What Is Intersex?

Baby being born

 

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What Is Intersex?

Intersexuality

Intersexuality is an overarching term that refers to human bodies that fall outside the strict male and female binary. Generally speaking, the term refers to the many variations—often present at birth—that can affect a person’s reproductive or sexual anatomy, which may involve genitalia, hormones, reproductive organs, and chromosomes.

For example, these variations might include being born with "female" anatomy on the outside, such as a vaginal opening, but having "male" sexual organs on the inside.

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.

Rachel Wright, Psychotherapist

However, if a person’s genitals do not fall within the typical male or female anatomy scope, then the doctor might identify that child as intersex at the time of their birth.

— Rachel Wright, Psychotherapist

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.

As of June 2020, Portugal is the only OECD (Organisation for Economic Co-operation and Development) country that bans medically unnecessary treatments on intersex minors without their consent.

Identification of Intersex at Birth

An infant may be identified as intersex if they:

  • Do not have a vaginal opening
  • Do not have testes
  • Do not have ovaries
  • Do not have a clitoris or inner labia
  • Have a penis with no urethral opening
  • Have a smaller penis than expected
  • Have outward genitalia that differs from their internal anatomy
  • Have 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.

In some cases, a person might not ever realize that they are intersex. This is more common when intersex presents through chromosomes or internal organs versus outward anatomy.

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.

“If you ask experts at medical centers how often a child is born so noticeably atypical in terms of genitalia that a specialist in sex differentiation is called in, the number comes out to about one in 1,500 to one in 2,000 births,” states the Intersex Society of North America.

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.

Frequently Asked Questions

  • What does 'hermaphrodite' mean?

    While the term was once widely used in medical literature to refer to intersex people, it is now considered stigmatizing, inaccurate, and confusing.

    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.


  • Can intersex people have babies?

    In many cases, intersex people are infertile. That said, whether an intersex person can reproduce depends on their specific situation. Intersex people can—and do—have children.

12 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. National Library of Medicine. Intersex.

  2. Intersex Human Rights Australia. Intersex is not a gender identity, and the implications for legislation.

  3. Amnesty International. Its intersex awareness day—here are 5 myths we need to shatter.

  4. Planned Parenthood. What's intersex?.

  5. Newbould M. When parents choose gender: intersex, children, and the law. Med Law Rev. 2016;24(4):474-496. doi:10.1093/medlaw/fww014

  6. InterACT. FAQ: What is intersex?.

  7. OECD. Over the Rainbow? The Road to LGBTI Inclusion.

  8. InterACT. How do I know if I have an intersex condition?

  9. Ontario Human Rights Commission. Gender identity and gender expression.

  10. Jacobson R, Joel D. Gender identity and sexuality in an online sample of intersex-identified individuals: A descriptive study. Psychology & Sexuality. 2021;12(3):248-260. doi:10.1080/19419899.2019.1711447

  11. Intersex Society of North America. How common is intersex?.

  12. InterACT. InterACT statement on intersex terminology.

By Wendy Rose Gould
Wendy Rose Gould is a lifestyle reporter with over a decade of experience covering health and wellness topics.