... And for a woman wert thou first created;
Till Nature, as she wrought thee, fell a-doting,
And by addition me of thee defeated,
By adding one thing to my purpose nothing.
But since she prick'd thee out for women's pleasure,
Mine be thy love, and thy love's use their treasure.
Shakespeare, Sonnet XX
The official position towards people with Variations of Sex Development (VSD) has changed remarkably since 2006. This has led the Intersex Society of North America to close. The following information is still factual.
About one child in 2000 is born such that doctors are unable to immediately assign it as "male" or "female". (As many as one in 100 have lesser degrees of gender variance.) They are commonly described as "hermaphrodite" or "intersexed". (The term Disorders of Sex Development has been coined, but this too has been condemned as judgmental and pathologising.) These variations are commonly, but not always, expressed in the genitalia. Those who think in binary male/female terms call them "ambiguous genitalia". (They have one set of genitals, uniquely their own, not two.)
VSDs can vary in degree; there may be just a slight variation of the genitals, such as hypospadias, where the urinary opening appears part way down the penis, or clitorimegaly, where the clitoris is bigger than usual. The standard by which a child is deemed to have a penis that is "too small" or a clitoris that is "too big" is purely arbitrary.
VSDs can have a variety of causes:
Androgen Insensivity Syndrome (AIS)
5-alpha-reductase deficiency (5-AR)
Congenital Adrenal Hyperplasia (CAH)
and others. 25 per cent of affected people remain without diagnosis or established cause.
These names all suggest a disease, disorder, or deviation from some (societal) norm. It is heavily ingrained in us that everyone must be one sex or the other. We don't even have the language (in English) to speak of intersexed people, states or conditions accurately. "He" and "she" leave no middle ground.
There is some evidence that gender identity (what sex we think we are) is internal, generated in the brain, independently of how we are socialised (nurture), but usually corresponding to our "nature" - the form of the genitals (phenotype) and the type of sex chromosomes in every cell (genotype).
Many people with VSDs self-identify as male or female. They may yet prefer to keep all of their genitals unmodified.
Non-European cultures, such as Polynesia and Native American, often have a third gender category into which people with VSDs can be assigned. In India the Hijra (commonly called "eunuchs"), comprising intersex, transgender and other gender-nonstandard people, form a community with a clear role.
(People are sometimes presented to the public as "hermaphrodite" for sexual reasons or for profit: those may be transgendered, born physically male, with their original male genitals, but with a female identity and taking female hormones to enlarge their breasts.)
Most parents in our society are inclined to panic at the birth of an intersexed baby (they are, after all, inclined to ask "Is it a boy or a girl?" even before they ask "Is s/he all right?"). In the past, a baby's sex variation might actually be concealed from the mother until the "problem" had been surgically "solved". Nowadays, systems of consultation are more inclined to swing into action, but intersexuality is still seen as something "wrong" which has to be "corrected" if possible, before the child is old enough to have a say in the matter.
The surgical "correction" is often entirely cosmetic, focussed on giving the appearance of "one sex or the other" and having the capacity for heterosexual intercourse. The sex chosen is more often female, since that is easier to achieve surgically. Where a person with testicles is assigned female gender, they are removed, making "her" infertile.
Hermaphrodites speak out
Now intersexed people are speaking for themselves in opposition to non-consensual genital modification. (Not all, however, and as with other genital cutting, many have reconciled themselves to such an extent that they may support what was done to them.)
The position is complicated by the intense grief and shame felt by the parents and communicated to the child. This makes the child want surgery in order to calm the parents, and makes it harder for intersexed adults to either complain about what was done to them or seek help.
For further information about Variations of Sex Development:
The Intersex Society of North America has closed. There is, however, an important farewell message at its website.
The largest UK campaign group is UKIA (the UK Intersex Association). Founded in 2000, UKIA now has 12 Associate groups around the world. "We campaign against all forms of medical pathologisation of intersex conditions, including the cosmetic surgical reassignment of intersex infants."
in New Zealand, the Intersex Trust of Aotearoa New Zealand at
ph +64 4 381 2221
PO Box 9196
IANZ distributes the PAL version of "Hermaphrodites Speak Out" worldwide.
Assume Nothing, a photographic essay about gender-variant people in New Zealand, by Rebecca Swan
The Captain and Thomasine, a historical novel featuring America's first known intersexual, Thomasine Hall, in 17th century Jamestown, by Don Floyd
Black and White, a documentary about the shooting of Assume Nothing Both: feature-length drama:
Bisexual but frustrated movie stuntwoman Rebecca in San Francisco is sent some photos of her brother Pedro, who died in their native Peru soon after his third birthday - or so she was told. But there are no photos of the two of them together. Rebecca is determined to find out why. Her gay colleague turns down another friend as a surrogate mother for him and his partner because the friend's child Morgan is intersexed - and she is raising Morgan unmodified to be whoever they will be. Rebecca's search takes her to the children's hospital where her brother died, but when she is told the surgery was successful and she sees his records, the pieces start falling into place. The arrogant doctor's name is Silver. (Any resemblance to Dr John Money is purely coincidental.)
Harsh Beauty, about the hijras ("eunuchs") of India Intersexion (NZ, 2012) "...director Grant LaHood follows [Mani] Mitchell ... in America, Ireland, Germany, South Africa and Australia to meet other intersex people. ... Mitchell says the result is a heartwarming story told with a mixture of laughter and tears in the most frank and revealing way. Best New Zealand Feature Documentary, Best Editing" - Capital Times (Wellington, NZ) May 16, 2012
Mani's Story, Qantas Media Award-winning documentary about Mani Bruce Mitchell of New Zealand
One in 2000, documentary about intersex people in the US
Circumcision and gender reassignment
Involuntary gender-reassignment (raising boys as girls) has in the past also been a treatment of (doctors' and parents') choice for boys whose entire penis was accidentally cut off in the course of circumcision. David Reimer's was an example celebrated as a success at the time, but now denounced as a total failure - most of all by him. He has since committed suicide.
Paediatric Surgeon, Mika Venhola, MD, PhD, Assistant Chief, Dept of Pediatric Surgery
Oulu University Hospital, Finland discusses his experiences and thoughts about intersex and related human conditions: