July 13, 2024

I, Science

The science magazine of Imperial College

We discuss the diversity of intersex people whose experience of gender goes beyond the traditional categories of male and female.

From a young age, we’re taught that the world is full of opposites: black and white, good and evil, men and women. We’re told that humans come in two ‘types’, two genders, two sexes. That’s it. Yet, as we grow up, and reach for life outside of our cots, we realise that our world exists in all different shades.

The transgender community is helping us understand that sometimes our gender identity on the inside doesn’t match our body on the outside. Our awareness of other cultures, which for centuries have acknowledged more than two genders, is helping us learn that gender is best understood as a spectrum of people; that gender roles and stereotypes are social constructs. But, what if the body you were born in doesn’t neatly ‘fit’ into being biologically ‘male’ or ‘female’?

The diverse world of Intersex

It’s called Intersex, and there are as many intersex people as natural born red-heads on the planet. Intersex people are those whose anatomy and/or physiology isn’t typically female or male. Instead, intersex individuals often have a mixture of sex related traits and are a unique biological blend of characteristics. There are over 40 intersex variations ranging across a spectrum of differences in genetics, chromosomal make up, hormones and internal/external anatomy. Sometimes intersex variation is identified at birth, due to ‘ambiguous’ genitalia, but in cases where external phenotype is unaffected many people do not know their biological differences until puberty or adulthood.

Image of list of Intersex conditions

In most cases medical intervention isn’t needed for individuals to live fulfilled, healthy lives. There is some debate, due to a lack of scientific understanding, about whether under developed testicular tissue carries increased cancer risk, an idea that, so far, seems to have sprung from a mythical origin. Yet, despite the facts remaining elusive, it has been common practise since the 1950’s in western society to subject intersex children to ‘gender assignment’ surgery at birth. Frequently, doctors will perform ‘normalisation’ surgeries, which can include clitorectamies (the removal of the clitoris), the removal of gonads or hormone therapy, to make young bodies fit the female/male binary. With a lack of information provided for parents, and by performing surgeries so early in individuals’ lives, potentially unnecessary medical intervention has led to much psychological disruption of individuals’ well-being and physical damage through complication. Many families have felt misinformed or lied to by professionals about the need for surgery at such an early age, if at all. “Doctors have taken it upon themselves to literally carve bodies so that they fit neatly into male and female body types” 69-year-old advocate David Strachan recently expressed. “We’re not stereotypically male or female. There’s a whole spectrum in between.”

A necessary procedure?

Advocates of intersex rights have frequently protested that it is unethical to force often irreversible gender assignment surgeries on non-consenting children, particularly as many take the form of genital mutilation. Since the millennium several national organisations, including IntersexUK and ISNA, have been founded to campaign for intersex rights and support families in their choices. Although intersex issues are becoming more visible through media stories and the growing celebration of Intersex Awareness Day, the first intersex birth certificate was not awarded until the beginning of this year. Moreover, only two countries, Chile and Malta, have produced any formal guidelines towards unnecessary interventions and coercive medical normalisation. They are also the only two countries that have banned such surgeries by law.

In some societies where surgery is not an option the stigma surrounding intersex, and the consequential discrimination, often has even more violent outcomes. Director of SIPD Uganda, Julius Kaggwa recently commented that: “in many African countries, the traditional way of dealing with perceived sexual ‘abnormalities’ has largely been staying silent – and wishing them away through various kinds of traditional rituals, which often meant killing the intersex infants.” Hate crimes, such as the killing of 17-year-old Muhadh Ishmael, born with both male and female genitalia, in Kenya two years ago are still scarily common. In recent years the UN has begun working to condemn violence against intersexual people and to support their human rights.

On the path to a more representative reality?

Media outlets of the 21st century, be they newspapers, TV or Vimeo, have provided both support and hindrance in the fight for intersex acceptance. The portrayal of intersex people on TV is becoming more representative, with the first intersex character to be played by an intersex actor guest starring on MTV’s Faking It last year. But there is concern that ill-informed accounts may be misleading or ignorant of important issues, like NBC’s Friends thanksgiving episode 2001 where one character is made fun of as ‘hermaphrodite’. Overall however, new media has played an important role in increased intersex visibility. Sites such as Tumblr, Facebook and YouTube have nurtured online intersex communities and allowed the sharing of stories where before there was only shaming and silence. Whilst it is still not uncommon for fearful parents to avoid revealing to their children their medical past, perhaps these new social platforms can help reduce the stigmas around being intersex and having surgery, giving more people power to embrace their own experiences.

Images of intersex celebrities

It seems that society has come a long way in the last decade towards acknowledging intersex issues and beginning to discuss the need for change in standard medical practise. The intersex community has ideas as to how to repair its damaged relationship with medical professionals if only they are willing to listen. Yet, the troubling absence of protocols or guidelines for medical communities in most countries reflects that there are still stigmas surrounding the existence of intersex variation. Fortunately, increased access to media platforms and representation on screen continues to give the intersex community an ever growing voice.

We can accept that there’s variation in other biological traits. There’s a spectrum of heights, hair colours, eye colours etc. So why not in the mixture of sex related traits an individual can have? Perhaps society’s slow progression towards accepting gender as non-binary will also lead to the acceptance that ‘sex’ can have more than two ordinary variants. Intersexuality need not be ‘fixed’: it is just part of humanity’s natural diversity. Surely, individuals’ have a right to decide the fate of their own bodies.

Emma Parkin is studying for an MSc in Science Communication

Open licence images sourced from Goggle