Intersex

18 May 2015

Intersex, in humans and other animals, is a variation in sex characteristics including chromosomes, gonads, or genitals that do not allow an individual to be distinctly identified as male or female. In this post, Taryn Cain takes us through a potted history of intersexuality.

Freud once said “when you meet a human being, the first distinction you make is ‘male or female?’ and you are accustomed to making the distinction with unhesitating certainty”. At the time, Freud was aware that his contemporaries, namely Hirschfeld and Ellis, knew the idea of absolute certainty was a lie and that they had documented many such people living long and full lives.

Known around the globe as hija, two spirit, kathoey, travestis and khuntha; for most of European history the terms hermaphrodite, and, later, intersex or Disorders of Sex Development (DSD) were used.

 Sigmund Freud in 1909.

Sigmund Freud in 1909.

Hermaphroditos was a beautiful man who was loved by the nymph, Salmakis. When Salmakis prayed to the Gods to unite her with her love, they took her request perhaps more literally than she would have liked. They combined the bodies of both Hermaphroditos and Salmakis into one person, creating a body that was both male and female, hence “hermaphrodite”. Although just a story, many examples of hermaphrodites have been found in nature.

 A sculpture of Hermaphroditus.

A sculpture of Hermaphroditus.

Clownfish are hermaphrodites as they can change from male to female in their lifetime. Earthworms are hermaphrodites, reproducing using both ovaries and testes. Cannabis is a hermaphrodite too as it can develop both male and female flowers simultaneously. Humans are not mythical creatures, nor do they reproduce like fish, worms or flowers, so it was eventually recognised that “hermaphrodite” as a label was outdated and misleading.

A German physician, Richard Goldschmidt coined the term intersex in 1917. Past terminology had implied that the intersex community was one big homogeneous group, whereas they are incredibly diverse. Some intersex people are very comfortable with the gender they were assigned at birth, while others don’t feel they have a gender or may wish to go through gender reassignment. Some may not have realised they were intersex until they hit adolescence or wished to start a family, while others may have always known they were different. These differences are due to biological sex being a complex process; any number of paths could lead a developing foetus to intersexuality.

One common cause of intersexuality is congenital adrenal hyperplasia (CAH), which is due to exposure to high concentrations of androgens in utero. This can cause medical problems as well as affect gender. A far less common issue is when a developing foetus absorbs the DNA material for two bodies rather than the usual one body, a process known as chimerism. Essentially a person could be their own twin. This isn’t necessarily an intersex condition, however, unless the individual carries both an XX and XY chromosome.

In an isolated village in the Dominican Republic there were rare instances of girls developing into boys in adolescence. Known as guevedoces, it turned out to be a defective enzyme which interfered with the hormones involved in foetal development, but not those in adolescence. All these seem very clear-cut, but many cases of intersex bodies have no obvious cause.

 Newly fertilised human egg.

Newly fertilised human egg.

The idea of two genders is deeply engrained in our culture, and we highlight that difference in every aspect of life. It wasn’t always this way however. Back in the Renaissance, women were seen as inverted, or underdeveloped, versions of men. To study a man was to study the whole of the human race. At this time, an intersex body was merely evidence of male superior development, rather than something that threatened a binary view of gender.

 Androgyne holding snake and chalice.

Androgyne holding snake and chalice.

From the 16th century the lines of male and female were being drawn, with heterosexuality as the norm. Anything else was considered abnormal, which meant that intersex individuals were increasingly being lumped in with all other non-conforming individuals, such as transvestites, homosexuals and women with feminist notions. Darwinian ideas were becoming accepted and, in a twist, the superiority of human evolution became synonymous with sexual dimorphism. It was a time of strict sexual and gender norms.

 Designer babies. (Credit: Catherine Riley)

Designer babies. (Credit: Catherine Riley)

It was in this climate that John Money, the man who became the authority on intersex conditions in the Western world, first coined the term “gender”. He was also the first to suggest that a gender identity and role could differ from that of a biological sex. Just as Freud determined that sex was dependent on the absence or presence of a penis, so did Money determine that the “true” sex of an intersex person was reliant on the penis. Unfortunately for Money he will be remembered through history as the man who inflated his own success, particularly since his most famous case tragically ended with the suicide of his patient.

 Artwork of fig leaf covering male genitals (Credit: Nanette Hoogslag.)

Artwork of fig leaf covering male genitals
(Credit: Nanette Hoogslag.)

In the 1970s and ’80s, feminists and the gay movement started to challenge ideas on gender and gender roles in society. As people began to accept the possibility of non-gender conforming individuals and behaviour, the world opened up for intersex people to reveal themselves. In the 1990s the internet finally gave a voice to the potentially 1.7% of the population who don’t fit neatly into our gender binary. Discussions finally opened up on the effect of childhood genital surgeries on later adult sexual function, with some physicians advocating giving families and patients more control over their own bodies.

 A group of men dressed in leather and S/M outfits.

A group of men dressed in leather and S/M outfits.

Legally, life started looking up for intersex people in the 21st century. In 2003 Australians were given the option of having an X on their passport; in 2007 Disorders of Sex Development came into common usage; in 2013 Germany chose to allow “indeterminate” on the birth certificates of new born babies while the UN condemned non-consensual surgery on intersex infants; and in 2014 intersex individuals in India won full legal protection in the Supreme Court.

Not everything is rosy, as intersex women in sport are subject to problematic gender policies. The Olympics in particular have been very concerned about gender “fraud” since an intersex man took part in a high jump event in 1939. Perhaps as we move towards a future where gender is no longer the most important aspect of your identity, there will finally be less societal concern about gender variation.

Taryn is a Visitor Experience Assistant at Wellcome Collection.