1. Intersex An Introduction for the ANU Equity and Diversity Unit
Author : Zoe Brain
An Introduction :
March 28th 2006
Author contact details :
DISCLAIMER
Along with well researched and scientifically proven data, this contains a few
subjective opinions by the author, based on her observations of various
support sites and forums.
Much of it is by its very nature sexist, as it accepts the very controversial but
very well evidenced theory that male and female brains are morphologically
different. Boys and Girls tend to think differently and this is unaffected by
sexual orientation. Nothing in it should be considered to negate the observed
fact that some people don’t fit into either category by any reasonable definition,
nor should one Gender be valued higher than any of the others. Gender is a
Multi-axis continuum, but each dimension has a bimodal distribution with two
distinct peaks.

2. What is Intersex?
“Intersex” is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.
There are many other formal definitions. This one’s from the Intersex Society of North America
The UK Intersex society definition is
“Intersexed people are individuals born with anatomy or physiology which differs from
contemporary ideals of what constitutes "normal" male and female.”
The Australian Medical Association’s Definition is far more restrictive
“A person with an intersex condition is born with sex chromosomes, external genitalia or an
internal reproductive system that is not exclusively either male or female. This word replaces
hermaphrodite.”
The ACT Government Definition is more restrictive still :
“An intersex person is a person who, because of a genetic condition, was born with reproductive
organs or sex chromosomes that are not exclusively male or female.”
Ibid.

3. Their bodies are neither wholly Female nor wholly Male
In other words...
Their bodies are neither wholly Female nor wholly Male
A pragmatic definition, consistent with a therapeutic or support role, is to not quibble
about whether someone was “born like it”, or whether it happened shortly after
birth, nor whether the cause is genetic or environmental, nor to worry about whether
both female and male characteristics are present, nor the exact meaning of those
terms in this context.
Anyone whose body is neither wholly male, nor wholly female, will have the same
sort of problems, though the details will vary.
Note though, that those who are “true” Intersexed people (by the AMA definition)
may not like others “jumping on the Intersex bandwagon”. Tact is required.

4. There are Hundreds of Different Intersex Conditions
Congenital Adrenal Hyperplasia (CAH), Androgen Insensitivity Syndrome (AIS), Kleinfelter Syndrome, Persistent Mullerian Duct Syndrome, etc etc
Different Problems
Different Concerns
Different Needs
Different Treatment Required
The notes on Intersex in the Ally datapack give some of the more common or more
well-understood Intersex Conditions (there are others…).
“Intersex” covers many different syndromes, and although they have a lot in
common, people who are Intersexed in different ways have very different needs.

5. Medical, Not Sexual or Gender
Separate from Sexual Orientation
May be attracted to Males, Females, Both, Neither....
Each person’s experience of AIS is different but there are probably very few of us who don’t feel their sexuality isn’t affected by it in some way. It’s very difficult not to feel some degree of insecurity about your sexuality when your reproductive organs and/or genitals are different from the norm.
Separate from Gender Identity
May self-Identify as Male, Female, 3rd Sex, “Other”
Unlike transsexualism and/or transgender where 100% of people have gender identity issues, only a small portion of people with intersex conditions (probably about 5-10%) have an issue with their gender.
It’s important to realise that Intersex is not any form of lifestyle choice, it’s
a medical condition, totally distinct from Sexual Orientation or Gender Identity..
Intersex often leads to intense difficulties in a bigendered society, for obvious
Reasons.
It is separate from Sexual Orientation – for how can someone with both 46xy and
46xx, male and female cell lines, (as some mosaics and chimerae are), be either
hetero- or homo-sexual within any normal definition ?
It is also separate from Gender Identity. Most Intersexed people identify, sometimes
strongly, as one of the two usual genders, and are both resentful and hurt if a minor
body anomaly causes others to question this. Others identify as a 3r dGender, Intersex
in its own right, and yet others prefer to have the pronoun “it” applied to them.

6. Issues Health Psychological Social Sexual Gender Legal Privacy
Ignorance
There are many issues to consider, but in the time available, we can only cover a few,
and those quite superficially.
Health, Gender, and Legal issues will be briefly looked at here.

7. Health Issues Some conditions are life threatening
Fertility is usually compromised
Physical effects of childhood persecution (beatings, rape)
Hormonal imbalances and mood swings
Effect of “corrective” neonatal surgery
May not be aware of condition
Lack of awareness of surgical and hormonal therapeutic options
The most important point is that a small proportion of Intersexed people require medical attention
and monitoring to keep alive and healthy. Not just hormones, but Salt balance is crucial for some. .
Fertility is usually compromised, but some therapeutic options exist for some conditions.
Far too many Intersexed people have suffered physical abuse at school, and some have been locked
in cupboards when visitors come round. Most have some broken bones from abuse by age 20.
Hormonal imbalances can affect physical and psychological health, students may need some special
Academic consideration for what is a disability, others won’t.
Some Intersexed people have been made Transsexual by inappropriate neonatal surgery.
Some have only become aware of their condition recently, and may be very Disoriented.
Medical personnel need training in the options available for Intersexed people, both Mental and
physical health. There’s precious little information out there, we need to provide it for them.

8. Gender Issues
Many identify as female, and usually want to conceal their condition
Many identify as male, and usually want to conceal their condition
A few identify as Intersexed, a 3rd alternative, and are usually out and proud
Some are just plain confused – questioning
Some suffer from surgically-induced Transsexualism
Most Intersexed people are strongly conventionally gendered, and are deeply hurt and
offended at any suggestion that their minor anomaly might make them anything other than
“normally” Male or Female. Recent work on Transsexuals and the Intersexed strongly
suggests Gender Identity is determined congenitally, and most people are aware of
their gender by age 18 months to 5 years. Their bigendered worldview should be treated with
respect.
Some on the other hand are militantly non-bigendered in outlook, and their views respected
too. They sometimes see themselves as outside the normal Gender spectrum entirely, or
firmly in the middle.
Some should be encouraged to experiment with finding what’s right for them. For them, the
normal natural variance of human gender, the continuum and multi-axis nature of
it should be emphasised. It’s not just OK, it’s natural to be “male” in some ways, “female”
in others, and most people are (whether they know it or not).
It all depends, and each case should be treated on its merits, with understanding.
Many unfortunates have been made Transsexual by surgery. Some have lost their fertility
this way, particularly hard on those who are women. (Sorry to be sexist, but that’s what
I’ve observed.) The Maternal Instinct, although not Universal, is not a myth, nor a societal
construct. It’s a continuum, and women tend to have a stronger version than men.

9. Actual Example – Legal Issues
UK birth certificate M
Australian Dept of Health F
UK passport F
Australian passport DENIED
Australian Tax Office F
Australian Electoral Office F
ACT Registrar of Births, Marriages M
and Deaths
Zurich insurance policy M
Westpac insurance policy F
Legal Issues – Advocacy and Activism has an important place here.
This is an actual, not a hypothetical, example. The individual concerned presents as female, but is the
biological father (with technical help) of a son now nearly 5. She self-identifies as female, and asexual
in orientation.
There are legal issues in travel documentation, in marriage, in Insurance, and many people who are
Intersexed run the risk of prosecution for giving incorrect information or denial of Insurance benefits
every time they answer a question where the only options are M or F – no matter what answer they give.
The Pharmaceutical Benefits Scheme allows subsidy of certain drugs only for treatment of one sex or the
other. This causes real hardship if an Intersexed individual requires treatment for two conditions, one
only found in males, the other only in females.
The person in question was originally prescribed a drug for “reduction of sex drive in deviant males”,
putting her on a government-held list of rapists and sex offenders undergoing chemical castration.
Since the Health Department decided she was actually female,. she’s now taking the same drug
for the treatment of “androgenisation of a non-pregnant female”.
The worst thing is that genital mutilation of neonatal infants to assign them a Somatic sex is
legal, before their brain-determined gender can be known (by simply asking them).

10. Issues of Ignorance Ignorance in Medical Service Providers
Ignorance in the General Population
Ignorance in the Government
(Bureaucracy, Legislature, Judiciary)
Ignorance in Academe
Philosophy: “gender is a social construct” vs. medical reality
Sociology : how many TS or IS people are there?
Medicine : what are the causative mechanisms?
Ignorance in the GLBITQ lobby
Ignorance amongst the Intersexed themselves
How many people here had a clear idea what “Intersex” meant before this
Introduction?
How many knew that about 1 in 100 people have a degree of Intersex
(usually minor)?
This ignorance is general.
12 months ago, I knew nothing about it either. (It’s a long story).

11. How to Help : Recommended Principles (IMHO)
Empowerment of the student is the key
Do NOT treat as per usual GLB situation
Each case different
Emphasise choice – we just provide the facilities, they choose their way forward
Emphasise “it's OK to be straight” “it's OK to conceal” as well as “it's OK to be gay” and “it's OK to be out”
Their way, not your way
Recommendations (Strictly Personal Opinions)
Treat each case on its merits, and don’t try to fit a square peg into a round hole.
Do not try to treat the individual as being GLB, they may resent it as much as someone
who’s GLB being encouraged or assumed to be Straight.
Listen to them. Point out options, and make suggestions, but don’t try to ram your own
political or sociological beliefs down their throats.
Also – be prepared to be told of Horrors beyond your imagining. genital mutilation
shortly after birth, being actually chained up in their home, subject to Religious
exorcism, multiple hospitalisations due to school violence, maternal rejection, rape…
I’ve been on a number of Internet support sites. I’ve seen all the above, usually
Multiple times. But I still get shocked on occasion.
Above all – be Kind. Telling them that gender is a bimodal distribution, a continuum,
may be true, but may be counter-productive in someone terribly insecure and hurt.

12. Transsexuality vs. Intersexuality
His Honour, Justice Chisholm said obiter:
In my view the evidence demonstrates (at least on the balance of probabilities) that the characteristics of transsexuals are as much "biological" as those of people now thought of as intersex. The difference is essentially that we can readily observe or identify the genitals, chromosomes and gonads, but at present we are unable to detect or precisely identify the equally "biological" characteristics of the brain that are present in transsexuals.
Transsexualism is now regarded by the world's leading experts in the field as another of the many
biological variations that occur in human sexual formation – an intersex condition - where the sex
indicated by the phenotype and genotype is opposite the morphological sex of the brain.
Anecdotal evidence on TS support sites indicates 20-30% of TS people have hormonal or somatic
anomalies (contrary to the literature), based on results of blood tests or other objective medical data.
Given the increasing amount of data supporting a biological cause of TS, it is statistically more likely
that other somatic anomalies may occur, all with a common (as yet undetermined) cause.
A significant proportion of TS people have been victims of a well-meaning attempt to give them a
normal life through “corrective” surgery, usually shortly after birth, sometimes at the onset of Puberty.
Transsexuality is not Intersexuality –
it’s probably an Intersex Condition (we think)