Maybe it was because I was hungry or maybe it was just the way she looked at me, but I almost went off on a lady at the mall this evening.
I held my tongue and did not say a thing, but oh I wanted to. It was by no means the most offensive stare I have received and she didn't say anything to me.
But she almost ran into the door she was staring so intently.
People stare at me. I get that. They need to figure me out.
I disrupt their perfectly aligned gender binary. But can folks please lay off the comments and venomous stares?
I once overheard a child ask their parent if I was a boy or a girl. Their response? "I don't know what it is."
Seriously. Take a wild guess, say boy, say girl, but never call another human being an it. And don't teach your child to call someone that, it is not okay! It is never okay!
What Does Intersexed Mean?
The term intersexed describes a group of conditions in which a person's external genitalia (vagina or penis) does not match with their internal genitalia (ovaries or testes). This can be very confusing for the parents and the child as he or she grows older.
Historically, it was not uncommon that a medical decision is made at the time of birth to "normalize" the appearance of the genitals when the genitals were ambiguous - or not clearly male or female. This often resulting in problems and self-esteem issues later in life for the intersexed individual who was raised as the opposite gender as they choose to identify with.
What Does Intersexed Look Like?
There are four main conditions that lead to a diagnosis of "intersexed." These conditions include the following:
46, XX - is a condition in which an intersexed individual has the sex characteristics and genetic makeup of a female; however, the external genitalia appear to be more male. This can include an elongated clitoris and labia that are not clearly defined or are grown together. This results in genitalia that resemble a penis.
There are multiple causes for 46, XX.
The most common cause of this condition is Congenital Adrenal Hyperplasia. For people with Congenital Adrenal Hyperplasia, their body does not produce the correct enzymes needed to make the hormones cortisol and aldosterone. These hormones create a balance, which otherwise is missing, leading the body to make more androgen that it should, causing male sex characteristics to form. This can occur in both males and females.
Other causes for 46, XX, include intrauterine exposure to an abundance of testosterone hormone, resulting in an increased testosterone level in the fetus; male-hormone-producing tumors in the mother (often ovarian tumors); or an aromatase deficiency, which converts male hormones to female hormones. This deficiency can cause problems such as excess estrogen. Further, it is possible for those intersexed individuals with this deficiency to be raised female, and take on visible male characteristics at puberty.
46, XY is a condition in which an intersexed individual has ambiguous or female genitals, but is genetically and chromosomally male. Often the testes are located inside the body, and may be anywhere from completely normal to completely absent.
This variation of intersex is caused by an improper balance between male- and female-produced hormones. The most common cause of this form of intersex is Androgen Insensitivity Syndrome. This describes a malfunction in the receptors that are supposed to receive the male hormones. Instead, while the body is completely male and hormones are typical for a male, the receptors do not allow the body to function properly, and lead to a feminization of genitalia.
Other causes may stem from problems with the testes. The testes may be under-developed, leading to an imbalance in hormones. There may also be problems with the proper creation and distribution of testosterone and other male hormones.
True Gonadal Intersex is a condition in which an intersexed individual has both ovaries and testes. These organs may be separate, combined, or partial, but the person must have both ovaries and testes to receive this diagnosis. Genitals may also be ambiguous to defined male or female. There is a lot of variety in the presentation of this "true" intersexed condition, and there is little understanding of the cause.
Complex/Undetermined Intersex Disorders refers to other presentations and descriptions that lead to unclear, mismatched, or ambiguous internal and external genitals. This includes incorrect numbers of chromosomes, sex hormone imbalances, and other alterations.
Presentation of Intersex:
Because of the varied nature of conditions that lead to an individual becoming intersexed, there are multiple and varied presentations of intersex. However some commonalities exist in the symptoms of intersex. These symptoms of intersex may include:
- Ambiguous genitalia at birth
- Enlarged clitoris
- Labial fusion
- Undescended testes in boys
- Groin masses in girls
- Urethra opening not at the tip of the penis
- Delayed or absent puberty
- Unexpected changes at puberty
- A feeling of being the wrong sex
Diagnosis of Intersex:
In addition to the above physical symptoms of intersex, there are other ways in which intersex can be diagnosed. The ways intersex may be diagnosed includes:
- Genetic testing
- Chromosomal testing
- Examination of hormone levels
- Electrolyte tests
- Molecular testing
- Endoscopic examination for testes or ovaries
- Ultrasound of the abdomen
Treatment for Intersex:
Treatment for intersexed individuals can be complex. Often a team of health care professionals that may include medical professionals and a therapist will work together to unravel the individual's particular situation.
The physical aspects of intersex can be treated with surgical options and medication to balance hormones or to manipulate the appearance of the genitals. However, this is an important and controversial decision, so make sure you speak with your healthcare provider at length before engaging in surgical options. While the historical practice was to conduct surgeries at birth, a more modern opinion is to delay surgery until the child is old enough to be involved and engaged in the decision.
In addition to the physical aspects of the disorder, there are many mental aspects to being intersexed. It is a complex issue that has immediate and long-term effects on the individual.
For example, there may be shame or embarrassment about being different. The person may feel a different sex than he or she is raised to be. They may be bullied. All of these aspects are confusing and hurtful, and a skilled therapist can assist in working through the issues that may arise.
Additional Resources About Being Intersexed:
Intersex Society of North America - This is a website and support site dedicated to "systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female." The side contains information about FAQ, legal information, and other resources.
Intersex Initiative - This FAQ provides information about commonly asked questions regarding being intersexed. The website also contains information and articles.
Congenital Adrenal Hyperplasia - This website contains an education and support network for those with CAH, a leading cause of intersex.
TurnerSyndrome.org - This website is dedicated to information about Turner's syndrome, which is a condition in which a sex chromosome is missing, leading to related issues.