Intersex (DSD*)

A medical definition of intersexuality which is applied to human beings is "conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female". Applying this precise definition, the true prevalence of intersex is seen to be about 0.018%
Differences of Sexual Development

What is Intersex. Netflix Pilot with Katie Couric
"I'm Half Girl And Half Boy" | Secret Intersex Part 1 |
Growing Up As A Man And A Woman | Secret Intersex Part 2
Living With Two Vaginas
Girl Is Born With No
Private Parts. Rare Condition One in 5,000
Male, Female and Intersex in the Image of God
Intersex Christians and the Image of God
What the Bible says about homosexuality
Intersex People and the Physics of Judgment
What I’ve learned from having balls
Intersex is Awesome | Kristina Turner & Ori Turner
Between Genders: Exploring Intersex
Born Intersex: we are human! |
A different kind of superpower: what it means to be intersex
Bodies beyond sex – what being intersex taught me about the world
. 3:25
. 14:57
. 24:07
. 53:06
What It's Like
To Be Intersex
What I’ve learned from having balls.
Living as an Intersex Person
How do Intersex people navigate life and the medical system?
The Gender Spectrum
. 16:51
. 13:39
. 28:55
. 42:44
. 54:555
Intersex Realities and the Church: The Unwelcomed, Unwanted Neighbour
Science Proves There
are More than Two
Human Sexes
My Life Being Intersex | Interesting & SeXY : Blume - Episode 1
Answering Intersex FAQ's | Interesting & SeXY : Blume - Episode 2
MIMI: Intersex Activist | Interesting & SeXY :
Blume - Episode 3
Neither Male or Female - Secret Intersex (Gender & Sex Documentary)
Living in a body between female and male | Orchids – My Intersex Adventure
Living as an Intersex Person
Neither He, Nor She, But Me | Hannah Fons
I was born 'Male' but I'm not Trans |
Episode 1
Answering Intersex FAQ's | Interesting & SeXY : Episode 2

What is intersex?


Key Issues Facing People With Intersex Traits
Malta Becomes First Country to Ban Intersex Genital Cutting - Chili Second, Germany next.
California Could Be First State to Ban Non-Consensual Surgeries on Intersex Babies (And NYC too)
Intersex rights in the United States - Wikipedia (Note: On August 28, 2018, California became the first U.S. State to condemn nonconsensual surgeries on intersex children, in Resolution SCR-110.[58][59])
What to Know About Having a Baby Who Is Intersex
What Intersex is not
The prevalence of intersex depends on which definition is used
“I Want to Be Like Nature Made Me” Medically Unnecessary Surgeries on Intersex Children in the US July 25, 2017 - 160 page PDF

Tennis Controversy: Female Player (with Male Past)
Going beyond X and Y (Scientific American)
Statistics of intersex frequency
Notable intersex people
Parents sue South Carolina for surgically making child female
Assigned to be a girl, but identifying as a boy
Intersex and Christian Theology

The Heartbreak Of Not Having A Vagina
YouTube Star Reveals She Has Two Vaginas
Woman Born With No Vagina Hopes To Have Children
The Heartache Of Having Two Vaginas

Talking About Transgender People & Restrooms - A 13 page PDF
Images and Charts: One | Two | Three | Four | Five

LGBT & Gender Non-Conforming (GNC) Girls Face in the CriminL Justicer System
Bisexuality in America
Transgender in America


What is intersex?

Technically, intersex is defined as "congenital anomaly of the reproductive and sexual system." Intersex people are born with external genitalia, internal reproductive organs, and/or endocrine system that are different from most other people. About 1 in 1,500 to one in 2,000 babies are born visibly intersexed. But a lot more people than that are born with subtler forms of sex anatomy variations, some of which won’t show up until later in life.

Just one of hundreds of varients.

The current medical protocol calls for the surgical "reconstruction" of these different but healthy bodies to make them "normal," but this practice has become increasingly controversial as adults who went through the treatment report being physically, emotionally, and sexually harmed by such procedures. There is no single "intersex body"; it encompasses a wide variety of conditions that do not have anything in common except that they are deemed "abnormal" by the society. What makes intersex people similar is their experiences of medicalization, not biology. Intersex is not an identity. While some intersex people do reclaim it as part of their identity, it is not a freely chosen category of gender--it can only be reclaimed. Most intersex people identify as men or women, just like everybody

Are intersex people "third gender"?

Many people with intersex conditions identify solidly as a man or as a woman, like many non-intersex people. There are some who identify as a member of an alternative gender, like some non-intersex people. While we support everyone's right to define her or his own identities, we do not believe that people with intersex conditions should be expected to be gender-transgressive just because of their condition.

What is the difference between "hermaphrodite" and "intersex"?

In biology, "hermaphrodite" means an organism that has both "male" and "female" sets of reproductive organs (like snails and earthworms). In humans, there are no actual "hermaphrodites" in this sense, although doctors have called people with intersex conditions "hermaphrodites" because intersex bodies do not neatly comform to what doctors define as the "normal" male or female bodies. We find the word "hermaphrodite" misleading, mythologizing, and stigmatizing. Although some intersex activists do reclaim and use this term to describe themselves, it is not an appropriate term to refer to intersex people in general. In short, snails are the hermaphrodites; humans are not. Also, please avoid using the word "intersexual" as a noun; we prefer "intersex people" or "people with intersex conditions/experiences."

Are intersex conditions harmful?
In general, intersex conditions do not cause the person to feel sick or in pain. However, some intersex conditions are associated with serious health issues, which need to be treated medically. Surgically "correcting" the appearance of intersex genitals will not change these underlying medical needs.

Can't they just do a test to find out babies' true sex?
Medicine cannot determine the baby's "true sex." For example, chromosomes do not necessarily dictate one's gender identity, as it is obvious from the fact that most people born with androgen insensitivity syndrome live as women despite their XY chromosomes. In other words: science can measure how large a clitoris is, but cannot conclude how large or small it needs to be. That is a social determination.

Beside stopping cosmetic genital surgeries, what are intersex activists working toward?
Surgery is just part of a larger pattern of how intersex children are treated; it is also important to stop shame, secrecy and isolation that are socially and medically imposed on children born with intersex conditions under the theory that the child is better off it they didn't hear anything about it. Therefore, it's not enough to simply stop the surgery; we need to replace it with social and psychological support as well as open and honest communication.

What is the correct pronoun for intersex people?
Pronouns should not be based on the shape of one's genitalia, but on what the person prefers to be called. For children too young to communicate what her/his preference is, go with the gender assignment parents and doctor agreed on based on their best prediction. Do not call intersex children "it," because it is dehumanizing.

Is intersex part of the trans community?
While some people with intersex conditions also identify as trans, intersex people as a group have a unique set of needs and priorities beyond those shared with trans people. Too often, these unique needs are made invisible or secondary when "intersex" becomes a subcategory of "transgender". For example, people who discuss about intersex in the context of transgender often stress the risk of assigning a "wrong" gender as an argument against intersex genital mutilation, which overlooks the fact that intersex medical treatment is painful and traumatic whether or not one's gender identity happens to match her or his assigned gender. It is for this reason that intersex people prefer to have "intersex" spelled out explicitly rather than have it included in the "transgender" umbrella.

The prevalence of intersex depends on which definition is used.
According to the ISNA definition above, 1 percent of live births exhibit some degree of sexual ambiguity, approximately one in every hundred births. Between 0.1% and 0.2% of live births are ambiguous enough to become the subject of specialist medical attention, including surgery to disguise their sexual ambiguity.

What's so significant about October 26?
On October 26, 1996, intersex activists from Intersex Society of North America (carrying the sign "Hermaphrodites With Attitude") and our allies from Transexual Menace held the first public intersex demonstration in Boston, where American Academy of Pediatrics was holding its annual conference. The action generated a lot of press coverage, and made it difficult for the medical community to continue to neglect our growing movement. That said, events related to
Intersex Awareness Day can take place throughout October and does not necessarily have to be on the 26th.

It's great! How can I help?
First, join our
email discussion list (we suggest the digest format if you want to keep the number of emails you receive under control). Then, look at our Get Involved section to see if there is already any IAD events scheduled for your area. If so, go and help them; if not, find a local organization that will sponsor the event--for example, try LGBT group in your city or college campus--and help them bring IAD to your city! We have "suggestions" for what activities to do, but what you will do is entirely up to you and your neighbors (and please tell us if you think of any great idea!) E-Mail

What Intersex is not

Intersex” is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female or male.

It is not "Hermanphroditism," as this is a complete set of female and male reproductive organs, which is impossible in humans.

It is not "transgender" or "transsexual," as gender identity and sex are not the same things, just like gender identity and sexual orientation are not the same.

It is not a disease or health prolem, nor does it cause diseases or health problems.



Historically, the term hermaphrodite has also been used to describe ambiguous genitalia and gonadal mosaicism in individuals of gonochoristic species, especially human beings. The word intersex has come into preferred usage for humans, since the word hermaphrodite is considered to be misleading and stigmatizing,[4][5] as well as "scientifically specious and clinically problematic".[6]

4 Dreger, Alice Domurat (1999). Intersex in the age of ethics (Ethics in Clinical Medicine Series ed.). Hagerstown, Md.: Univ. Publ. Group. ISBN 978-1555721008.

5.Jump up ^ "Is a person who is intersex a hermaphrodite?". Intersex Society of North America. Retrieved 2 October 2011.

6. Jump up ^ Herndon, April. "Getting Rid of "Hermaphroditism" Once and For All". Intersex Society of North America. Retrieved 2 October 2011.


The Heartbreak Of Not Having A Vagina

A young woman born without a vagina hopes to have a life-changing surgery that would allow her to have sex with her boyfriend and, in her own words, "feel like a woman.” Kaylee Moats, 22, from Gilbert, Arizona, was born with Mayer Rokitansky Küster Hauser syndrome (MRKH), which means she has no cervix, uterus, or vaginal opening.


YouTube Star Reveals She Has Two Vaginas

YOUTUBE star Cassandra Bankson was amazed to discover that she has TWO vaginas during a routine kidney scan. Cassandra has been afflicted by severe acne since she was a teenager and even had to leave school because the bullying got so bad. But the 22-year-old – who also works as an international fashion model - shocked her fans last year when she announced the discovery of her second vagina on her channel DiamondsAndHeels14.


Woman Born With No Vagina Hopes To Have Children

A young woman who was born without a vagina is speaking out about her condition – and is now hoping to become a mother. Devan Merck was devastated after finding out she had no vagina when she was just 12-years-old. The 23-year-old was diagnosed with Mayer-Rokitansky-Küster-Hauser syndrome meaning she had no vaginal canal, a malformed uterus and no cervix. Surgeons created a ‘man-made’ vagina using skin taken from her bottom - allowing her to have sex and lead a normal life. And now Devan and her husband Trent, from Georgia, USA, are hoping to start a family with the help of a surrogate.

The Heartache Of Having Two Vaginas

A Young nurse was shocked to discover her constant pelvic pain was due to her having two vaginas. Nicci Triefenbach, 32, found out that her vaginal cavity was split in two – and that she had two uteruses, two cervix and two vaginal canals.The rare condition, called uterus didelphus, affects just one per cent of women and left Nicci, from St Louis, Missouri, feeling like a ‘circus freak’.


Malta Becomes First Country to Ban Intersex Genital Cutting

This is a landmark case for intersex rights within European law reform

On the 1st of April 2015 a historic reform is taking place within the Maltese law code. With the Gender Identity, Gender Expression And Sex Characteristics Act, historic steps are being taken to bring forth an end to non-medically necessary, cosmetic genital surgeries on intersex infants driven by social expectations enforced by the binary sex model. A key factor of the new law pertaining to protection for intersex individuals can be found in article 15.1-15.2.

“15. (1) It shall be not be lawful for medical practitioners or other professionals to conduct any sex assignment treatment and, or surgical intervention on the sex characteristics of a minor which treatment and, or intervention can be deferred until the person to be treated can provide informed consent.

(2) In exceptional circumstances treatment may be effected once there is an agreement between the Interdisciplinary Team and the persons exercising parental authority or tutor of the minor who is still unable to provide consent: Provided that medical intervention which is driven by social factors without the consent of the individual concerned will be in violation of this Act.”

By making these procedures unlawful until the individual can provide informed consent Malta is taking vital steps to ensure that the individual’s primary rights to self- determination, bodily integrity and personal dignity are respected. For the first time in history intersex individuals will no longer be forced to endure arbitrary surgical sex assignment based on sociological factor´s. The past has seen national, theoretical and personal attitudes towards gender, surgical limitations and best guesses guide the process of gender assignment, of intersex infants worldwide, with dire sociological consequences and a lifetime of physical health complications for many following socially driven surgical intervention. With research showing that parental decision making is influenced greatly by information provided, no adverse effects of non-surgical intervention being found, poor surgical outcomes and satisfaction rates and almost no real research substantiating surgical intervention this timely law reform is finally acknowledging that purely social factors are being used as the basis for surgical interventions.

Malta´s express acknowledgement of the social factors driving the surgical intervention of intersex infant´s sex characteristic´s is to be applauded as a first, worldwide, in affording intersex infant´s protection from so called reparative therapies. However while leading the way in this form of reform Malta must careful to take great care to ensure that social attitudes towards atypical sex characteristics do not lead interventions aimed at “fixing” or “repairing” a child, thus flouting this law and discriminating against individuals on the basis of their sex characteristics not being found socially acceptable.

Simultaneously the new bill addressed gender identity and expression extensively and we are pleased that our Trans friends and allies are afforded greater protection, dignity and guaranteed a life of self-determination by the adoption of the reform found within the bill.

OII-Europe emphatically urges the governments of other nations, along with the European Parliament and other law making entities to look towards the Malta law reform and adopt similar reform within their own countries and areas, ending decades of abusive reparative and gender confirming surgical intervention, taking place worldwide.


OII Europe (Organisation Intersex International Europe) is the umbrella organisation of European human rights based intersex organisations. OII Europe was founded on Human Rights Day, 10 December, during the Second Intersex Forum at Stockholm in 2012.

OII Europe is an autonomous affiliate of OII (Organisation Internationale des Intersexués), a decentralised global network of intersex organisations, which was founded in 2003 and has operated since then through its national groups in every region of the world.
Source: Press Release

Tennis Controversy: Female Player (with Male Past)

Who does a person born with both male and female sex organs, but who identifies as one gender, compete against in sex-segregated sporting events?

Sarah Gronert, a 22-year-old tennis pro from Germany who was born with both male and female genitalia, has chosen to compete against women, and that has some in the tennis community up in arms. "There is no girl who can hit serves like that, not even Venus Williams," says the coach of an opponent Gronert recently beat. The coach, Schlomo Tzoref, also claims, "This is not a woman, it's a man." Is Tzoref just a disgruntled coach, trying to stir up controversy, or is there any validity to his claim? What makes a man a man, and what makes a woman a woman -- and how does being either affect one's ability to win?

The Olympics has one answer; the WTA has another; across the board at national and international levels there seems to be a free-for-all in deciding how to allow players who do not fit into the binary division of traditionally defined female and male to compete. Meanwhile, science has its own explanations and advice for the sports community.

Going beyond X and Y (Scientific American)

The June 2007 issue of Scientific American features a profile of Eric Vilain MD (a world renowned genetic researcher, pediatric endocrinologist, and member of ISNA’s Medical Advisory Board). The article, "Going beyond X and Y", discusses the recent international medical consensus which agreed to drop the term “hermaphrodite” in favor of the more neutral “disorders of sex development” (DSD).

Parents sue South Carolina for surgically making child female

The adoptive parents of a child born with male and female organs say South Carolina mutilated their son by choosing a gender and having his male genitalia surgically removed.

The surgery took place when the child was 16 months old and a ward of the state, according to a lawsuit filed by the parents against three doctors and several members of the South Carolina Department of Social Services.

The child's biological mother was deemed unfit, and the biological father had apparently abandoned him, according to the suit. So others made the decision.

The child, now 8 years old, feels more like a boy and "wants to be a normal boy," said Pamela Crawford, the boy's adoptive mother.

"It's become more and more difficult, just as his identity has become more clearly male, the idea that mutilation was done to him had become more and more real," she said in a video released by the Southern Poverty Law Center, which is assisting in the case.

"There was no medical reason that this decision had to be made at this time."

Marilyn Matheus, a spokeswoman for the South Carolina Department of Social Services, said the agency does not have any comment on the pending litigation.

The defendants named in the suit also include doctors from Medical University of South Carolina and Greenville Memorial Hospital.

Sandy Dees, a spokeswoman for the Greenville Health System, said she could not comment because of the litigation.
Source: Source: Email from Attorneys for the Rights of the Child

Assigned to be a girl, but identifying as a boy

The child, identified in the lawsuit as "M.C.," refuses to be called a girl and lives as a boy. His family, friends, school, religious leaders and pediatrician support his identity.

"We just let him follow his instincts as much as we can," his adoptive father, John Mark Crawford, said in the video.

Pamela Crawford said performing gender assignment surgery on a baby robbed her child of the ability to make the decision for himself.

"I would have never made the decision to choose the gender either way," she said. "What I would have been working with is how do we preserve as much functioning in either direction because we can't know what this child's gender identity is going to be."

The lawsuit claims doctors at a state hospital and Department of Social Services workers "decided to remove M.C.'s healthy genital tissue and radically restructure his reproductive organs in order to make his body appear to be female."

The suit says the surgery violated the 14th Amendment, which says that no state shall "deprive any person of life, liberty, or property without due process of law."

The suit also asks for "compensatory damages in an amount to be determined at trial."

But the adoptive father said the real intent of the lawsuit "is just to uphold these constitutional principles -- integrity of a person's body, and some kind of due process for infants where people around them in power are considering doing surgeries like this."

Pamela Crawford agreed. "I would give anything for this to not have been done to our child," she said. "I don't want it to happen to any more kids."
Source: Email from Attorneys for the Rights of the Child

Intersex and Christian Theology

Over the summer, I spent many hours combing through Megan DeFranza’s fascinating sex difference book Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God. I don’t think I’m being overly dramatic when I say that Megan’s book is quite simply one of the most important and challenging books I’ve read in the last couple years. This is why I’m going to spend a few blogs interacting with it.

Let me say upfront that I consider Megan to be a friend. We don’t know each other very well, but our interactions have been both engaging and humanizing. Megan is a very kind person and it’s clear that she’s passionate about Jesus and his kingdom. And I’m very honored that she wrote a gracious endorsement for my forthcoming book People to Be Loved, even though we come to different conclusions on several interpretive issues related to homosexuality.

I also want to acknowledge that Megan’s book interacts with a large body of research that I’ve yet to engage. In many ways, I don’t feel very qualified to interact with her book—like Dusty Bottoms when he was handed that massive pistola at El Guapo’s birthday party in The Three Amigos. But I still want to interact with her book. In fact, I need to. Her arguments are quite compelling and her claims so significant that it would be irresponsible for me not to interact with to her work. But as I do, I’m going to be completely open and honest about my ignorance with many things she discusses. Hopefully I can learn more about her perspective, because there were several places where I found myself scratching my head thinking, “I don’t know; this just doesn’t seem right.”

Dr. Megan DeFranza

As the title suggests, Megan (pronounced MEE-gan, BTW) explores the significance of sex-difference in Christian theology in light of the presence of intersex persons. Intersex is a newer term that has replaced the older term “hermaphrodite.” Intersex persons are born with some sort of ambiguous biological sex. They don’t fit neatly into the categories of male or female. For instance, some people are born with XY (male) chromosomes, but have external female genitalia. Or they are born with ambiguous male or female genitalia. Or in some cases, their genitalia appears to be male (or female) at birth, but after puberty they begin to experience hormonal changes typical of the opposite sex. A “boy” who looks like a boy and experiences life as a boy during childhood may develop some female biological traits upon puberty (see Sex Difference ch. 1 for more details).

This certainly challenges my assumptions about sexuality. Do we determine someone’s biological sex based on chromosomes or genitalia? What if a baby has gonads and a uterus? Is it a boy or girl? In the case of genital ambiguity, who gets to decide what sex the baby is? Could it be that some people are born neither male or female?

Megan spends more than 40 pages exploring all the different intersex conditions; there’s no way I can do justice to the complexity in this short blog. Her discussion is super helpful and delves into some complicated issues without being overly technical. What I love most about her approach—something that’s woven throughout the entire book—is her compassion and empathy for intersex people. She doesn’t treat them like some issue, and she avoids using intersex people as evidence for her larger argument about human sexuality. She treats them like they deserve to be treated: like real people created in God’s beautiful image. I love that she includes testimonies of people who are intersex throughout the book, letting their voices shape our heart and mind on the question of sexuality.

Megan’s overarching point is that the presence of intersex people challenges the common binary model of sexuality. Not everyone is either male or female. “The simplistic binary model is no longer sufficient,” Megan says. “It is dishonest to the diversity of persons created in the image of God” (p. 67). Now you may think that this goes against Christian teaching. The Bible clearly says that people are either male or female. But Megan spends a good deal of time looking at what the Bible says about Eunuchs (Isa 56)—especially “naturally born Eunuchs” (Matt 19)—as a lens to explore the possibility that some people are neither male nor female. “By recovering the concept of the eunuch, theologians will find fresh avenues for rethinking the meanings of sex and gender for theological anthropology…” (p. 67).

The rest of Megan’s book digs into history, theology, biblical studies, sociology, and various other relevant fields in order to challenge the simplistic binary model of human sexuality that most Christians assume to be true. There’s no way I can sum up everything she says. You’ve got to read this book for yourself. But be warned: It will take you a while to digest it. The book is nearly 300 pages of thick research. Yet in my opinion, it’ll be time very spent.

In short, Megan argues that we have wrongly forced “sexual others” into a male/female binary system. Society has done this. Christians have done this. And yet the Bible itself celebrates sexual others (e.g. Eunuchs) as possessing God’s image and becoming full participants in God’s kingdom—without being forced to identify as male or female.

If Megan is right, then her conclusions will have massive consequences for how we think about sex difference, sexuality, gender, homosexuality, and other related topics. Are male and female the only two sexes? If sex difference is necessary for marriage, then who should intersex persons marry when sex differences aren’t clear? Does the presence of intersex persons validate those who identity as gender fluid or non-binary transgender (i.e. they don’t identify as male or female)?

Christians can’t just shove their fingers in their ears and say, “No! No! LahLahLahLahLah…” We need to interact with these questions in order to cultivate a robust Christian anthropology. Megan has done the church a great service in raising many good questions that most of us have never considered.

What to Know About Having a Baby Who Is Intersex

It can be scary for new parents to hear anything unexpected from a doctor once their baby is born. But intersex traits occur naturally, and it’s not a disease or condition that affects a baby’s physical health.

When a baby is born, they’re assigned a biological sex — either male or female — based on their genitals.

You may have even learned your baby’s sex before birth in a similar way. Nothing between the legs on the ultrasound? “Congratulations — it’s a girl,” you hear. (Unless something is hidden from view, right?)

But it can actually be a bit more complicated than that.

Sometimes, a baby can have genitalia with some male characteristics and some female characteristics. And even deeper than external appearance, some people are born with a mix of male and female biological features (such as a uterus and testicles) that can’t be seen on the outside.

When someone doesn’t fall exactly into the “male” or “female” sex designation, the term “intersex” may be used.

Intersex isn’t new, and it isn’t political in and of itself. It’s just a more widely recognizable term now — though a lot of people still don’t understand it.

So what does intersex look like?

This is a popular question to Google, but it may not be the right one to ask.

Keep in mind that people who are intersex are our co-workers, friends, neighbors, and classmates — in other words, you’ve likely interacted with someone who is intersex and had no idea. That’s because they look like anyone else you meet.

Yes, sometimes the genitalia of a baby who has intersex traits is noticeably different. Here are some possibilities:

  • a clitoris that’s larger than expected
  • a penis that’s smaller than expected
  • no vaginal opening
  • a penis without a urethra opening at the tip (the opening might instead be on the underside)
  • labia that are closed or otherwise resemble a scrotum
  • a scrotum that is empty and resembles labia

But the baby’s genitalia may also look completely male or completely female. In other words, they may have male anatomy on the outside but female anatomy on the inside or vice versa.

It could be that a child’s status as intersex doesn’t become obvious until puberty when their body produces more of a hormone that doesn’t match their assigned sex.

Or perhaps certain expected puberty milestones — like a deepening voice or growing breasts — don’t happen. Or maybe the ones that happen are characteristic of what you thought was the “opposite” sex.

In these cases, a person who had more biological male features as a child might look more feminine after puberty, according to a society slow to reject the traditional binary system. Or a person who looked female as a child might start to look more stereotypically male as a teenager.

And sometimes, a person might not learn they have intersex traits until even later, such as if they have difficulty having children and see specialists to learn why. (Note: Not all people with intersex traits have issues with fertility.)

It’s even possible to have intersex traits and never know.

Regardless, a person doesn’t “become” intersex. It’s what they’re born with, whether it’s clear at birth or not until later.

A note about terminology

Opinions differ about the term “intersex” and whether it’s a medical or social designation.

Some people with intersex traits identify as either male or female rather than as intersex. Obviously, this is often true for those who spend their entire lives not knowing about their intersex traits.

What causes a baby to have intersex traits?

The term “intersex” doesn’t describe one particular thing. There are many different varieties — it’s a spectrum. They typically occur naturally.

If you’re a new parent trying to figure all this out, know that there’s nothing that you did or didn’t do to “make” your baby intersex.

For example, you may have learned in sex ed that we’re born with sex chromosomes. Generally, females have a pair of X chromosomes and males have one X and one Y chromosome.

But did you know that there are other variations? For example:

  • XXY, or Klinefelter syndrome
  • XYY syndrome
  • mosaicism, when chromosomes differ by cell (e.g., some cells are XXY and some are XY)

These variations can happen randomly and spontaneously during conception. Sometimes it’s due to egg cells, and sometimes it’s due to sperm cells. The variations can also happen due to other causes.

These chromosomal variations sometimes result in what might be labeled as intersex.

More commonly, though, a baby born with intersex traits does fit into either the XX or XY category. But we now know that biological sex is more complex than our chromosomes.

For example: If a baby is born with female anatomy on the outside and male anatomy on the inside, this is something that happened randomly around the time of conception. They may have XX or XY chromosomes, but that alone doesn’t mean they’re a “girl” or a “boy.”

‘Treatment’ and things to consider

Intersex isn’t a disease, and it can’t be “cured.” So in that sense, there’s no treatment.

It’s possible to have health conditions that need to be addressed that relate to intersex anatomy. For example, if you have a uterus but no uterine opening, you may have painful menstrual cycles in which the blood doesn’t exit your body. In this case, you may want to have surgery to create an opening.

But this isn’t “treating intersex.” This is treating a closed uterus.

So what about your baby, who may not have typical genitalia?

Do you ‘choose a sex’?

The short answer: Unless there’s also a health condition (like urine not flowing out of the body properly), you don’t need to do anything in terms of medical intervention.

But your doctor may recommend surgery to make the genitalia appear more typically male or typically female. American doctors have been doing this since at least the 1930s — especially performing clitoral surgery when parents intend to raise a baby with a large clitoris as a girl.

There may be social reasons for this recommendation, and your doctor can go over these with you. But it’s essential to also consult non-medical professionals, like counselors.

Currently, in the vast majority of U.S. states, every baby is assigned a binary sex — your baby’s birth certificate will say either male or female. So you may need to choose, at least initially.

However, this practice is changing. A growing number of states are allowing an “X” in place of “M” or “F” on things like ID cards. However, this is still generally something that is changed later, when your child is older — or even an adult — and decides for themselves. And in most places, changing the sex on your birth certificate means changing it from male to female or vice versa.

When it comes to raising your child, there’s good news for babies born with intersex traits — it’s more acceptable to raise kids in a “gender-neutral” way than ever before.

But social stigma and barriers are still very real. Again, this is why many doctors still recommend surgery to make your baby’s genitals match the sex they’re assigned.

This can lead to all sorts of questions, though:

  • What if my child later identifies as the opposite sex instead of the one we chose for them?
  • What if we have a micropenis removed, only to learn during our child’s puberty that they produce a dominant amount of male hormones?
  • What if our child resents our decision and wishes we had left everything as it was when they were born?
  • What if we opt not to do surgery, and our child later wishes we had done the “obvious” surgery when it was less complicated/memorable?

All of these questions are more commonly stated as, “What if we chose wrong?” This worry can weigh heavily.

This is why it’s crucial to talk with counselors familiar with intersex, social workers, a variety of medical professionals, trusted friends and family, and people with intersex traits themselves.


Genital surgery that’s done solely for appearance reasons (cosmetic surgery) is never urgent. You can take your time, enjoy your newborn, get to know your child as they grow, and continue an open dialogue with your doctor and others.

Here’s what to do next

For many parents who are told that their baby is intersex, fears about their child’s future acceptance, relationships, and self-esteem are front and center.

You may have questions like, “Will my child be able to go to sleepovers?” and “What if they’re made fun of in high school gym class locker rooms?”

These are natural worries that show your love and concern for your little one. But you don’t have to go it alone. There are resources available that can help.

In addition to a number of firsthand accounts from people who identify as intersex, helpful resources include:

  • InterAct, which advocates for intersex youth
  • the Dutch government’s guide for supporting your intersex child
  • Intersex Initiative
  • online support groups on social media platforms like Facebook
  • in-person support groups

Ask your doctor to put you in touch with a counselor or social worker who can recommend support groups in your area.

Remember: There is no shame in having a child with intersex traits or in being intersex yourself. Until society is completely aligned with this view, there will be some challenges ahead. But with a strong support system that includes you, your baby can thrive into adolescence and beyond.

California Could Be First State to Ban Non-Consensual Surgeries on Intersex Babies - 1/15/21

Activists hope a newly introduced bill could set a historic precedent for the rest of the country.

A new bill introduced this week is looking to make California the first state in the U.S. to restrict doctors from performing non-consensual surgeries on intersex infants.

On Thursday evening, openly gay state Sen. Scott Wiener (D-San Francisco) introduced Senate Bill 225, a proposal that would delay irreversible operations intended to “correct” the genitalia of people born intersex until they are six years old. That age requirement is based on research showing that children develop their gender identity as early as five, per a 2013 study published in the journal Psychological Science.

Supporters of the legislation hope that delaying these surgeries will give young patients time to be able to develop greater understanding regarding what they entail, rather than immediately operating on newborn children with genital differences.

In a statement, Wiener said SB 225 is intended to ensure these critical decisions about intersex people’s bodies are not “made for them and without their input.”

“This legislation gives children and their families more time to research and opt in or out of non-emergency surgeries to irreversibly change a child’s sex characteristics,” Wiener said. “We must provide people the ability to make important healthcare decisions for themselves — especially when healthcare decisions are associated with a person’s gender assignment, and can result in long-term pain, PTSD, depression, and a loss of sexual sensation.”

SB 225 is being backed by the advocacy groups interACT: Advocates for Intersex Youth, Equality California, and the American Civil Liberties Union of California, all of which have signed on as co-sponsors of the legislation.

In a press release timed to the introduction of Wiener’s bill, interACT noted in a statement that the majority of operations on intersex youth are “performed on children under two years old.” These procedures, which include clitoroplasty and clitoral reduction, often result in “extreme scarring, chronic pain, chronic incontinence, loss of sexual sensation, post-traumatic stress disorder, incorrect gender assignment, and the need for additional surgeries to treat complications from the original surgery,” according to the organization.

“Many adults who underwent these surgeries as infants have expressed deep concern and anguish about the procedures,” interACT said in an email. “The intersex community is leading the movement to ensure that no matter what gender identity a person grows up to have, everyone born with unique sex anatomy should be able to play a role in major healthcare choices.”

Although no state legislature has ever passed a law like SB 225, advocacy groups are hopeful that California will break that trend after two hospitals announced last year that they would cease performing some forms of surgery on intersex children: Chicago’s Ann & Robert H. Lurie Children’s Hospital in Chicago and the Boston Children’s Hospital. (It must be noted, however, that neither of these medical institutions committed to halting the surgeries in all cases.)

“Building on 15 years of advocacy work by interACT, we saw two premier children's hospitals finally commit to stopping infant clitoral and vaginal surgeries in 2020,” said Kimberly Zieselman, executive director of interACT, in a statement. “Now it's California's time to shine.”

While legislation restricting nonconsensual intersex surgeries had been put forward in the California State Legislature in recent years, the bills were killed after meeting with resistance from the California Medical Association and Societies for Pediatric Urology. Wiener was able to successfully lobby for the passage of a resolution in 2018 calling on doctors to wait “until the child is able to participate in decision making” before operating, but that statement was nonbinding.

But after Wiener narrowed the scope of this year’s bill to weaken opposition from past critics of the effort, LGBTQ+ advocates hope 2021 will be different.

“The LGBTQ+ community — and transgender, nonbinary and intersex folks in particular — have been fighting for decades to secure our rights to make decisions about our own bodies,” Equality California Executive Director Rick Chavez Zbur said in a statement released Thursday. “That fight continues today. Children born with diverse physical sex traits and their parents should be able to participate in the critically important decision-making process regarding medically unnecessary and often irreversible surgical interventions.”

Although the passage of California’s bill would be unprecedented, it’s not the only U.S. municipality that is seeking to prevent intersex young people from irreparable harm. New York City is weighing an ordinance that would mandate an education and outreach campaign intended to teach doctors, parents, and young people about the estimated 1.7% of children born intersex and the impact these operations can have on their bodies.

According to the news publication Bay Area Reporter, federal legislation regarding the medical treatment that can be provided to intersex youth “is likely to be introduced in Congress this year” with Democrats now in control of both houses.

Statistics of intersex frequency

Note that the frequency of some of these conditions, such as congenital adrenal hyperplasia, differs for different populations. These statistics are approximations.

Not XX and not XY

one in 1,666 births

Klinefelter (XXY)

one in 1,000 births

Androgen insensitivity syndrome

one in 13,000 births

Partial androgen insensitivity syndrome

one in 130,000 births

Classical congenital adrenal hyperplasia

one in 13,000 births

Late onset adrenal hyperplasia

one in 66 individuals

Vaginal agenesis

one in 6,000 births


one in 83,000 births

Idiopathic (no discernable medical cause)

one in 110,000 births

Iatrogenic (caused by medical treatment, for instance progestin administered to pregnant mother)

no estimate

5 alpha reductase deficiency

no estimate

Mixed gonadal dysgenesis

no estimate

Complete gonadal dysgenesis

one in 150,000 births

Hypospadias (urethral opening in perineum or along penile shaft)

one in 2,000 births

Hypospadias (urethral opening between corona and tip of glans penis)

one in 770 births

Total number of people whose bodies differ from standard male or female

one in 100 births

Total number of people receiving surgery to “normalize” genital appearance

one or two in 1,000 births

More recent discoveries

uterus didelphus - two vaginas

1% of women

Mayer-Rokitansky-Küster-Hauser syndrome. (MRKH), which means she has no cervix, uterus, or vaginal opening

no estimate

Source: Short-cut to this chart

Notable intersex people



  • "Intersex in the Age of Ethics" ed. by Alice Dreger
  • "Hermaphrodites and the Medical Invention of Sex" by Alice Dreger
  • "Sexing the Body" by Anne Fausto-Sterling
  • "Lessons from the Intersexed" by Suzanne Kessler
  • "As Nature Made Him" by John Colapinto

Films (Available through available from ISNA)

  • "Total Patient Care"
  • "Hermaphrodites Speak!"
  • Is it a Boy or a Girl? (Discovery Channel)
  • San Francisco Human Rights Commission Hearings
  • Talking Back to Science: Art, Science, and the Personal
  • The Child with an Intersex Condition: Total Patient Care
  • XXXY - A short documentary about intersex (view online )
  • Yellow for Hermaphrodites: Mani's Story

Web Sites

Key Issues Facing People With Intersex Traits

New CAP data and analysis offer insights into the experiences of people with intersex traits.

This column was produced in collaboration with interACT, an organization dedicated to using innovative strategies to advocate for the human rights of children born with intersex traits.

There are currently limited data and information available on the population health and overall well-being of people with intersex traits. However, recent research has found that health disparities among intersex populations are driven largely by stigmatization, prejudice, and discrimination similar to what LGBTQ+ communities experience, and that people with intersex traits report identifying as noncisgender or nonheterosexual at higher rates than people who are not intersex. For these reasons, the National Institutes of Health and The National Academies of Sciences, Engineering, and Medicine include people with intersex traits as a sexual and gender minority population in their research agendas.

This column presents Center for American Progress survey data that shed new light on the experiences of intersex respondents. It also provides policy recommendations informed by these data to improve the well-being and advance the rights of people with intersex traits.

“Intersex” is an umbrella term used to describe people born with sex traits that do not fit binary medical definitions of male or female sexual or reproductive anatomy. Intersex populations are born with these differences in sex traits or may develop them during childhood. Human sex development is naturally diverse, with many variations possible in genitalia, hormones, internal anatomy, and/or chromosomes. It is estimated that up to 1.7 percent of the population has an intersex trait and that approximately 0.5 percent of people have clinically identifiable sexual or reproductive variations.

Medically unnecessary, nonconsensual interventions are violations of human rights

Mistreatment of intersex individuals begins early in life, with intersex infants and children commonly subjected to nonconsensual, medically unnecessary interventions to alter natural variations in genital appearance or reproductive anatomy with the aim of conforming their bodies to binary sex stereotypes. These procedures on intersex infants and children, such as clitoral reductions and sterilizing gonadectomies, are often justified by discriminatory attitudes about healthy variations in sex characteristics. They have high complication rates and lifelong consequences such as infertility, reduced sexual function, and other physical and mental health impacts. These outcomes contribute to the high physical and mental health disparities that intersex populations experience. In a 2018 study, for example, 43 percent of adult intersex respondents reported their physical health as “fair” or “poor,” and 53 percent reported the same of their mental health. Similar patterns are also evident in CAP’s nationally representative 2020 survey data of LGBTQI+ adults* that show mental and physical health disparities between LGBTQ+ intersex respondents and LGBTQ+ nonintersex respondents. (see Figure 1)

Figure 1

The United Nations has found that these forced and coercive intersex surgeries on minors, frequently performed without their full, free, and informed consent, “violate rights to the security of person, right to bodily and mental integrity, freedom from torture and ill-treatment, and freedom from violence.” Increasingly, medical associations, LGBTQI+ advocates, human rights bodies, and intergovernmental organizations are asking policymakers to prevent medical professionals from engaging in these harmful practices and to postpone procedures on intersex minors until they can provide informed consent.


The U.S. Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS) should issue guidance to state health officials for Medicaid and the Children’s Health Insurance Program (CHIP) on prohibiting nonconsensual, medically unnecessary surgeries on intersex youth and deferring all nonemergent interventions until patients can provide free, fully informed consent and drive decision-making. The guidance should also provide information on making the documentation of a patient’s informed consent a prerequisite for health care reimbursement for sterilizing or genital surgeries, absent an imminent risk of physical harm, and urge state health officials and providers to comply with Medicaid quality, comparability, and sterilization requirements; the Affordable Care Act (ACA); and the federal genital mutilation statute, all of which as written currently prohibit many of the procedures performed on intersex infants.

HHS should also establish an education campaign for health professionals that would increase training, knowledge, and cultural competency on providing affirming, appropriate health care that respects the rights of people with intersex traits.

Intersex people face high rates of discrimination and stigma

According to CAP’s nationally representative 2020 survey data of LGBTQI+ adults, LGBTQ+ intersex individuals, when compared with their LGBTQ+ peers who are not intersex, experience higher rates of stigma and discrimination and high rates of engaging in behavior to avoid exposure to discriminatory treatment, such as avoiding going to the doctor. (see Figure 2)

Figure 2

Sixty-nine percent of LGBTQ+ intersex respondents reported experiencing some form of discrimination in the year prior, roughly two times the rate of discrimination reported by LGBTQ+ nonintersex respondents (35 percent).

Because people with intersex traits do not conform to binary sex and gender norms, they can encounter significant stigma and discrimination when accessing health care. According to the CAP survey, 88 percent of LGBTQ+ intersex respondents reported experiencing some form of discrimination from a doctor or health care provider in the year prior to CAP’s survey—including refusal of care, harsh language, or physical abuse—compared with 19 percent of LGBTQ+ nonintersex respondents. (see Figure 3

Figure 3

Thirty-four percent of LGBTQ+ intersex respondents to the CAP survey reported a household income of less than $25,000 annually, compared with 27 percent of LGBTQ+ nonintersex respondents. The high rates of economic insecurity and poverty experienced by intersex adults limit access to health care and contribute to higher rates of using social safety net programs, as shown in Figure 4.

Figure 4

When it becomes known that someone has intersex traits or they are perceived as not conforming with gender norms, intersex individuals are often subjected to discrimination and harassment in other key areas of life, such as education, employment, sports, and beyond. Forty-seven percent of LGBTQ+ intersex respondents reported that they have “made specific decisions about where to work” in order to avoid experiencing discrimination, compared with 34 percent of LGBTQ+ nonintersex respondents.

Figure 5


The U.S. Supreme Court’s decision in Bostock Clayton County, Georgia, should be enforced in a manner that is inclusive of its prohibition of discrimination based on sex characteristics, including intersex traits, in areas including but not limited to health care, employment, and educational settings. Discrimination based on sex characteristics, including intersex traits, should also be explicitly prohibited in future rulemaking on the ACA’s Section 1557, its central nondiscrimination provision, as well as CMS regulations for marketplace, Medicaid, and Medicare coverage.

HHS should also create an awareness campaign focused on the need for affirming care and informed consent for intersex youth. The campaign should be designed with input from intersex communities and should target community stakeholders, families of people with intersex traits, and the public to increase awareness, visibility, and representation.

Intersex people must have access to accurate identification

Accurate forms of identification are crucial for accessing employment, essential services, transportation and more. In many states, burdensome requirements or lack of inclusive identification options prevent people with intersex traits and transgender people from obtaining accurate identification, increasing the risk of harassment, discrimination, and violence. Data from CAP’s 2020 survey find that 77 percent of LGBTQ+ intersex respondents who reported discrimination in the year prior said that it affected their “ability to obtain accurate ID documents” to some degree, compared with 23 percent of LGBTQ+ nonintersex respondents who reported discrimination.** Recently, the State Department has made progress on removing the medical requirement for gender marker selection and adopting “X” as a third gender marker for people who identify as nonbinary, intersex, and/or gender nonconforming.


The White House should expand its efforts by directing all federal agencies to review their policies regarding the display of gender markers on federal identification documents with a focus on both ensuring that all individuals can self-select an M, F, or X designation and considering a phaseout of the display of personal gender information on certain documents that do not require that information.

There is a lack of data on people with intersex traits

The lack of available data on people with intersex traits and their experiences is a significant concern. Estimates of the size of the intersex population vary based on the definition researchers use, and ensuring a representative sample size outside clinical contexts is difficult. Stigma around intersex traits also makes many intersex individuals unwilling to disclose their intersex status. Unfortunately, no intersex status questions currently exist on any federally funded general population surveys, and population-level data on people with intersex traits are unavailable. Additionally, there are no nationwide data on the prevalence of surgeries performed on intersex individuals, as most hospitals opt not to disclose this information.


HHS should expand research on intersex populations by testing, validating, and implementing measures for intersex status on large-scale federally funded surveys.

It should also increase the inclusion of people with intersex traits in qualitative and quantitative health research, including cognitive interviews; promote best practices for intersex community-based participatory research; and invest in supporting the advancement of these research agendas.


Like other sexual and gender diverse populations, people with intersex traits experience significant discrimination, stigma, and prejudice that detrimentally affect their health and well-being. Policymakers have a responsibility to implement robust nondiscrimination protections, human rights safeguards, and research agendas that will deepen the understanding of intersex populations and generate data-driven policy solutions to improve their welfare. Additionally, Congress should pass the Equality Act, which would update federal civil rights laws to protect people from discrimination based on sexual orientation, gender identity, and sex characteristics (including intersex traits) in employment, housing, credit, jury service, and federally funded programs—such as those for health and education—as well as public accommodations.

Caroline Medina is a policy analyst for the LGBTQ Research and Communications Project at the Center for American Progress. Lindsay Mahowald is a research assistant with the LGBTQ Research and Communications Project.

The authors would like to thank Kimberly Zieselman, Alesdair Ittelson, and Bria Brown-King of interACT, as well as Harper Jean Tobin and Dr. Katherine Dalke, for their valuable feedback on this column.

* This survey includes a sample of 1,528 LGBTQI+-identifying adults and was jointly conducted by the Center for American Progress and NORC at the University of Chicago. The sample has been weighted to account for both U.S. population characteristics and survey nonresponse. The study’s full results and methodology are on file with the authors. All in-text comparisons between LGBTQ+ intersex respondents (n = 75) and LGBTQ+ nonintersex respondents (n = 1,439) are significant at the 0.05 level.

** Select survey questions were asked only of respondents who reported experiencing discrimination in the year prior. This sample includes 46 intersex respondents and 467 nonintersex respondents.

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