Health

Medical Provisions for People Born as Intersex

Intersex is a condition where there is a discrepancy between the external genitals and the internal genitals (the testes and ovaries – chromosomes).

The older term for this condition is hermaphroditism. Although the older terms are still included in this article for reference, they have been replaced by most experts, patients, and families. Increasingly, this group of conditions is being called disorders of sex development (DSDs).

Causes

Intersex can be divided into 4 categories:

  • XX intersex
  • XY intersex
  • True gonadal intersex
  • Complex or undetermined intersex

XX Intersex

The person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This most often is the result of a female fetus having been exposed to excess male hormones before birth.

The labia (“lips” or folds of skin of the external female genitals) fuse and the clitoris enlarges to appear like a penis. In most cases, this person has a normal uterus and fallopian tubes. This condition is also called 46, XX with virilization. It used to be called female pseudohermaphroditism.

XY Intersex

The person has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female. Internally, testes may be normal, malformed, or absent. This condition is also called 46, XY with undervirilization. It used to be called male pseudohermaphroditism.

The formation of normal male external genitals depends on the appropriate balance between male and female hormones. Therefore, it requires the adequate production and function of male hormones.

True Gonadal Intersex

The person must have both ovarian and testicular tissue. This may be in the same gonad (an ovotestis), or the person might have 1 ovary and 1 testis. The person may have XX chromosomes, XY chromosomes, or both. The external genitals may be ambiguous or may appear to be female or male. This condition used to be called true hermaphroditism.

In most people with true gonadal intersex, the underlying cause is unknown, although in some animal studies it has been linked to exposure to common agricultural pesticides.

Complex or Undetermined Intersex Disorders of Sexual Development

Many chromosome configurations other than simple 46, XX or 46, XY can result in disorders of sex development. These include 45, XO (only one X chromosome), and 47, XXY, 47, XXX – both cases have an extra sex chromosome, either an X or a Y.

These disorders do not result in a condition where there is a discrepancy between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes. (Source: MedlinePlus)

Most intersex people are not born with atypical genitalia; however, this is common for certain intersex variations. In these cases, a decision is made about what sex the child should be raised as shortly after birth.

Intersex advocacy groups believe intersex children should be raised as either male or female, but that surgeries to remove physical ambiguities should not occur until the child can provide informed consent.

Intersex is not about sexual orientation, gender identity or being gender diverse. Intersex people have the same range of sexual orientations and gender identities as non-intersex people.

Many intersex people identify with the sex they were raised and are heterosexual. Others identify with the sex they were raised and are attracted to people of the same sex or are bisexual. Some intersex people reject the sex they were assigned at birth and identify as the opposite sex, as gender diverse or as neither male nor female.

Read also: To Our Fathers!

People with intersex variations experience a range of issues. In childhood, issues range from access to medical treatment, disclosure of clinical treatments made in infancy, lack of counseling and support for parents, and genetic counseling.

Issues for adult intersex people relate to living with earlier non-consensual medical treatment, being infertile, disclosing their intersex status to partners, having relationships, and physical conditions connected with their specific intersex variation.

The term intersex is widely used in some contexts however, some people with intersex variations do not describe themselves as being intersex and object to the term, preferring instead to use the name of the medical condition relating to their sex characteristic variation. It is important to respect each individual’s choice of the descriptor. (Source: health.vic)

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