Intersex
Intersex people are those born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical binar ...
people are born with
sex characteristics (such as
genitals,
gonads
A gonad, sex gland, or reproductive gland is a 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 gonad, the testicle, ...
, and
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) that "do not fit the typical definitions for
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 ...
or
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 ...
bodies".
They are substantially more likely to identify as
lesbian
A lesbian is a homosexual woman or girl. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate nouns with female homosexu ...
,
gay,
bisexual
Bisexuality is romantic attraction, sexual attraction, or sexual behavior toward both males and females. It may also be defined as the attraction to more than one gender, to people of both the same and different gender, or the attraction t ...
, or
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 ...
(
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 ...
) than
endosex people. According to a study done in Australia of Australian citizens with intersex conditions, participants labeled 'heterosexual' as the most popular single label (selected at 48%) with the rest being scattered among various other labels. According to another study, an estimated 8.5% to 20% experiencing
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 ...
. Although many intersex people are
heterosexual and
cisgender
The word ''cisgender'' (often shortened to ''cis''; sometimes ''cissexual'') describes a person whose gender identity corresponds to their sex assigned at birth, i.e., someone who is not ''transgender''. The prefix '' cis-'' is Latin and ...
, and not all of them identify as LGBTQ+,
this overlap and "shared experiences of harm arising from dominant societal sex and gender norms" has led to intersex people often being included under the LGBT umbrella, with the acronym sometimes expanded to LGBTI.
Some intersex activists and
organisations have criticised this inclusion as distracting from
intersex-specific issues such as
involuntary medical interventions.
Intersex and homosexuality
Intersex can be contrasted with ''
homosexuality
Homosexuality is romantic attraction, sexual attraction, or Human sexual activity, sexual behavior between people of the same sex or gender. As a sexual orientation, homosexuality is "an enduring pattern of emotional, romantic, and/or sexu ...
'' or ''same-sex attraction''. Numerous studies have shown higher rates of same sex attraction in intersex people,
with a recent
Australian study of people born with atypical sex characteristics finding that, while 48% labeled themselves as straight, 52% of respondents labeled themselves as various other categories besides heterosexual.
Clinical research on intersex subjects has been used to investigate means of preventing homosexuality.
In 1990,
Heino Meyer-Bahlburg wrote on a "prenatal hormone theory of sexual orientation." The author discussed research finding higher rates of same sex attraction among women with congenital adrenal hyperplasia, and consistent sexual attraction to men among women with complete androgen insensitivity syndrome - a population described by the author as "genetic males." Meyer-Bahlburg also discussed sexual attraction by individuals with
partial androgen insensitivity syndrome,
5α-Reductase deficiency and
17β-Hydroxysteroid dehydrogenase III deficiency, stating that sexual attraction towards females in individuals with these conditions was facilitated by "prenatal exposure to and utilization of androgens."
He concluded:
In 2010, Saroj Nimkarn and
Maria New wrote that, "Gender-related behaviors, namely childhood play, peer association, career and leisure time preferences in adolescence and adulthood, maternalism, aggression, and sexual orientation become" masculinized in women with
congenital adrenal hyperplasia
Congenital adrenal hyperplasia (CAH) is a group of Genetic disorder#Autosomal recessive, autosomal recessive disorders characterized by impaired cortisol synthesis. It results from the deficiency of one of the five enzymes required for the Biosy ...
.
Medical intervention to prevent such traits has been likened by
Dreger, Feder and
Tamar-Mattis to a means of preventing homosexuality and "uppity women."
A poll sampled from primarily LGBTQ intersex youth in the US by
The Trevor Project found that 55% identified as
bisexual
Bisexuality is romantic attraction, sexual attraction, or sexual behavior toward both males and females. It may also be defined as the attraction to more than one gender, to people of both the same and different gender, or the attraction t ...
/
pansexual, 28%
gay/
lesbian
A lesbian is a homosexual woman or girl. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate nouns with female homosexu ...
, 12%
queer
''Queer'' is an umbrella term for people who are non-heterosexual or non- cisgender. Originally meaning or , ''queer'' came to be used pejoratively against LGBTQ people in the late 19th century. From the late 1980s, queer activists began to ...
, 2%
straight and 3%
questioning.
Queer bodies
Intersex activists and scholars such as
Morgan Holmes,
Katrina Karkazis and
Morgan Carpenter have identified heteronormativity in medical rationales for medical interventions on infants and children with intersex characteristics.
Holmes and Carpenter have sometimes talked of intersex bodies as "queer bodies",
while Carpenter also stresses inadequacies and "dangerous" consequences from framing intersex as a sexual orientation or gender identity issue.
In ''What Can Queer Theory Do for Intersex?''
Iain Morland contrasts queer "hedonic activism" with an experience of insensate post-surgical intersex bodies to claim that "queerness is characterized by the sensory interrelation of pleasure and shame."
Intersex and transgender
Intersex can also 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 ...
'',
which describes the condition in which one's
gender identity
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 in ...
does not match one's assigned sex.
Some people are both intersex and transgender. A 2012 clinical review paper reported that between 8.5% and 20% of people with intersex variations experienced
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 report by
The Trevor Project on polling intersex youth in the US found that 42% identified as
cisgender
The word ''cisgender'' (often shortened to ''cis''; sometimes ''cissexual'') describes a person whose gender identity corresponds to their sex assigned at birth, i.e., someone who is not ''transgender''. The prefix '' cis-'' is Latin and ...
, 32%
non-binary
Non-binary or genderqueer Gender identity, gender identities are those that are outside the male/female gender binary. Non-binary identities often fall under the transgender umbrella since non-binary people typically identify with a gende ...
, 17%
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 ...
, and 9%
questioning, the poll sampled primarily LGBTQ youth.
The rate of being transgender/non-binary in the overall US youth population is 5%.
Non-binary gender
Recognition of third sex or gender classifications occurs in several countries.
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 52% are women, 23% men, and 6% unsure.
A
German law requiring that infants which can be
assigned to neither sex have their status left blank on their birth certificate was criticised by intersex rights groups on the basis that it could encourage parents who see a neutral option as undesirable to have their child undergo genital surgery. In 2013, the third
International Intersex Forum made statements for the first time on sex and gender registration in the
Malta declaration, advocating for "register
ngintersex children as females or males, with the awareness that, like all people, they may grow up to identify with a different
sex or gender" and "ensur
ngthat sex or gender classifications are amendable through a simple administrative procedure at the request of the individuals concerned." It also advocates for non-binary options and self-identification for all while calling for an end to registering sex on birth certificates.
Alex MacFarlane is believed to be the first person in
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 ...
to obtain a birth certificate recording sex as indeterminate, and the first Australian passport with an 'X' sex marker in 2003.
["Neither man nor woman"](_blank)
, Sydney Morning Herald. 27 June 2010 On September 26, 2016,
California
California () is a U.S. state, state in the Western United States that lies on the West Coast of the United States, Pacific Coast. It borders Oregon to the north, Nevada and Arizona to the east, and shares Mexico–United States border, an ...
resident Sara Kelly Keenan became the second person in the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
(after
Elisa Rae Shupe) to legally change their gender to 'non-binary'. Keenan cited Shupe's case as inspiration for their petition, "It never occurred to me that this was an option, because I thought the gender change laws were strictly for transgender people. I decided to try and use the same framework to have 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 ...
." Keenan later obtained a birth certificate with an
intersex
Intersex people are those born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical binar ...
sex marker. In press reporting of this decision, it became apparent that Ohio had issued a 'hermaphrodite' sex marker in 2012.
Intersex scholar
Morgan Holmes argues that thinking of societies that incorporate a 'third sex' as superior is overly simplistic, and that "to understand whether a system is more or less oppressive than another we have to understand how it treats its various members, not only its 'thirds'."
The
Asia Pacific Forum of National Human Rights Institutions states that the legal recognition of intersex people is firstly about access to the same rights as other men and women, when assigned male or female; secondly it is about access to administrative corrections to legal documents when an original
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 ...
is not appropriate; and thirdly it is not about the creation of a third sex or gender classification for intersex people as a population but it is, instead, about
self-determination
Self-determination refers to a people's right to form its own political entity, and internal self-determination is the right to representative government with full suffrage.
Self-determination is a cardinal principle in modern international la ...
.
LGBT and LGBTI
The relationship of intersex to lesbian, gay, bisexual and trans, and queer communities is complex,
but intersex people are often added to
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 ...
to create an LGBTI community.
A 2019 background note by the
has stated that intersex persons are a distinct population with concerns about "representation, misrepresentation and resourcing", but who share "common concerns" with LGBT people "due to shared experiences of harm arising from dominant societal sex and gender norms." The paper identifies both how intersex people can suffer human rights violations "before they are able to develop or freely express and identity" and how "stereotypes, fear and stigmatization of LGBT people provide rationales for forced and coercive medical interventions on children with intersex variations."
Julius Kaggwa 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 has written that
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 ...
people and organizations "need to stop approaching intersex issues as if they were trans issues" including use of intersex 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."
Pidgeon Pagonis states that adding an I to LGBTQA may or may not help increase representation, and may increase funding opportunities for intersex organizations, but may also be harmful to intersex children due to stigma associated with being LGBTQA.
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 same sex attracted, and some are heterosexual, but "LGBTI activism has fought for the rights of people who fall outside of expected binary sex and gender norms."
On July 1, 2020, Russian intersex organizations (Interseks.ru, ARSI, NFP+,
Intersex Russia) issued a statement on the use of LGBTI abbreviation urging not to use it in and about countries with widespread prejudice and violence in attitudes of individuals based on their sexual orientation and gender identity.
Protecting intersex people in law
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.
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 ...
protects intersex people from discrimination as part of a prohibition of discrimination on grounds of sex. Organisation Intersex International Australia successfully lobbied for inclusion of a legal attribute of "intersex status" in anti-discrimination law, stating that protection on grounds of
sexual orientation
Sexual orientation is an enduring personal pattern of romantic attraction or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender. Patterns ar ...
and
gender identity
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 in ...
was insufficient.
Following 2015 legislation in
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 ...
,
an attribute of
sex characteristics is now more widespread.
"Pinkwashing"

Multiple organizations have highlighted appeals to LGBT rights recognition that fail to address the issue of unnecessary "normalising"
intersex medical interventions on intersex children, including by using the portmanteau ''
pinkwashing''. In a 2001 paper for the (now defunct)
Intersex Society of North America, Emi Koyama and Lisa Weasel stating that teaching of intersex issues is "stuck" at talking about intersex as a mean instead of an end:
In June 2016, Organisation Intersex International Australia pointed to contradictory statements by
Australian governments, suggesting that the dignity and rights of LGBT and intersex people are recognized while, at the same time, harmful practices on intersex children continue.
In August 2016,
Zwischengeschlecht described actions to promote equality or civil status legislation without action on banning "intersex genital mutilations" as a form of
pinkwashing. The organization has previously highlighted evasive government statements to UN Treaty Bodies that conflate intersex, transgender and LGBT issues, instead of addressing harmful practices on infants.
Terms
LGBT+ is an
initialism
An acronym is a type of abbreviation consisting of a phrase whose only pronounced elements are the initial letters or initial sounds of words inside that phrase. Acronyms are often spelled with the initial letter of each word in all caps wi ...
that stands for
lesbian
A lesbian is a homosexual woman or girl. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate nouns with female homosexu ...
,
gay,
bisexual
Bisexuality is romantic attraction, sexual attraction, or sexual behavior toward both males and females. It may also be defined as the attraction to more than one gender, to people of both the same and different gender, or the attraction t ...
, and
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 ...
, and others. The initialism has become mainstream as a self-designation; it has been adopted by the majority of
sexuality and gender identity-based community centers and media in the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, as well as many other countries.
Another variant is ''LGBTQIA'', which is used, for example, by the "Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual Resource Center" at the
University of California, Davis
The University of California, Davis (UC Davis, UCD, or Davis) is a Public university, public Land-grant university, land-grant research university in Davis, California, United States. It is the northernmost of the ten campuses of the University ...
.
The United States
National Institutes of Health
The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in 1887 and is part of the United States Department of Health and Human Service ...
(NIH) have framed LGBT, others "whose sexual orientation and/or gender identity varies, those who may not self-identify as LGBT" and also intersex populations (as persons with
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 ...
) as "sexual and gender minority" (SGM) populations. This has led to the development of an NIH SGM Health Research Strategic Plan.
The concept of
queer
''Queer'' is an umbrella term for people who are non-heterosexual or non- cisgender. Originally meaning or , ''queer'' came to be used pejoratively against LGBTQ people in the late 19th century. From the late 1980s, queer activists began to ...
can also be included to form the initialisms ''LGBTIQ''
and (in Spanish).
Other intersectionalities
Intersex and children's rights
Kimberly Zieselman of
interACT has described how the LGBT community has helped open doors, but how intersex rights are broader: "at its core this is a children's rights issue. It is also about health and reproductive rights, because these operations can lead to infertility."
Intersex and disability
Multiple authors and civil society organizations highlight intersectionalities between intersex people and disability, due to issues of medicalization, and the use of
preimplantation genetic diagnosis.
In an analysis of the use of preimplantation genetic diagnosis to eliminate intersex traits, Behrmann and Ravitsky state: "Parental choice against intersex may ... conceal biases against same-sex attractedness and gender nonconformity."
A 2006 clinical reframing of intersex conditions as
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 ...
made associations between intersex and disability explicit,
but the rhetorical shift remains deeply contentious.
Sociological research in Australia, published in 2016, found that 3% of respondents used the term "disorders of sex development" or "DSD" to define their sex characteristics, while 21% use the term when accessing medical services. In contrast, 60% used the term "intersex" in some form to self-describe their sex characteristics.
In the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, intersex persons are protected by the
Americans with Disabilities Act.
In 2013, the
Australian Senate
The Senate is the upper house of the Bicameralism, bicameral Parliament of Australia, the lower house being the Australian House of Representatives, House of Representatives.
The powers, role and composition of the Senate are set out in Chap ...
published a report on the ''Involuntary or coerced sterilisation of intersex people in Australia'' as part of a broader inquiry into the involuntary or coercive sterilization of people with disabilities.
In Europe,
OII Europe has identified multiple articles of the UN
Convention on the Rights of Persons with Disabilities
The Convention on the Rights of Persons with Disabilities is an international human rights instrument, international human rights multilateral treaty, treaty of the United Nations intended to protect the rights and dignity of persons with Disabil ...
, including on equality and non-discrimination, and freedom from torture, and protecting the integrity of the person. Nevertheless, the organization has expressed concern that framings of intersex as disability can reinforce medicalization and lack of human rights, and do not match self-identification.
Notes
References
{{LGBTQ
Intersex topics in society
Intersex rights
LGBTQ