Intersexual – news.lgbti.org

Differences of Sex Development & Intersexuality

Inarguably, the intersex community was not dealt an easy hand to play with. The secrecy, shame and social marginalization they deal with has built a kind of camaraderie that those who undergo sexual assignment surgery often face: guilt for leaving their comrades, PTSD and difficulty adjusting to their new life.

Today activists are trying to enlighten others while letting those with intersex traits and differences of sex development (DSD) know that there are people out there who are advocating for and supporting them. Activists like Jim Ambrose, Pidgeon Pagonis and Bo Laurent want them to know they are worthwhile individuals who deserve the same rights, respect and love as everyone else.

Co-founder of The Interface Project Jim Ambrose says of this, “It’s hard for people to wrap their head around what exactly is going on. It gets everywhere — it’s nothing but sprawl. It’s not limited to the bedroom.” The Interface Project is a website that collects personal anecdotes of those with DSD or intersex conditions. These conditions are not uncommon. According to the World Health Organization (WHO), one out of every 1,500 or 2,000 infants are born with a visible difference in sex organs. For instance, in cases where women have androgen insensitivity syndrome, they will have testes and an XY chromosome. Going as far back as the 50’s, doctors would often advise surgery on a baby born with analogous genitals. Girls were generally chosen as the surgical procedure is easier to perform.

Complications arose in later times with intersexuals as Doctors began to understand that although they had assigned a sex, many of those assigned to be girls actually felt more like boys. There were whole generations of DSD and intersex people growing up in the wrong bodies. Some felt estranged from their parents. Often they hid their genitals from romantic partners. Many were filled with shame, angst, guilt and repressed anger. Sadly, they had no one to turn to.

Today the DSD and intersex population is more accepted than ever before, but they still face strong obstacles. It is important for DSD and intersex people to come to terms with who they are and learn to love themselves. That said, it’s also critical to address the particular situation as early on and as honestly as possible. More education, outreach and anti-discrimination campaigns must be enacted to protect this often silent minority. They must learn their self-esteem is not relative to other’s opinions, rather their own so they may move towards a successful and joyous life.

Questions About Intersexaulity

1. What is intersexuality?

Intersexuality is a group of medical conditions that blur or make nonstandard the physical sex of the individual intersexual. They include Klinefelter’s Syndrome (XXY chromosomes), congenital adrenal hyperplasia, androgen insensitivity syndrome, and a host of other syndromes.

Some intersexuals are born with genitalia that are “ambiguous”, meaning not ccompletely male or female. Others are genitally normal at birth but develop mixed secondary sexual characteristics at puberty. Intersexuals used to be referred to as “hermaphrodites”, but we now prefer the term intersexual, as it does not have the connotations of being a mythical creature. That connotation has often led to our being dismissed in the mids of many people as not really existing. We do, however, exist; and it is time that people knew it.

2. How common is intersexuality?

Still being measured. About 1 in 2000 births (0.5%) have some sort of ambiguous genitalia, but there are other intersexuals who are not “caught” until puberty. According to Dr. Anne-Fausto sterling, data suggests that 1.7% of the population has some degree of intersexuality.

3. How are intersexuals treated by the medical establishment?

This is a subject of much debate in the intersexual community. The standard treatment of infants and children with intersexed genitalia is to surgically modify them into “normal-looking” babies as quickly as possible. However, such modifications not only leave the individual with little or no sexual sensation – and sometimes increased risk of urniary tract and other infections – they also have a less than desirable cosmetic appearance, leaving scars and other disfigurements due to the difficulty of operating on infant-size genitalia.

Also, some forms of follow-up care, such as frequent viewings by doctors and medical students, and the daily use of “stents” to dilate artificial vaginas in small children, would be considered sexual abuse if visited on a “normal” child. Many intersexuals have lasting sexual and emotional issues long into adulthood from such treatment.

There is also the issue that intersexuals do not always end up choosing to be the sex that their parents and pediatric surgeons decide that they will be. A sizeable number end up requesting sex reassignment as adults, which is generally more difficult for intersexuals to get than for standard transsexuals. Some would prefer to remain as they originally had or would have developed and not choose either one sex or the other. Many of us are are against any surgical mutilation of infants and believe that such “corrections” should be made at the age of legal consent, when the individual can choose their own options.

4. How should the TG community deal with intersexuals?

Intersexuals have in many cases had a rough time within the TG community, and this has led to many of them being wary of working with transgenderfolk. Hoping to build a firmer bridge between these two communities, many members of which overlap, I list here some of the major complaints that intersexuals have had:

(1) Please don’t express envy directed at those of us who had “SRS” in childhood. The overwhelming majority of intersexuals that I know who had childhood surgery are unhappy with their situation. Remember, this was done without consent and usually not as well as the average adult SRS. Many mutilated intersexuals have a host of medical problems and sexual dysfunctions as a side effect of what was done. Besides, just because you might want it doesn’t mean it is good for everyone. (A corollary to this is not telling us how “lucky” we are if we at least “pass” as the gender you’d like to pass for.)

(2) Please don’t hit on intersexuals who come to conferences, support groups, or other events. We’ve often had to navigate between two separate and equally annoying responses to our bodies: disgust and fetishism. We tend to be pretty wary of anyone who seems to be treating us like an “exotic experience” or objectifying us. As an example, the operator of a web page for intersexuals had to remove her phone number (available for suicidal intersexuals to call and talk) from the page because she was bombarded with calls asking how to obtain sex with intersexuals. Make friends with an intersexual first; don’t approach and ask for dates straight up, as you may be regarded with suspicion.

(3) Don’t “colonize” the intersex political struggle. Although there are many overlapping issues between TG and IS concerns (as well as many overlapping individuals) it is not in the IS movement’s best interest to be completely drowned in the TG agenda. Solidarity is good, but appropriation is not. Showing up and standing with us when we speak or demonstrate is fine and appreciated, but let the IS folks be the spokespeople.

5. What can I do to help?

You can talk to people you know who are planning to have children and make them aware of the situation. Most doctors are able to bully uninformed parents into accepting surgery on their children by using misinformation. Make them aware of what is and is not true about such a potential child. If you know people who are pediatricians or surgeons, speak out against nonconsensual genital surgery to them.

2004, American Boyz @amboyz.org

What is Intersex?

Not all people come into the world as boys or girls. Little is known about intersex people and some sketchy information is circulating. Moreover, such information is not scarce.

Intersexual individuals have bodily sex characteristics that cannot be classified as merely masculine or feminine. These are defined as variations of inborn bodily sex characteristics and include, for example, genitals, hormone production or chromosome sequencing, body contours, hair distribution or muscle ratio.

Intersex may become visible at or after birth.

What is the number of intersex people?

There are no official statistics on the ratio of intersex people to the total population. Scientific estimates range from 0.02 percent to 1.7 percent, depending on how many types of intersex are considered. This means that approximately every 60th child born is likely to be intersex.

In any case, there are more intersex people than it seems. Because many people do not reveal that they are intersex in order to protect themselves from discrimination. Often times, even individuals themselves do not know that they are intersex.

Is intersex a third gender?

No. Intersex people have very different bodily gender characteristics like other people. Gender identities also vary from person to person: they may describe themselves as feminine, masculine, non-binary, and / or intersex.

Is intersexuality a disease?

No, however, rare strains of intersex may be associated with certain health risks. Apart from that, intersex people are as sick or healthy as other people.

However, there are medical diagnoses for different types of intersex. These are grouped together under the heading “Disorders of Sex Development” (DSD, ie gender development disorders). Many intersex people reject defining their sexuality as “syndrome” or “disorder”. Because of these definitions, there is an impression that their bodies are defective and should be treated.

Intersexual organizations still and frequently today complain that these individuals are still and frequently complain about having surgery or receiving medication in infancy or childhood in order to make intersex people sexually “clear”. Such interventions are often without health obligation and with prior notification. It is carried out without a consent. These irreversible interventions require additional treatment for life and significantly limit the quality of life of intersex people. International human rights organizations characterize this as a violation of the rights to physical immunity and sexual self-determination.

Two-spirit People Of Indigenous North Americans

Many Native American indigenous cultures have traditionally held intersex, androgynous people, feminine males, and masculine females in high respect. The most common term to define such persons today is to refer to them as Two Spirit people, but in the past feminine males were sometimes referred to as “berdache” by early French explorers in North America, who adapted a Persian word “bardaj,” meaning a close intimate male friend. Because these androgynous males were commonly married to a masculine man, or had sex with men, and the masculine females had feminine women as wives, the term berdache had a clear homosexual connotation. Both the Spaniards in Latin America and the English colonists in North America condemned them as “sodomites.”

Rather than emphasizing the homosexual orientation of these persons, however, many Native American cultures focused on the spiritual gifts of such persons. American Indian traditionalists, even today, tend to see a person’s basic character as a reflection of their spirit. Since everything that exists is thought to come from the spirit world, androgynous or transgender persons are seen as doubly blessed, having both the spirit of a man and the spirit of a woman. Thus, they are honored for having two spirits, and are seen as more spiritually gifted than the typical masculine male or feminine female.

From this religious perspective, androgynous or transgendered persons are honored as sacred. Therefore, many Native American religions, rather than stigmatizing such persons, often looked to them as religious leaders and teachers. Because researchers are so dependent upon the written sources of early European explorers, it is difficult to say with certainty exactly how widespread were these traditions of respect. Quite similar religious traditions existed among the native peoples of Siberia and many other parts of Asia. Since the ancestors of Native Americans migrated from Siberia over 15,000 years ago, and since reports of highly respected Two Spirit androgynous persons have been reported among indigenous Americans from Alaska in the north to Chile in the south, androgyny seems to be quite ancient among humans.

Though some anthropologists have equated Two Spirit people with transsexuality, there was no tradition of Native Americans castrating Two Spirit males. Rather than attempting to change the physical body, Native Americans emphasized a person’s “spirit,” or character, as being most important. Instead of seeing Two Spirit persons as transsexuals who try to make themselves into “the opposite sex”, it is more accurate to understand them as unique individuals who take on a gender status that is different from both men and women. This alternative gender status offers a range of possibilities, from only-slightly effeminate males or masculine females, to androgynous or transgender persons, to those who completely cross-dress and act as the other gender. The emphasis of Native Americans is not to force every person into one box, but to allow for the reality of diversity in gender and sexual identities.

Because so many eastern North American cultures were so quickly overwhelmed by the European invasion, there is not much evidence of Two Spirit traditions in those societies. But the little evidence that does exist suggests that, especially before they converted to Christianity, these eastern Indians also respected Two Spirit people. Most of the evidence for respectful Two Spirit traditions is focused on the native peoples of the Plains, the Great Lakes, the Southwest, and California. With over a thousand vastly different cultural and linguistic backgrounds, it is important not to overgeneralize for the indigenous peoples of North America. Some documentary sources suggest that a minority of societies treated Two Spirit persons disrespectfully, by kidding them or discouraging children from taking on a Two Spirit role. However, many of the documents which report negative reactions are themselves suspect, and should be evaluated critically in light of the preponderance of evidence that suggests a respectful attitude. Some European commentators, from early frontier explorers to modern anthropologists, also were influenced by their own homophobic prejudices to distort Native attitudes.

Two Spirit people were respected by native societies not only due to religious attitudes, but also because of practical concerns. Because their gender roles involved a mixture of both masculine and feminine traits, Two Spirit persons could do both the work of men and of women. They were often considered to be hard workers and artistically gifted craftspersons, of great value to their extended families and community. Among some groups, such as the Navajo, a family was believed to be economically benefited by having a “nadleh” (literally translated as “one who is transformed”) androgynous person as a relative. Two Spirit persons assisted their siblings’ children and took care of elderly relatives, and often served as adoptive parents for homeless children.

A feminine male who preferred to do women’s work (gathering wild plants or farming domestic plants) was logically expected to marry a masculine male, who did men’s work (hunting and warfare). Because a family needed both plant foods and meat, a masculine female hunter, in turn, usually married a feminine female, to provide these complementary gender roles for economic survival. The gender-conforming spouse of Two Spirit people did not see themselves as “homosexual” or as anything other than “normal.”

In the twentieth century, as homophobic European Christian influences increased among many Native Americans, respect for same-sex love and for androgynous persons greatly declined. Two Spirit people were often forced, either by government officials, Christian missionaries or their own community, to conform to standard gender roles. Some, who could not conform, either went underground or committed suicide. With the imposition of Euroamerican marriage laws, the same-sex marriages of Two Spirit people and their spouses were no longer legally recognized. But with the revitalization of Native American “Red Power” cultural pride in the 1960s and 1970s, and the rise of gay and lesbian liberation movements at the same time, a new respect for androgyny started slowly reemerging among Indian people.

Because of this tradition of respect, in the 1990s many gay and lesbian Native American activists in the United States and Canada rejected the French word berdache in favor of the term “Two Spirit People” to describe themselves. Many non-Indians have incorporated knowledge of Native American Two Spirit traditions into their increasing acceptance of same-sex love, androgyny and transgender diversity. Native American same-sex marriages have been used as a model for legalizing same-sex marriages in the new millennium, and the spiritual gifts of androgynous persons have started to become more recognized.

by Walter L. Williams
Professor of Anthropology and Gender Studies
University of Southern California

References:

Paula Gunn Allen. The Sacred Hoop: Recovering the Feminine in American Indian Traditions. Boston: Beacon Press, 1986.
Sue-Ellen Jacobs, Wesley Thomas, and Sabine Lang, editors. Two-Spirit People: Native American Gender Identity, Sexuality, and Spirituality. Urbana: University of Illinois Press, 1997.
Jonathan Katz. Gay American History. New York: Crowell, 1976.
Sabine Lang. Men as Women, Women as Men: Changing Gender in Native American Cultures. Austin: University of Texas Press, 1998.
Will Roscoe, editor. Living the Spirit: A Gay American Indian Anthology. New York: St. Martin’s Press, 1988.
Will Roscoe. The Zuni Man-Woman. Albuquerque: University of New Mexico Press, 1991.
Will Roscoe, The Changed Ones
Walter L. Williams. The Spirit and the Flesh: Sexual Diversity in American Indian Culture. Boston: Beacon Press, 1986 and 1992.
Walter L. Williams and Toby Johnson. Two Spirits: A Story of Life with the Navajo. Lethe Press, 2006.

transgender.org – 2011

Intersex Conditions

According to Prof. John Money, who has carried out extensive work within the field of gender identity, as many as four per cent of people are born with neither a clear male nor a clear female identity. This would mean around two and a quarter million people in Britain may be living with some form of intersex condition. Of these, many may suffer no discomfort or distress, they may not even be aware that medically they are classified as intersex. For others the condition produces profound symptoms at many levels.

Diagnosis of intersex is based mainly on physical observation, where biological and structural differences within the body are seen to vary from the accepted model for male or female. This is in contrast to transsexualism, which largely concerns brain sex because the brain perceives the individual’s gender identity to be the opposite of their physical appearance. At birth the first classification of a new human being is usually ‘boy’ or ‘girl’ according to the genitals. There are in fact four ways of recognising a baby’s sex, these are: genetic sex, biological sex according to internal organs, biological sex according to external sex organs, and brain sex. Where there is no obvious abnormality of the external sex organs the baby will be registered accordingly and its social conditioning into the relevant gender role immediately begins. In a small percentage of people, however, the external genitals may be ambiguous at birth, so no clear assessment of male or female is possible, or hidden conditions may come to light in the course of the child’s development.

The sex of a baby is established early in pregnancy and depends on which chromosome pair exists within the developing foetus. A foetus bearing an XY chromosome pair develops as male while the XX chromosome pair will develop a female. It is the Y chromosome that stimulates development of male testes and regression of female ovaries, and where this Y chromosome is absent the female system continues to develop unimpeded. However, other chromosome combinations are possible, leading to development which may produce an intersex state to a greater or lesser degree. The most commonly seen are Turner’s Syndrome (XO), Klinefelter’s Syndrome (XXY or XXXY) and combinations such as XXX (super female) or XYY (super male). Wherever there is a Y in the combination it is likely the foetus will develop along male lines, although exposure to hormones is also a crucial factor in sex development. Over or under exposure in the womb to male or female hormones may lead to a physical appearance at birth which does not match the chromosomal make up and/or brain identity. When considering the extremely complex cocktail of factors which must combine correctly to produce a clear and undisputed identity of male or female, it becomes easier to understand how the balance may be disturbed during foetal development producing intersex conditions. Gender dysphoria, the sense of dissatisfaction experienced when brain and body identity do not match, can begin in early childhood, while for some intersex children the confusion does not begin until their condition starts to reveal itself at puberty. It can be alarming for a boy to suddenly begin developing breasts, or for a girl to find testes descend from her body or a beard growing on her face. Nor is society always kind to such children. Family, friends and even the medical profession may fail them, leading to unhappy and sometimes tragic consequences.

Hermaphroditism and Intersexuality

Cases of a true hermaphrodite, someone with both sets of genitals formed and functioning, are considered to be extremely rare. Because both male and female genitalia develop from a common source, it would not be possible for an individual to have two ovaries and two testes, but it may be possible for one ovary and one testicle to develop. More common would be a case where both male and female genitalia are present but one or both are not fully formed. Such a case may be referred to as intersex, as the two terms are frequently synonymous. The genitals may resemble those of a female with a large clitoris and the labia fused together, or they may look more like those of a male with a small penis and empty scrotum. Severe cases may be obvious at birth where the baby is said to have ambiguous genitalia and surgery may be carried out so that the child can be assigned to either the male or female gender. In some cases the child is not told about this and there are stories of people who suffer extreme distress on discovering the truth in later life. Even where surgery has created a passable exterior presentation, function may be limited with ‘girls’ failing to menstruate or become fertile and ‘boys’ unable to produce an erection or father children. It may only be when the person visits the doctor for investigation into problems such as these that the underlying condition comes light. Where surgery is carried out soon after birth, it is too early to recognise the brain sex of the individual. Further problems may arise later in life if the child has been assigned one sex but proves to have the gender identity of the opposite sex, they may experience degrees of gender dysphoria similar to that found in transsexuality, alternatively, they may be happy with their sex or rearing but dissatisfied because their physical body does not conform to accepted norms of being completely male or female.

Klinefelter’s Syndrome

In these cases the chromosome mosaic is XXY or XXXY. A baby will often be classified as male at birth, and there may be no unusual signs until puberty. It is believed to be present in about 1 in 1000 male births, but there are wide variations in intensity of symptoms and degree of ambiguity. Men with Klinefelter’s may have small testes, or they may be normal in size but produce lower than average qualities of testosterone. At puberty therefore strong secondary male characteristics may fail to develop, some boys will develop breasts, and in some cases there may be a distinct hermaphrodite structure with womb and ovaries. Most Klinefelter’s people will show common distinguishing features to a greater or lesser degree. These include being tall, a tendency to obesity, rounded shoulders, soft skin and face, a soft voice, no adams apple and possibly breasts. There may be low testosterone production and some oestrogen production as well. Individuals may suffer from some mental retardation or could show super intelligence. Depending on the degree of symptoms, and the presence and intensity of gender dysphoria or social discomfort, the Klinefelter’s person may choose medical treatment, including surgery, to identify more fully with one gender role, or may develop a dual gender lifestyle.

Turner’s Syndrome

In these cases the chromosome mosaic is X, with the second X missing and children are usually classified as female. It is believed to affect around 1 in 10,000 girl births. The external genitalia usually appear normal and the brain sex is female, but the ovaries do not develop leading to infertility and low hormone production. There is a strong possibility of mental retardation.

Testicular Feminisation

Some babies who are genetically male with an XY chromosome while in the womb do not produce male hormones, especially testosterone, in sufficient quantities to develop male external sex organs. Alternatively they may produce testosterone but it is not recognised by the body and so does not trigger off such development. This condition is believed to occur in 1 in 50,000 births. Because of the female appearance at birth they are likely to be registered and raised as female, only when they fail to menstruate at puberty might their true genetic makeup be discovered. Although legally female, a ‘girl’ with this syndrome may develop secondary male characteristics such as a deep voice.

Congenital Adrenal Hyperplasia

These are genetically female with an XX chromosome but the adrenal glands produce large amounts of hormones similar to testosterone. It is believed to occur in around 1 in 80,000 births. At birth the genitalia may appear male or ambiguous, although the person usually possesses ovaries. There may also be metabolic imbalances, and this may lead to early diagnosis of the condition.

Androgen Insensitivity Syndrome

This condition can occur spontaneously, but is usually an inherited genetic condition that tends to run in families. The AIS person has the male XY chromosome and produces hormones which inhibit development of interior female organs such as uterus and cervix. However due to failure to respond to testosterone the baby does not develop male genitals and at birth will appear female. Although they may develop breasts at puberty the vagina is small or absent and they do not menstruate. They are also unlikely to develop much body hair. Where the syndrome is diagnosed, undescended testes may be surgically removed due to risk of cancer, and vaginoplasty can be performed in some cases to lengthen the vagina.

There are two types of AIS: most (90%) of girls have external genitals that are completely female (but with no internal female organs) and this is known as Complete AIS (CAIS, technically AIS Grades 7 & 6). The remaining girls have Partial AIS (PAIS), their outward genital appearance may lie anywhere from almost completely female (AIS Grade 5) through to almost completely male (Grade 3).

In partial AIS the person may have the appearance of normal male genitalia but be infertile However most PAIS and all CAIS babies are reared as female for the following reasons: they will be infertile as males; they will have a female type puberty; they will not be able to function sexually as a man but they will be able to do so as a woman. However, there are cases where some PAIS persons raised as boys change over to being female in later life. (see the AIS group website as listed below).

Cloecal Extrophy

This is an extremely rare genetic disorder where it is impossible to determine the sex of the baby at birth. There may be no sign of any sex organs, or only small and undeveloped parts, the person will be unable to have children and may need to take hormone supplements throughout their life. Surgery may be carried out to assist the person to live a normal life. This condition was highlighted in the UK in the case of Joella who was initially registered as male but at 16 months was reassigned as female following surgery. Joella’s mother fought a highly publicised battle to change her child’s birth certificate.

Hypospadias

This condition is found in males where the penis is not formed correctly. The urethra does not run to the tip of the penis but exits along the underside. The degree of displacement can vary, and the condition is usually corrected with surgery in uncomplicated cases. Hypospadias may be present in certain intersex conditions or may be the only abnormality present.

Gender Trust – 2003, This information sheet is distributed by the Gender Trust and is intended as a basis for information only. The Gender Trust does not accept responsibility for the accuracy of any information contained in this sheet.

Intersex and Gender Identity

There is a growing tendency to assume that all the varieties of phenotype (apparent physical sex), gender identification and sexual orientation are all merely different shades in one large rainbow. It is becoming increasingly common to hear people lump together transsexual, intersexual, transgender, gay and lesbian in the one sentence with the implication that all these issues share a common history or have common interests.

In many respects it is reminiscent of the attempts in Britain in the 80s to create a “Broad Democratic Alliance” of oppressed people consisting of left-wing and liberal political activists, women, gay people, ethnic minorities, disabled people and those who were unemployed, homeless and otherwise socially-disadvantaged. This was based on the presumption that, as all were victims of economic and social discrimination, there could be constructed a shared platform from which they could combine to resist the policies of the somewhat right-wing UK Government of the time.

It was unsuccessful for several reasons: it presumed that the experiences of discrimination by these diverse groups were similar in substance; it presumed that these groups all shared a common opposition to the Government; it presumed that the interests of those groups in ending discrimination could result in them all speaking with one voice, under one leadership; it ignored the diversity of views and experiences not just between but within each of these groups and presumed that each was homogeneous.

The presumed commonality turned out to be illusory. The reality was that each group held radically different views of who “the real enemy” was, not just from other groups, but from other views within their own groups. For example, Asian men did not on the whole regard lesbians as natural allies against discrimination, Sikhs did not perceive their interests as coincidental with those of Muslims or Hindus, Conservative women did not take kindly to alliance with left-wing men, Afro-Caribbean women regarded themselves as doubly oppressed, as black and as women, and so on. All these contradictions carried an in-built guarantee of failure and the alliance never got off the ground, except in the minds of its proponents.

The lesson is clear – the idea that discrimination and oppression indicate commonality of interests among those oppressed is wishful thinking. While collaboration and co-operation may be possible where interests coincide, attempts at coalition are unlikely to be successful.

There is a similar set of contradictions facing those who would try to combine the various interests of those within the intersex, transsexual, transgendered and gay communities.

Yes, there are many areas of overlap. There are gay trans people, there are intersex people who are also trans, there are crossdressers who are gay etc. But these do not imply natural alliances.

As one who is intersexed but also has a history of involvement in the trans community, let me talk about my own experience for a moment.

I was born physically intersexed and was medically assigned as male. If you like, I transitioned at an early age, without my consent. Like many intersexed people, neither I nor my parents were given any information regarding my condition or treatment (“trust us, we’re doctors, this is all for the best, you wouldn’t understand the big words we use”), I was one of those who slipped through the net of follow-up medical care and only uncovered the truth in later life, slowly and painfully, after a lifetime of confusion and conflict and undiagnosed health difficulties as I refused to go anywhere near anyone in a white coat for several decades.

I had never heard of “intersexed”, had never heard of “Congenital Adrenal Hyperplasia”, had no idea of the fact that I was living with several potentially serious endocrine malfunctions or that the whole secrecy surrounding my condition left my health in a very exposed and dangerous position.

I had been assigned as male – but I was not, I was intersex. But that is not an option in our society. There are only two possible classifications of sex, “male” or “female”, and the doctors in those days, pre-Money, before it became routine to surgically modify people like me to “female”, decided they could make “a man” of me. Nobody ever asked me what I was.

After many, many years of social ineptitude and blundering through life, I reached the point where I could no longer continue trying to live in the very restrictive social role assigned to me through medical intervention and I rebelled. There were only two possible options open and it was patently obvious that I did not fit the box marked “male”, so therefore I must belong in the other box, that marked “female”.

I could not understand why I was the way I was and I had no language with which to express what was inside me. So I began to search and finally came across the word “transsexual”. This concept seemed to offer an explanation and so I sought out the trans community and realised that transition of gender roles was a possibility. I then began to seek medical treatment in order to transition and the recovery of the truth of my history began.

And, as I learned more about my self, a fundamental difference between people like me and those in transition who were “trans” began to surface. I was transitioning out of a role assigned to me, most trans people seemed to be similarly transitioning out of but they were also transitioning into. Equally valid but with different objectives.

The majority of trans people I know have the desire for confirmation of gender in one of the two categories accepted by society, which is why they transition, i.e., to express a definite gender identity, male or female, different from the one usually indicated by their current phenotype. The major topics of discussion within the trans support spaces are concerned with such confirmation and, in my opinion, it is entirely a legitimate objective and one which I have worked hard to support.

However, given the choice of “male”, “female”, “intersex”, I would unhesitatingly select “intersex” – but society does not give me that option so I select “female”. I do so with deep reservations, gritting my teeth at a society which will not accept my right to simply be who I am.

I do not know many trans people who would experience such a conflict; there may well be, but I have never heard any express it. Most trans people I know identify themselves absolutely comfortably within one or other of the specified classes. And they have my full blessing in so doing. My life would have been a lot less problematic had I been able to do so as well.

Yes, I regard myself as a woman – but I am an intersex woman … there is a multi-faceted complexity to my sense of self which the two labels imposed by society cannot embrace. My desire was not to transition into female – it was to transition out of male. Period.

To use experiences such as mine as evidence of commonality between “intersex” and “trans” is erroneous. My experience is not typical of intersex people – but neither is it typical of trans people. My conflict is not an internal dichotomy between gender identity and physiology – it is between the integrity of my being and the consequences of medical intervention. The conflict is an artificially created one. Had I been left alone and raised as I was at birth, there would have been no conflict and my identity would have been secure.

Because the question of gender identity is such a fundamental element in trans experience, many trans people have difficulty in understanding that gender identity is usually not quite such a big deal to most intersexed people. It is only a minority who feel a need to transition, usually those who have been surgically or hormonally coerced into a role to which they have serious difficulty conforming. For example, while there are those who are also trans, most people with XXY chromosomes (“Klinefelter’s Syndrome”) usually quite happily identify as men, most people with Turner’s Syndrome or complete AIS usually identify quite happily as women and so on. The need to transition is nothing like a common experience for all intersex people. But it is the defining experience for all trans people.

This fact causes fundamentally different views between trans and intersex people on many issues.

One example – when it comes to views of medical reassignment of “gender”, the interest is very different. In general, trans people seek medical intervention to assist them in physically becoming who they really are while (again, in general) those intersex people affected by medical reassignment seek the abandoning of medical intervention because it makes us physically other than who we really are.

Another example – for most trans people, the question of birth certificate correction is a very serious and basic human rights issue; for most intersex people it is a complete non-issue.

It is the frequent overlooking of this basic existential difference between the experiences of trans people and intersex people which gives rise to the caution and suspicion amongst intersex people which greet attempts by members of the trans community to broker the idea of commonality of interests between the two communities.

It is not my purpose here to discuss the “trans is a subset of intersex” argument. The debate on this has a long way to go before it is resolved and there is still no definitive aetiology of transsexualism.

For those intersex people who find themselves with a need to transition there are many areas of experience which are shared with trans people and which can create areas of co-operation, provided both are aware that there also many areas where our experiences are different and that they make construction of a common agenda problematic.

The solution to that is to listen.

Experience suggests that intersex people already know pretty much where the line needs to be drawn, trans people less so. So it is important for trans people who wish to co-operate in areas of common interest with intersex people, where such exist, to learn as much as they can about us, about the medical priorities which are sometimes essential for life-preservation, about the very distinct natures of the various intersex conditions and therefore about the special interests of each group, about the instinctive resistance to outside influence and about our overriding need for each of us to speak for ourselves in our own voices.

We are people whose very lives have been affected by outside interference and by others, especially the medical community, presuming to speak on our behalf. Therefore, in general, we are distrustful of those who wrongly presume that their experiences are similar to ours. We tend to view suggestions of alliances built on this basis as invasive and attempting to appropriate our experiences for agendas other than our own. And we are particularly suspicious of those who imagine that our various histories can be reduced to a matter of gender identity.

I would suggest that there are actually fewer areas of common interest than most trans people suppose there are. This is not to say that such do not exist but they are usually those areas involving intersex people who are also in transition. The clear distinction should be acknowledged and respected.

A personal viewpoint by Mairi MacDonald
UK Intersex Association, ukia.co.uk/voices/is_gi.htm – 2000