It is increasingly difficult to ignore the stigmatisation and non-recognition of certain sections of people in the society. In this case, they are the millions of Intersexual People living amongst us. They are the people who were born with sex characteristics including genitals, gonads (ovaries/testes), and chromosome compositions; which make it difficult to distinguish them as male or female. Being intersex is different from being transgender. Being transgender means there is no ambiguity around the sex of the person, rather the individual identifies with, and chooses to live as the opposite sex. Intersex is also not a sexual orientation. It is biological. As a paediatric nurse, I can testify that some children are born with indeterminate sex. People erroneously call them hermaphrodites, a name meant for plants and animals, hence presenting them as mythical beasts. I want to make a case for them…please.
Millions of children are born with some degree of sex ambiguity. Most people are not aware of it because parents, due to fear of societal stigmatisation, hide it. Let’s look at Gary…an only son to his parents. He has three sisters who are all older than him. At 12 years of age, Gary started showing physical features of a girl. He developed breasts and his gait was feminine. At 15, his voice was high pitched, and he stood out amongst his friends. He was mocked for being “too girly”. His dad found him embarrassing, always asking him to “man up”. He was ostracised when he started showing sexual attraction towards men. Gary still lives in Nigeria somewhere, ignored by his family and friends.
I’m close to Gary’s sister and she has permitted me to share this family secret. Gary was born was with ambiguous genitalia. It wasn’t determined at birth whether Gary was male or female. Since their parents already had girls, a decision was made in conjunction with the doctors, to carry out what they perceived as corrective operation on him. From that point on, Gary was a boy. When he got to 12 and puberty kicked in, Gary started developing as a girl, to the horror and shame of his family, and sadly, to Gary’s horror as well. The society didn’t get him, he (Gary) didn’t get himself too.
The case of Fatimah who is one of three daughters… When puberty hit Fatimah, she noticed that unlike other girls, she didn’t have any periods. Her breasts didn’t develop. Her voice became deeper. Like Gary, her parents made a decision to make her have a ‘corrective’ surgery when she was a baby born with indeterminate genitalia. They reared her as female. All her life, Fatimah identified with boys. Puberty brought on further doubts about her actual sex.
In 2012, Caster Semenya a South African runner, won gold at the World Championships, and silver in the Summer Olympics women’s 800 meter races. Although it is wasn’t determined if she is intersex or not, she was mocked to the point that she was subjected to gender verification by the International Association of Athletics Federations (IAAF). Her crime? Her build, her deep voice and speed on the tracks. She was later cleared as female, but imagine her agony.
Not as simple as XX or XY
To understand intersex people, some biology needs to be analysed. A woman’s egg cell contains an X chromosome, and the father’s sperm cell contains either an X or a Y chromosome. Up until about 8 weeks post conception, a foetus is neither male or female. Around 8 weeks, the hormones that determine a baby’s sex kicks in. For males, the father’s Y chromosome triggers the sex organs (gonads) to form testicles. This Y chromosome also sends testosterone to a structure called tubercle, where the testosterone changes into a stronger hormone – dihydro-testosterone. The latter transforms the tubercle into a penis. For girls, the father’s X chromosome triggers the gonads to form ovaries, and the tubercle transforms into the clitoris.
In intersex babies, for various reasons, this process is disrupted causing different degrees of ambiguity of sex development. This could be evident in different ways such as the development of an ambiguous genitalia or a mixture of both male and female genitalia. The gonads will not form only testes or only ovaries. Their genetic composition is not clearly XX (girls) or XY (boys). The extent of this ambiguity varies from one baby to another. In some babies, it is difficult to identify the baby as male or female. In other cases (rarely), the genitalia of the baby will be clearly defined as male or female, whereas their genetic composition is different. There are reported cases where men born with male genitalia, found out that they had ovaries. Others manifest in puberty, when development does not conform to expectations.
Unreported Intersex Genital Mutilation
The first sentence after the birth of a baby is either “it’s a girl” or “it’s a boy”. Where there are biological factors that impact the validity of this statement, panic sets in, especially for parents. That was the case with Gary and Fatimah. I assume that their parents transcended from joy to fear, due to stigma associated with their children’s biological form. They chose to have their babies have ‘corrective’ surgeries, which like Female Genital Mutilation, involves the excision of some parts of their genitalia. Recently, there are arguments questioning the acceptance of this kind of mutilation. If Female Genital Mutilation is seen as barbaric, what makes this type of excision acceptable? Although science has advanced so much and more tests are carried out to determine the biological composition of an intersex baby prior to surgeries, there are calls to allow children grow up and make decisions about their identity. Let nature take its course. Ironically, when intersex children grow and identify with a gender opposite to the one their parents and doctors chose, the same feared society will victimise them.
There are more intersex people around us than we know. Sadly, due of lack of societal recognition of their existence, they are snubbed by most. Official forms in most countries recognise only the male or female sexes, when in reality there are people outside that spectrum. Intersex people are definitely not called hermaphrodites. They have names, so please call them by their names. It is very easy for us to judge people we don’t understand. Intersexuality has no geographical boundaries. It can happen to anyone. Remember there are family secrets most of us are not privy to. The fact that some intersex people are able to conform to societal expectations, does not mean others do not have their struggles. From a religious point of view, remember they didn’t create themselves. A variation in their biological formation is no fault of theirs. It’s no fault of their parents either. Please think twice before stigmatising anyone.
Issues around intersex people are too vast to report in this post. Please read about it to understand more.
Here are the sources of my post knowledge:
Dreger, Alice (May 16, 2013). “When to Do Surgery on a Child With ‘Both’ Genitalia”. The Atlantic. Retrieved 2015-07-20.
Holmes, Morgan. “Is Growing up in Silence Better Than Growing up Different?”. Intersex Society of North America.
NHS Choices: Disorders of Sex Development
Intersex Society of North America. “What’s wrong with the way intersex has traditionally been treated?”.
United Nations Free and Equal Factsheet: Intersex
Carpenter, Morgan (February 3, 2015). Intersex and ageing. Organisation Intersex International Australia.
World Health Organization (2015). Sexual health, human rights and the law. Geneva: World Health Organization. ISBN 9789241564984.
Image from: nursingclio.com