough" in 1993 that the term reached popularity. According to the UN Office of the High Commissioner for Human Rights:


Attitudes towards the term

Some
intersex organizations Intersex civil society organizations have existed since at least the mid-1980s. They include peer support groups and advocacy organizations active on health and medical issues, human rights, legal recognition, and peer and family support. Some gr ...
reference "intersex people" and "intersex variations or traits" while others use more medicalized language such as "people with intersex conditions", or people "with intersex conditions or DSDs (differences of sex development)" and "children born with variations of sex anatomy". In May 2016,
interACT Advocates for Informed Choice, dba interACT or interACT Advocates for Intersex Youth, is a 501(c)(3) nonprofit organization advocating for the legal and human rights of children with intersex traits. The organization was founded in 2006 and fo ...
published a statement recognizing "increasing general understanding and acceptance of the term 'intersex'". Australian sociological research on 272 "people born with atypical sex characteristics", published in 2016, found that 60% of respondents used the term "intersex" to self-describe their sex characteristics, including people identifying themselves as intersex, describing themselves as having an intersex variation or, in smaller numbers, having an intersex condition. Respondents also commonly used diagnostic labels and referred to their sex chromosomes, with word choices depending on audience. Research on 202 respondents by the
Lurie Children's Hospital Ann & Robert H. Lurie Children's Hospital of Chicago, formerly Children's Memorial Hospital and commonly known as Lurie Children's, is a nationally ranked pediatric acute care children's hospital located in Chicago, Illinois. The hospital has ...
, Chicago, and the AIS-DSD Support Group (now known as InterConnect Support Group) published in 2017 found that 80% of Support Group respondents "strongly liked, liked or felt neutral about intersex" as a term, while caregivers were less supportive. The hospital reported that the use of the term "disorders of sex development" may negatively affect care. Another study by a group of children's hospitals in the United States found that 53% of 133 parent and adolescent participants recruited at five clinics did not like the term "intersex". Participants who were members of support groups were more likely to dislike the term. A "dsd-LIFE" study in 2020 found that around 43% of 179 participants thought the term "intersex" was bad, 20% felt neutral about the term, while 37% thought the term was good.


The term "hermaphrodite"

Historically, the term "hermaphrodite" was used in law to refer to people whose sex was in doubt. The 12th century states that "Whether an hermaphrodite may witness a testament, depends on which sex prevails" ("Hermafroditus an ad testamentum adhiberi possit, qualitas sexus incalescentis ostendit"). Similarly, the 17th century English jurist and judge
Edward Coke Sir Edward Coke ( , formerly ; 1 February 1552 – 3 September 1634) was an English barrister, judge, and politician. He is often considered the greatest jurist of the Elizabethan era, Elizabethan and Jacobean era, Jacobean eras. Born into a ...
(Lord Coke), wrote in his ''
Institutes of the Lawes of England The ''Institutes of the Lawes of England'' are a series of legal treatises written by Sir Edward Coke. They were first published, in stages, between 1628 and 1644. Widely recognized as a foundational document of the common law, they have been cit ...
'' on laws of succession stating, "Every heire is either a male, a female, or an hermaphrodite, that is both male and female. And an hermaphrodite (which is also called ''Androgynus'') shall be heire, either as male or female, according to that type of sexe which doth prevaile." During the
Victorian era In the history of the United Kingdom and the British Empire, the Victorian era was the reign of Queen Victoria, from 20 June 1837 until her death on 22 January 1901. Slightly different definitions are sometimes used. The era followed the ...
, medical authors attempted to ascertain whether or not humans could be hermaphrodites, adopting a precise biological definition for the term, and making distinctions between "male pseudohermaphrodite", "female pseudohermaphrodite" and especially " true hermaphrodite". These terms, which reflected
histology Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...
(microscopic appearance) of the
gonad A gonad, sex gland, or reproductive gland is a Heterocrine gland, mixed gland and sex organ that produces the gametes and sex hormones of an organism. Female reproductive cells are egg cells, and male reproductive cells are sperm. The male gon ...
s, are rarely used in the 2020s. Until the mid-20th century, "hermaphrodite" was used synonymously with "intersex".Cawadias, A. P. (1943) ''Hermaphoditus the Human Intersex'', London, Heinemann Medical Books Ltd. Medical terminology shifted in the early 21st century, not only due to concerns about language, but also a shift to understandings based on
genetics Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinians, Augustinian ...
. The term "hermaphrodite" is also controversial as it implies the existence of someone fully
male Male (Planet symbols, symbol: ♂) is the sex of an organism that produces the gamete (sex cell) known as sperm, which fuses with the larger female gamete, or Egg cell, ovum, in the process of fertilisation. A male organism cannot sexual repro ...
and fully
female An organism's sex is female ( symbol: ♀) if it produces the ovum (egg cell), the type of gamete (sex cell) that fuses with the male gamete (sperm cell) during sexual reproduction. A female has larger gametes than a male. Females and ...
. As such the term "hermaphrodite" is often seen as degrading, although many
intersex activist Intersex people are born with sex characteristics, such as genitals, gonads and chromosome patterns that, according to the UN Office of the High Commissioner for Human Rights, "do not fit the typical definitions for male or female bodies". In ...
s use it as a direct form of self empowerment and critique such as in the ISNA's first newsletter ''
Hermaphrodites with Attitude ''Hermaphrodites with Attitude'' was a newsletter edited by Cheryl Chase and published by the Intersex Society of North America (ISNA) between 1994 and 2005. The full archives are available online. In 2008, ISNA transferred its remaining funds, ...
''. The
Intersex Society of North America The Intersex Society of North America (ISNA) was a non-profit advocacy group founded in 1993 by Cheryl Chase (activist), Cheryl Chase to end shame, secrecy, and unnecessary genital surgeries on intersex people.Matthews, Karen (Oct 22, 2000). Debat ...
has stated that hermaphrodites should not be confused with intersex people and that using "hermaphrodite" to refer to intersex individuals is considered to be stigmatizing and misleading.


Prevalence

Estimates of the number of people who are intersex vary, depending on which conditions are counted as intersex. The now-defunct
Intersex Society of North America The Intersex Society of North America (ISNA) was a non-profit advocacy group founded in 1993 by Cheryl Chase (activist), Cheryl Chase to end shame, secrecy, and unnecessary genital surgeries on intersex people.Matthews, Karen (Oct 22, 2000). Debat ...
said:
Anne Fausto-Sterling Anne Fausto-Sterling ( Sterling; born July 30, 1944) is an American sexologist who has written extensively on the social construction of gender, sexual identity, gender identity, gender roles, and intersexuality. She is the Nancy Duke Lewis Pr ...
''et al.'', said in 2000 that " ding the estimates of all known causes of nondimorphic sexual development suggests that approximately 1.7% of all live births do not conform to a Platonic ideal of absolute sex chromosome, gonadal, genital, and hormonal dimorphism"; these publications have been widely quoted by intersex activists. Of the 1.7%, 1.5% points (88% of those considered "nondimorphic sexual development" in this figure) consist of individuals with
late onset congenital adrenal hyperplasia Late onset congenital adrenal hyperplasia (LOCAH), also known as nonclassic congenital adrenal hyperplasia (NCCAH or NCAH), is a milder form of congenital adrenal hyperplasia (CAH), a group of autosomal recessive disorders characterized by impair ...
(LOCAH) which may be asymptomatic but can present after puberty and cause infertility.
Leonard Sax Leonard Sax is an American psychologist and family physician. He is the author of three books for parents: ''Boys Adrift'', ''Girls on the Edge'', and ''Why Gender Matters''. According to his website, he is currently employed as a physician at ...
, in response to Fausto-Sterling, estimated that the prevalence of intersex was about 0.018% of the world's population,Alt URL
discounting several conditions included in Fausto-Sterling's estimate that included LOCAH, Klinefelter syndrome (47,XXY),
Turner syndrome Turner syndrome (TS), commonly known as 45,X, or 45,X0,Also written as 45,XO. is a chromosomal disorder in which cells of females have only one X chromosome instead of two, or are partially missing an X chromosome (sex chromosome monosomy) lea ...
(45,X), the chromosomal variants of 47,XYY and 47,XXX, and vaginal agenesis. Sax reasons that in these conditions chromosomal sex is consistent with phenotypic sex and phenotype is classifiable as either male or female. In a 2003 letter to the editor, political scientist Carrie Hull analyzed the data used by Fausto-Sterling and said the estimated intersex rate should instead have been 0.37%, due to many errors. In a response letter published simultaneously, Fausto-Sterling welcomed the additional analysis and said "I am not invested in a particular final estimate, only that there BE an estimate." A 2018 review reported that the number of births with ambiguous genitals is in the range of 0.02% to 0.05%.
Intersex Human Rights Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
says it maintains 1.7% as its preferred upper limit "despite its flaws", stating both that the estimate "encapsulates the entire population of people who are stigmatized—or risk stigmatization—due to innate sex characteristics", and that Sax's definitions exclude individuals who experience such stigma and who have helped to establish the intersex movement. According to
InterACT Advocates for Informed Choice, dba interACT or interACT Advocates for Intersex Youth, is a 501(c)(3) nonprofit organization advocating for the legal and human rights of children with intersex traits. The organization was founded in 2006 and fo ...
, a major organization for
intersex rights in the US Intersex people in the United States have some of the same rights as other people, but with significant gaps, particularly in protection from non-consensual cosmetic medical interventions and violence, and protection from discrimination. Actions ...
, states that 1.7% of people have some variation of
sexual development Puberty is the process of physical changes through which a child's Human body, body matures into an adult body capable of sexual reproduction. It is initiated by hormone, hormonal signals from the Human brain, brain to the gonads: the ovary ...
, 0.5% have atypical genitalia, and 0.05% have mixed/ambiguous genitalia. A study relying on a nationally representative survey conducted in Mexico between 2021 and 2022 obtained similar estimates: around 1.6% of individuals aged 15 to 64 reported being born with sex variations. The following summarizes
prevalence In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number o ...
s of traits that some medical experts consider to be intersex (where
sex chromosome anomalies Sex chromosome anomalies belong to a group of genetic conditions that are caused or affected by the loss, damage or addition of one or both sex chromosomes (also called ''gonosomes''). In humans this may refer to: * 45, X, also known as Turner s ...
are involved, the
karyotype A karyotype is the general appearance of the complete set of chromosomes in the cells of a species or in an individual organism, mainly including their sizes, numbers, and shapes. Karyotyping is the process by which a karyotype is discerned by de ...
is often summarized by the total number of chromosomes followed by the sex chromosomes present in each cell): Notes:


History

From early history, societies have been aware of intersex people. Some of the earliest evidence is found in mythology: the Greek historian
Diodorus Siculus Diodorus Siculus or Diodorus of Sicily (;  1st century BC) was an ancient Greece, ancient Greek historian from Sicily. He is known for writing the monumental Universal history (genre), universal history ''Bibliotheca historica'', in forty ...
wrote of the mythological
Hermaphroditus In Greek mythology, Hermaphroditus (; , ) was a child of Aphrodite and Hermes. According to Ovid, he was born a remarkably beautiful boy whom the naiad Salmacis attempted to rape and prayed to be united with forever. A god, in answer to her pra ...
in the first century BC, who was "born with a physical body which is a combination of that of a man and that of a woman", and reputedly possessed supernatural properties. He also recounted the lives of
Diophantus of Abae Diophantus (), born Herais (; 2nd century BC), was an intersex person who lived in the second century BC and fought as a soldier with Alexander Balas. His life is known from the works of Diodorus Siculus. Biography Diophantus was born in the ci ...
and
Callon of Epidaurus Callon (born Callo; fl. 2nd century BC) was an intersex person, whose medical treatment is the first recorded example of gender affirmation surgery. His life is known from the works of Diodorus Siculus. Biography Callon was born in Epidaurus in ...
.
Ardhanarishvara Ardhanarishvara () is a form of the Hindu deity Shiva combined with his consort Parvati. Ardhanarishvara is depicted as half-male and half-female, equally split down the middle. Ardhanarishvara represents the synthesis of masculine and feminin ...
, an androgynous composite form of male deity
Shiva Shiva (; , ), also known as Mahadeva (; , , Help:IPA/Sanskrit, ɐɦaːd̪eːʋɐh and Hara, is one of the Hindu deities, principal deities of Hinduism. He is the God in Hinduism, Supreme Being in Shaivism, one of the major traditions w ...
and female deity
Parvati Parvati (, , IPA: /Sanskrit phonology, pɑɾʋət̪iː/), also known as Uma (, , IPA: Sanskrit phonology, /ʊmɑː/) and Gauri (, , IPA: /Sanskrit phonology, gə͡ʊɾiː/), is one of the principal goddesses in Hinduism, revered as the Devi, ...
, originated in
Kushan ''Kushan'' or Kushana may refer to: * Kushan Empire The Kushan Empire (– CE) was a Syncretism, syncretic empire formed by the Yuezhi in the Bactrian territories in the early 1st century. It spread to encompass much of what is now Afghanistan ...
culture as far back as the first century AD. A statue depicting Ardhanarishvara is included in India's
Meenakshi Temple Arulmigu Meenakshi Sundareswarar Temple, also known as Arulmigu Meenakshi Amman Thirukkovil, is a historic Hindu temple located on the southern bank of the Vaigai River in the temple city of Madurai, Tamil Nadu, India. It is dedicated to the go ...
; this statue clearly shows both male and female bodily elements.
Hippocrates Hippocrates of Kos (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...
( – BC, Greek physician) and
Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...
(129 – AD,
Roman Roman or Romans most often refers to: *Rome, the capital city of Italy *Ancient Rome, Roman civilization from 8th century BC to 5th century AD *Roman people, the people of Roman civilization *Epistle to the Romans, shortened to Romans, a letter w ...
physician, surgeon, and philosopher) both viewed sex as a spectrum between men and women, with "many shades in between, including hermaphrodites, a perfect balance of male and female".
Pliny the Elder Gaius Plinius Secundus (AD 23/24 79), known in English as Pliny the Elder ( ), was a Roman Empire, Roman author, Natural history, naturalist, and naval and army commander of the early Roman Empire, and a friend of the Roman emperor, emperor Vesp ...
(AD 23/24–79), a Roman
naturalist Natural history is a domain of inquiry involving organisms, including animals, fungi, and plants, in their natural environment, leaning more towards observational than experimental methods of study. A person who studies natural history is cal ...
, described "those who are born of both sexes, whom we call hermaphrodites, at one time '' androgyni''" (from the
Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...
, "man", and , "woman").
Augustine Augustine of Hippo ( , ; ; 13 November 354 – 28 August 430) was a theologian and philosopher of Berber origin and the bishop of Hippo Regius in Numidia, Roman North Africa. His writings deeply influenced the development of Western philosop ...
(354 – 430 AD), the influential Catholic theologian, wrote in ''The Literal Meaning of Genesis'' that humans were created in two sexes, despite "as happens in some births, in the case of what we call androgynes". In medieval and early modern European societies,
Roman law Roman law is the law, legal system of ancient Rome, including the legal developments spanning over a thousand years of jurisprudence, from the Twelve Tables (), to the (AD 529) ordered by Eastern Roman emperor Justinian I. Roman law also den ...
, post-classical
canon law Canon law (from , , a 'straight measuring rod, ruler') is a set of ordinances and regulations made by ecclesiastical jurisdiction, ecclesiastical authority (church leadership) for the government of a Christian organization or church and its membe ...
, and later
common law Common law (also known as judicial precedent, judge-made law, or case law) is the body of law primarily developed through judicial decisions rather than statutes. Although common law may incorporate certain statutes, it is largely based on prece ...
, referred to a person's sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant. The 12th century states, "Whether an hermaphrodite may witness a testament, depends on which sex prevails." The foundation of common law, the 17th century ''
Institutes of the Lawes of England The ''Institutes of the Lawes of England'' are a series of legal treatises written by Sir Edward Coke. They were first published, in stages, between 1628 and 1644. Widely recognized as a foundational document of the common law, they have been cit ...
'' described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile". Legal cases have been described in canon law and elsewhere over the centuries. Some non-European societies have
sex or gender Sex is the biological trait that determines whether a sexually reproducing organism produces male or female gametes. During sexual reproduction, a male and a female gamete fuse to form a zygote, which develops into an offspring that inheri ...
systems that recognize more than the two categories of male/man and female/woman. Some of these cultures, for instance the South-Asian
Hijra Hijra, Hijrah, Hegira, Hejira, Hijrat or Hijri may refer to: Islam * Hijrah (also ''Hejira'' or ''Hegira''), the migration of Muhammad from Mecca to Medina in 622 CE * Migration to Abyssinia or First Hegira, of Muhammad's followers in 615 CE * L ...
communities, may include intersex people in a
third gender Third gender or third sex is an identity recognizing individuals categorized, either by themselves or by society, as neither a man nor a woman. Many gender systems around the world include three or more genders, deriving the concept either from ...
category. Although—according to Morgan Holmes—early Western anthropologists categorized such cultures as "primitive", Holmes has argued that analyses of these cultures have been simplistic or romanticized and fail to take account of the ways that subjects of all categories are treated. During the
Victorian era In the history of the United Kingdom and the British Empire, the Victorian era was the reign of Queen Victoria, from 20 June 1837 until her death on 22 January 1901. Slightly different definitions are sometimes used. The era followed the ...
, medical authors introduced the terms " true hermaphrodite" for an individual who has both ovarian and testicular tissue, "male pseudo-hermaphrodite" for a person with testicular tissue, but either female or ambiguous sexual anatomy, and "female pseudo-hermaphrodite" for a person with ovarian tissue, but either male or ambiguous sexual anatomy. Some later shifts in terminology have reflected advances in genetics, while other shifts are suggested to be due to pejorative associations. The term "intersexuality" was coined by
Richard Goldschmidt Richard Benedict Goldschmidt (April 12, 1878 – April 24, 1958) was a German geneticist. He is considered the first to attempt to integrate genetics, development, and evolution. He pioneered understanding of reaction norms, genetic assimilatio ...
in 1917. The first suggestion to replace the term "hermaphrodite" with "intersex" was made by Cawadias in the 1940s. Since the rise of modern medical science, some intersex people with ambiguous external genitalia have had their genitalia surgically modified to resemble either female or male genitals. Surgeons pinpointed intersex babies as a "social emergency" when born. An 'optimal gender policy', initially developed by
John Money John William Money (8 July 1921 – 7 July 2006) was a New Zealand American psychologist, sexologist and professor at Johns Hopkins University known for his research on human sexual behavior and gender. Money advanced the use of more accur ...
, stated that early intervention helped avoid gender identity confusion, but this lacks evidence. Early interventions have adverse consequences for psychological and physical health. Since advances in surgery have made it possible for intersex conditions to be concealed, many people are not aware of how frequently intersex conditions arise in human beings or that they occur at all. Dialogue between what were once antagonistic groups of activists and clinicians has led to only slight changes in medical policies and how intersex patients and their families are treated in some locations. In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention. In April 2015,
Malta Malta, officially the Republic of Malta, is an island country in Southern Europe located in the Mediterranean Sea, between Sicily and North Africa. It consists of an archipelago south of Italy, east of Tunisia, and north of Libya. The two ...
became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people. Many civil society organizations and human rights institutions now call for an end to unnecessary "normalizing" interventions, including in the Malta declaration.


Human rights and legal issues

Human rights institutions are placing increasing scrutiny on harmful practices and issues of discrimination against intersex people. These issues have been addressed by a rapidly increasing number of international institutions including, in 2015, the
Council of Europe The Council of Europe (CoE; , CdE) is an international organisation with the goal of upholding human rights, democracy and the Law in Europe, rule of law in Europe. Founded in 1949, it is Europe's oldest intergovernmental organisation, represe ...
, the United Nations
Office of the United Nations High Commissioner for Human Rights The Office of the United Nations High Commissioner for Human Rights (OHCHR) is a department of the United Nations Secretariat that works to promote and protect human rights that are guaranteed under international law and stipulated in the Univers ...
and the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
(WHO). In 2024, the
United Nations Human Rights Council The United Nations Human Rights Council (UNHRC) is a United Nations body whose mission is to promote and protect human rights around the world. The Council has 47 members elected for staggered three-year terms on a United Nations Regional Gro ...
adopted its first resolution to protect the rights of intersex people. These developments have been accompanied by
International Intersex Forum The International Intersex Forum is an annual event organised, then later supported, by the International Lesbian, Gay, Bisexual, Trans and Intersex Association, ILGA and ILGA-Europe that and List of intersex organizations, organisations from mul ...
s and increased cooperation among civil society organizations. However, the implementation, codification, and enforcement of
intersex human rights Intersex people are born with sex characteristics, such as chromosomes, gonads, or genitals, that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies." Intersex pe ...
in national legal systems remains slow.


Physical integrity and bodily autonomy

Stigmatization and discrimination from birth may include infanticide, abandonment, and the stigmatization of families. The birth of an intersex child was often viewed as a curse or a sign of a witch mother, especially in parts of Africa. Abandonments and infanticides have been reported in
Uganda Uganda, officially the Republic of Uganda, is a landlocked country in East Africa. It is bordered to the east by Kenya, to the north by South Sudan, to the west by the Democratic Republic of the Congo, to the south-west by Rwanda, and to the ...
,
Kenya Kenya, officially the Republic of Kenya, is a country located in East Africa. With an estimated population of more than 52.4 million as of mid-2024, Kenya is the 27th-most-populous country in the world and the 7th most populous in Africa. ...
,
South Asia South Asia is the southern Subregion#Asia, subregion of Asia that is defined in both geographical and Ethnicity, ethnic-Culture, cultural terms. South Asia, with a population of 2.04 billion, contains a quarter (25%) of the world's populatio ...
, and
China China, officially the People's Republic of China (PRC), is a country in East Asia. With population of China, a population exceeding 1.4 billion, it is the list of countries by population (United Nations), second-most populous country after ...
. Infants, children and adolescents also experience "normalising" interventions on intersex people that are
medically unnecessary Medical necessity is a legal doctrine in the United States related to activities that may be justified as reasonable, necessary, and/or appropriate based on evidence-based medicine, evidence-based clinical standard of care, standards of care. In c ...
and the pathologisation of variations in sex characteristics. In countries where the human rights of intersex people have been studied, medical interventions to modify the sex characteristics of intersex people have still taken place without the consent of the intersex person. Interventions have been described by human rights defenders as a violation of many rights, including (but not limited to) bodily integrity, non-discrimination, privacy, and experimentation. These interventions have frequently been performed with the consent of the intersex person's parents, when the person is legally too young to consent. Such interventions have been criticized by the WHO, other UN bodies such as the Office of the High Commissioner for Human Rights, and an increasing number of regional and national institutions due to their adverse consequences, including trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity. The UN organizations decided that infant intervention should not be allowed, in favor of waiting for the child to mature enough to be a part of the decision-making—this allows for a decision to be made with total consent. In April 2015,
Malta Malta, officially the Republic of Malta, is an island country in Southern Europe located in the Mediterranean Sea, between Sicily and North Africa. It consists of an archipelago south of Italy, east of Tunisia, and north of Libya. The two ...
became the first country to outlaw surgical intervention without consent. In the same year, the Council of Europe became the first institution to state that intersex people have the right not to undergo sex affirmation interventions.


Anti-discrimination and equal treatment

People born with intersex bodies are seen as different. Intersex infants, children, adolescents and adults "are often stigmatized and subjected to multiple human rights violations", including discrimination in education, healthcare, employment, sport, and public services. Researchers have documented significant disparities in mental, physical, and sexual health when comparing intersex individuals to the general population, including higher rates of bullying, stigmatization, harassment, violence, and suicidal intention, as well as substantial barriers in the workplace. Several countries have so far explicitly protected intersex people from discrimination, with landmarks including
South Africa South Africa, officially the Republic of South Africa (RSA), is the Southern Africa, southernmost country in Africa. Its Provinces of South Africa, nine provinces are bounded to the south by of coastline that stretches along the Atlantic O ...
,Government Gazette
, Republic of South Africa, Vol. 487, Cape Town, 11 January 2006.
Australia Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
,Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013, No. 98, 2013
, ComLaw, C2013A00098, 2013.
On the historic passing of the Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013
,
Organisation Intersex International Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
, 25 June 2013.
and, most comprehensively, Malta.


Remedies and claims for compensation

Claims for compensation and remedies for human rights abuses include the 2011 case of Christiane Völling in
Germany Germany, officially the Federal Republic of Germany, is a country in Central Europe. It lies between the Baltic Sea and the North Sea to the north and the Alps to the south. Its sixteen States of Germany, constituent states have a total popu ...
. A second case was adjudicated in
Chile Chile, officially the Republic of Chile, is a country in western South America. It is the southernmost country in the world and the closest to Antarctica, stretching along a narrow strip of land between the Andes, Andes Mountains and the Paci ...
in 2012, involving a child and his parents. A further successful case in Germany, taken by Michaela Raab, was reported in 2015. In the United States, the Minor Child ( ''M.C. v Aaronson'') lawsuit was "a medical malpractice case related to the informed consent for a surgery performed on the Crawford's adopted child (known as M.C.) at edical University of South Carolinain April 2006". The case was one of the first lawsuit of its type to challenge "legal, ethical, and medical issues regarding genital-normalizing surgery" in minors, and was eventually settled out of court by the Medical University of South Carolina for $440,000 in 2017.


Information and support

Access to information Access may refer to: Companies and organizations * ACCESS (Australia), an Australian youth network * Access (credit card), a former credit card in the United Kingdom * Access Co., a Japanese software company * Access International Advisors, a h ...
, medical records, peer and other counselling and support. With the rise of modern medical science in Western societies, a secrecy-based model was also adopted, in the belief that this was necessary to ensure normal physical and psychosocial development.


Legal recognition

The
Asia Pacific Forum The Asia Pacific Forum (APF) is one of four regional networks of national human rights institutions (NHRIs) within the International Co-ordinating Committee of NHRIs. The APF formerly accredited NHRIs for compliance with the United Nations' Pari ...
of
National Human Rights Institutions A national human rights institution (NHRI) is an independent state-based institution with the responsibility to protect and promote human rights in a country. The Office of the United Nations High Commissioner for Human Rights (OHCHR) aids these ...
states that
legal recognition Legal recognition of a status or fact in a jurisdiction is a formal acknowledgment of it as being true, valid, legal, or worthy of consideration, and may involve approval or the granting of rights. For example, a nation or territory may require ...
is firstly "about intersex people who have been issued a male or a female birth certificate being able to enjoy the same legal rights as other men and women". In some regions, obtaining any form of birth certification may be an issue. A Kenyan court case in 2014 established the right of an intersex boy, "Baby A", to a birth certificate. Like all individuals, some intersex individuals may be raised as a certain sex (male or female) but then identify with another later in life, while most do not. Recognition of third sex or gender classifications occurs in several countries, however, it is controversial when it becomes assumed or coercive, as is the case with some German infants. Sociological research in Australia, a country with a third 'X' sex classification, shows that 19% of people born with atypical sex characteristics selected an "X" or "other" option, while 75% of survey respondents self-described as male or female (52% as women, 23% as men), and 6% as unsure. On January 20, 2025, US president
Donald Trump Donald John Trump (born June 14, 1946) is an American politician, media personality, and businessman who is the 47th president of the United States. A member of the Republican Party (United States), Republican Party, he served as the 45 ...
signed
Executive Order 14168 Executive Order 14168, titled "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government", is an executive order issued by Donald Trump on January 20, 2025, the day of his second inauguration as pre ...
, entitled "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government". This executive order asserts that it is the policy of the United States that there are only two sexes, male and female, and that these sexes are immutable throughout a person's life, starting at conception. The executive order does not acknowledge the existence of, or make provision for, intersex people. According to intersex advocate Alicia Roth Weigel, this order "attempts to negate our very existence".


LGBT and LGBTI

Intersex conditions can be contrasted with
transgender A transgender (often shortened to trans) person has a gender identity different from that typically associated with the sex they were sex assignment, assigned at birth. The opposite of ''transgender'' is ''cisgender'', which describes perso ...
gender identities Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. In most individuals, the various biological determinants of sex are congruent and consistent with the i ...
and the attached
gender dysphoria Gender dysphoria (GD) is the distress a person experiences due to inconsistency between their gender identitytheir personal sense of their own genderand their sex assigned at birth. The term replaced the previous diagnostic label of gender i ...
a transgender person may feel, wherein their gender identity does not match their assigned sex. However, some people are both intersex and transgender; although intersex people by definition have variable sex characteristics that do not align with either typically male or female, this may be considered separate to an individual's assigned gender, the way they are raised and perceived, and their internal gender identity. A 2012 clinical review paper found that between 8.5% and 20% of people with intersex variations experienced gender dysphoria. In an analysis of the use of
preimplantation genetic diagnosis Preimplantation genetic diagnosis (PGD or PIGD) is the genetic profiling of embryos prior to implantation (as a form of embryo profiling), and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal ...
to eliminate intersex traits, Behrmann and Ravitsky state: "Parental choice against intersex may ... conceal biases against same-sex attractedness and gender nonconformity." The relationship of intersex people and communities to LGBTQ communities is complex, but intersex people are often added to the
LGBT LGBTQ people are individuals who are lesbian, gay, bisexual, transgender, queer, or questioning. Many variants of the initialism are used; LGBTQIA+ people incorporates intersex, asexual, aromantic, agender, and other individuals. The gro ...
acronym, resulting in the acronym LGBTI (or when also including
asexual Asexual or Asexuals may refer to: *Asexual reproduction **Asexual reproduction in starfish *Asexuality, the lack of sexual attraction to anyone or lack of interest in or desire for sexual activity. **Gray asexuality, the spectrum between asexualit ...
people, LGBTQIA+). Emi Koyama describes how inclusion of intersex in LGBTI can fail to address intersex-specific human rights issues, including creating false impressions "that intersex people's rights are protected" by laws protecting LGBT people, and failing to acknowledge that many intersex people are not LGBT.
Organisation Intersex International Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
states that some intersex individuals are homosexual, and some are heterosexual, but "LGBTI activism has fought for the rights of people who fall outside of expected binary sex and gender norms."
Julius Kaggwa Julius Kaggwa is a prominent Ugandan intersex and transgender activist and executive director of intersex support organization ''Support Initiative for People with atypical sex Development'' (SIPD). In 2010, Kaggwa was a joint winner of the Human ...
of SIPD Uganda has written that, while the gay community "offers us a place of relative safety, it is also oblivious to our specific needs".
Mauro Cabral Mauro Cabral Grinspan, also known as Mauro Cabral, is an Argentinian intersex and trans activist and researcher. He coordinates the project on intersex depathologization at InterAction for Health and Human Rights. Previously, he served as the Seni ...
has written that transgender people and organizations "need to stop approaching intersex issues as if they were trans issues", including use of intersex conditions and people as a means of explaining being transgender; "we can collaborate a lot with the intersex movement by making it clear how wrong that approach is."


In society


Fiction, literature and media

Heinlein's acclaimed 1959 "'—All You Zombies—'" is an early intersex science fiction story, based on
time-travel Time travel is the hypothetical activity of traveling into the past or future. Time travel is a concept in philosophy and fiction, particularly science fiction. In fiction, time travel is typically achieved through the use of a device known a ...
. An intersex character is the narrator in
Jeffrey Eugenides Jeffrey Kent Eugenides (born March 8, 1960) is an American author. He has written numerous short stories and essays, as well as three novels: '' The Virgin Suicides'' (1993), ''Middlesex'' (2002), and '' The Marriage Plot'' (2011). ''The Virgin Su ...
' Pulitzer Prize-winning novel ''
Middlesex Middlesex (; abbreviation: Middx) is a Historic counties of England, former county in South East England, now mainly within Greater London. Its boundaries largely followed three rivers: the River Thames, Thames in the south, the River Lea, Le ...
''. The memoir, ''Born Both: An Intersex Life'' (
Hachette Books Hachette Books, formerly Hyperion Books, is a general-interest book imprint of the Perseus Books Group, which is a division of Hachette (publisher), Hachette Book Group and ultimately a part of Lagardère Group. Established in 1990, Hachette pu ...
, 2017), by intersex author and activist
Hida Viloria Hida Viloria (born May 29, 1968) is an American writer, author, producer, and human rights activist of Latin American origin. Viloria is intersex, nonbinary, and genderfluid, using they/them pronouns. They are known for their writing, their int ...
, received strong praise from ''
The New York Times Book Review ''The New York Times Book Review'' (''NYTBR'') is a weekly paper-magazine supplement to the Sunday edition of ''The New York Times'' in which current non-fiction and fiction books are reviewed. It is one of the most influential and widely rea ...
'', ''
The Washington Post ''The Washington Post'', locally known as ''The'' ''Post'' and, informally, ''WaPo'' or ''WP'', is an American daily newspaper published in Washington, D.C., the national capital. It is the most widely circulated newspaper in the Washington m ...
'', ''
Rolling Stone ''Rolling Stone'' is an American monthly magazine that focuses on music, politics, and popular culture. It was founded in San Francisco, California, in 1967 by Jann Wenner and the music critic Ralph J. Gleason. The magazine was first known fo ...
'', ''
People Magazine ''People'' is an American weekly magazine that specializes in celebrity news and human-interest stories. It is published by Dotdash Meredith, a subsidiary of IAC (company), IAC. With a readership of 46.6 million adults in 2009, ''Peopl ...
'', and ''
Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. The publication began as a bimonthly magazine, which first appeared in 1967. The print magazine's reported circulation is 275,000 as of 2023. ...
'', was one of ''
School Library Journal ''School Library Journal'' (''SLJ'') is an American monthly magazine containing reviews and other articles for school librarians, media specialists, and public librarians who work with young people. Articles cover a wide variety of topics, wi ...
'' 2017 Top Ten Adult Books for Teens, and was a 2018
Lambda Literary Award Lambda Literary Awards, also known as the "Lammys", are awarded yearly by Lambda Literary Foundation, Lambda Literary to recognize the crucial role LGBTQ+ writers play in shaping the world. The Lammys celebrate the very best in LGBTQ+ literatur ...
nominee. Television works about intersex and
films about intersex Intersex, in humans and other animals, describes variations in sex characteristics including chromosomes, gonads, sex hormones, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary noti ...
are scarce. The Spanish-language film '' XXY'' won the Critics' Week grand prize at the 2007
Cannes Film Festival The Cannes Film Festival (; ), until 2003 called the International Film Festival ('), is the most prestigious film festival in the world. Held in Cannes, France, it previews new films of all genres, including documentaries, from all around ...
and the ACID/CCAS Support Award. '' Faking It'' is notable for providing both the first intersex main character in a television show, and television's first intersex character played by an intersex actor.


Civil society institutions

Intersex peer support and advocacy organizations have existed since at least 1985, with the establishment of the
Androgen Insensitivity Syndrome Support Group Australia Intersex Peer Support Australia (IPSA), also known as the Androgen Insensitivity Syndrome Support Group Australia, is possibly the oldest known intersex organization, established in 1985. It provides peer and family support, information and advo ...
in 1985. The Androgen Insensitivity Syndrome Support Group (UK) was established in 1988. The
Intersex Society of North America The Intersex Society of North America (ISNA) was a non-profit advocacy group founded in 1993 by Cheryl Chase (activist), Cheryl Chase to end shame, secrecy, and unnecessary genital surgeries on intersex people.Matthews, Karen (Oct 22, 2000). Debat ...
(ISNA) may have been one of the first intersex civil society organizations to have been open to people regardless of diagnosis; it was active from 1993 to 2008.


Events

Intersex Awareness Day Intersex Awareness Day is an internationally observed awareness day each October 26, designed to highlight human rights issues faced by intersex people. History The event marks the first public demonstration by intersex people in North America ...
is an internationally observed civil awareness day designed to highlight the challenges faced by intersex people, occurring annually on 26 October. It marks the first public demonstration by intersex people, which took place in Boston on 26 October 1996, outside a venue where the
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is the largest professional association of pediatricians in the United States. It is headquartered in Itasca, Illinois, and maintains an office in Washington, D.C. The AAP has published hundreds of poli ...
was holding its annual conference.
Intersex Day of Remembrance Intersex Day of Remembrance, also known as Intersex Solidarity Day, is an internationally observed civil awareness day designed to highlight issues faced by intersex people. It marks the birthday of Herculine Barbin, a French intersex person who ...
, also known as Intersex Solidarity Day, is an internationally observed civil awareness day designed to highlight issues faced by intersex people, occurring annually on 8 November. It marks the birthday of , a French intersex person whose memoirs were later published by
Michel Foucault Paul-Michel Foucault ( , ; ; 15 October 192625 June 1984) was a French History of ideas, historian of ideas and Philosophy, philosopher who was also an author, Literary criticism, literary critic, Activism, political activist, and teacher. Fo ...
in '' Herculine Barbin: Being the Recently Discovered Memoirs of a Nineteenth-century French Hermaphrodite.''


Flags and symbolism

File:Intersex Pride Flag.svg, The intersex flag created in July 2013 by
Morgan Carpenter Morgan Carpenter is a bioethicist, intersex activist and researcher. In 2013, he created an intersex flag, and became president of Intersex Human Rights Australia (formerly OII Australia). He is now executive director. Following enactment of l ...
of
Intersex Human Rights Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
File:Intersex-inclusive pride flag.svg, The
Progress Pride Flag The rainbow flag or pride flag (formerly gay pride flag) is a LGBT symbols, symbol of LGBT pride, LGBTQ pride and LGBTQ movements, LGBTQ social movements. The colors reflect the diversity of the LGBTQ community and the spectrum of human sexu ...
flag with the intersex flag, created in 2021 by Valentino Vecchietti of Intersex Equality Rights UK File:Cattleya lueddemanniana costera.JPG, upAn
orchid Orchids are plants that belong to the family Orchidaceae (), a diverse and widespread group of flowering plants with blooms that are often colourful and fragrant. Orchids are cosmopolitan plants that are found in almost every habitat on Eart ...
flower
The intersex flag was created in July 2013 by
Morgan Carpenter Morgan Carpenter is a bioethicist, intersex activist and researcher. In 2013, he created an intersex flag, and became president of Intersex Human Rights Australia (formerly OII Australia). He is now executive director. Following enactment of l ...
of
Intersex Human Rights Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
to create a flag "that is not derivative, but is yet firmly grounded in meaning". The circle is described as "unbroken and unornamented, symbolising wholeness and completeness, and our potentialities. We are still fighting for bodily autonomy and genital integrity, and this symbolises the right to be who and how we want to be."An intersex flag
,
Intersex Human Rights Australia Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...
, 5 July 2013
In 2021, Valentino Vecchietti of Intersex Equality Rights UK redesigned the
Progress Pride Flag The rainbow flag or pride flag (formerly gay pride flag) is a LGBT symbols, symbol of LGBT pride, LGBTQ pride and LGBTQ movements, LGBTQ social movements. The colors reflect the diversity of the LGBTQ community and the spectrum of human sexu ...
to incorporate the intersex flag. This design added a yellow triangle with a purple circle in it to the chevron of the Progress Pride flag. It also changed the color of green to a lighter shade without adding new symbolism. Intersex Equality Rights UK posted the new flag on Instagram and Twitter. Because the word "
orchid Orchids are plants that belong to the family Orchidaceae (), a diverse and widespread group of flowering plants with blooms that are often colourful and fragrant. Orchids are cosmopolitan plants that are found in almost every habitat on Eart ...
" comes from the Greek word for
testicle A testicle or testis ( testes) is the gonad in all male bilaterians, including humans, and is Homology (biology), homologous to the ovary in females. Its primary functions are the production of sperm and the secretion of Androgen, androgens, p ...
, and the
orchiectomy Orchiectomy (also named orchidectomy) is a surgery, surgical procedure in which one or both testicles are removed. The surgery can be performed for various reasons: *treatment for testicular cancer *as part of gender-affirming surgery for trans ...
is a common surgery performed on intersex infants, the orchid flower is a symbol of being intersex and of opposition to non-consensual genital surgery.


Religion

In
Judaism Judaism () is an Abrahamic religions, Abrahamic, Monotheism, monotheistic, ethnic religion that comprises the collective spiritual, cultural, and legal traditions of the Jews, Jewish people. Religious Jews regard Judaism as their means of o ...
, the
Talmud The Talmud (; ) is the central text of Rabbinic Judaism and the primary source of Jewish religious law (''halakha'') and Jewish theology. Until the advent of Haskalah#Effects, modernity, in nearly all Jewish communities, the Talmud was the cen ...
contains extensive discussion concerning the status of two types of intersex people in Jewish law; namely, the androgynous, who exhibit both male and female external sexual organs, and the , who exhibit neither. In the 1970s and 1980s, the treatment of intersex babies started to be discussed in Orthodox Jewish medical
halacha ''Halakha'' ( ; , ), also transliterated as ''halacha'', ''halakhah'', and ''halocho'' ( ), is the collective body of Jewish religious laws that are derived from the Written and Oral Torah. ''Halakha'' is based on biblical commandments ('' mi ...
by prominent rabbinic leaders, such as
Eliezer Waldenberg Eliezer Yehuda Waldenberg (; December 10, 1915 – November 21, 2006) was a rabbi, posek, and dayan in Jerusalem. He is known as a leading authority on medicine and Jewish law and referred to as the Tzitz Eliezer after his 21-volume halachic tre ...
and
Moshe Feinstein Moshe Feinstein (; Lithuanian pronunciation: ''Moishe Fainshtein''; ; March 3, 1895 – March 23, 1986) was a Russian-born American Orthodox Jewish rabbi, scholar, and ''posek'' (authority on ''halakha''—Jewish law). He has been called ...
.


Sport

Erik Schinegger Erik Schinegger (born 19 June 1948) is an Austrian intersexuality, intersex skier. He was the FIS Alpine World Ski Championships, women's downhill ski world champion in 1966, at which time he was recognized as female and known as Erika Schinegger. ...
,
Foekje Dillema Foekje Dillema (; 18 September 19265 December 2007) was a Dutch track and field athlete. She competed in Sprint (running), sprinting where she was a rival of Fanny Blankers-Koen. When she refused a Sex verification in sports, sex verification te ...
,
Maria José Martínez-Patiño Maria may refer to: People * Mary, mother of Jesus * Maria (given name), a popular given name in many languages Place names Extraterrestrial * 170 Maria, a Main belt S-type asteroid discovered in 1877 * Lunar maria (plural of ''mare''), large, ...
and Santhi Soundarajan were subject to adverse sex verification testing resulting in ineligibility to compete in organised competitive competition.
Stanisława Walasiewicz Stanisława Walasiewicz (3 April 1911 – 4 December 1980), also known as Stefania Walasiewicz, and Stella Walsh, was a Polish-American track and field athlete, who became a women's Olympic champion in the 100 metres. Born in Poland and raised ...
, an athlete diagnosed posthumously with
Turner syndrome Turner syndrome (TS), commonly known as 45,X, or 45,X0,Also written as 45,XO. is a chromosomal disorder in which cells of females have only one X chromosome instead of two, or are partially missing an X chromosome (sex chromosome monosomy) lea ...
was posthumously ruled ineligible to have competed. The South African middle-distance runner
Caster Semenya Caster Semenya Order of Ikhamanga, OIB (born 7 January 1991) is a South African middle-distance runner and winner of two Olympic medal, Olympic gold medals and three World Athletics Championships, World Championships in the women's 800 metres ...
won 3 World Championships gold medals and 2 Olympic gold medals in the women's 800 metres. When Semenya won gold at the 2009 World Championships, the
International Association of Athletics Federations World Athletics, formerly known as the International Amateur Athletic Federation and International Association of Athletics Federations and formerly abbreviated as the IAAF, is the international governing body for the sport of athletics, coverin ...
(IAAF) requested sex verification tests on the very same day. The results were not released, and Semenya was ruled eligible to compete. In 2019, new IAAF rules came into force for athletes like Semenya with certain disorders of sex development (DSDs) requiring medication to suppress testosterone levels in order to participate in 400m, 800m, and 1500m women's events. Semenya objected to undergoing the treatment which is now mandatory. She has filed a series of legal cases to restore her ability to compete in these events without testosterone suppression, arguing that the World Athletics rules are discriminatory. Katrina Karkazis,
Rebecca Jordan-Young Rebecca M. Jordan-Young (born 1963), is an American feminist scientist and gender studies scholar. Her research focuses on social medical science, sex, gender, sexuality, and epidemiology. She the Ann Whitney Olin Professor of Women’s, Gender, ...
, Georgiann Davis and Silvia Camporesi have claimed that IAAF policies on "hyperandrogenism" in female athletes are "significantly flawed", arguing that the policy does not protect against breaches of privacy, requires athletes to undergo unnecessary treatment in order to compete, and intensifies "gender policing", and recommended that athletes be able to compete in accordance with their legally-recognised gender. In April 2014, the ''
BMJ ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world' ...
'' reported that four elite women athletes with XY chromosomes and
5α-reductase 2 deficiency 5α-Reductase 2 deficiency (5αR2D) is an autosomal recessive condition caused by mutations impairing the function of ''SRD5A2'', a gene located on chromosome 2 and encoding the enzyme 5α-reductase type 2 (5αR2). 5αR2 is expressed in specific ...
were subjected to sterilization and "partial clitoridectomies" in order to compete in sport. The authors noted that partial clitoridectomy was "not medically indicated" and "does not relate to real or perceived athletic 'advantage'". Intersex advocates regarded this intervention as "a clearly coercive process". In 2016, the
United Nations Special Rapporteur Special rapporteur (or independent expert) is the title given to independent human rights experts whose expertise is called upon by the United Nations (UN) to report or advise on human rights from a thematic or country-specific perspective. De ...
on health, Dainius Pūras, criticized "current and historic" sex verification policies, describing how "a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial clitoridectomy (a form of
female genital mutilation Female genital mutilation (FGM) (also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision) is the cutting or removal of some or all of the vulva for non-medical reasons. Prevalence of female ge ...
) in the absence of symptoms or health issues warranting those procedures."


Biology

The notion of intersex individuals can be understood in the context of sexual system biology that varies across different types of organisms. Most animal species (~95%, including humans) are gonochoric, in which individuals are of either a female or male sex. Hermaphroditic species (some animals and most flowering plants) are represented by individuals that can express both sexes simultaneously or sequentially during their lifetimes. Intersex individuals in a number of gonochoric species, who express both female and male phenotypic characters to some degree, are known to exist at very low prevalences. Although "hermaphrodite" and "intersex" have been used synonymously in humans, a hermaphrodite is specifically an individual capable of producing female and male gametes. While there are reports of individuals that seemed to have the potential to produce both types of gamete, in more recent years the term hermaphrodite as applied to humans has fallen out of favor, since female and male reproductive functions have not been observed together in the same individual.


Medical

Research in the late 20th century led to a growing medical consensus that diverse intersex bodies are normal, but relatively rare, forms of human biology. Clinician and researcher
Milton Diamond Milton Diamond (March 6, 1934 – March 20, 2024) was an American professor of anatomy and reproductive biology at the University of Hawaiʻi at Mānoa. After a career in the study of human sexuality, Diamond retired from the university in Decem ...
stresses the importance of care in the selection of language related to intersex people:


Medical classifications


Sexual differentiation

The common pathway of
sexual differentiation Sexual differentiation is the process of development of the sex differences between males and females from an undifferentiated zygote. Sex differentiation is usually distinct from sex determination; sex determination is the designation of the de ...
, where a productive human female has an XX chromosome pair, and a productive male has an XY pair, is relevant to the development of intersex conditions. During fertilization, the sperm adds either an X (female) or a Y (male) chromosome to the X in the ovum. This determines the genetic sex of the embryo. During the first weeks of development, genetic male and female fetuses are "anatomically indistinguishable", with primitive gonads beginning to develop during approximately the sixth week of gestation. The gonads, in a bipotential state, may develop into either testes (the male gonads) or ovaries (the female gonads), depending on the consequent events. Up until and including the seventh week, genetically female and genetically male fetuses appear identical. At around eight weeks of gestation, the gonads of an XY embryo differentiate into functional testes, secreting testosterone. Ovarian differentiation, for XX embryos, does not occur until approximately week 12 of gestation. In typical female differentiation, the Müllerian duct system develops into the
uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...
,
fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (: salpinx), are paired tubular sex organs in the human female body that stretch from the ovaries to the uterus. The fallopian tubes are part of the female reproductive sy ...
, and inner third of the vagina. In males, the Müllerian duct-inhibiting hormone
AMH AMH may refer to: Geography *''Academia Mexicana de la Historia'', the national academy of history, in Mexico *Alaska Marine Highway, ferry services along the southern coast of Alaska and to Washington state *AMH, IATA airport code for Arba Minc ...
causes this duct system to regress. Next, androgens cause the development of the Wolffian duct system, which develops into the
vas deferens The vas deferens (: vasa deferentia), ductus deferens (: ductūs deferentes), or sperm duct is part of the male reproductive system of many vertebrates. In mammals, spermatozoa are produced in the seminiferous tubules and flow into the epididyma ...
, seminal vesicles, and ejaculatory ducts. By birth, the typical fetus has been completely sexed male or female, meaning that the genetic sex (XY-male or XX-female) corresponds with the phenotypical sex; that is to say, genetic sex corresponds with internal and external gonads, and external appearance of the genitals.


Signs

There are a variety of symptoms that can occur. Ambiguous genitalia is the most common sign. There can be
micropenis A micropenis or microphallus is an unusually small Human penis, penis. A common criterion is a dorsal (measured on top) Human penis size, penile length of at least 2.5 standard deviations smaller than the mean human penis size for age. A micr ...
,
clitoromegaly Clitoromegaly (or macroclitoris) is an abnormal enlargement of the clitoris that is mostly congenital; it is otherwise acquired through deliberately induced clitoral enlargement, a form of body modification, by use of anabolic steroids, in parti ...
, partial
labial fusion Labial fusion is a medical condition of the vulva where the labia minora become fused together. It is generally a pediatric condition. Presentation Labial fusion is rarely present at birth, but rather acquired later in infancy, since it is caused ...
, electrolyte abnormalities, delayed or absent puberty, unexpected changes at puberty, hypospadias, labial or inguinal (groin) masses (which may turn out to be testes) in girls and undescended testes (which may turn out to be ovaries) in boys.


Ambiguous genitalia

Ambiguous genitalia may appear as a large
clitoris In amniotes, the clitoris ( or ; : clitorises or clitorides) is a female sex organ. In humans, it is the vulva's most erogenous zone, erogenous area and generally the primary anatomical source of female Human sexuality, sexual pleasure. Th ...
or as a small
penis A penis (; : penises or penes) is a sex organ through which male and hermaphrodite animals expel semen during copulation (zoology), copulation, and through which male placental mammals and marsupials also Urination, urinate. The term ''pen ...
. Because there is variation in all of the processes of the development of the sex organs, a child can be born with a
sexual anatomy A sex organ, also known as a reproductive organ, is a part of an organism that is involved in sexual reproduction. Sex organs constitute the primary sex characteristics of an organism. Sex organs are responsible for producing and transporting ...
that is typically female or feminine in appearance with a larger-than-average
clitoris In amniotes, the clitoris ( or ; : clitorises or clitorides) is a female sex organ. In humans, it is the vulva's most erogenous zone, erogenous area and generally the primary anatomical source of female Human sexuality, sexual pleasure. Th ...
( clitoral hypertrophy) or typically male or masculine in appearance with a smaller-than-average penis that is open along the underside. The appearance may be quite ambiguous, describable as female genitals (a
vulva In mammals, the vulva (: vulvas or vulvae) comprises mostly external, visible structures of the female sex organ, genitalia leading into the interior of the female reproductive tract. For humans, it includes the mons pubis, labia majora, lab ...
) with a very large clitoris and partially fused labia, or as male genitals with a very small penis, completely open along the midline (" hypospadic"), and empty
scrotum In most terrestrial mammals, the scrotum (: scrotums or scrota; possibly from Latin ''scortum'', meaning "hide" or "skin") or scrotal sac is a part of the external male genitalia located at the base of the penis. It consists of a sac of skin ...
. Fertility is variable.


Measurement systems for ambiguous genitalia

The
orchidometer An orchidometer (or orchiometer) is a medical instrument used to measure the volume of the testicles. Instrument The orchidometer was introduced in 1966 by Swiss pediatric endocrinologist Andrea Prader of the University of Zurich. Page 16in: ...
is a medical instrument to measure the volume of the testicles. It was developed by Swiss pediatric endocrinologist Andrea Prader. The Prader scale and
Quigley scale The Quigley scale is a descriptive, visual system of phenotypic grading that defines seven classes between "fully masculinized" and "fully feminized" genitalia. It was proposed by pediatric endocrinologist Charmian A. Quigley et al. in 1995. It is ...
are visual rating systems that measure genital appearance. These measurement systems were satirized in the Phall-O-Meter, created by the (now defunct)
Intersex Society of North America The Intersex Society of North America (ISNA) was a non-profit advocacy group founded in 1993 by Cheryl Chase (activist), Cheryl Chase to end shame, secrecy, and unnecessary genital surgeries on intersex people.Matthews, Karen (Oct 22, 2000). Debat ...
.


Other signs

In order to help in classification, methods other than a genitalia inspection can be performed. For instance, a
karyotype A karyotype is the general appearance of the complete set of chromosomes in the cells of a species or in an individual organism, mainly including their sizes, numbers, and shapes. Karyotyping is the process by which a karyotype is discerned by de ...
display of a tissue sample may determine which of the causes of intersex is prevalent in the case. Additionally, electrolyte tests, endoscopic exam, ultrasound and hormone stimulation tests can be done.


Causes

Intersex can be divided into four categories which are: 46, XX intersex; 46, XY intersex; true gonadal intersex; and complex or undetermined intersex.


=46, XX intersex

= This condition used to be called "female
pseudohermaphroditism Pseudohermaphroditism is an outdated term for when an individual's gonads were mismatched with their internal reproductive system and/or external genitalia. The term was contrasted with "true hermaphroditism" (now known as ovotesticular syndrome), ...
". People with this condition have female internal genitalia and karyotype (XX) and various degree of external genitalia
virilization Virilization or masculinization is the biological development of adult male characteristics in young males or females. Most of the changes of virilization are produced by androgens. Virilization is a medical term commonly used in three medical a ...
. External genitalia is masculinized congenitally when female fetus is exposed to excess androgenic environment. Hence, the chromosome of the person is of a female, the ovaries of a female, but external genitals that appear like a male. The
labia The labia are the major externally visible structures of the vulva. In humans and other primates, there are two pairs of labia: the ''labia majora'' (outer lips) are large and thick folds of skin that cover the vulva's other parts, while the ''la ...
fuse, and the
clitoris In amniotes, the clitoris ( or ; : clitorises or clitorides) is a female sex organ. In humans, it is the vulva's most erogenous zone, erogenous area and generally the primary anatomical source of female Human sexuality, sexual pleasure. Th ...
enlarges to appear like a penis. The causes of this can be male hormones taken during pregnancy, congenital adrenal hyperplasia, male-hormone-producing tumors in the mother and aromatase deficiency.


=46, XY intersex

= This condition used to be called "male pseudohermaphroditism". This is defined as incomplete masculinization of the external genitalia. Thus, the person has male chromosomes, but the external genitals are incompletely formed, ambiguous, or clearly female. This condition is also called 46, XY with undervirilization. 46, XY intersex has many possible causes, which can be problems with the testes and testosterone formation. Also, there can be problems with using testosterone. Some people lack the enzyme needed to convert testosterone to
dihydrotestosterone Dihydrotestosterone (DHT, 5α-dihydrotestosterone, 5α-DHT, androstanolone or stanolone) is an endogenous androgen sex steroid and hormone primarily involved in the growth and repair of the prostate and the penis, as well as the production o ...
, which is a cause of 5-alpha-reductase deficiency.
Androgen insensitivity syndrome Androgen insensitivity syndrome (AIS) is a condition involving the inability to respond to androgens, typically due to androgen receptor dysfunction. It affects 1 in 20,000 to 64,000 XY (karyotype, karyotypically male) births. The condition result ...
is the most common cause of 46, XY intersex.


=True gonadal intersex

= This condition used to be called "
true hermaphroditism Ovotesticular syndrome (also known as ovotesticular disorder or OT-DSD) is a rare congenital condition where an individual is born with both ovarian and testicular tissue. It is one of the rarest disorders of sex development (DSDs), with only 50 ...
". This is defined as having asymmetrical gonads with ovarian and testicular differentiation on either sides separately or combined as ovotestis. In most cases, the cause of this condition is unknown.


=Complex or undetermined intersex

= This is the condition of having any chromosome configurations rather than 46, XX or 46, XY intersex. This condition does not result in an imbalance between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.


Conditions

There are a variety of opinions on what conditions or traits are and are not intersex, dependent on the definition of intersex that is used. Current human rights based definitions stress a broad diversity of sex characteristics that differ from expectations for male or female bodies. During 2015, the
Council of Europe The Council of Europe (CoE; , CdE) is an international organisation with the goal of upholding human rights, democracy and the Law in Europe, rule of law in Europe. Founded in 1949, it is Europe's oldest intergovernmental organisation, represe ...
, the
European Union Agency for Fundamental Rights The European Union Agency for Fundamental Rights, usually known in English as the Fundamental Rights Agency (FRA), is a Vienna-based agency of the European Union inaugurated on 1 March 2007. It was established by Council Regulation (EC) No 168/ ...
and
Inter-American Commission on Human Rights The Inter-American Commission on Human Rights (the IACHR or, in the three other official languages Spanish, French, and Portuguese language, Portuguese CIDH, ''Comisión Interamericana de los Derechos Humanos'', ''Commission Interaméricaine des ...
have called for a review of medical classifications on the basis that they presently impede enjoyment of the right to health; the Council of Europe expressed concern that "the gap between the expectations of human rights organisations of intersex people and the development of medical classifications has possibly widened over the past decade."


Medical interventions


Rationales

Medical interventions take place to address physical health concerns and psychosocial risks. Both types of rationale are the subject of debate, particularly as the consequences of surgical (and many hormonal) interventions are lifelong and irreversible. Questions regarding physical health include accurately assessing risk levels, necessity, and timing. Psychosocial rationales are particularly susceptible to questions of necessity as they reflect social and cultural concerns. There remains no clinical consensus about an evidence base, surgical timing, necessity, type of surgical intervention, and degree of difference warranting intervention. Such surgeries are the subject of significant contention due to consequences that include trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity. This includes community activism, and multiple reports by international human rights and health institutions and national ethics bodies. In the cases where gonads may pose a cancer risk, as in some cases of
androgen insensitivity syndrome Androgen insensitivity syndrome (AIS) is a condition involving the inability to respond to androgens, typically due to androgen receptor dysfunction. It affects 1 in 20,000 to 64,000 XY (karyotype, karyotypically male) births. The condition result ...
, concern has been expressed that treatment rationales and decision-making regarding cancer risk may encapsulate decisions around a desire for surgical "normalization".


Types

* Feminizing and masculinizing surgeries: Surgical procedures depend on the diagnosis, and there is often a concern as to whether surgery should be performed at all. Typically, surgery is performed shortly after birth. Defenders of the practice argue that individuals must be clearly identified as male or female for them to function socially and develop "normally". Psychosocial reasons are often stated. This is criticised by many human rights institutions, and authors. Unlike other aesthetic surgical procedures performed on infants, such as corrective surgery for a
cleft lip A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nasal cavi ...
, genital surgery may lead to negative consequences for sexual functioning in later life, or feelings of freakishness and unacceptability.Intersex Society of North America (24 May 2006)
What evidence is there that you can grow up psychologically healthy with intersex genitals (without "normalizing" surgeries)?
. Retrieved 25 November 2006.
*
Hormone treatment Hormone therapy or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also be referred to as hormonal therapy or antihormone therapy. The most general classes of hormone therapy are oncologic horm ...
: There is widespread evidence of prenatal testing and hormone treatment to prevent or eliminate intersex traits,Bioethics Forum blog – Preventing Homosexuality (and Uppity Women) in the Womb?
,
Alice Dreger Alice Domurat Dreger () is an American historian, bioethicist, author, and former professor of clinical medical humanities and bioethics at the Feinberg School of Medicine, Northwestern University, in Chicago, Illinois. Dreger engages in acade ...
, Ellen K. Feder,
Anne Tamar-Mattis Anne Tamar-Mattis is an American attorney, human rights advocate, and founder of interACT (formerly Advocates for Informed Choice). She currently serves as interACT's Legal Director. Career Tamar-Mattis spent six years as the Director of the N ...
(2010), at Hastings Center Bioethics Blog, retrieved 18 May 2012.
associated also with the problematization of sexual orientation and gender non-conformity. * Psychosocial support: All stakeholders support psychosocial support. A joint international statement by participants at the Third
International Intersex Forum The International Intersex Forum is an annual event organised, then later supported, by the International Lesbian, Gay, Bisexual, Trans and Intersex Association, ILGA and ILGA-Europe that and List of intersex organizations, organisations from mul ...
in 2013 sought, among other demands: "Recognition that medicalization and stigmatisation of intersex people result in significant trauma and mental health concerns. In view of ensuring the bodily integrity and well-being of intersex people, autonomous non-pathologising psycho-social and peer support be available to intersex people throughout their life (as self-required), as well as to parents and/or care providers." * Genetic selection and terminations: The ethics of
preimplantation genetic diagnosis Preimplantation genetic diagnosis (PGD or PIGD) is the genetic profiling of embryos prior to implantation (as a form of embryo profiling), and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal ...
to select against intersex traits was the subject of 11 papers in the October 2013 issue of the '' American Journal of Bioethics''. There is widespread evidence of pregnancy terminations arising from prenatal testing, as well as prenatal hormone treatment to prevent intersex traits. Behrmann and Ravitsky find social concepts of sex, gender and sexual orientation to be "intertwined on many levels. Parental choice against intersex may thus conceal biases against same-sex attractedness and gender nonconformity." * Medical display. Photographs of intersex children's genitalia are circulated in medical communities for documentary purposes, and individuals with intersex traits may be subjected to repeated genital examinations and display to medical teams. Problems associated with experiences of medical photography of intersex children have been discussed p. 72. along with their ethics, control and usage. "The experience of being photographed has exemplified for many people with intersex conditions the powerlessness and humiliation felt during medical investigations and interventions." p. 70. *
Gender dysphoria Gender dysphoria (GD) is the distress a person experiences due to inconsistency between their gender identitytheir personal sense of their own genderand their sex assigned at birth. The term replaced the previous diagnostic label of gender i ...
: The
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...
included a change from using gender identity disorder to gender dysphoria. This revised code now specifically includes intersex people who do not identify with their sex assigned at birth and experience clinically significant distress or impairment, using the language of
disorders of sex development Disorders of sex development (DSDs), also known as differences in sex development, variations in sex characteristics (VSC), sexual anomalies, or sexual abnormalities, are congenital conditions affecting the reproductive system, in which developme ...
.


See also

*
Intersex Awareness Day Intersex Awareness Day is an internationally observed awareness day each October 26, designed to highlight human rights issues faced by intersex people. History The event marks the first public demonstration by intersex people in North America ...
*
Intersex people and military service Military service of intersex people varies greatly by country. Some armed forces such as the Australian Defence Force fully embrace intersex people in the modern era, while others such as the United States Armed Forces have vague rules or polic ...
*
Sexual differentiation in humans Sexual differentiation in humans is the process of development of sex differences in humans. It is defined as the development of phenotypic structures consequent to the action of hormones produced following gonadal determination. Sexual differ ...
*
Intersex healthcare Intersex healthcare differs from the healthcare of non-intersex (often referred to as endosex) people. This due to stigma and potential health complications arising from their bodily variations. People with intersex variations, also called disord ...
*
Gynandromorphism Gynandromorphism is the phenomenon that occurs when an individual organism possesses both male and female phenotypes due to genetic chimera of sex chromosomes in cells across the body and is most easily recognized in species that display sex ...
*
Endosex An ''endosex'' person is someone whose innate sex characteristics fit normative medical ideas for female or male bodies. The word ''endosex'' is an antonym of ''intersex''. Etymology and meaning The prefix '' endo-'' comes from the Ancient Gre ...
*
True hermaphroditism Ovotesticular syndrome (also known as ovotesticular disorder or OT-DSD) is a rare congenital condition where an individual is born with both ovarian and testicular tissue. It is one of the rarest disorders of sex development (DSDs), with only 50 ...
*
Androgyny Androgyny is the possession of both masculine and feminine characteristics. Androgyny may be expressed with regard to Sex, biological sex or gender expression. When ''androgyny'' refers to mixed biological sex characteristics in humans, it oft ...
*
46,XX/46,XY 46,XX/46,XY is either a chimeric or mosaic genetic condition characterized by the presence of some cells that express a 46,XX karyotype and some cells that express a 46,XY karyotype in a single human being. Individuals with these conditions are c ...


Notes


References


Bibliography

* * * * * * * * * * * * * * * * * * * * * *


External links

* * {{Authority control Intersex topics Sex Medical controversies