Can intersex reproduce
Some kids do grow up to be cisgender women, and may want to block testosterone to prevent changes such as thicker body hair.
I was self-conscious that I felt comfortable with my body when I was constantly told that I should medically change it. For the longest time, I was ashamed about being different. Once I learned the term intersex and started to find an identity and community within it, I stopped feeling bad for myself. I embraced my body as beautiful and as a measure of how diverse humans are. I started to feel more confident. Not all intersex experiences involve surgery.
To anyone who thinks their bodily experiences might fall under the intersex umbrella, my advice is to explore intersex community and identity. You only have awareness and understanding to gain. My intersex body has XY chromosomes, internal testes that were removed when I was 14, and no other internal reproductive organs. I was assigned and raised female, which luckily has always been my gender identity. My voice dropped, leading to bullying at school, I never grew any armpit hair score , and I started noticing other changes down there.
I hid all of these differences from those closest to me — denial, shame, and stigma clouded my judgement. I knew that once I told anyone, there would be no going back. When I finally grew the balls intersex pun to come out to my mum, I had been suffering alone for four years. Right before I told her, I asked her not to laugh at me, and I think that says it all: I thought my body was laughable. At that point, I had never even heard the word intersex, let alone seen any media representation or met a fellow intersex person.
I thought finding out I was different would be the end of the world, but it turns out it was only the beginning! I have met so many incredible people on my journey to self-love and acceptance. Embracing my intersex identity gave me a truly worthy purpose that consistently grounds me and sets me in the right direction. All the best things in life take work, but as a result I am more empathetic, inclusive and resilient.
Happy Intersex Awareness Day ! Courtesy of Bria. Courtesy of Banti. Courtesy of Johnny. Courtesy of Cat. Courtesy of Francis. Courtesy of Irene. Courtesy of Mari. Surgery creates scar tissue. Scar tissue affects appearance, sexual function, and even fertility, as it can impact being able to have penetrative sex. Removing ovaries or testes prevents a natural puberty.
It also makes a person permanently dependent on external hormones. Infant clitoral surgeries are proven to reduce sexual sensation. Surgeries to create a vagina or move a hypospadic urethra are similarly invasive, with very high complication rates.
Some infant intersex surgeries increase the lifelong risk of UTIs. Many people require multiple surgeries to feel relief from issues caused by their first infant surgery. These are highly personal decisions best left up to the individual. Could a person be intersex without knowing it? Without a medical diagnosis? It has certainly happened before. These are the most common ways for a person to notice that their body is different:. Most intersex people can point to recognizable patterns in their bodies and social experiences.
These patterns generally hold up across different groups of intersex people, and across medical terms for different intersex variations. Most intersex people have been shamed because their genitals or reproductive anatomy are different. Many, but not all, experience medical pressure to change their bodies. Often this pressure starts with doctors offering parents surgeries or hormone treatments for their children. Not all intersex people have genital differences. Not all intersex people have medical diagnoses or records.
And suggesting that they should ignores the fact that intersex people have been around much longer than the medical industry we know today! A person will generally know if they have intersex traits. The clues are in bodies and past experiences, whether or not those experiences are medical. However, many people who do have differences in their sex traits may never hear the word intersex, or may not know how broad the word can be.
Some people reject the word or use other terms. The short answer is: maybe. Like any person, it depends on body parts. And sometimes, help from technology. Making an embryo requires sperm from testes to meet an egg from an ovary.
These days, there are many ways for all of that to happen, even for non-intersex people. It is not possible for any human to reproduce without another person, including with donation and medical technology! If an intersex person has a penis and testes that make sperm, they may be able to cause a pregnancy.
Some intersex people have a vulva, vagina, and internal testes. If an intersex person has a uterus, they may be able to carry a pregnancy. If they have ovaries or ovotestes, that tissue could be used for reproduction in some cases. Some intersex people do have ovaries, a uterus, and a vagina, and could get pregnant by contact with sperm.
Fertility is different for each intersex person. Many, but not all, intersex variations do result in infertility. This is a sensitive topic. Let intersex people share at their own pace, if they choose.
Welcome to the community! You are not alone. There are many intersex support groups, often on Facebook, where intersex people come together to connect. There is also InterConnect , who hosts a yearly in-person conference in the United States. If a child has active gonadal cancer, the cancer should be treated immediately. What about other kinds of surgeries in cases of intersex? We believe that competent patients should be allowed to get the surgeries they want after they have been fully informed of the risks and benefits and the evidence, or lack thereof, for both.
They should be given access to expert, humane surgeons, as well as peer support before and after their procedures. What we object to are elective surgeries done on people usually children without their informed consent.
Such surgeries subject patients to unnecessary harm and risk. In fact, before CAH was well understood, it was thought to occur much more frequently in girls. Now we know that this really reflects the fact that newborn girls with genital ambiguity often came quickly to medical attention, whereas CAH boys who don't have an intersex appearance often died without being diagnosed.
People with CAH both XY individuals, who are not intersexed, and XX individuals, who may be intersexed have problems making their own cortisone, a hormone which helps the body respond to stress like a cold, or a broken bone, or severe trauma in a bad automobile accident, or undergoing surgery. This problem can be addressed by administering cortisone, but only if medical professionals know that the person has CAH.
Another problem that can happen is called "Salt wasting. These people can get very sick, and even die, without medication to correct their body's salt level. Many people with "salt wasting" CAH also say that they crave salt, and feel better when they eat very salty food. Any child who has XX chromosomes and CAH, and is raised as a boy may experience feminizing puberty and menstruation.
We believe that in such a case, the child deserves a clear explanation of his own medical condition, and a choice about medical interventions. A mental health specialist, working with the child and the parents, should determine the child's gender identity.
If the child's identity is female, she may wish to have psychosocial support to change her social sex to female. She may also wish cosmetic genital surgery to make her genitals look more female. If the child's gender identity is male, he may wish to prevent menstruation from occurring. This is not a permanent solution, but a delaying tactic. If the child's gender identity is male, he may choose to have his ovaries removed to prevent further feminization.
As reproductive technology advances, consideration should be given to preserving gonadal tissue for future assisted fertility. In general, gonadal tumors are unlikely in the absence of a Y chromosome or Y genes which may be present on the X chromosome.
When there is a Y chromosome or Y genes are surmised to be present, the gonads are at elevated risk, and should be carefully monitored. Because the risk is slight before early adulthood, gonadectomy should not be imposed on infants. Functioning gonads, even partially functioning gonads, are a big advantage over hormone replacement therapy. Note, though, that it is critical to remove partially functioning testes before puberty from an intersexual who identifies as female and wishes her body not to virilize.
Testosterone or estrogen are necessary to maintain healthy adult bones. If you were born without functioning gonads ovaries or testes , or if your gonads have been removed, you should be under an endocrinologist's care and maintain hormone replacement therapy for life. Many people with intersex conditions, having developed a distrust or aversion for medical people, avoid medical care and drop hormone replacement therapy which was prescribed during puberty. This can result in extreme osteoporosis brittle bones.
Osteoporosis worsens silently, but at advanced stages it can destroy your quality of life. Persons with advanced osteoporosis are vulnerable to frequent bone fractures, especially of the spine, hip, and wrist.
These fractures can be caused by a small amount of force, and are extremely painful and debilitating. Each spine fracture may put you flat on your back for one to two months.
If you have been without gonads or hormone replacement therapy for years, it is vital to get a bone density scan performed, to evaluate the condition of your bones a simple, non-invasive procedure using a specialized x-ray machine , and to seek the advice of an endocrinologist in order to establish a regimen of hormone replacement therapy that works for you. If you have had bad experience in the past with hormones, we encourage you to find an endocrinologist who will work with you to adjust the mix and schedule of hormones until you find what works.
If your bone density is low, your endocrinologist will probably recommend calcium supplements and weight-bearing exercise not swimming! If your bone density scan is performed on a DEXA machine, make certain to do any follow-up scans on the same machine, and with the same reader. A number of drugs currently in the biomedical news may prove useful for rebuilding lost bone density. If your bone density is low, check in with a qualified specialist regularly for the latest information.
The danger of osteoporosis is considerably worse for people with intersex conditions than for post-menopausal women, because they will be without hormones for many decades. If you're having trouble talking with your doctor about HRT hormone replacement therapy , take a look at what "Dr. But if you do know that you have an intersex condition, we encourage you to try to get copies of your medical records.
Many of us have found it invaluable to obtain copies of our medical records, especially those of our births or early genital surgeries. The medical information and the emotional confirmation of what was done to us as children and how we were evaluated by medical personnel helps us to heal. With this information we can better know ourselves and understand who we are. In the U. Until recently, hospitals rarely discarded old records. Sometimes they are moved into warehouses or onto microfilm. Now there is a trend to throw out old records.
You may be able to obtain your records by having a physician request them. If your records are not easily found and your first request is refused or ignored, you may be able to enlist the help of a records clerk. Try telling your story; if you can enlist his or her sympathy, the clerk may be willing to look harder for records misfiled or stored in a warehouse or on microfilm.
Showing up in person at the hospital or office may help. A lot, as it turns out. People who are proponents of prohibitions against "same sex" marriage think it is easy to figure out who is "same sex" and who is "opposite sex.
Check out our FAQ called "What is intersex? Lots of people with intersex that we know are legally married. What will happen to them if we end up with simplistic notions of sex? And lots of people with intersex we know can't get legally married, because some doctor decided for them which sex they would count as forever more. Why should a doctor get to decide who you can grow up to marry?
David Reimer was born an identical non-intersex twin boy in At the age of 8 months, David and his brother each had a minor medical problem involving his penis, and a doctor decided to treat the problem with circumcision. The doctor botched the circumcision on David, using an inappropriate method and accidentally burning off virtually all of David's penis.
At the advice of psychologist John Money at Johns Hopkins University, David's parents agreed to have him "sex reassigned" and made into a girl via surgical, hormonal, and psychological treatments--i. For many years, John Money claimed that David known in the interim as "Brenda" turned out to be a "real" girl with a female gender identity.
As it turns out, Money was lying. He knew Brenda was never happy as a girl, and he knew that as soon as David found out what happened to him, David reassumed the social identity of a boy.
The case of David Reimer has been used by the proponents of the "gender is inborn" nature theory as proof that they are right. We don't think we can ever predict, with absolute certainty, what gender identity a person will grow up to have. What we can predict with a good degree of certainty is that children who are treated with shame, secrecy, and lies will suffer at the hands of medical providers who may think they have the best of intentions and the best of theories.
Beginning in the late nineteenth century, medicine became the primary means for dealing with intersex. Before then, the vast majority of people with intersex conditions went unnoticed by legal, religious, or medical establishments and only a few cases per year came to the attention of authorities.
Presumably other people with so-called "abnormal" sex anatomies lived average lives, either because their anatomical variance was undetectable or was not considered especially important. When a newborn had a high degree of genital ambiguity, midwives, grandmothers, and other local elders appear to have assigned the sex. In terms of sexual orientation, all people were expected to then have sexual relations solely with those who had been identified as the "opposite" sex; in many places, violation of this rule was punishable by violent, sometimes fatal means.
However, by the late s, through gynecological sciences and numerous wartime military medical examinations, doctors gained a much better sense that "abnormal" sex anatomies were actually quite common.
Indeed, late-nineteenth century medical men began reporting dozens of cases a year of "hermaphroditism" and "pseudo-hermaphroditism. The conflation of sex, sexual orientation, and gender expression becomes clear in the s use of the term "psychic hermaphroditism" to refer to gay men, and in the common "scientific" claim that university education physically "masculinized" women. Therefore, biomedical specialists devised a system that would label everyone "truly male" or "truly female," regardless of the extent and natural reality of sexual blending.
A person with non-standard sex anatomy and ovaries is seen as a "female pseudo-hermaphrodite"; a person with non-standard sex anatomy and testes, is seen as a "male pseudo-hermaphrodite"; and if a person has ovarian and testicular tissue, they are seen as a "true hermaphrodite.
All other people thought to be intersex, including pseudo-hermaphroditic, were labeled "truly male" or "truly female" and told to act socially and sexually normative in their assigned gender. However, with improved medical techniques and increased access to healthcare, many more people were being diagnosed with a biological "true sex" that made no sense socially.
In the s as today, women with androgen insensitivity couldn't practically be labeled men just because they had testes. And, in a bi-polar gender paradigm, there was no simple social category for those diagnosed with "true hermaphroditism.
And they began to more actively offer surgical "corrections" to bring the biological sex into line with the assigned gender. It should be noted that, in the last half of the nineteenth century, a small percentage of patients with intersex had started to ask for, and some surgeons had started to offer surgical reconstruction of large clitorises, small vaginas, and hypospadic penises.
With the exception of the rare clitorectomy performed on a child because she had a large clitoris, most of the genital surgeries performed for cosmetic reasons in the nineteenth century were performed on adults at their request. Both patients and surgeons generally avoided elective surgery for reasons of safety. There is also reason to believe that most people with intersex were socially healthy without surgery; they did not disproportionately live as hermits or attempt suicide.
Psychologist John Money studied adults with intersex and found--before the era of standard cosmetic surgical intervention for intersex--that they enjoyed a lower rate of psychopathology than the general population. Nevertheless, like many other realms of biology, sexuality, and psychology, intersex increasingly became the purview of medicine. For a small number of people with intersex--namely those at risk for gonadal cancers and salt-wasting--the medicalization of intersex probably improved their health, sometimes even saving their lives.
Nevertheless, most of the treatment of intersex was motivated not by metabolic health concerns, but by psychosocial concerns; as in the s, by the s, intersex was viewed primarily as a psychosocial problem that mixed sex categories in socially uncomfortable ways. In the s, Johns Hopkins University created a team and became the first medical center to offer an organized multi-disciplinary approach to intersex, one that sought to essentially eliminate intersex in early childhood.
The approach developed there came to be known as the "optimum gender of rearing" model. The basic idea was that each child's potential for a "normal" gender identity should be maximized by making each child's body, upbringing, and mind align as much as possible.
Because of the belief that it was harder to surgically engineer a boy than a girl, most children with intersex were made as feminine as possible, utilizing surgery, endocrinology, and psychology. A "successful" patient was one judged to be stable and "normal" i. In an era of vice squads raiding gay bars, it is not surprising that homosexuality appeared to most of these professionals an untenable identity. Though the early texts from this team advocated truth-telling and consistent psychological support, in practice many patients were deceived and given minimal psychological support.
As in most of medicine, doctors made the decisions for patients. There was little investment in the ideas of informed consent or of studying outcomes in a systematic way. It wasn't until the s that medical professionals began aggressively looking for cases of intersex.
Psychologist John Money provided theoretical support for the Hopkins model, arguing that gender identity was largely mutable early in life, that nurture was more important than nature.
While performing a circumcision, a doctor accidentally burned off eight-month-old David's penis. David's parents consulted with the team at Hopkins, and Money recommended they change the sex and gender of their child and raise David as a girl. For decades Money erroneously touted a successful outcome because the child reportedly had become a normal, female-identified, heterosexual girl.
Indeed, when his parents told him the truth about what happened to him, he immediately re-assumed the gender role of a man. It is unknown why Money--who in had found a relatively low rate of psychopathology among adults with intersex--thought people with intersex needed to have their sexes and genders surgically and socially engineered to be psychologically healthy.
It is better understood why people did not question Money's controversial theory of nurture-over-nature approach. Surgeons and psychologists liked the theory because it signified that they were providing necessary, good care to "abnormal" children. Feminists liked the theory because they preferred the idea that gender - and therefore gender norms - were socially constructed and malleable.
Parents probably liked it because they could be reassured that their queer-bodied children would grow up to be straight-acting adults. But some people didn't like this system: people who--like David Reimer--felt mistreated at best, and medically assaulted at worst, by their medical treatment. Nevertheless, most stayed silent, believing they were alone in their experiences. That changed in , when feminist biologist Anne Fausto-Sterling published articles in The Sciences and The New York Times exposing the basic fact that intersex exists.
She founded the group because of her own attempts to recover her history of sex-reassignment in infancy and medically-induced shame, and because of the disinterest of most of her former care providers in what had happened to her. Soon Chase had brought together dozens of people with intersex. Like many of the early ISNA members, Chase drew on her political consciousness as a lesbian woman to recognize the degree to which intersex had been unnecessarily socially and medically pathologized.
Early on, very few medical professionals recognized ISNA's critiques as legitimate. Many responded that the standard of care was necessary, successful, and justified, even going so far as to actively defend lying to patients about their medical histories.
Those at the top simply tried to ignore ISNA. As the leader of the newly formed intersex rights movement, Chase moved rapidly, sometimes able to engage in dialog, and having group protests when doctors would not listen. With her professional background in computer science, she was particularly adept at using the tools of the Internet to spread ISNA's message. By about , it had become clear to all that the intersex rights movement was not going away.
Finally, many medical professionals began to respond to calls for outcome data, research, full disclosure of information, and revision of homophobic and sexist protocols. The intersex rights movement undoubtedly was helped in its success by surrounding trends in favor of LBGT lesbian, bi, gay, transgender rights, patients' rights, and children's rights. Since , due to increased public education, tens of millions of people have learned about intersex.
ISNA members have gone from picket lines to having a seat at the table in medical conferences. We give grand rounds presentations, help with medical school curricular development, and receive emails from physicians asking for our advice on how to handle intersex cases. Our website is recognized as the definitive source for all things intersex, and for being a life-saving porthold for thousands of people desperate for answers and directions to "their tribe".
We have convinced hospitals around the world to examine their practices, to find out what has happened to former patients, and to be accountable for the sometimes-poor effects of good intentions. Over a decade into the work of ISNA, medical professionals are less inclined to lie to patients and parents in intersex cases, are less likely to make openly homophobic or sexist remarks, and are more likely to admit uncertainty about the right course of action.
In these cases, a person who had more biological male features as a child might look more feminine after puberty according to a society slow to reject the traditional binary system.
Or a person who looked female as a child might start to look more stereotypically male as a teenager. And sometimes, a person might not learn they have intersex traits until even later, such as if they have difficulty having children and see specialists to learn why. Note: Not all people with intersex traits have issues with fertility. Generally, females have a pair of X chromosomes and males have one X and one Y chromosome. These variations can happen randomly and spontaneously during conception.
They can also happen due to other causes. These chromosomal variations sometimes result in what might be labeled as intersex. More commonly, though, a baby born with intersex traits does fit into either the XX or XY category.
But we now know that biological sex is more complex than our chromosomes. For example: If a baby is born with female anatomy on the outside and male anatomy on the inside, this is also something that happened randomly around the time of conception. In this case, you may as an adult want to have surgery to create an opening. But your doctor may recommend surgery to make the genitalia appear more typically male or typically female.
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