What Does It Mean to Identify as Intersex?

Have you ever wondered what the ‘I’ in LGBTQIA+ stands for? Well, it’s one of the least understood identities within the spectrum and represents only a tiny minority of people. But nevertheless, having a deeper appreciation for what intersex means, and some of the challenges intersex people may face in life, is so important when it comes to being inclusive, open-minded and empathetic. 

First, the science bit. Intersex is a term used to describe a range of physical, genetic, hormonal, or chromosomal variations that result in an individual's reproductive or sexual anatomy not fitting typical definitions of male or female. Intersex people may be born with variations in their sex characteristics that make it difficult to classify them as strictly male or female. These variations can occur at different levels, including:

Typically, people have two sex chromosomes: XX for females and XY for males. However, some may have atypical combinations, such as XXY or XYY.

Intersex people might have atypical gonads (testes or ovaries) or have both testicular and ovarian tissue in their bodies.

Some intersex folk may produce or respond to sex hormones (such as testosterone and oestrogen) differently from ‘typical’ biological males or females.

Intersex individuals can be born with genitalia that do not fit the typical male or female appearance. This can include variations in the size, shape, or structure of the genital organs.

The main difference is that the word intersex refers to variations in physical sex characteristics, while the term transgender is used to describe someone whose gender identity differs from the sex assigned to them at birth.

An intersex person might relate more strongly to a particular gender or be non-binary. In fact the existence of intersex people, albeit a small demographic (intersex is a natural biological variation, and it occurs in approximately 1 in 2,000 live births)^[1] helps us recognise how distinct gender identity can be from biology, specifically genitalia.

Everyone should be respected and supported in their self-identification and have the right to make decisions about their own bodies. Many intersex people and organisations advocate for awareness, education, and legal protections to prevent unnecessary medical interventions and discrimination.

The sad fact is that a great many intersex folk undergo unnecessary and often irreversible medical interventions at a young age, which can have physical and psychological consequences. These treatments might have been performed without their informed consent or the consent of their parents, who are often pressured by medical professionals to ‘normalise’ their child's anatomy. This can lead to lifelong consequences because the individual wasn’t able to make their own decisions.^[2]

Historically, medical interventions on intersex people were often justified by the belief that they would lead healthier and more ‘normal’ lives if their bodies conformed to typical male or female appearances. However, the medical necessity of these interventions has been widely questioned and challenged in recent years as society begins to be more open and accepting of the fluidity of gender and the spectrum of identity.^[3]

Surgical procedures to modify the genitalia and other sex characteristics can result in physical complications, including scarring, loss of sensitivity, and the potential need for additional surgeries. These procedures do not always achieve the desired outcomes and this can lead to significant psychological distress, including feelings of shame, isolation, and body dysphoria. These experiences may lead to long-term mental health challenges.^[4]

Thankfully, in recent years, there has been a growing recognition of the importance of patient-centred care for intersex people. This approach prioritises informed consent, bodily autonomy, and psychological well-being, allowing people to make decisions about their own bodies when they are old enough to do so.

Deciding when, how, and to whom to disclose your intersex status can be challenging, as you are trying to balance personal privacy with the need to be honest and vulnerable with a partner, whilst also potentially educating them.

First things first— it's essential to prioritise your own comfort and well-being. There is no fixed timeline for disclosing your intersex status. Share when you feel ready and when you believe it is the right time.

Healthy relationships are built on open and honest communication. If being intersex is an important aspect of your life or identity, sharing this information can help nurture trust and intimacy. It can also be an opportunity to educate your date about what it means to be intersex, breaking down stereotypes and misconceptions. You can use this as a chance to demonstrate understanding and empathy within a new relationship.

While many people are understanding and supportive, there is a chance that some may react negatively or ignorantly. Consider your safety when deciding when and how to disclose. Set clear boundaries for yourself regarding what you are willing to discuss. You can choose to share as much or as little as you are comfortable with. It’s always helpful to have a support system or friends you can talk to about your decision to disclose your intersex identity. Even if they’re not experts on the intersex experience, they will be able to give you some emotional support.

Ultimately, it's important to be yourself in any relationship. If being intersex is a part of your identity, sharing it allows your partner to know and accept the real you.

Remember that being intersex isn’t necessarily a problem that needs to be fixed. Many intersex people are happy and confident in who they are, it’s just that society, and often the medical profession needs to catch up. So listening and finding out about someone’s experience, their challenges along with the positives, is the best thing you can do before making any assumptions.

It might also be a nice idea to educate yourself on the science and biology of being intersex by reading articles such as this one and looking up information in books and online. Coming to conversations with a level of basic knowledge and asking informed questions is a great way to show you care. 

Generally, you can’t go wrong by being kind and empathetic. But do respect privacy and boundaries. It’s not appropriate to ask personal questions about someone’s genitals, for example. But if they offer the information during an intimate and honest conversation you could sensitively ask follow up questions. Focusing on how they feel, or have felt in the past is a positive approach to take. 

Being a good ally means standing up against discrimination, prejudice, and stereotypes that intersex people may face. Educate others and challenge harmful beliefs and behaviours when you encounter them. You’ll also no doubt be hyper aware of accepting and respecting your friend's self-identified gender. As discussed earlier in the article, intersex people may identify as male, female, non-binary, or other gender identities, just like anyone else. Use the name and pronouns they prefer.

Intersex people represent a small yet significant part of our diverse human spectrum, and their experiences deserve our understanding and support.

[1] Intersex Society of North America (2005) Intersex Society of North America. Available at: https://isna.org/faq/frequency/ (Accessed 12 October 2023)

[2] Intersex Society of North America (2005) Intersex Society of North America. Available at: https://isna.org/faq/conditions/ (Accessed 12 October 2023)

[3] Intersex Society of North America (2005) Intersex Society of North America. Available at: https://isna.org/faq/conditions/ (Accessed 12 October 2023)

[4] Intersex Society of North America (2005) Intersex Society of North America. Available at: https://isna.org/faq/patient-centered/ (Accessed 12 October 2023)