Intersex

Alice Dreger Is anatomy destiny?

A TED talk examining the interaction of anatomy on our social constructions of body and identity. Areas of particular interest: 1:50, 5:53, and 13:58.

Intersex describes individuals who do not fit neatly into the dominant social notions of biologically male or female bodies but instead have features of both sexes. Male and female are often depicted as natural, biological categories of sex.  The characteristics used to determine sex include chromosomal makeup, anatomy (gonads, internal reproductive structures and external genitals) and hormonal conditions (Crooks and Baur 48).  A typical male is expected to have XY chromosomes, a penis, testes, and androgens (48).  A typical female has XX chromosomes, ovaries, estrogens and progestational compounds (48).  In intersex individuals, the combinations of these sex characteristics vary from typical development.

Intersex Development

During typical fetal development, embryos begin largely the same, but over time their structures differentiate into the previously described anatomical sex characteristics.  Intersexuality comes from a variance in this development.  Within the category of intersex exist true hermaphrodites who possess ovarian and testicular tissue, and pseudohermaphrodites who have a combination of male and female internal and external structures or ambiguous structures (Crooks and Baur 54).

Further classification of intersex occurs according to the developmental cause:

Chromosomal differences may lead to intersex conditions, as is the case with Klinefelter’s syndrome (Crooks and Baur 54).  Individuals with Klinefelter’s syndrome have a chromosomal makeup of XXY, develop male genitalia, generally have underdeveloped penises and testes, and are sterile (55).

There are also a few hormonal conditions that affect development, such as Androgen Insensitivity Syndrome or AIS (54). Individuals with AIS have XY chromosomes but are insensitive to androgens (the hormone more prevalent in males) and as a result develop more female anatomical characteristics (55).  While the external genitals match those of typical females, the internal structures are largely absent, and the individual is consequently sterile (55). 

Social Implications 

Intersex status is treated with apprehension because it does not fit into social constructions of sex and gender. Intersexuality is not generally accepted as a form of being but instead seen as something in need of treatment.  Treatment generally begins in early infancy when the individual’s unique combination of sex characteristics is considered to determine which gender identity the child will likely develop (Fausto-Sterling 123).  This gender is then assigned to the child.

Treatment

Following gender classification, treatment is conducted in one of two ways. In the more historically popular treatment path, infants undergo surgery to match the external structures to those associated with the newly assigned gender.  They may also undergo hormonal treatment to encourage typical male or female development.  This treatment   has become controversial due to the emergence of individuals who develop gender identities different from their gender assignment (Crooks and Baur 60; Fausto-Sterling 123). Surgery may also reduce sexual sensitivity (Fausto-Sterling 123). 

In response to growing concerns on the effects of early surgical treatment, medical practitioners proposed new approaches to intersex children. New treatment models recommend choosing a gender identity for the child, avoiding surgery in childhood, providing counseling for the family, and allowing the child to make informed decisions about any further treatment later on in development (Crooks and Baur 60). Some propose intersexuality should be acknowledged as a normal form of sex and that intersex individuals should be able to embrace whatever gender identity they choose, be it male, female, intersex, or other (Crooks and Baur 61; Fausto-Sterling 123). 

Some conceptualizations of the relationship between sex and gender suggest that sex and gender are the same or that sex determines our attribution of gender (Foss, Domenico, and Foss 6-7). Intersex individuals greatly challenge the validity of the gender binary and challenge the “natural” categories of male and female, shedding light on the social construction of both gender and sex (56, 8). 

Works Cited

Crooks, Robert, and Baur, Karla. Our Sexuality. 10 ed. Belmont: Wadsworth, 2008. Print.

TEDtalksDirector. “Alice Dreger: Is Anatomy Destiny?” Online video clip. YouTube. YouTube, 10 Jun. 2011. Web. 9 Jan. 2013

Fausto-Sterling, Anna. "The Five Sexes, Revisited." Women's Voices Feminist Visions. Ed. Shaw, Susan, & Lee, Janet. 5 ed. New York: McGraw-Hill, 2011. Print.

Foss, Sonja K., Mary E. Domenico, and Karen A. Foss. Gender Stories: Negotiating Identity in a Binary World. Long Grove: Waveland Press, Inc., 2013. Print.