Intersex: Meaning, Sex Characteristics, Identity, and Healthcare

For example, an intersex person may have:

• chromosomes that differ from the most common XX or XY patterns;
• external genitals that developed differently;
• internal reproductive organs that do not match external appearance;
• gonads that developed differently;
• hormone levels or hormone responses that vary from typical patterns;
• puberty changes that were not expected from the sex assigned at birth.

Simple usage examples include:

• An intersex variation may be noticed at birth.
• Another intersex variation may become apparent during puberty.
• An intersex person may identify as a woman, man, or nonbinary person.
• Being intersex does not reveal someone’s sexual orientation.
• An intersex person may or may not need medical care.

Intersex variations are biological differences. They are not caused by a person’s behavior, parenting, morality, or sexual activity.

• an intersex person;
• an intersexchild;
• an intersex variation;
• the intersex community;
• intersex rights.

It may also be used as a noun describing an identity or population:

• The organization advocates for intersex people.
• The survey included people who identified as intersex.

Referring to someone as an intersex may sound unnatural or reducing. An intersex person is usually clearer and more respectful.

Common Usage Patterns

The word commonly appears in expressions such as:

• born intersex;
• identify as intersex;
• intersex traits;
• intersex variation;
• intersex person;
• intersex community;
• intersex healthcare;
• intersex rights.

The term hermaphrodite should not be used for people. It is scientifically inaccurate in human contexts and is widely considered stigmatizing or offensive.

These include:

• chromosomes;
• genes involved in sex development;
• ovaries, testes, or other gonadal tissue;
• hormone production;
• the body’s response to hormones;
• internal reproductive structures;
• external genital anatomy;
• secondary sex characteristics that develop during puberty.

These characteristics do not always follow one uniform female or male pattern. The National Academies’ review of variations in sex traits explains that sex development involves complex interactions among genes, hormones, tissues, and timing, producing a wide range of physical characteristics.

An intersex variation does not necessarily involve visibly different genitals.

Examples may include:

Androgen Insensitivity Syndrome

In androgen insensitivity syndrome, or AIS, the body responds partially or completely differently to androgens such as testosterone.

A person may have XY chromosomes while developing external characteristics commonly associated with female bodies.

Congenital Adrenal Hyperplasia

Some forms of congenital adrenal hyperplasia, or CAH, affect hormone production and may influence genital development, puberty, menstruation, or fertility.

Certain forms can also cause serious salt and hormone imbalances that require medical treatment.

Sex-Chromosome Variations

Variations may include patterns such as:

• XXY;
• X0 or a single X chromosome;
• mosaic chromosome patterns;
• other differences in chromosome number or structure.

Not every person with a sex-chromosome variation identifies as intersex.

Gonadal or Reproductive Variations

Some people have gonads, internal reproductive structures, or genital anatomy that develop differently from typical expectations.

The exact effects depend on the individual variation. Two people with the same diagnosis may have different bodies, health needs, fertility, and identities.

Some medical sources use disorders of sex development, but many intersex people and advocates prefer differences or variations because disorder may imply that every intersex body is unhealthy.

Preferences vary:

• some people use intersex;
• some use DSD;
• some use the name of a specific diagnosis;
• some use more than one term;
• some do not consider intersex part of their identity.

Respectful language follows the terminology the individual chooses.

Intersex concerns physical sex characteristics. Transgender describes a gender identity that differs from the sex or gender assigned at birth.

An intersex person may identify as:

• a woman;
• a man;
• nonbinary;
• genderqueer;
• transgender;
• another gender.

Some intersex people identify with the sex assigned to them at birth, while others do not. Anatomy alone cannot establish a person’s gender identity.

Third gender is a gender identity, cultural role, or legal category outside exclusive male and female classifications. Intersex refers to physical sex characteristics.

An intersex person may identify as third gender, but many identify as women or men. Similarly, most third-gender people are not necessarily intersex.

A person should never be assigned a third-gender identity merely because they have an intersex variation.

An intersex person may be:

• heterosexual;
• gay;
• lesbian;
• bisexual;
• pansexual;
• asexual;
• queer;
• another orientation.

Intersex people may date, marry, have sex, remain celibate, become parents, or choose not to form romantic or sexual relationships.

Their sex characteristics do not reveal whom they find attractive or which sexual activities they prefer.

Some people experience typical spontaneous puberty. Others may need hormone treatment or medical monitoring.

An intersex person may:

• be fertile without assistance;
• experience reduced fertility;
• use fertility treatment;
• preserve eggs, sperm, or reproductive tissue;
• be unable to produce reproductive cells;
• have no interest in biological parenthood.

Infertility should not be assumed merely because someone is intersex.

However, not every physical difference requires immediate treatment.

Historically, some intersex infants and children underwent surgery intended mainly to make their genitals appear more typically female or male. Such procedures may affect sensation, sexual function, fertility, and bodily autonomy.

The United Nations intersex fact sheet raises human-rights concerns about medically unnecessary, irreversible treatment performed before a person can participate in the decision.

Urgent treatment for a serious medical problem should be distinguished from surgery performed mainly for appearance or social conformity.

Respectful behavior includes:

• using the person’s chosen name and pronouns;
• not asking invasive questions about genitals;
• not demanding medical proof;
• not revealing someone’s intersex status without permission;
• avoiding assumptions about fertility or sexual function;
• using the person’s preferred terminology;
• not treating an intersex body as strange or incomplete.

Parents and healthcare professionals should provide age-appropriate, truthful information rather than creating secrecy or shame around a child’s body.

Intersex means transgender.
Intersex concerns sex characteristics, while transgender concerns gender identity.

Intersex is a third gender.
Some intersex people identify as third gender, but many identify as women or men.

Every intersex person is infertile.
Fertility varies according to the individual and the specific variation.

All intersex traits require surgery.
Some need medical care, while others require only monitoring or no treatment.

Intersex identity reveals sexual orientation.
Intersex people may have any sexual or romantic orientation.

1. Intersex describes natural variations in physical sex characteristics.
2. An intersex variation may involve chromosomes, hormones, gonads, or genitals.
3. Can an intersex person identify as a woman or a man?
4. An intersex trait may not become apparent until puberty.
5. Being intersex does not determine someone’s sexual orientation.
6. The intersex patient preferred the name of their specific diagnosis.
7. Not every intersex person needs medical treatment.
8. An intersex person should control who receives information about their body.
9. The school adopted a policy protecting intersex students from discrimination.
10. Respectful care allows an intersex person to participate in decisions about treatment.

However, intersex traits do not determine attraction, sexual behavior, gender identity, or capacity for intimacy. Intersex people have varied bodies, identities, relationships, and sexual experiences.

Accurate sexuality education recognizes natural diversity in sex characteristics, separates anatomy from gender and orientation, protects medical privacy, and supports informed consent and bodily autonomy in healthcare.