Until a few years ago, it was considered an intersexual disorder, that is, having sexual characteristics intermediate between those that are typical in men and those that are in women.
Nowadays the conception of what intersex is changing as knowledge of human biology grows and awareness of gender and gender diversity increases.
What is intersex?
The term “intersexuality” refers to a series of variations in organs and sexual characteristics, both anatomically and genetically, which cause the person to have female and male characteristics simultaneously. these variations they can affect chromosomes, hormones, genitals and / or secondary sex traits, Such as the distribution of muscle and fat.
The result of variations produced by intersexuality is the ambiguity of sexual anatomy or the mismatch between genotype and phenotype. In summary, it can be said that intersex people are those who are born without all of the typical female or male physical traits. In addition, as this does not have to manifest itself externally but can also occur only in the genes, not all intersex people know they are.
From the biological sciences, intersexuality is currently conceived as a set of disorders or variations in sexual development. The second concept is more and more widespread, less stigmatizing for intersex people.
Although in many cases it has been medicalized, the truth is that intersex is generally not a danger to survival, although in some cases it carries a risk of pain and infertility and can cause sexual intercourse. embarrassment about gender identity.
Synonymous with “hermaphrodite”?
previously intersex people were called “hermaphrodites” but today this term is considered pejorative: hermaphroditism consists of the simultaneous presence of male and female reproductive organs which occurs in certain species of animals and plants.
In ancient and medieval Europe people who had ambiguous sex characteristics were considered hermaphrodites. The law of these companies stipulated that they were to be regarded as men or women on the basis of predominant external traits. To a large extent, this conception has been maintained to the present day.
During the 20th century, the term “intersexuality”, coined by geneticist Richard Golschmidt in 1917, replaced “hermaphroditism” in such cases. The medical advancements of the last century have allowed surgical and hormonal procedures would become popular modify the anatomy of intersex people so that their bodies more closely resemble the prototype of a man or a woman.
However, the efficacy and questionable risks of these treatments, often practiced in a non-consensual manner among minors, have contributed to the emergence of movements to defend the rights of intersex people.
Causes and types of intersexuality
There are many possible causes of intersexuality that cause different variations in genotype and phenotype. These causes can be divided into four main categories according to their most defining characteristics.
1. Intersexuality 46, XX (with virilization)
In these cases, the person’s chromosomes match those typical of a woman, but their external genitalia is that of a man. Again in intersexuality 46XX, the person has a uterusExposure to high levels of male hormones during fetal development, produced by several possible causes, causes the clitoris and vaginal lips to develop like a penis.
The most common cause of this type of intersex is Congenital adrenal hyperplasia, Which consists of defects in the adrenal glands that cause excessive secretion of androgens, as well as a deficiency in cortisol and other hormones. This disorder can affect menstruation and hair growth, but in severe cases it can also affect heart rate or blood levels of sodium and potassium.
The presence of ovarian tumors and the consumption of male hormones during pregnancy by the mother can also cause intersexuality with virilization.
2. Intersexuality 46, XY (with under-virilization)
Intersexuality 46, XY consists of the presence of male chromosomes and female or ambiguous external genitalia. In this type of intersexuality, the normal development of the male phenotype from the inhibition of female characteristics does not materialize.
The most common cause of intersex with subvirilization is androgen insensitivity syndrome; in these cases, the body is resistant to male hormones, which are necessary for the development of the gonads and other sexual characteristics of the man.
Testicular malformations and insufficient testosterone production are also common causes of intersex 46, XY.
3. True gonadal intersexuality
This type of intersexuality occurs when the person has both ovaries and testes at the same time, Whether complete or incomplete. These variations were once known as “true hermaphroditism”, as opposed to the terms “female pseudohermaphroditism” and “male pseudohermaphroditism” which were used for intersex XX and XY, respectively.
In true gonadal intersexuality, the external genitalia can be male, female or intermediate, and XX, XY or both chromosomes can be present at the same time. The cause of these variations is unknown.
4. Complex or indeterminate intersexuality
We speak of complex or indeterminate intersexuality when sexual development is impaired without any incongruity between genotype and phenotype. Among other things, sex hormones or the number of chromosomes can be affected.
For example, cases where there are two X chromosomes (47, XXY or 47, XXX) and where there is only one X chromosome (45, XO) would be included in this category.