It might also present as a baby boy being born with a penis that, medically, is considered very small, or a baby girl being born with a large clitoris. Internally, an intersex person might have an atypical sequence of genetics where some cells have XX chromosomes (female) while others have XY chromosomes (male). These are only a handful of examples; the intersex umbrella encompasses a wide variety of nuances. Estimates suggest there are at least 40 different intersex variations. Also, while many times these differences are detectable at birth, sometimes intersexuality isn’t discovered until later in a child’s—or even adult’s—life.
What Happens When Someone Is Born Intersex?
Being intersex is a natural variation and not a disease or disorder. While there are no exact statistics on how prevalent being intersex is, some estimates suggest that around 1.7% of the U.S. population is intersex—about the same number of people with red hair or green eyes. There is a history of medicalization of being born intersex, including treating it as a medical condition requiring treatments such as surgery and hormone therapy to assign a sex or make people conform to male or female anatomy. Advocacy groups are increasingly raising awareness of the importance of distinguishing between unnecessary treatments performed without the individual’s consent and treatments to address medical issues that might arise from being intersex. “When a baby is born, the delivery doctor will assign it a legal sex. In many states, this is either male or female,” says Rachel Wright, a New York City-based psychotherapist who specializes in topics of modern relationships, sex, and sexuality. According to Planned Parenthood, in some cases surgery might be performed on the baby’s genitals so that they present more “normally” as male or female. Some children might also be given hormone therapy so they better “fit” into the binary. In cases where doctors and parents can’t discern which side of the binary the child would most easily fit into, parents might ultimately choose to assign a sex to their child and raise them as such. However, there’s growing activism and awareness around this topic. Many feel it is not emotionally or mentally advantageous to push a child into either the male or female box if they weren’t born as someone who is clearly binary. In addition, intersex surgeries may result in significant scarring and fertility issues later in life.
Identification of Intersex at Birth
An infant may be identified as intersex if they:
Do not have a vaginal openingDo not have testesDo not have ovariesDo not have a clitoris or inner labiaHave a penis with no urethral openingHave a smaller penis than expectedHave outward genitalia that differs from their internal anatomyHave a clitoris that is larger than expected
While many intersex identifications are made at the time of birth, that isn’t always the case. It is not uncommon for someone to realize that they are intersex until later in life; this later identification seems to be more common around puberty or when trying to conceive. According to InterAct, a person (or their parent) might discover they are intersex when they experience puberty changes too early, in unexpected ways, very late, or not at all. Adults who struggle with infertility might also come to realize they are intersex after medical assessment and identification.
Intersex Gender Identity and Sexuality
It is important to recognize that being intersex is not a sexual orientation or gender identity. People who are born intersex can have many different variations in terms of gender identity and sexuality.
Gender Identity
Gender identity refers to a person’s internal experience of gender, which may or may not correspond to their birth-assigned sex. Gender refers to norms that are socially constructed expectations for how people should behave and express themselves. Intersex people may have a wide range of gender identities. Some may identify with a “male” or “female” identity, but others may align with other options. It is important to note that being intersex is not the same as being non-binary or transgender. Non-binary is a gender identity that is not exclusively “male” or “female.” A person who is transgender has a gender identity that differs from their birth-assigned sex. Intersex does not refer to a person’s internal sense of gender identity. Intersex people may have a variety of gender identities, including cisgender, agender, bigender, femme, gender fluid, transgender, or non-binary. How they express their gender may vary and may or may not conform to their gender identity.
Gender and Sexuality
Wright is careful to point out that, just like non-intersex people, the gender they’re identified as at birth isn’t always the gender identity that they’ll grow up to have. Additionally, just like non-intersex people, their sexuality—as in who they’re attracted to sexually—can run the gamut. Research also indicates that there is no correlation between gender identity and sexuality. Again, intersex strictly refers to a group of conditions in which one’s sexual development (genitalia, internal organs, and sexual hormone levels) diverges from the typical binary pattern.
How Common Is It to Be Intersex?
The answer here isn’t so straightforward. This is partly because much subjectivity comes into play in that delivery room and/or medical analysis. The Intersex Society of North America notes that nature does not delineate where “male” or “female” end and where “intersex” begins. The decision of which combination of variations of anatomy or chromosomal differences count as intersex are determinations often made by medical professionals, and there is considerable variability in these determinations. For instance, one doctor may deem a large clitoris as relatively normal, while the other might feel it is too large to clearly identify the baby as “female” at birth. The inverse is true regarding the size of a baby’s penis. There’s also variance in opinion regarding how many chromosomal anomalies are “required” before an intersex call is made. However, it’s important to note that these are only exceptionally noticeable cases where it is easier to make that intersex call. There are many more babies born with less obvious forms of anatomical variations. Further, as we mentioned above, sometimes an intersex identification doesn’t occur until much later (if at all). Wright says that general estimates predict that, in the United States, roughly 1% to 2% of the total population is actually intersex. This equates to about one or two people out of every 100.
A Word From Verywell
Intersex is a blanket term that refers to a wide range of variations in human bodies in terms of sex chromosomes, genitalia, reproductive anatomy, and hormones. These are typically present at birth, though they might be discovered later in life or sometimes not at all. Stigma about intersex people has decreased over the years as more medical professionals—and the general population—gain a better understanding. However, people who are intersex still face bullying, discrimination, and stigmatization. If you are intersex, connecting with others with similar experiences might be helpful. We recommend joining a support group or community. InterAct Intersex Support and Advocacy Groups are located across the globe. The word was derived from a Greek mythological character named Hermaphroditus, who had the formation of someone who was equal parts male and female. This is not representative of the intersex spectrum. Many people consider “hermaphrodite” to be a slur and InterACT states that the term should never be used to refer to an interest person.
