{"id":32,"date":"2019-05-12T12:31:49","date_gmt":"2019-05-12T11:31:49","guid":{"rendered":"https:\/\/mrkhvoice.nfshost.com\/?p=32"},"modified":"2019-08-12T15:09:33","modified_gmt":"2019-08-12T14:09:33","slug":"statistics-and-semantics-is-intersex-as-common-as-red-heads","status":"publish","type":"post","link":"https:\/\/mrkhvoice.com\/index.php\/2019\/05\/12\/statistics-and-semantics-is-intersex-as-common-as-red-heads\/","title":{"rendered":"Statistics and Semantics: Is Intersex “as common as red heads”?"},"content":{"rendered":"\n

Today we\u2019re going to talk statistics and semantics. I\u2019m going to do so via the medium of one of social media\u2019s favourite stats 1.7% (aka \u201cintersex is as common as red heads.\u201d). The statistic comes from Fausto-Sterling\u2019s work, which you can see a review of here<\/a>. <\/p>\n\n\n\n

To understand the statistic, we have to drill down into what the meaning of the word \u201cintersex\u201d is. Most people think of hermaphrodites. Let\u2019s stress at the beginning, there has been no example ever of a human being with both sets of working reproductive organs. There is a very tiny percentage of people who are born with both testicular and ovarian tissue (what Fausto-Sterling calls \u201ctrue hermaphrodites\u201d). And when I say tiny, we\u2019re talking intersex tiny, as in 0.0117\/1,000 livebirths, or one in 100,000. These are very complex cases, but still not actual hermaphrodites<\/a>.  <\/p>\n\n\n\n

So, how do we arrive at 1.7%? What Fausto-Sterling does is apply a wider scope. Instead,\u00a0she argues that intersex is anything that\u00a0doesn\u2019t fit into a platonic ideal. The platonic\u00a0ideal, in this case, being a phenotypically\u00a0perfect XX female and a phenotypically perfect\u00a0XY male.\u00a0This means that intersex, used in the context\u00a0of the 1.7% statistic, includes people for whom there is no sexual ambiguity.\u00a0\u00a0<\/p>\n\n\n\n

Take, for example, Klinefelter syndrome (XXY males). As Fausto-Sterling acknowledges, many males can go their whole life and not realise they are XXY. In fact, the section on chromosomal conditions (anything outside of XX or XY) specifically sets out how they can be categorised, into male or female, according to gonadal (sperm\/egg production) sex and phenotype (other primary and secondary sex characteristics e.g. genitals). <\/p>\n\n\n\n

Other cases that are easily categorised into\u00a0male or female include conditions like mine\u00a0(MRKH),\u00a0and males with penile agenesis. We have XX or\u00a0XY chromosomes but absent or incomplete\u00a0penis or vagina. In males this only occurs in\u00a0around 1\/1,000,000 births but it is more\u00a0common in women.\u00a0Nonetheless, we are still genotypically,\u00a0chromosomally, phenotypically and usually\u00a0gonadally typical males or females.\u00a0\u00a0<\/p>\n\n\n\n

See how robust this sexual dimorphism is? Nature is amazing. <\/p>\n\n\n\n

Fausto-Sterling also includes variations such\u00a0as CAH. This is more complex. Classic CAH\u00a0can lead to ambiguous genitalia. This probably\u00a0isn\u2019t what people think it is though. In the case\u00a0of CAH it would be virilised female genitalia.\u00a0Males with CAH will not have ambiguous\u00a0genitalia.\u00a0Typically, virilised female genitalia\u00a0means\u00a0an\u00a0enlarged clitoris and sometimes a fused labia.\u00a0These might appear\u00a0\u201cmasculine\u201d\u00a0but they are\u00a0female. An enlarged clitoris is not a penis. I\u2019ve\u00a0written<\/a>\u00a0more about this before.\u00a0\u00a0<\/p>\n\n\n\n

However, Fausto-Sterling also includes any ambiguity\u00a0caused during someone\u2019s entire lifetime,\u00a0known as late onset, which extends the\u00a0definition beyond congenital cases not of \u201cthe\u00a0platonic ideal\u201d to cases where no difference or\u00a0ambiguity would be present at birth at all.\u00a0This is important as late onset adrenal\u00a0hyperplasia, people who are unambiguously\u00a0genotypically, phenotypically and gonadally\u00a0either male or female at birth, account for\u00a01.5%<\/a>\u00a0of that 1.7% statistic.\u00a0<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

So far, what we have seen is that, apart from those rare 1\/100,000 cases, \u201cintersex\u201d now includes a lot of people who are actually still unambiguously male or female. I know this is really boring and nowhere near as exciting as \u201cintersex people are clown fish actually\u201d, sorry. <\/p>\n\n\n\n

This is quite long, and I\u2019m going to wrap it up soon but there is one condition that needs discussing, as it\u2019s probably one of the most frequently cited…AIS.  <\/p>\n\n\n\n

AIS (Androgen\u00a0Insensitivity Syndrome) is complicated as\u00a0there are different forms.\u00a0A quick overview; it affects genetic males, as in\u00a0XY individuals. The individuals are unable, to\u00a0varying degrees, to process androgens. In\u00a0other words, they cannot respond to\u00a0testosterone in the way other XY males can.\u00a0Phenotypical features range from a fully\u00a0female external phenotype, with a blind-ending vagina and little axillary hair\u00a0development, to someone with infertile male\u00a0syndrome. AIS is one of the rare occasions\u00a0where sex may be assigned rather than\u00a0observed.\u00a0As women with CAIS have bodies that are\u00a0unable to respond to the hormones that\u00a0produce a male appearance, they are\u00a0observed and recorded as female at birth and raised as girls, their condition does not usually becoming evident until puberty when their periods do not start.\u00a0\u00a0<\/p>\n\n\n\n

I always find it ironic when people rollout \u201csome CAIS women have given birth<\/a>\u201d as a gotcha. Yes, they have, with the help of extensive fertility treatments and other medical interventions, and it kinda underlines why using female makes sense here and isn\u2019t an imposition or a mistake, nor proof that other XY individuals need the same inclusion. I recommend following @ClareCAIS<\/a>, on Twitter, to learn more about CAIS. <\/p>\n\n\n\n

The thing that annoys me most about Fausto-Sterling, and the copycats who followed, is their need to make it all visually tidy. Sterling does it with this graph, which represents precisely nothing that\u2019s said.  <\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

You\u2019ll see\u00a0similar\u00a0being used in lots\u00a0of the \u201csex spectrum\u201d arguments, such as this one which is often shared online by trans activists.\u00a0<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

In what way are many of these conditions a coexistence of male and female or \u201csomewhere in between\u201d? It\u2019s conceptually pretty but scientifically drivel.  <\/p>\n\n\n\n

I\u00a0want to make one thing clear here, I\u2019m not\u00a0against the 1.7% being acknowledged as a\u00a0group. It\u2019s sensible for us to work together.\u00a0Just not this.\u00a0What I am trying to point out is that there is\u00a0an incongruence between the statistics used for\u00a0intersex conditions and what people think\u00a0intersex means. The vast majority of\u00a0the 1.7% are unambiguously male or female.\u00a0These conditions prove how robust\u00a0dimorphism is.\u00a0To get an idea of what I mean, read this all again, then try explaining it to someone\u00a0else without using the words male or female.\u00a0Biology, and sex, matters.\u00a0<\/p>\n\n\n\n

Addendum: Since I first wrote this thread on Twitter, the BBC have done their own excellent fact check of the 1.7% statistic, you can catch their podcast about it here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Today we\u2019re going to talk statistics and semantics. I\u2019m going to do so via the medium of one of social media\u2019s favourite stats 1.7% (aka \u201cintersex is as common as red heads.\u201d). The statistic comes from Fausto-Sterling\u2019s work, which you can see a review of here.  To understand the statistic, we have to drill down into what the meaning of the word \u201cintersex\u201d is. Most […]<\/p>\n","protected":false},"author":2,"featured_media":35,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[4],"tags":[21,20,9,6,23,22,24,25],"class_list":["post-32","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-intersex","tag-biology","tag-development","tag-dsds","tag-intersex","tag-reproduction","tag-science","tag-sex","tag-statistics","entry"],"jetpack_featured_media_url":"https:\/\/mrkhvoice.com\/wp-content\/uploads\/2019\/05\/intersex-stats.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/posts\/32","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/comments?post=32"}],"version-history":[{"count":4,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/posts\/32\/revisions"}],"predecessor-version":[{"id":202,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/posts\/32\/revisions\/202"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/media\/35"}],"wp:attachment":[{"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/media?parent=32"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/categories?post=32"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mrkhvoice.com\/index.php\/wp-json\/wp\/v2\/tags?post=32"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}