Alice D. Dreger, Ph.D.
Associate Professor of Science and Technology Studies, Michigan State University and Chair of the Board of
Directors, Intersex Society of North America.


There was a time not so long ago when parents couldn’t answer the question “boy or girl?” until a child was born. But nowadays, most people expect parents to be able to answer that question well before birth. That makes things even more awkward for parents whose children have an intersex condition.

When a child is born with an intersex condition, even though the doctors and parents may have thought they knew what sex the child was from prenatal sonograms, the sex of the child may be unclear. There may be several days of tests before doctors and parents decide what gender to assign such a child.

‘Intersex’ is a general term used for any form of congenital {inborn} mixed sex anatomy. This doesn’t mean that a person with an intersex condition has all the parts of a female and all the parts of a male; that is physiologically impossible.

What it does mean is that a person with an intersex condition has some parts usually associated with males and some parts usually associated with females, or that she or he has some parts that appear ambiguous {like a phallus that looks somewhere between a penis and a clitoris, or a divided scrotum that looks more like labia}.

It’s important to understand that intersex doesn’t always involve ‘ambiguous’ or blended external sex anatomy. Sometimes a child or adult who is intersexed can look quite unambiguous sexually, although internally their sex anatomy is mixed. This happens, for example, with complete androgen insensitivity syndrome, where a person has some male parts {including a Y chromosome and testes} internally, but is quite clearly feminine on the outside. It’s important to also be clear that intersex is different from transgender in that a person with intersex is born with mixed sex anatomy, where as a person who is transgendered is a person who feels himself or herself to be a gender different than the one he or she was assigned at birth.

When a baby or child is recognized to have an intersex condition, it can be quite traumatic for the parents.

What, then, should parents of a child with an intersex condition know? Parents should be aware that legal scholars have recently shown that parents of children with intersex conditions are often not fully informed before they consent to “normalizing” surgeries.

In the recent past they have not been told, for example, that the claim that gender comes from nurture has fallen into serious question, and that doctors cannot actually know what gender a child will end up feeling. As a consequence, some parents have consented to have their micropenis boys turned into girls, only to discover later that studies by Dr. William Reiner at Johns Hopkins University have shown that many children born with micropenis ultimately take on the male gender identity regardless of having been raised as girls with surgically ‘feminized’ genitalia.

When facing the possibility of intersex, parents should know that every child can and should be assigned a gender as boy or girl and that doing so does not require any surgery.

Gender assignment is accomplished for every child {intersexed or not} through the social and legal labeling of a child as boy or girl. In intersex cases, doctors and parents can work together to try to figure out what gender a child is likely to feel given that particular child’s anatomy and physiology. Removing parts doesn’t remove the possibility that the child may change gender later; it only makes it a lot harder for the child to do what she or he wants or needs later.

Finally, parents should know that intersex does not have to be treated with shame and secrecy.

The bottom line is that children with intersex conditions and their parents deserve honesty, respect, and support.

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