“Intersex” is the term that a person may use when they have both male and female sex characteristics. These include genitalia, hormones, chromosomes, and reproductive organs.
Being intersex is not a disease. It is a naturally occurring variation in humans. Likewise, being intersex does not affect an infant’s physical health, though it may cause complications as time goes on, including potential issues with fertility.
This article will explore what it means to be intersex, including its relationship with sexuality and identity.
Intersex is an umbrella term that describes differences in sex characteristics that do not fit the typically binary idea of male or female. Sex characteristics include genitals, hormones, and chromosome patterns.
There are many ways that a person can be intersex. The organization Intersex Human Rights Australia state that there are at least 40 different intersex variations.
Some intersex traits may be visible at birth, while others may not appear until the person reaches puberty. In some cases, a person may never know that they are intersex.
According to some estimates, up to 1.7% of the population has intersex traits. This is comparable with the number of people who have red hair.
Some people may also refer to someone who is intersex as having differences in sex development.
One 2020 study indicates that intersex people may show a range of gender identities. Gender identity refers to the personal sense of an individual’s gender regardless of their sex.
A 2015 Australian survey reports a similar finding, with 75% of intersex respondents identifying their gender as either “male” or “female” and the remaining 25% choosing a variety of other options, including intersex. It was possible for respondents to choose multiple options.
Intersex is not the same as nonbinary, wherein people do not identify exclusively as a man or a woman.
The National Center for Transgender Equality explain that nonbinary people are usually not intersex. They typically have either male or female sex characteristics, but they do not see their gender identity as being either a man or a woman.
Intersex is also not the same as transgender, wherein a person’s gender identity may differ from the traditional expectations of the sex a doctor assigned them at birth.
Some intersex people may describe themselves as being transgender or nonbinary, however.
How to identify
Doctors will always assign intersex infants a legal sex. In most of the United States, this will be male or female. However, this does not have to influence a person’s gender identity.
People can self-identify as another gender and choose to live according to this gender. Some may identify as nonbinary and have multiple genders or no gender, while others may move between genders or consider themselves other-gendered.
It should be the person’s choice as to which gender they identify with. They should not feel that they must adhere to the gender typically associated with the sex a doctor or family assigned them at birth or to the gender that society may assign them based on their appearance or anatomy.
Sometimes, it is obvious that an infant is intersex. An intersex infant may have:
- no vaginal opening
- labia that do not open
- a penis without a urethral opening
- a smaller penis than expected
- a larger clitoris than expected
- outwardly male or female genitalia but the internal anatomy of the other sex
Other times, it may only become apparent that someone is intersex during puberty, when they do not reach the expected milestones for their sex due to hormonal differences.
In other cases, a person may not discover that they are intersex until adulthood. For example, some may find out when they are trying to conceive, while others may find out during an unrelated medical procedure.
When an infant is born intersex, doctors and the infant’s parents will often decide to “assign” the infant a sex and raise them according to the gender norms associated with that sex.
Doctors may sometimes perform surgery on the infant’s genitals, but most medical organizations now consider this unacceptable. Some may also prescribe hormone treatments during puberty, but this is also seen as unacceptable.
The aim of these treatments has typically been to make the infant better “fit” into either the male or female category.
However, there is a growing movement that aims to change how medical professionals, parents, and others view intersex people. As it is not a disease, many believe that intersex does not require treatment.
Amnesty International, the United Nations, and intersex advocacy groups are all highlighting concerns associated with performing medically unnecessary surgeries and treatments on infants and young children who cannot make their own decisions.
Instead, these groups advocate for intersex people to be able to make their own decisions about treatment when they are older.
Occasionally, however, children and young adults may need treatment for health conditions associated with having intersex anatomy. It is, therefore, important to distinguish between interventions that are medically necessary and those that are not.
Sexuality refers to a person’s sexual feelings, thoughts, and behaviors toward others.
There are several types of sexuality, including heterosexual, homosexual, and pansexual, among others. Some individuals may prefer not to use any labels to describe their sexuality.
Sexuality is independent of a person’s physical anatomy or gender identity. Research involving intersex people shows no correlation between sexuality and gender identity, just as there is no correlation among those who are not intersex.
In the 2015 Australian survey, 48% of respondents identified as heterosexual, 22% identified as bisexual, and 18% identified as homosexual.
Sometimes, an intersex person will have male or female reproductive organs and genitals but have chromosomes typically associated with the other sex.
Other people may have various combinations of chromosomes that are different from the typically male chromosomes (XY) or the typically female chromosomes (XX).
Some conditions that may affect chromosomes and can cause intersex anatomy include Klinefelter syndrome and Turner syndrome.
Klinefelter syndrome occurs when a person is born with an extra copy of the X chromosome (XXY). People with this condition may have smaller testicles than expected, lower testosterone levels, reduced muscle mass, and enlarged breast tissue.
Turner syndrome occurs when a person is born with a missing or partially missing X chromosome. It can cause a variety of issues, including ovarian failure, heart defects, and slowed growth.
It is important to note that a person’s chromosomal makeup does not have to define their gender identity. People should support those with intersex characteristics and encourage them to choose their own gender identity.
LGBTQIA+ resources
To discover more evidence-based health information and resources for LGBTQIA+ individuals, visit our dedicated hub.
The following are some frequently asked questions about intersex.
Is the term ‘hermaphrodite’ offensive?
InterACT, the advocacy group for intersex youth, advise that people should never use the term hermaphrodite to describe an intersex person.
Many intersex people consider it a slur, though some may choose to reclaim the word.
Is intersex the same as ambiguous genitalia?
No, it is not the same thing. Some intersex people have typically male or typically female genitalia, yet their hormones or chromosomes may more closely align with the other sex.
Some intersex people may not like the term ambiguous genitalia, as they do not feel that there is anything ambiguous about their genitalia.
Do intersex people need treatment or surgery?
No. Being intersex is not a disease. Therefore, it does not require treatment.
However, some people may choose to undergo surgery to get genitalia that correspond with those typically associated with their gender identity. Others may require medical intervention due to complications that arise from having intersex genitalia, such as difficulty urinating.
How and why do people assign sex at birth?
Most countries and states in the U.S. require doctors to assign infants a sex (typically male or female) at birth. However, this is something that people may be able to change later on.
Doctors and families may believe that performing surgery at birth may make life easier, both medically and socially, for the infant as they grow up. However, this can lead to issues later in life, especially if the person later identifies as another gender.
Can intersex people have children or get pregnant?
Some intersex people can reproduce, but others cannot. Some may be able to with the help of in vitro fertilization. It depends on the individual, their anatomy, and their hormones.
According to InterACT, many intersex variations do cause infertility, but not all do.
Are there support groups for intersex people?
There are intersex support groups in various states and countries. There are also online forums and groups for intersex people. InterACT maintain a list of intersex support and advocacy groups here.
The term intersex describes a range of bodily variations that do not fit into conventional definitions of male or female. People with intersex traits may identify with a range of genders and sexualities, just as non-intersex people do.
Being intersex is not a disease, and it does not require treatment unless complications arise.
Support and advocacy groups for those who are intersex and those who have intersex children can help people navigate the challenges of being intersex and connect with other intersex people.