BY EMMA BURKE – Imagine you have just become the proud parent of a newborn. You hear the baby cry just before the doctor whisks your child away for examination. After a few tense moments, the doctor turns around and congratulates you with hesitation. You are told that you baby was born with both female and male genitalia – the diagnosis is intersex.
Anatomical sex, an issue often taught as being black and white, is a social issue like many others which comes with gray areas. However, scientifically speaking, there are three main types of intersex, which are defined as abnormalities in sexual anatomy that cannot be easi
ly classified as male or female. Those born with true hermaphroditism have male and female internal sex organs, tissue of both the testes and the ovaries, and ambiguous external genitalia. Some people with this condition also have mosaicism of the sex chromosomes, meaning that some cells are XY (male) while others are XX (female). The second type is gonadal dysgenesis. This type of intersex is characterized by undeveloped sex organs, internal female sex organs, and external genitalia that can fall anywhere on the spectrum from male to female. Sex chromosomes in a person with gonadal dysgenesis can be normal, mosaic, or simply one X chromosome. Finally, pure gonadal dysgenesis is a condition only seen in females. In this variety of intersex, the girls have XY sex chromosomes, female external genitalia, and underdeveloped internal female sex organs.
Many of the causes of intersex are genetically linked, resulting from insensitivity to male sex hormones or the dysfunction of enzymes that play a critical role in sex determination. Once it is realized that a child is born with atypical genitalia, doctors try to discover the cause of the condition and help the parents in determining the sex of the child – which has become an extremely controversial issue.
Although searching for an “answer” to a baby’s gender may seem ridiculous, this need stems from a parent’s wish for their baby to live a normal life. Therefore, parents are willing to follow a protocol determined by doctors. This includes inspection of the external and internal sex organs, determination of future fertility, and karyotyping to determine the genetic sex. In most cases, doctors and parents evaluate the testing results to determine what sex the baby will be assigned and raised as. However, there are some patients who are not diagnosed as intersex until puberty or even until they die. In these cases, patients have less severe external presentation of symptoms. They do not realize that something is amiss until they have issues related to infertility or an abnormal progression of events in puberty.
While surgery is an option for those born with ambiguous genitalia, the Intersex Society of North America recommends that babies born as intersex are raised as whatever gender the child wants — allowing for him or her to decide at an appropriate age what gender and genitalia to have. However, in some cases, surgery on internal sex organs must be done sooner, forcing the sex of the individual to be determined by doctors. For example, sex organ tumors are common in intersex patients. In these situations, the organs containing the tumor are removed and hormone therapy is implemented. No matter which treatment is chosen for the patient, therapy through counseling and honesty from family members are widely accepted as ways to help intersex patients have the best possible quality of life.