Intersex is a blanket term covering a variety of medical conditions for a person born with biologically male/female traits that are not typical for humans. Such individuals are known as intersex persons (also known as intersexuals, or capitalized as Intersex/Intersexuals). Like every community within the LGBTQ collective, the Intersex community may be seen as distinct from the Gay collective, or be considered sufficiently Gay-related to be placed within LGBTQI (Lesbian, Gay, Bisexual, Trans, Queer, and Intersex) identity spectra.
Whether by birth or by surgery done to them as infants, Intersex people are proof that biological sex does not always conform to a strict man/woman binary. Awareness of intersexuality has the potential to bring about a greater tolerance of gender fluidity as well as a greater respect for Gay identities.
Intersex-Related Beings in Myth
Precursors to Intersex identity may be found in important spiritual beings mentioned in folk myths of societies around the world. In Hinduism, Ardhanarishvara is a deity formed from the merging of Shiva and his wife Parvati, and is portrayed as half man/half woman. In Yoruba religion, Ossain (Deity of Plants) and Oshumaré (Deity of the Serpent and the Rainbow) may be considered intersex. Among Zuñi kachina-spirits, there is Ko’lhamana, who is both man and woman. Some interpretations of Judaism postulate that Adam Kadmon, the first human soul, was male and female, as were the ancestors of heterosexuals described by Aristophanes in Plato’s Symposium.
The word “hermaphrodite,” which is the English version of a popular term used throughout Western Europe for an intersex person, has its origins in Greek myth. Hermaphroditus was the son of Hermes (Messenger God) and Aphrodite (Goddess of Love). He was seized by the nymph Salmacis when he bathed in her pool, and then transformed into an intersex person when she refused to separate from him. “Hermaphrodite” can sometimes refer to transpeople, but is rarely used in the LGBTQ community due to a tendency to associate it with monstrosity.
Intersex in Early Western European Scholarship and Law
References to hermaphrodites in Western European scholarship go back to the twelfth century. From this period until the Enlightenment, hermaphrodites were largely considered to be a rarely mentioned third sex. Scholars in the twelfth century imagined the uterus as divisible into hot and cold parts. If the male’s seed landed in the hot section, a male child resulted. If it landed in the opposite portion, a girl was born. However, should the seed lodge itself somewhere in between the hot and cold sections, a hermaphrodite was produced.
Some people in the pre-Enlightenment era believed hermaphrodites to be monsters, but the general consensus held that hermaphroditism was a natural phenomenon in Jewish, Christian, and Muslim theologies, albeit one that had to be regulated by both moral and legal authorities. Christian clergy and lawmakers in Western Europe assumed that, if left unregulated, hermaphrodites would be more likely to engage in sodomy. In order to prevent this, Peter the Chanter of Paris (who died in 1197) determined that hermaphrodites would be permitted to enter into matrimony with a member of the gender opposite their assumed predominant sex. This left hermaphrodites with some measure of choice regarding gender expression. However, once a choice was made, that decision was final. To change the gender of one’s sexual interest was equivalent to sodomy and punishable under the law. Another concern was that hermaphrodites whose dominant sex was female would use their masculine qualities to claim rights belonging to men. Like sodomy, such a transgression was punishable by severe penalties, including death.
Guarded tolerance for gender ambiguity ended in the nineteenth century. During the Enlightenment, the supervision of births began to shift from women in families and midwives to men in the medical establishment. As science evolved to produce more sophisticated technologies, the role of male doctors in birthing was further cemented, and management of hermaphroditism increasingly became the domain of medicine. The convergence of advances in surgery, morality concerning appropriate gender behavior, and condemnation of homosexuality led to the conceptualization of hermaphroditism as a medical condition that should be corrected through surgery. Genitals of intersex people were deemed aesthetically inadequate, and reshaped or eliminated to fit aesthetic physiological standards of mainstream society. However, it was not until the 1950s that a uniform standard of intersex management was proposed.
John Money and Intersex Management
Post-1950s intersex management was initially dictated by the protocol developed by physician John Money. Basing his theories on a singular study of 105 intersex children conducted in 1957, he concluded that all children are gender neutral at birth, that gender identity is due solely to environmental factors, and that a stable gender identity is essential for healthy development. Untreated intersex children could never achieve proper development as there would always be incongruence between their external genitalia and their socially ascribed gender identity.
His solution was corrective genital surgery followed by unambiguous childrearing based on gender assignment made by physicians at birth. Money recommended that gender assignment be made as soon as possible to avoid confusion at a later age. This decision was not to be made based on the child’s chromosomal gender or internal genitalia, which he ruled to be largely irrelevant, but rather on outward genital appearance. Once done, it was never to be discussed with the child in question. If the child found out, the proper course of action was to never talk about it. In other words, the condition and the procedure to remedy it must be thoroughly closeted.
Money was particularly concerned about penis length of males, and placed tremendous importance upon whether the child’s penis would grow to a socially acceptable length. It was assumed that a boy with a micropenis would suffer psychologically and be unable to have a functional, heterosexual relationship. Regardless of a child’s chromosomal, hormonal, and gonadal sex, female assignment was far more common. While surgeons could easily produce a cosmetic vagina, creating an acceptable penis was considered beyond the bounds of medical science.
Money surgically altered children based on the assumption that he could turn them into healthy heterosexuals. The changes forced upon these children were largely the product of widespread fear that children with ambiguous genitalia might develop homosexual identities.
The cornerstone case that Money and his followers would use for years as proof involved a typical XY male. The child in question, known in literature as “John,” was one of two identical twin boys born in Canada in 1965.
When “John” was brought in to be circumcised, his penis was burned accidentally during the routine procedure. Money recommended that “John” be reassigned as a girl, maintaining that John would function better in society as a female than as a traumatized boy without a penis. “John” was rechristened as “Joan,” surgically altered to appear female, and raised as a girl. Money pronounced the assignment as a success and claimed it as proof that gender (and, consequently, sexual orientation) is the result of socialization, not biology.
Rethinking Intersex Management
Protocols for intersex management went relatively unchallenged until the mid- to late 1990s. Social movements such as the Gay Liberation led people to question the validity of gender and sexual norms. Increasing visibility for the Gay community allowed critics to doubt the assertion that the ability to engage in a heterosexual relationship should be the main criterion in gender assignment.
Of even greater importance is the Trans movement within the Gay movement. Though Intersex is distinguished from Trans, criteria determining sex and gender are not always clear at the hormonal or chromosomal level, neither are they necessarily obvious in terms of visible physical traits or emotional response. In addition, the existence of people who believe that their gender identity does not match their physiological appearance and upbringing fundamentally challenges the claim that congruent genitalia and upbringing will lead to socially and psychologically well-adjusted adulthood.
As the aforementioned cultural movements began, anecdotal evidence that gender reassignments were not always successful slowly emerged. The most damaging of these stories concerns John/Joan. Money and his colleagues only monitored the child until he entered puberty. “Joan” never truly felt as though he was a girl, preferring typically masculine activities to more feminine pursuits despite the estrogen pills forced upon him. He felt so isolated by his gender confusion that he became depressed and contemplated suicide. When his father revealed the truth about his gender assignment at age 14, “Joan” elected to become “John” again, reversing years of social conditioning designed to render him female and feminine. He took David as his name (previously, he was Brenda), had his estrogen-induced breasts removed, underwent surgery for a penis, and married in 1990. Fourteen years later David Reimer took his life in Winnipeg after he lost his job, his twin brother died, and his marriage fell apart.
Intersex Community, Identity, and Activism
As more cases of faulty gender assignment became known, a sense of Intersex community and identity evolved (“Intersex” is capitalized when referring to the community and identity rather than the condition). Initially, support groups were founded in the late 1980s for people with specific intersex conditions. General support groups were founded throughout the 1990s to provide information and a sense of belonging to intersex people. However, not all groups were content to remain passive sources of support. In 1993, the Intersex Society of North America (ISNA) was established by Cheryl Chase to eradicate the negative perceptions of intersexuality.
Some of the basic principles promoted by the Intersex community includes four rights:
1. The right of intersex people to decide at puberty whether or not surgery should be used on their genitalia if a condition is not harmful to physical health,
2. the right to determine gender/orientation (including unimpeded access to the means by which one may realize one’s determination),
3. the right to marry that is not restricted to the one man/one woman formula, and
4.a change in the language associated with intersexuality.
A primary aim of most Intersex activist groups is to rethink intersex management. An underlying presupposition of professionals like Money is that intersexuality is shameful and must be erased at birth, possibly followed up with further surgical intervention over the years. If and when the patient discovers the condition later in life, it must be hidden from others. Surgery for the sake of sex and gender conformity is often labeled by Intersex activists as intersex genital mutilation (IGM) because of damage done to pleasure sensors in genitalia, and physiological complications that can plague the patient for a lifetime. Hiding one’s Intersex identity solely because it is deemed shameful is rejected out of hand.
There is also a problem with language. Medical terms referring to intersex physiology, such as ambiguous genitalia, true hermaphrodite (also known as herm), and male or female pseudohermaphrodite (merm and ferm, respectively) are considered part of a poorly worded taxonomy for human beings who may be biologically atypical but are not abnormal. “Hermaphrodite” is rejected for its connotation of being freakish, although some intersex people reclaim it, the way some Lesbians use “dyke” and LGBTQI people might claim Queer identity.
Phall-O-Meter as Intersex Folk Humor
Suzanne Kessler observes that traditional intersex management doctors describe large clitorises as “defective,” “embarrassing,” and troublesome,” the same way that Money considered a very short penis was defective and embarrassing. It is doctors’ aesthetic and moral judgment concerning proper genital size, not the health of the patient, that is the impetus for surgical intervention. IGM too often leaves a patient with chronic health issues, emotional stress, and impaired ability to feel erotic stimulation or incapable of feeling erotic stimulation at all.
Intersex activists subvert the rationale for unnecessary surgery by bringing details of diagnosis to the public eye. As with other communities within the LGBTQI spectrum, the Intersex community mixes its own folk humor with activism. Intersex activist Kiira Triea is attributed with the design of the Phall-O-Meter, a three-inch ruler printed on paper to satirize standards for appropriate clitoris and penis length used in intersex clinical practice to determine whether to amputate. The ruler has metric markers placed within those three inches. Clitorises larger than .9 centimeters and penises smaller than 2.5 centimeters are candidates for surgical reduction or removal. The area from 0 to .9 centimeters is shaded in pink and labeled “Just A Girl.” From .9 to 2.5 centimeters (just under an inch), the area is lavender and labeled “SURGERY! FIX IT QUICK!” The length from 2.5 centimeters to 3 inches is blue, with up to 1.5 inches labeled “Just squeaks by!” 1.5-2 inches is “Whew! OK,” 2-2.5 inches is “Texan!” and 2.5-3 inches is “Wow! SURGEON!”
Colapinto, John. As Nature Raised Him: The Boy Who Was Raised as a Girl. New York: HarperCollins, 2000.
Crawford, Mary. Transformations: Women, Gender, and Psychology. Boston: McGraw-Hill, 2006.
Diamond, Milton. “Pediatric Management of Ambiguous and Traumatized Genitalia”. Contemporary Sexuality, 2004. 38: pp. i-vii.
Kessler, Suzanne J. 1990. “The Medical Construction of Gender: Case Management of Intersexed Infants”. Signs 16:3-26.
Preves, Sharon E. 2002. “Sexing the Intersexed: An Analysis of Sociocultural Response to Intersexuality” Signs 27:523-556.