As a male, it is hard for me to get what it's like to be a girl. Growing up, I would think of girls as weird and not get why they didn't have a willy too. Puberty happened. I figured out some of the basic anatomy in humans and can now proudly say I know girls don't pee out of their vagina (come on lads back me up here, you did too!). School followed and I realised more about the world around me. Yet, there was something that took me by surprise: there are some people that are male or female, but also intersex men and intersex women.
The concept of transgender people was one thing, but then I came across the existence of intersex people: a collective term for those with a biological, chromosomal or anatomical variation from the expected embodiment of male or female. It may be a combination of all three elements. This is something that cannot be new as evolution is pretty slow, so how can this be such a new term for me and so many others who hadn't thought outside the gender norms of what it takes to 'look like a man' or 'look like a woman' before?
In a time where sexuality differences are thankfully becoming more accepted, we are basically just at the start of the journey to understanding and therefore accepting, that society has many variations in different forms of people too. Yet, intersex isn't an issue of gender: it's a biological reality. This may be a new concept for many but has been medically defined as a 'congenital anomaly of the reproductive and sexual system'. This means intersex people are born with external genitalia, internal reproductive systems and/or an endocrine system (hormone production) that are different from most other people. This means there is no generic 'intersex body' and encompasses a wide variety of body types that are not dysfunctional, but are deemed 'abnormal' by society. The language used to describe intersex differences is viewed as deeply pejorative by people born intersex. Some may identify themselves as intersex, but most will see themselves as a man or woman, if a little different.
This is helpful to those confused by the use of the term 'hermaphrodite' - having both male and female sets of reproductive organs - this is an impossibility in humans, but is observable in snails, earthworms and some fish. It is an old and incorrect term that was adopted by medics in the past about intersex anatomical differences, but it is now considered a very offensive term to many intersex people as it is both misleading and stigmatising.
In a world where as soon as a baby is born the child is faced with 'Is it a boy or a girl?' with great anticipation, why can't there be the option of being intersex? Some intersex people are seen as a medical issue: they don't produce a certain protein, have a missing receptor, or another genetic/biological explanation. But there are many others for whom there is no identifiable cause that can explain their intersex status. Clinicians then employ a battery of tests and investigations before making a best guess as to which sex to designate the child in order to fit within our limited view of gender as being two iron clad boxes of male/female.
While some people with intersex variations reject binary gender labels of 'male' or 'female', the assumption that they belong to a 3rd gender is problematic on a number of levels. Firstly, it leads to mis-gendering very many intersex people who identify as men or women. Intersex people are male or female AND they are intersex. Denying that also denies their right to choose their own gender identity and their intersex status. It's not so simple as to do a genetic test to decide medically either, as gender is not predicated on sex chromosomes. One is simply assumed to follow another.
Even more upsetting are those who are subjected to genital surgery where the only reason is to assign them as male or (more commonly) female just so they conform to societal stereotypes. What a penis or vulva would be shaped to look like would be at the mercy of the surgeon, leading to the not so surprising outcome of some being unhappy with their assigned sex and having to deal with the mental torment of that ordeal.
As Morgan Carpenter points out, "Surgery is ultimately predicated on an assumption that identities and bodies need to match each other to be valid - and that's an argument that leads to surgery on intersex infants to align genitals with sex of rearing. It's also transphobic: it leads to requirements for trans* people to be sterilised or otherwise modified to obtain gender recognition." However, note should be taken not to mix trans* and intersex issues as intersex surgeries are always non-consensual and take place in infancy and childhood.
These (often multiple) surgeries can lead to an intersex person being sterilised as a 'condition' of their surgical assignment. Trans* individuals have agency and often choose not to engage surgery. People born intersex have no such agency. Thankfully, surgical intervention has improved over the years and decisions about surgery are more commonly being deferred until pubertal age in order to respect the autonomy of the person in the UK. This is not the truth for all intersex people but certainly is more so in the past, therefore still affecting people living nowadays, and in other parts of the world. Bodily autonomy should be respected and surgery limited only to matters that are life threatening or affecting physical function.
Intersex people are one of the most marginalised groups of people in terms of human rights. They have virtually no legal recognition and face a significant chance of being ostracised by others around them, to the extent that intersex is often ignored in equality issues. When the acronym LGBT is used, it invariably misses out 'I' in the same way that asexuality is not considered either. LGBTIA is the way forward. However, it is important that initials are not added to acronyms without the underlying issues being properly addressed.
Usually, blogs about gender and LGBT issues, are written by someone who is a member of that community. I have made it clear I am not and I also am not an expert. But it is the non-LGBTIA people, who make up most of the world, that need to educate themselves and I appeal to the people of my own community to change our views and behaviours. You may still not fully understand what LGBTIA fully entails, but that doesn't stop you from just accepting it as part of the world and having a better attitude. Carpenter also says, "The key issues for most people with intersex variations are not the existence of two binary sexes but what is done to us to make them conform to those sex norms."
There has already been a lot of progress by great organisations such as Scottish Transgender Alliance and OII-UK, but there is so much more that can be done. The STA campaign for legal recognition of a 3rd gender and other rights to further equality is one such step that we need to push forward with. This is an option that some in the intersex community will welcome, although it is a provision that has more resonance in the trans* community. The main issue, however, still remains: what has and is done to make these people conform to a gender binary. If someone wants to change their genital anatomy, it should at least be done at an age where they can give informed consent, yet that is not the case at present.
We often use 'normal' to actually mean 'common'. Of course, the most common person you meet on the street in the UK is cis-gendered, heterosexual and identifying to the dichotomy of male or female (statistically speaking, although, the number of intersex people has not been fully quantified). But that does not, I repeat NOT, mean that it is therefore the norm and that anything else is abnormal. The majority of people in the UK are Caucasian but being different from that is still normal, just less common. When figures show the total number of people whose bodies differ from standard male or female is 1 in 100, then it is time to accept reality for what it is. There is absolutely nothing wrong with being intersex, it is others' degrading attitudes towards them that are unacceptable. We used to have only the standard colours to define life as a world of primary colours; now it's time to let the full spectrum of the sexual anatomy rainbow shine.
With special thanks to Leslie Jaye (OII-UK) and Morgan Carpenter (OII-Australia) for their guidance and help with this piece.
This post as been updated to reflect the quotes from Morgan Carpenter and to link to those works.