Intersex and the Gender Binary

The first question we ask when a baby is born: is it a boy or girl? We consider the male/female binary a core distinction of life, but on the the most basic level of how our bodies are constructed, life isn’t that simple.

The world was shocked by the recent questioning of the gender of a South African track star. Caster Semenya identified as female, and won races across the world. Yet her deep voice and muscular physique lead to questions about her sex. Subsequent tests revealed a complex answer. Semenya has no uterus or ovaries, and has internal testes that produce three times the normal testosterone for a woman. (We all produce both testosterone and estrogen, so it the presence in our system is always a matter of degree.) Given that we sort athletics our male/female binary, where should Semenya, who does not fit clearly into either category, run?

Semenya is not alone. A friend of a friend is a 6’5” man with a vagina. Many people have variations of both internal and external sex organs that befuddle labeling, along with varying hormone levels, and even varieties of chromosomes beyond XX and XY. Some women are just X, referred to as Turner syndrome, and some men are XXY, or Klinefelter syndrome. As many as 1% of us are intersex in some way, and surgeries to “normalize” genital appearance is done in one or two births in 1,000.

It is easy to see how these body variations occur. In his March 1993 Atlantic article on Homosexuality and Biology, Chandler Burr described the sexual development of the fetus:

Human beings of both sexes start out with complete female and male “anlages,” or precursors of the basic interior sexual equipment — vagina, uterus, and fallopian tubes for women, and vas deferens, seminal vesicles, and ejaculatory ducts for men. These packages are called the Mullerian (female) and Wolffian (male) ducts, and are tubes of tissue located in the lower abdomen… At the moment of conception an embryo is given its chromosomal sex, which determines whether it will develop testes or ovaries. In female human beings (as in female rats) the female structures will simply develop, without any help from hormones; the Wolffian duct will shrivel up. The process of becoming male, however, is more complex. Where women need none, men need two kinds of hormones: androgens from the testes to prompt the Wolffian duct into development, and a second substance, called Mullerian inhibiting hormone, to suppress the Mullerian duct and defeminize the male fetus.

We used to view any variation in a child’s genitalia as unacceptable. Parents and doctors would immediately perform corrective surgery so the aberrant child was clearly sculpted into one sex or the other, as if cutting off a child’s micropenis and putting him in a dress makes him a girl. Intersex people are now speaking out against this kind of mutilation, saying these actions are based on the discomfort of the parents rather than the best interest of the child. Intersex people are lobbying for acceptance of their physical variations exactly as they are, allowing them to sort out the physical and emotional issues later when the individual can speak to their own personal sense of identity: male, female, or somewhere in-between.

Are these variation really so shocking? I would think it is obvious to anyone who watches the Olympics or uses locker rooms that we vary. As the old joke goes, whoever said we were created equal has not seen many naked people.