When Sex 'Needs' to Be Fixed

Article excerpt

Nonstandard embryonic developments can lead to individuals whose genes and anatomy do not line up to specify either male or female and who face profound challenges in developing a clear sense of sexual selfhood.

"When puberty made me a monster

they didn't do it right; if life was fair

fairness would have given me fangs

justice would have given me claws

& venom more potent than the curses I spat

through my tears

as my mother held me down on the bed

& sat on me, all two hundred and fifty pounds of her

& proceeded, with tweezers

to pull out every hair

that had erupted unbidden

on my lips, my chin,




in her eyes I saw her

fear of failure

that 13 years of feminine boot camp

had not been enough

to stop my body's silent stubborn mutiny

every wiry blond hair

a mockery of her efforts

in that year

we became each other's



Posted on the Web site of the Coalition for Intersex Support, Activism, and Education

The most private parts of human anatomy, the sexual organs, both internal and external, are subject to a wide range of birth defects. When an individual's internal sexual organs, with their hormonal effects, do not match the individual's externally apparent sex, efforts by parents to direct the individual into one sexual identity or the other can be more hurtful than helpful.

It is commonly thought that genes determine gender. But do they? If an individual believes she is a woman, looks like a woman, acts like a woman, and has female external genitalia but instead of the usual XX chromosomes and ovaries has XY chromosomes and internal testes, is "she" really a "he"? For 30 years, starting in 1968, the International Olympic Committee (IOC) tested the chromosomes (which consist of genes) of all female athletes to disqualify those with a Y chromosome from competing as women. Such individuals were believed to have an athletic advantage over "normal" women. The sex test led to the disqualification of approximately 1 in 400 athletes per competition. This past year the IOC decided to suspend chromosome testing in the Olympics because, as leading geneticists and physicians have argued for years, XY does not always equal male.

The thought of individuals whose anatomy is female but whose chromosomes are male or of persons who have both male and female sexual organs in their abdominal cavities makes most people uneasy. The idea of mixed sexual organs or ambiguous genitalia contravenes one of the most fundamental premises in American society--dimorphic expression of sex. We think we know that at least the genes and the anatomy line up to specify male or female.

Based on this premise, gender identity occupies a key position in the broader category of personal identity, and little leeway exists for those whose combination of genes and anatomy lies outside both the male and female categories, other than to join one of the two sexes. As the renowned and highly controversial sexologist Dr. John Money of Johns Hopkins University once said, "It seems just fine in our society to have birth defects of any organ--as long as it isn't the sex organs."

Medical literature defines gender identity as the identification of self as either male or female. It should not be confused with sexual orientation, which defines one's choice of sexual partner, whether male, female, or both. Gender identity results from a complex mixture of factors, including genes, gonads (testes and ovaries), hormones, internal duct systems, external genitalia, and environmental influences. People whose chromosomes, anatomy, and social learning environment all point in the same direction (to either the male or female sex) generally develop a gender identity unconsciously. …