What is Intersex? - Step To Health

What is Intersex?

Do you know what intersexuality is? In this article, we'll discuss its characteristics, how it's classified and some misconceptions about it.
What is Intersex?

Last update: 25 November, 2021

The majority of the population interprets sexuality from the point of view of binarism. That is, they use the labels male and female. In the last few decades, however, we’ve seen an awakening of how genders are categorized. In many cases, this is backed by scientific evidence. Today, we’ll talk about what intersex is and what its characteristics are.

Intersex is a label that is a departure from other more common labels, such as transgender or transsexual. However, many people are completely unaware of its meaning. In the following article, we’ll meticulously explain what it is, why you should know about it, and some common misconceptions.

Characteristics of intersex people

Intersex is a general word used to describe various conditions characterized by alterations in a person’s sexual, reproductive, hormonal, or genetic anatomy. This precludes the use of classical male or female standards.

The term is relatively new. In a paper published in 2006, the Lawson Wilkins Pediatric Endocrine Society (LWPES) and the European Society for Pediatric Endocrinology (ESPE) agreed to call all of these conditions “disorders in sexual development.”

The use of this label is not without controversy, as some researchers use it to group Klinefelter syndrome or Turner’s syndrome as well. Regardless of the terminology, the important point is that an intersex person is characterized by genital, hormonal, or genetic ambiguity (however, the latter is more controversial).

For example, a person may have male sex organs on the outside but female organs on the inside (or vice versa). It can also refer to men with a very small penis or women with a very large clitoris. A disorder in the genetic sequence can provide XX (male) or XY (female) cells in the same person.

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Intersex classifications

If the use of terminology is subject to controversy, so is the classification. It’s often referred to as intersex states.

The problem is that even though intersex has been the subject of study by thousands of scientists, it’s an umbrella condition with no fixed parameters of determination. In many cases, as we’ll see below, the assignment of the intersex label is subjective.

Cuestiones de género en la intersexualidad.
The classification and terminology of these situations haven’t been subject to unified consensus worldwide.

Male pseudohermaphroditism

This group includes people with testicles or genital organs that have not fully developed. It has subcategories (mild, severe, or atypical).

The most important condition in this category is androgen insensitivity syndrome, also known as Morris syndrome. Some of its features are as follows:

  • An undeveloped vagina
  • The absence of armpit and pubic hair
  • Testosterone levels similar to those of a healthy man

Female pseudohermaphroditism

This is also known as congenital adrenal hyperplasia or, in some contexts, adrenogenital syndrome. It’s divided into classic, mild, masculinizing, and atypical.

Some distinguishing features in this group are as follows:

  • A phenotype with masculine traits
  • A normal vagina and uterus in classic or mild cases, or – in more masculine cases – the external genitalia tends to develop a masculine appearance
  • A hypertrophied clitoris

True hermaphroditism

True hermaphroditism is a condition that refers to those born with both ovarian and testicular cells. According to the evidence, the most common symptoms are ambiguous genitalia, clitoral hypertrophy, and hypospadias (the opening of the urethra is not at the tip of the penis). In any case, the person has both testes and ovaries.

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Gonadal dysgenesis

Finally, gonadal dysgenesis refers to various conditions characterized by impaired development of the gonads (ovaries or testes). Researchers point out that the most common is Turner syndrome, which we’ve already mentioned, with 1 case per 2500 births.

Among its distinctive features, we highlight the following:

Cromosomas sexuales.
Genetic intersex is the most debated form, as there’s still no scientific clarity about its classification and typing.

These four categories are used to describe cases of intersex. Of course, many people can be grouped into several of them, and the labels are sometimes not sufficient to explain their situation completely.

How common is intersexuality?

Because of the ambiguity of the term intersex, and because the diagnosis is often made subjectively, it’s not known how common it is to be intersex. Biologist and gender studies expert Anne Fausto-Sterling proposed a couple of decades ago that the number of intersex people could be around 1.7% of society.

This figure is not without controversy, as some researchers have severely criticized it. They claim that the prevalence is lower, as many conditions that fall into the categories outlined above cannot be considered as part of intersex. In this sense, the actual number could remain around 0.018%.

It’s important to add one more variable: not all intersex people are diagnosed. In fact, many of them reach the end of their lives unaware of the condition. This happens with genetic disorders or those in which external genital development has not been altered.

Misconceptions about being intersex

To close this article on intersex, we would like to point out some misconceptions about intersexuality.

In the beginning, we said that it’s not to be confused with the term transgender or transsexual. An intersex person is neither transgender nor transsexual.

While it’s true that an intersex person may identify at some point in their life as transgender, this does not imply that everyone is considered transgender. Similarly, treatment options based on surgery or hormones do not mean that they become transgender.

This leads to the next misconception: that it’s a condition that should always be treated in childhood. As Amnesty International points out, its consequences can be felt psychologically, in gender identity, health, and sex life. In any case, many of the interventions are unnecessary or could condition the child’s future, so it’s best to wait until the child makes their own informed decision.

Another misconception is that everyone has a female or androgynous appearance. However, many cases of intersexuality have nothing to do with physical appearance.

Finally, although we have used the term hermaphrodite in the classification categories, it’s a term very few intersex people identify with. It’s used only in medical literature.

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  • Breehl, L., & Caban, O. Genetics, Gonadal Dysgenesis. StatPearls [Internet]. 2020.
  • Hughes, I. A., Houk, C., Ahmed, S. F., Lee, P. A., & Society, L. W. P. E. Consensus statement on management of intersex disorders. Journal of pediatric urology. 2006; 2(3): 148-162.
  • Sax L. How common is intersex? a response to Anne Fausto-Sterling. J Sex Res. 2002 Aug;39(3):174-8.
  • Yordam N, Alikasifoglu A, Kandemir N, Caglar M, Balci S. True hermaphroditism: clinical features, genetic variants and gonadal histology. J Pediatr Endocrinol Metab. 2001 Apr;14(4):421-7.