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Intersexuality & Body Image

Although we tend to assume that the world is divided into just two sexes, male and female, some people are born with both male and female anatomical traits. Intersexuals are individuals who possess ambiguous reproductive or sexual anatomy (and/or chromosomes) that cannot be definitively categorized as either male or female (ISNA, 2008). The causes of intersexuality are purely biological, usually associated with chromosomal variations (Vilain, 2006). Intersexuality is not psychological in origin, nor is it a mental disorder. 

How Common is Intersexuality?

Statistics on the prevalence of intersexuality are estimates, and there is some controversy about which conditions count as intersex.  The statistics only represent those conditions of acute ambiguity that are reported. Additionally people often do not discover their intersexuality until puberty or later in life (as in the case of someone who appears externally female, but has internal male reproductive anatomy), and some never discover their condition so an accurate prevalence rate is impossible to determine. However:

  • Experts generally agree that the prevalence of intersexuality is 1 in every 2000 births.
  • It is also estimated that about 1 in 100 infants exhibit some anomaly in sex differentiation that is not extreme enough to be considered intersex (ISNA, 2008).

“Corrective” Surgery

In the past, parents and doctors often hid a diagnosis of intersexuality from children in an attempt to shield them from psychological harm (Diamond, 1997). Intersex infants would undergo "corrective" surgery to make their genitalia unambiguously male or female. However, then as now, in most cases, such surgery is not necessary for the physical health of the child; surgeries were done to make the child's body conform to societal expectations about sex and gender.

While the intent behind the surgery was to allow intersex children to develop “normal” gender identities and healthy self-esteem, research proved that when families and medical professionals failed to acknowledge intersexuality, children often experienced a sense of shame and isolation (Preves, 2002). Furthermore, such cosmetic surgery done in infancy can result in loss of sensation in the genitals, infertility, physical discomfort, psychological distress, and impairment of sexual function and satisfaction (Preves, 2002).

This controversial procedure has been disputed in great depths over the past few years.  Now, it is more common for most specialists to organize “Differences of Sex Development” or “DSD” teams composed of many different specialists for intersex-born individuals.  While, even today, some medical professionals may go ahead and do the surgery at the parent’s request, increasingly, parents choose to leave their child’s body as it is and allow them to decide what they would like to do when they are old enough to make that decision. (Human Rights Watch 2020)

Effects on Body Image

Intersexuals often find such childhood medical interventions traumatic both to their bodies and their minds (Turner, 1999 and Human Rights Watch 2020). They are left with physical and emotional scars that serve as constant reminders of their difference (Chase, 1998). Some come to view their bodies as grotesque, damaged and undesirable. Researchers have reported increased incidence of certain mental health issues related to body image and self-concept in the intersexual population: 

  • Self-consciousness, self-hatred and resentment toward their bodies (Preves, 2002).
  • Feelings of shame, inadequacy, and anger that affect the way they see themselves and interact with others (Preves, 2002).
  • Self-consciousness in sexual experiences, avoidance of sexual contact, and difficulty forming healthy relationships (Chase, 1998).
  • And contemplated, attempted, and sometimes successful suicide (Diamond, 1997).

Creating a Positive Intersexual Identity

Intersexuality has been described as a “lifelong pattern of secrecy, isolation, shame, and confusion” (Koyama, 2008). However, once intersexuals learn their true medical histories, many experience relief at finally having their confusion and sense of difference explained. They can identify as intersexuals and they can connect with other people who share similar experiences. 

Support networks help intersexuals realize that they’re not alone, (Hermaphrodites Speak!, 1997). Speaking with others who understand the complex emotions they experience can ease feelings of isolation, shame and guilt (Turner, 1999), and lead to greater body acceptance.

Intersexuality Around the World 

As one form of naturally occurring biological variation, intersexuality exists in all societies around the world. However, it is not equally stigmatized in all cultures, and is even celebrated in some. 

In India, for example, most intersex infants are classified as Hijra, a socially recognized third gender group. Hijra are characterized by their distinctive dress and language style, and they fulfill special ritual roles, particularly in matters related to fertility, marriage and childbirth. Their unique blend of male and female physical characteristics is believed to endow them with certain spiritual powers, beliefs no doubt related to the fact that many Hindu deities have both male and female aspects. Hijra generally oppose surgical or cosmetic “correction,” and instead embrace their special place in Indian society (Reddy 2005; Goel 2019).

Last update:  16 April 2021

Ask Yourself

Why does our society demand that individuals are unambiguously male or female? How do people react when they can't determine someone's gender? 

If intersexuality is a naturally occurring form of sexual variation, do we need to rethink our sex and gender categories to include more than two?

In what ways does "corrective" cosmetic surgery for non-consenting infants differ from male or female circumcision (also sometimes called genital mutilation)? In what ways is it similar?