Thread by @interACT_adv

Long #THREAD discussing questions:

💭 What is intersex?
💭Is ____ intersex?

Preface: everyone is different, this is of course one opinion. Also, while they are common themes among intersex people, medical trauma, non-consensual surgeries, or even a diagnosis are not requirements to ID as intersex, and we don't endorse gatekeeping.

What is or is not intersex is somewhat subjective. At its simplest, IDing as #intersex is about having experiences with your body's inherent sex differences, and if that word feels right to you.

Again, being #intersex is different from being transgender, though there's a lot of themes we share, and some intersex people are also trans. Intersex people can have any sexual orientation and gender.

First, myths/inaccuracies/simplifications of what #intersex is, for all (+esp journalists) to AVOID AVOID AVOID:

❌ Born "both" / with "both" genitalia
❌ Born with "ambiguous genitalia" (not best term)
❌ "Hermaphrodite," widely considered a slur reclaimed by intersex people

You've probably heard us and others, at the broadest level, define #intersex as a difference in sex traits, which could include any of genitals, chromosomes, hormones, secondary traits, etc. which is true, but maybe still mentally vague. Here we'll go a bit deeper in.

There are 30+ diagnosis terms that are used, on paper, to describe types of intersex bodies. Of course our goal is to get away natural sex differences being seen as a problem to be "fixed" by medicine, though we still often have to communicate considering that lens.

So to better understand "what is intersex" and "is ___ intersex," here's a theory: we can consider #intersex traits as falling into 3 archetypes:

1. Mix
2. "Overdevelopment"
3. "Underdevelopment" or difference

Type 1, the "mix," is having sex traits that usually don't go together, e.g. XY+vagina+vulva+internal testes, or XX+ovotestes. These types are typically the least debated as falling under the intersex umbrella, both by doctors and individuals with those types.

These types can also include when hormonal and other changes happen at puberty that are not expected based on a person's genital appearance, and chimeras that have some XX cells and some XY cells in their bodies.

Type 2, doctors might paint not as a mix, but as an "overdevelopment" of one binary sex. Perhaps the most common example is called CAH, where a person is XX with ovaries and a uterus, but may have a small vagina and a large or even sometimes close to penis-sized clitoris.

Doctors may brand type 2 as "not intersex," because they position the overdevelopment as "fixable," and thus they can spare that person from being lumped into a true "intersex" category like those with a mix, which they may view as a stigma.

Type 3 is "underdevelopment," or different development of the traits that are still more typical to one binary sex. An example might be Klinefelter's, where someone has mostly "male-typical" traits, but low T, small genital features, and sometimes "feminine" secondary traits.

People born with otherwise aligning anatomy, just without something, e.g. XX+vagina+ovaries, but born without a uterus, as with MRKH, may also fall under this type 3.

Individuals that are simply born without a part, but otherwise aligning, tend to be less likely to ID themselves as intersex, which likely has to do with how we have socially positioned "truer" mix types versus under or over developed types.

Type 3 also includes hypospadias, when a child has aligning "typically male" traits, just with a functional urethra that opens somewhere other than the penis tip. This common difference is still targeted to be "fixed," though as long as urine can pass at all, it is 100% cosmetic.

Doctors unfamiliar with intersex are generally less likely to conceptualize types 2 and 3 as intersex. But these types certainly are (per medical literature, too), especially if a person wants to use the term to identify themselves.

So at the broadest level, intersex people are intersex because of 1) their experiences (medical or not) with differences in sex traits, and 2) if they want to use that word for those experiences.

This is also why it can be difficult to understand how common intersex is, because different people have different definitions of what counts. "Classical" or type 1/mix types occur at much, much lower frequencies compared to the other categories.

Some folks with PCOS, wherein hormonal differences are associated with causing ovarian cysts, even consider their PCOS to be an intersex trait, because hormones ARE a sex characteristic. (Though this type of thinking is probably rarer.)

so tldr; identifying as intersex is fairly open ended, and is up to the person with sex differences!

Though of course this comes with consideration of the unique history and associations of being intersex, which are not to be co-opted.

The most important takeaway is: whether or not someone prefers the term "intersex," all individuals of any category deserve bodily autonomy and the right to make their own decisions about irreversible medical procedures! 😌