Intersex Inclusion

Why do we Need Inclusion?

For a very long time, our culture has afforded more rights to one group of people than to another group, based merely on the appearance of their genitals at birth. We’ve been working as a culture to change that.

But the intersexed – those whose genitals or other markers of sex are mixed – have been afforded no acceptance, rights, or protection at all.

To be granted citizenship, have a birth registered, get a health card, or even sign up to participate in any aspect of our culture, one is always asked whether one is “male” or “female” – whether this is a realistic choice, or not.

There is no acknowledgement of the fact that it isn’t that simple – that human sex characteristics overlap, and that there may not be a ‘pure male’ or ‘pure female’ alive on this Earth – at least not that we will ever be able to prove. There is no acknowledgement that the shape of one’s genitals is irrelevant to one’s basic humanity.

Our culture’s current model for defining human sex is a very damaging and discriminatory way of looking at a natural variation of form – because it simply does not allow or make room for the reality of intersex differences. Nor does it acknowledge that anyone could be intersex.

The idea that people must be separated into two non-overlapping physical classes is a biological fiction, and a toxic cultural fixation. The right to exist, and to claim the truth of one’s reality should not be subject to purely cultural preferences and expectations.  To be shamed or mutilated out of existence is a heavy and severely limiting burden to bear. It’s also entirely unnecessary.

Imagine how it feels to be unable to simply state the truth of who you are, to be forced to lie about your sex, to be legally required to define yourself in a way that invalidates the truth of your physical reality, perhaps only acknowledging half of your being.

 

Intersex Rights are Human Rights

We say it’s time to include – and welcome – these variations of sexual form in our cultural awareness. We say it’s time to stop the systemic discrimination that comes with such a refusal to acknowledge that these differences exist, and that they are normal, if not culturally normative.

Intersex rights are human rights. It is the right of every human being to be treated and recognized as such, without having to conform to a legal, medical and cultural fiction that sex is binary. It is the right of every human being to be treated with dignity and respect, acknowledged and validated, with no coercion to conform to the cultural ideal, the fiction, of binary sex.

All of us have the right to be here. All of us have the right to be acknowledged as human beings. All of us have the right to feel safe in our own skins, to feel accepted as we are, without needing to be physically altered before we can be granted human status, our human dignity or our human rights. Even the intersexed.

How we can all be inclusive

When we announce the shape of a baby’s genitals at birth, what we are really doing is announcing the child’s social sex, providing a template of expectations about how this child will engage with the world, and how this child should be treated in order to successfully master these expectations.

What if the child’s genitals are not stereotypically male or female? Then, we don’t have this shorthand cultural information.   How are we supposed to know how to raise a child, if we don’t know which category of human they belong to?

We say maybe it’s time we stopped working so hard on enculturating our children to believe that there are only two possible ways to walk through life, clearly lit up by the shape of the genitals, and that one must choose one or the other.  

The problem is that our stereotypes and expectations are not just descriptive. They are proscriptive, limiting some behaviours and exaggerating others.

We think such cultural designations are profoundly limiting in terms of the true possibilities of human experience – which might truly be experienced as both, or as neither, of these culturally-mandated social sexes.

We know that the idea that sex is strictly or always binary is a cultural construct, not supported by scientific observations of objective, physical reality. If the idea of binary sex is a culturally constructed, then our ideas about how the sexes are supposed to be different from each other are also culturally constructed, policed and reinforced.  

Really, the ideal of strict binary sex is a cultural inheritance from the Levantine religions that are at the core of our legal system, and which still form our culture’s predominant religions.  To continue to enforce these cultural and religious beliefs about human sex, which are at odds with established science, is not appropriate in a diverse, democratic and rational culture.

We say it’s time for our culture to acknowledge the fact that the intersexed exist, and that we have always existed.

We say it’s time to end our experiments with erasing the intersexed from existence and from human consciousness. We say it is time that the intersexed were welcomed back into the family of humanity.  

Let’s begin by acknowledging and embracing the fact that any of us – or maybe even all of us – could be intersexed. After all, we all start out in the womb as intersex, and branch out from there. All of us carry both male and female potentialities within us.

Abolish the tickbox

Every time we make an assumption about which gendered pronoun to use, or ask someone to list their sex as either “M” or “F” on a tickbox, we are participating in cultural programming to accept only these two choices, and invalidating all other possibilities.

Many intersex people do experience their own sex and gender as being binary – either male or female. But that is not the case for all. Why should any person be required to make a choice about which of the two culturally-endorsed sexes they are, if their reality is that they are both? We say no one should be forced or coached to believe that they must be binary, that they must make a choice between two legally endorsed, cultural fictions, of being either male or female.

The intersexed are continually reminded that, in this culture, their reality is invalid. abnormal and invisible – or at least, part of them is, and must remain so.  Many intersex people report this presumptive and limiting sex and gender assignation to be an ongoing source of trauma.

We want to see intersexed people simply be allowed to live with full integrity and authenticity, to have the courage to be true to themselves, and not feel the need to conform to a cultural story that does not include them.

But not only the intersexed.  All of us should be allowed to speak our truth about our own experience of living in our own bodies, of honouring our own sexual orientations.

Many intersex people have internalized the shame and secrecy they grew up with about their condition, and are not willing to disclose their difference, irksome or injurious though it may be to be constantly invalidated by other people’s presumptions.

We think that maybe what a person’s genitals look like, or their gender(s) is really nobody else’s business, unless that information is offered or necessary.

The omnipresent tickbox, asking which binary camp one belongs to every time one tries to take part in society is an invasion of privacy. It seems to deliberately exclude the intersexed, the genderfluid and the transitioning, for whom such a question does not make sense.

If someone’s sex is non-binary, or if their general phenotype or assigned sex doesn’t match their gender, they are already being constantly invalidated, made to feel that a critical part of their own essential being, their very identity, is unacceptable or unthinkable, and must be suppressed, hidden or ignored – or be ready to fight about it every time they try to engage in their own culture.

A good place to start is by witnessing one’s own, and our culture’s assumptions about sex. Becoming aware of how and when we police and enforce our cultural beliefs about binary sex is the first step to changing them.

Reflect on the stereotypes and assumptions you hold, and notice how often you make automatic sex-based assumptions about someone based on their appearance or their name. Notice what happens when you are faced with a name that is not clearly male or female. Do you panic, not knowing how to address them, not having a ‘male’ or ‘female’ archetype to envision them as conforming to?

Keep in mind that you can’t necessarily tell what sexes or genders someone is ‘by looking,’ either at their general appearance, or at what’s in their pants. Remember that anyone could be intersex. Remember that the idea of dyadic sex is an oversimplified version of a diverse and complex reality. Remember that our binary ideas of social sex are a shortcut and a convenience, a way of quickly sorting people into categories based on cultural expectations or stereotypes.

Remember that these cultural categories and shortcuts may shortchange the person in front of you. Remember that some people experience ongoing trauma at being constantly invalidated by our assumptions that everyone is binary.  

To be an ally to the intersexed, use inclusive language.

Make a game of avoiding binary descriptors.  Instead of using standard binary greetings like: “Ladies and gentlemen, boys and girls!”, use something like “Hello, everyone,” instead. Making people feel welcome and included means remembering they may be present, even if they are unannounced or closeted about their difference. It means not using social conventions that will exclude or invalidate people.  

Be a rebel for gender justice. Risk the wrath of the grammar police. We say “they” is a perfectly fine first-person pronoun for anyone. As anyone could have more than one genetic profile (i.e.: be twins or triplets fused early in the pregnancy), then anyone could be a grammatically unassailable “they.”

English is a very flexible language, one whose rules change based on usage. The more people who use “they” instead of “he” or “she,” the faster “they” will make it into the dictionary as officially acceptable to use as a first-person pronoun. That’s all it takes.

Our culture goes beyond classifying bodies and behaviours as being “male” or “female.” We assign binary sex alliances to qualities, as well, which tends to make them the exclusive property of one binary sex or the other. Being inclusive means being aware of how we’ve gotten into the habit of assigning gender to almost everything.

“Strength” and “toughness” are not masculine qualities. They are simply qualities, shared by and necessary for all human beings to survive.  But if we assume “strength” and “toughness” are qualities that belong to the cultural class known as “males,” then we are creating a social reality in which “females” are dissuaded from owning “strength” or “toughness.”  

Likewise, “gentleness” and “delicacy” are not feminine qualities. They are part of the fabric of being that makes up every one of us. We all need to learn how to be gentle and delicate, or we have shortchanged ourselves of our rightful human inheritance. It does not contaminate “maleness” to develop fine motor control or to be fully human.

We suggest cultural cross-training to loosen up constrictive cultural conditioning. We advocate teaching to our culturally-noted and enabled weak spots as well as to our stereotypical and idealized binary strengths.

That means expecting and teaching “girls,” as well as “boys,” to dust themselves off when then fall, and say: “I’m alright,” and carry on. We should all be taught to be confident and assertive, to walk with a bit of a swagger.  We should all be taught  to state clearly why a situation or behaviour is not OK with us, instead of being socialized to expect others to figure out that something is wrong.  

Cultural cross-training means expecting and teaching “boys,” as well as “girls,” how to be empathetic and observant of others’ emotions. We should all be taught to honour and make room for our own, and others’ emotions. We should all be taught that tears are a powerful and necessary release, and that there is no shame in letting one’s heart overflow through one’s eyes, because that is what it means to be human and to have a heart that feels at all.

We see “girls” in our culture free to choose any colour in the spectrum to express themselves in clothing, leaving boys only a monochromatic, dullard’s palate of grey, black or brown. We see this as self-policing behaviour to conform to binary expectations. Perhaps we need to remind people that all colours belong to everyone who can see and experience them and enjoy their vibrations, and that creativity in self-expression is everyone’s domain.

If we consciously extract our binary sex labels from human qualities or things, we will go a long way toward undoing our cultural fetish for classifying people – and everything else – as being either “male” or “female.” Otherwise, we risk becoming, and possibly have become, a culture of self-policing self-caricatures, each doing our best impression of “maleness” or “femaleness,” but leaving half of our essential humanity behind.

Read more about how we can all be more inclusive here.

How medicine can be inclusive:

This basic, fundamental knowledge about human sex determination needs to be acknowledged by medicine:  there is no strict dividing line in nature between male and female genitals, nor is there any guarantee that they will be the same sex as any of the other markers of sex.  

Surgically enforcing culturally-endorsed sexes is discriminatory, as it does not make room for the reality that not all people are sexually binary, nor do they have to be. We want our public health care system to affirm the right of intersexed people to exist.

We want our public medical system to affirm the right of the intersexed to be able to access rational, respectful, informed medical care that acknowledges their existence and needs, and that does not do any harm to their bodies or their psyches.

To do this, medicine needs to let go of its scientifically untenable and inherently discriminatory belief that sex is necessarily binary.

The general, global assignations of “M” and ‘F” are medically obstructive and inaccurate,  and need to be abandoned for a more realistic model of cataloguing sex characteristics, which may or may not be just one sex.

 

Cultural expectations for genital appearance are not a credible scientific basis on which to deny or agree to investigate a person’s sexual health care needs, but that is the current standard. We want to see greater scientific rigour, and a realistic respect for uncertainty within medicine.

Medicine needs to acknowledge that in any practice, an unknown number of their clients will necessarily be intersexed, in ways that are not suspected by a casual glance at the genitals. Making room for this reality means abandoning the presumptive and obstructive model that categorizes everyone as being either “binary male” or “binary female,” based merely on their genitals’ appearance.  

 

We suggest classifying every determinant of sex individually (gonads, genitals, genes, hormones, internals sex organs, etc.) We suggest giving three alternatives for each and every determinant, which can then be checked off as  “male,” “female,” or a “combination of the two”.  These checkboxes for individual determinants of sex would necessarily be understood to be changeable, as more detailed information about the individual’s sex markers became available, or as the individual transitioned to a sex that matched their psychological sex.

Medicine betrays its discriminatory assumptions about non-binary sexual conditions in its nomenclature.

The medical culture currently uses terms like “abnormal,”  “deformed,” or “disordered” to describe intersex differences. We suggest the profession adopt instead the terms “stereotypical” vs. “atypical” or  “culturally normative” vs. “culturally non-normative” in order to more accurately and sensitively describe intersex differences and individual sex differences.

In 2006, the profession renamed “intersex differences,” calling them instead “Disorders of Sexual Development.” Intersex activists hotly contest this change, stating it broadly and inappropriately pathologizes what are mostly individual differences that cause no health problems at all.

It is difficult for the intersexed to access respectful medical care. The attempt can be traumatizing: the medical culture refuses to acknowledge the intersexed, actively tries to erase all evidence that the intersexed do exist, and does not acknowledge the profound, ongoing and historic psychosexual trauma that are the result of these practices. For the intersexed, getting medical care “down there” can feel like stepping deep into enemy territory. Medicine needs to acknowledge and address the ongoing trauma that its attitudes of disbelief, entitlement to alter, and revulsion engender in its intersex client base.

For a reading list about medicine vs. the intersexed, including the debate over medicine’s renaming “intersex differences” as “Disorders of Sexual Development,” click here.

Read more about how medicine can be more inclusive here.

How our legal system can be inclusive

If our markers of sex do not have to be, and are not always just one sex, and if we cannot necessarily tell when this has happened, then binary sex is no longer scientifically or legally definable or defensible. Science concedes we don’t even know how to strictly define the terms ‘male’ and ‘female’ anymore – except by cultural agreement.

So, is it fair or realistic to expect that all people will, or must fit into this culturally significant, but scientifically fictive binary classification system?

No.  To automatically categorize humans by the shape of their genitals is dangerous, discriminatory, obsolete and irrelevant.

Human Rights Legislation

We ask that our policy and law makers ensure that the human and legal rights of intersexed people be recognized and safeguarded, at last. Our legal system further needs to recognize and enshrine in law the right of the intersexed to exist as they are.  We need to make room in our society for the fact that a human being is a human being, regardless of the shape of their genitals.

At present, our laws regarding aggravated assault specifically exclude doctors to enable them to perform unconsented sex reassignment surgeries on minors who are born with culturally non-normative genitals, in order to create the appearance of one or the other “binary” sex. Such purely cosmetic genital “normalization” surgeries are done to bring everyone in our society’s genitals into line with our culture’s preferences for genital appearance. This is systematically done even if the baby or child’s culturally non-normative looking genitals are perfectly healthy, and pose no health risk at all.

We ask that section 3(a) of law C-268 be stricken, as it is based on scientifically untenable and inherently discriminatory beliefs: that a person’s sex can be determined by looking at their genitals, and that sex is always or necessarily binary. We state the obvious:  performing unconsented sex reassignment surgeries on infants and children in order to bring them into conformity with cultural expectations and preferences violates the human rights of those children.

To read more about inclusion, recognition and human rights for the intersexed in other juridsdictions, follow these links:

European Union: The fundamental rights of intersex people fra.europa.eu/sites/default/files/fra-2015-focus-04-intersex.pdf  

UN Free and Equal Campaign Intersex Awareness Campaign  https://www.unfe.org/intersex-awareness/

UN Free and Equal Campaign Intersex Fact Sheet  https://www.unfe.org/wp-content/uploads/2017/05/UNFE-Intersex.pdf

We need to make room in our society for the fact that a human being is a human being, regardless of the shape of their genitals. Our legal system needs to acknowledge that a human being can have both male and female sex characteristics simultaneously, whether these individual differences have been medically noted, or not.

The fact that some people will be required to lie in order to be granted legal status or take part in our society has been ignored altogether. Not everyone can truthfully make such a choice. Some people are clearly both sexes, and identify as both.

We inherited our cultural belief that sex is binary from the Levantine religious traditions. To medically and legally limit one’s basic biology and natural sexual state in order that it should conform to the beliefs and expectations of our predominant and foundational religious systems is clearly inappropriate in a rights-based society.

Parents are routinely sworn to secrecy by their doctors about their child’s sex change operation and binary sex assignment. Parents may not even be informed of the true nature of the operation being done in order to “correct” a minor intersex difference.  

We want it to be made explicit in law: under no circumstances are doctors allowed to defraud their clients or guardians of their own basic biological and medical information by deliberately withholding or misrepresenting this information.

Offering a third option for sex (such as ‘X’) is one remedy for those whose psyches or bodies do not conform to our culture’s expectations for binary physical and social sexes. But this might lead to a new form of discrimination.

But, let’s also acknowledge that a person’s sex(es) and gender(s) are personal, private and ultimately unknowable, both scientifically and as an outside observer.

Perhaps as a society it’s time to just come out and admit that binary sexual classification is inaccurate and obsolete. What we call a person’s “sex” can only ever describe their social sex or gender, and that is, ultimately, whatever the person in question says it is.

Perhaps, legally, we should reassess whether it makes sense to denote sex at all in legal or personal documentation, unless such information is necessary or relevant, given that sex cannot scientifically be defined in strict binary terms with any certainty. 

When is Sex Relevant?

Those people who bear children may or may not be completely female, in terms of their sex markers. One can never assume child-bearing individuals are physically or psychologically 100% female, as our culture expects. But protections for child-bearing humans are, and should remain, an important part of public policy.

Likewise, testosterone levels are considered relevant for car insurance providers, but it must be understood that an individual’s hormone levels and gonads might not always agree with a male sex assignation.

Perhaps, legally, we should acknowledge the right of individuals to their privacy, and reassess whether it makes sense to denote sex at all in legal or personal documentation, unless such information is necessary or relevant to the situation, given that sex cannot scientifically be defined in strict binary terms with any certainty.

We believe it is the right of every individual not to be forced to disclose any private information about the appearance of their genitals or their social sex(es), unless this information is necessary. Some people do not want to be identified as either. Intersex (as well as genderfluid or transitioning) people can find the ever-present, assumption-based tickbox invasive and triggering, a constant reminder that they do not fit in to this society, and that our culture is not willing to include them unless they are willing to change or lie. Nor do they necessarily welcome the opportunity to “out” themselves with respect to their difference.

We say: what difference does it make, and whose business is it what someone else’s genitals look like?

We would like to see the intersexed specifically acknowledged and protected as a distinct sexual minority that is at risk for human rights abuses and discrimination.

Malta Declaration, Public Statement by the Third International Intersex Forum, December 1, 2013. http://intersexday.org/en/malta-declaration/

Read more about how our legal system can be more inclusive here.