What is intersex?

I was helping a friend of a friend out last night and they asked me to describe what intersex is. Although there are a couple of posts on here that explore the different conditions and how they affect development, I realised I haven’t answered the basic question ‘what is intersex?’ So, I thought I’d share my thoughts here too, as it also addresses use of language, which is something I’ve been meaning to write about anyway.

In sort of broad terms, intersex an umbrella term for a number of different medical conditions that affect reproductive development. It encompasses hormones, chromosomes or body parts which don’t match what we would typically expect for someone of their sex.

For example, MRKH is when someone is born without a full female reproductive system, but with ovaries, XX chromosomes and a female phenotype (externally female in appearance e.g. genitalia). Some other differences, particularly hormonal, impact genital development or other primary and secondary sex characteristics. Chromosomal variations are not physically apparent, without a blood test, but can affect fertility or other aspects of development.

A phrase you’ll sometimes see used is DSD. This can mean disorder of sex development, although a lot of intersex people don’t like the word disorder, so use difference instead. The use of language is contentious.

The biggest issue facing intersex people is unnecessary surgeries on infants. People who use DSD tend to believe speaking to doctors, education and better research is how best to address this. People who oppose DSD tend to be more concerned with identity and third gender markers.

Intersex conditions will always exist in a medical context. If a child has a genital difference at birth, for example, it could be a sign of a serious medical condition. It will always be investigated. This is the same for any difference in development, not just DSDs.

To be honest, this is something the intersex community needs to come to terms with. Intersex history is awash with people being mistreated by the medical profession and scientists. This has led to an unhelpful, general mistrust of all doctors among some intersex activists. I don’t think this is helpful to those who have just received a diagnosis and are looking for help and support.

I think the most important thing to know is intersex variations/DSDs are all physiological, observable differences. Although they are diagnosed as medical conditions, and some can have other health implications, the difference itself is not unhealthy. It does not need “fixing”, unless there is a risk to health, impairment of function or the individual chooses to later in life.

That, in a nutshell, is intersex.