Intersex

This article is about intersex in humans. For intersex in other animals, see Intersex (biology).
Not to be confused with Hermaphrodite.

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A group of people standing on a staircase in a hotel facing the camera.
Participants at the third International Intersex Forum, Malta, in December 2013

Intersex people are individuals born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies".[1][2]

Sex assignment at birth usually aligns with a child's external genitalia. The number of births with ambiguous genitals is in the range of 1:4,500–1:2,000 (0.02%–0.05%).[3] Other conditions involve the development of atypical chromosomes, gonads, or hormones.[4][2] Some persons may be assigned and raised as a girl or boy but then identify with another gender later in life, while most continue to identify with their assigned sex.[5][6][7] The number of births where the baby is intersex has been reported differently depending on who reports and which definition of intersex is used. Anne Fausto-Sterling and her book co-authors claim the prevalence of "nondimorphic sexual development" in humans might be as high as 1.7%.[8][9] However, a response published by Leonard Sax reports this figure includes conditions such as late onset congenital adrenal hyperplasia and Klinefelter syndrome, which most clinicians do not recognize as intersex; Sax states, "if the term intersex is to retain any meaning, the term should be restricted to those conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female", stating the prevalence of intersex is about 0.018% (one in 5,500 births), about 100 times less than Fausto-Sterling's estimate.[4][10][11]

Terms used to describe intersex people are contested, and change over time and place. Intersex people were previously referred to as "hermaphrodites" or "congenital eunuchs".[12][13] In the 19th and 20th centuries, some medical experts devised new nomenclature in an attempt to classify the characteristics that they had observed, the first attempt to create a taxonomic classification system of intersex conditions. Intersex people were categorized as either having "true hermaphroditism", "female pseudohermaphroditism", or "male pseudohermaphroditism".[14] These terms are no longer used, and terms including the word "hermaphrodite" are considered to be misleading, stigmatizing, and scientifically specious in reference to humans.[15] In biology, the term "hermaphrodite" is used to describe an organism that can produce both male and female gametes.[16][17] Some people with intersex traits use the term "intersex", and some prefer other language.[18][19][page range too broad] In clinical settings, the term "disorders of sex development" (DSD) has been used since 2006,[20] a shift in language considered controversial since its introduction.[21][22][23]

Intersex people face stigmatization and discrimination from birth, or following the discovery of intersex traits at stages of development such as puberty.[24] Intersex people may face infanticide, abandonment, and stigmatization from their families.[25][26][27] Globally, some intersex infants and children, such as those with ambiguous outer genitalia, are surgically or hormonally altered to create more socially acceptable sex characteristics. This is considered controversial, with no firm evidence of favorable outcomes.[28] Such treatments may involve sterilization. Adults, including elite female athletes, have also been subjects of such treatment.[29][30] Increasingly, these issues are considered human rights abuses, with statements from international[31][32] and national human rights and ethics institutions.[33][34] Intersex organizations have also issued statements about human rights violations, including the 2013 Malta declaration of the third International Intersex Forum.[35] In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention.[36] In April 2015, Malta became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people.[37][38]

  1. ^ "Intersex people". OHCHR. Archived from the original on 8 July 2023. Retrieved 11 June 2023.
  2. ^ a b Cite error: The named reference unfe-fact was invoked but never defined (see the help page).
  3. ^ Selma Feldman Witchel (2018). "Disorders of Sex Development". Best Practice & Research. Clinical Obstetrics & Gynaecology. 48: 90–102. doi:10.1016/j.bpobgyn.2017.11.005. PMC 5866176. PMID 29503125. The estimated frequency of genital ambiguity is reported to be in the range of 1:2000–1:4500
  4. ^ a b Cite error: The named reference sax was invoked but never defined (see the help page).
  5. ^ Alice Domurat Dreger (2001). Hermaphrodites and the Medical Invention of Sex. US: Harvard University Press. ISBN 978-0-674-00189-3.
  6. ^ "New publication "Intersex: Stories and Statistics from Australia"". Organisation Intersex International Australia. 3 February 2016. Archived from the original on 29 August 2016. Retrieved 18 August 2016.
  7. ^ "Intersex population figures". Intersex Human Rights Australia. 28 September 2013. Archived from the original on 17 July 2018. Retrieved 1 January 2021.
  8. ^ Cite error: The named reference Anne_Fausto-Sterling_2000 was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference Anne_Fausto-Sterling_2000b was invoked but never defined (see the help page).
  10. ^ "How Common is Intersex? An Explanation of the Stats". Intersex Campaign for Equality. 1 April 2015. Archived from the original on 11 February 2021. Retrieved 1 January 2021.
  11. ^ Ripley A (27 February 2005). "Who Says A Woman Can't Be Einstein?". Time. Time. Archived from the original on 1 August 2008. Retrieved 29 December 2008.
  12. ^ Mason H.J. (1978). "Favorinus' Disorder: Reifenstein's Syndrome in Antiquity?". Janus. 66 (1–2–3): 1–13. PMID 11610651.
  13. ^ Nguyễn Khắc Thuần (1998), Việt sử giai thoại (History of Vietnam's tales), vol. 8, Vietnam Education Publishing House, p. 55
  14. ^ Zucker KJ, Bradley SJ, Sullivan CB (March 1992). "Gender Identity Disorder in Children". Annual Review of Sex Research. 3 (1): 73–120. doi:10.1080/10532528.1992.10559876.
  15. ^ Dreger AD, Chase C, Sousa A, Gruppuso PA, Frader J (18 August 2005). "Changing the Nomenclature/Taxonomy for Intersex: A Scientific and Clinical Rationale". Journal of Pediatric Endocrinology and Metabolism. 18 (8): 729–33. doi:10.1515/JPEM.2005.18.8.729. PMID 16200837. S2CID 39459050.
  16. ^ Kilman R (14 April 2016). Encyclopedia of Evolutionary Biology. Elsevier Science. ISBN 978-0-12-800426-5.
  17. ^ Avise J, Nicholson T (15 March 2011). Hermaphroditism. Columbia University Press. pp. 1–7. ISBN 978-0-231-52715-6.
  18. ^ Preves SE (2003). Intersex and identity: the contested self. New Brunswick, N.J.: Rutgers University Press. ISBN 0-8135-3228-0. OCLC 50334056.
  19. ^ Harper C (2007). Intersex (English ed.). Oxford: Berg. ISBN 978-1-84788-339-1. OCLC 608598019.
  20. ^ Houk CP, Hughes IA, Ahmed SF, Lee PA, Writing Committee for the International Intersex Consensus Conference Participants (August 2006). "Summary of Consensus Statement on Intersex Disorders and Their Management". Pediatrics. 118 (2): 753–757. doi:10.1542/peds.2006-0737. PMID 16882833. S2CID 46508895.
  21. ^ Davis G (11 September 2015). Contesting Intersex: The Dubious Diagnosis. New York University Press. pp. 87–89. ISBN 978-1-4798-8704-0.
  22. ^ Holmes M (September 2011). "The Intersex Enchiridion: Naming and Knowledge". Somatechnics. 1 (2): 388–411. doi:10.3366/soma.2011.0026.
  23. ^ Beh H, Diamond M (27 July 2006). "Variations of Sex Development Instead of Disorders of Sex Development". Archives of Disease in Childhood. 91 (7): 554–563. doi:10.1136/adc.2006.098319. PMC 2082839. PMID 16624884.
  24. ^ Muñoz E, Saavedra M, Sansone D (6 June 2024), The Lives of Intersex People: Socio-Economic and Health Disparities in Mexico, doi:10.18235/0013001, hdl:10419/300963.
  25. ^ Cite error: The named reference cschrcl was invoked but never defined (see the help page).
  26. ^ Cite error: The named reference bbc2017 was invoked but never defined (see the help page).
  27. ^ Cite error: The named reference beyond2015 was invoked but never defined (see the help page).
  28. ^ Submission 88 to the Australian Senate inquiry on the involuntary or coerced sterilisation of people with disabilities in Australia Archived 23 September 2015 at the Wayback Machine, Australasian Paediatric Endocrine Group (APEG), 27 June 2013
  29. ^ Cite error: The named reference jysk was invoked but never defined (see the help page).
  30. ^ Macur J (6 October 2014). "Fighting for the Body She Was Born With". The New York Times. Archived from the original on 12 January 2015. Retrieved 9 February 2015.
  31. ^ Report of the UN Special Rapporteur on Torture Archived 29 April 2019 at the Wayback Machine, Office of the UN High Commissioner for Human Rights, February 2013.
  32. ^ Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement Archived 11 July 2015 at the Wayback Machine, World Health Organization, May 2014.
  33. ^ Involuntary or coerced sterilisation of intersex people in Australia. Canberra: Senate of Australia Community Affairs References Committee. 2013. ISBN 978-1-74229-917-4. Archived from the original on 23 September 2015.
  34. ^ Cite error: The named reference swissnek was invoked but never defined (see the help page).
  35. ^ Cite error: The named reference afp2016 was invoked but never defined (see the help page).
  36. ^ Cite error: The named reference icj1 was invoked but never defined (see the help page).
  37. ^ "Surgery and Sterilization Scrapped in Malta's Benchmark LGBTI Law". The New York Times. Reuters. 1 April 2015. Archived from the original on 4 April 2015. Retrieved 29 August 2020.
  38. ^ "Malta passes law outlawing forced surgical intervention on intersex minors". Star Observer. 2 April 2015. Archived from the original on 14 August 2015.