Intersex Awareness and Allyship

Goal of the Campaign

The goal of this campaign is to validate and celebrate the intersexed –   those people whose physical sex characteristics contain elements of both sexes, and who cannot be defined as exclusively either male or female. Our medical culture has shown a queasy discomfort with intersex conditions, but we believe it’s time our culture and our institutions acknowledged the intersexed, without erasure or shame.

We support the right of physically non-binary individuals not to have to choose between one of two categories – “M” or “F” –  if this flies in the face of their physical, lived experience. We acknowledge the rights of the sexually non-binary to be able to tell the truth about who they are, to be told the truth about who they are, and to be afforded basic human rights.  No child should be subjected to genital mutilation or unconsented sex reassignment surgeries, merely to ‘fit in’ to the cultural fiction that sex is necessarily binary. No one should have their most basic biological and medical information hidden from them.  No one should be forced to lie about who and what they are in order to have legal status or rights.

We stand behind the right of the intersexed not only to exist, free of shame and erasure, but to be able to express and honor their own bodily and sexual integrity and unique sexual identities. We stand behind the right of the intersexed to live with full authenticity, without pressure to conform to societal expectations and assume a false, binary identity, in order to be accepted into society.

The idea that males and females are separate and distinct categories, with no overlap is an oversimplification. Science has established that there is overlap, to the degree that the terms “male” and “female” are no longer considered mutually exclusive or strictly definable terms. Our culture has yet to acknowledge this fact, but still uses the oversimplified classification system that recognizes only two binary, or “opposite” sexes out of a wide spectrum of possibilities. Other cultures have recognized that there are more than two sexes. We believe the time has come for our culture to acknowledge this fact, too.  

We want to make it easier for health facilities, agencies, schools, and community organizations to acknowledge, accept and celebrate the existence of intersexed people and the spectrum of sex in their day to day reality.  To this end, we’ve included an online learning tool for individual learning. We also offer access to our speaker’s bureau, which is made up of intersex educators.


Who are Intersex People?

In our culture, there are two ways of looking at this question:

Way #1: Anyone could be intersex

(This statement is true in terms of current science.)

We used to think that sex is binary, a pole with “male” at one end, and “female” at the ‘opposite’ end. We used to believe that all the various ways of measuring sex would match up and be the same sex. We used to think that the way you told boys and girls apart was by looking in their pants. It turns out to be a lot more complicated than that. Science has replaced that binary with the idea of a spectrum of possibly overlapping male and female elements.  

There are actually a number of ways to determine a person’s sex. Gonads, genes, hormones, internal structures yield precise, measurable data. The appearance of the genitals (pants check) and phenotype (general body shape) can only be assessed in terms of culture. These different ways of determining sex don’t always have to agree with each other, and show the same sex.

Whenever someone’s markers of sex do not all show the same sex, or overlap male and female elements in some way, this is termed an “intersex condition.”  Some intersex conditions create health concerns that require medical intervention, but science has conceded that most intersex conditions are invisible and unsuspected.

In fact, so many intersex conditions have been discovered by accident that science accepts that humans are simply not reliably or 100% sexually binary, and that the terms ‘male’ and ‘female’ cannot be strictly defined anymore, because of this potential overlap in all people of male and female sex characteristics. Science also tells us there is absolutely no way of predicting or assessing who is intersex ‘by looking,’ or by virtue of a ‘pants check,’ which is considered the least scientific way of assessing sex, as the answer depends entirely on cultural expectations. Science concedes it’s not possible to categorically rule out an intersex condition in anyone, not even if you tested every single cell in their body, because the genes of human sex determination have even been shown to change their sex over time.

What this means is that anyone could be intersex, and not even know it. Even you.

 

Way #2: “Intersex people are rare and tragic individuals”

Intersex people are rare and tragic individuals in whom something has gone wrong, because no one can tell which sex they are supposed to be. Unless this mistake is fixed, they will never be able to fit in, find love or live a normal life.

(This statement is true, in terms of the preferred beliefs of our culture, but it would not be considered true for other cultures. Although this viewpoint is endorsed by medicine, it is not considered defensible in terms of biology or human rights.)

Our culture takes it for granted that males and females are separate and distinct classes of humans, easily told apart by looking at the shape of the genitals. This idea depends on a couple of shortcut assumptions, neither of which can be assumed to be true:

Assumption # 1: Genitals come in two basic shapes, “male” and “female.” 

Genitals do not come in two basic shapes. Although most people’s genitals do tend to look the way our culture expects, they don’t always, nor do they have to. Like other determinants of sex, they can overlap or combine male and female elements. There is no precise line between male and female genital forms, and genitals can range over the entire spectrum between stereotypical male to stereotypical female genital forms.  Even when they don’t look the way our culture would prefer, the underlying cause for ‘ambiguous’ genitalia can only ever be figured out 20% of the time. That doesn’t necessarily pose a problem, except in terms of our culture’s expectations for appearance and for social roles based on genital appearance.

Assumption # 2: a person’s genitals will match all their other markers of sex.

Nothing whatsoever can be assumed about a person’s other markers of sex from looking at their genitals.  There are a number of different ways to measure sex. Genes, gonads, hormones, internal reproductive structures give quantifiable measurements. But classifying genitals and phenotype by appearance is the territory of culture, not biology, in terms of yielding useful data. The different ways of measuring sex don’t all have to agree with each other and be the same sex. Most often, intersex conditions happen with no visible cues.

 

The pants check really only tells us how close or far an individual comes to our culture’s expectations for genital appearance, and nothing more. One can make no assumptions whatsoever about the other markers of sex based on a visual inspection of the genitals.

Most people’s genitals do tend to look like the far binary ends, where we find our culturally idealized forms. But not everyone’s genitals look like our culture’s idealized forms.

How is sex decided?

There are actually a number of ways to assess a person’s physical sex. Scientifically measurable ways are through assessments of the gonads, genes, hormones and internal reproductive structures, while the genitals and phenotype can only yield cultural assessments. If our system of sex were truly binary, these different ways to measure sex would all be the same sex – either unequivocally male, or unequivocally female. They would all match up.

This is the assumption our culture makes when we announce a baby’s sex at birth. We assume that sex is a binary system, that if a baby has a penis, all of the other ways of assessing sex will all match up and will also be male. If the baby has female-appearing genitalia, all of the other ways of assessing their sex will reveal themselves to be female, too.

Like this:sex as a binary

Our expectation is that all the different ways of assessing or measuring a person’s sex will be the same sex.

But that isn’t always the case.  

Possibilities beyond the binary.

It turns out the different ways of measuring sex (Genes, gonads, genitals, internal structures, hormones, phenotype) do not always have to agree with each other.  Sex determinants can be either male or female (for example,  having one ovary and one testicle), can be both male and female (for example, having both male and female chromosomes or cell lines, or being a typical male, but with a uterus), or can  combine male and female elements (for example, having mid-spectrum genitals or a combinatory ovotestis instead of pure ovaries or pure testicles).

These different ways to measure sex give different qualities of data.

Gonads, hormones and internal reproductive structures can give precise, measurable data.

Genetic testing also gives precise, measurable data as well, but it is notoriously tricky to undertake. To show that one has multiple cell lines (i.e.: is twins or triplets fused in utero), at least two different kinds of tissue samples are routinely taken and compared, including blood, saliva, nails and hair.  Because different cell lines can be distributed throughout the body in random and unpredictable ways, genetic testing can only be used to prove, but never to disprove an intersex condition. In genetic testing of this kind, absence of proof is not considered proof of absence because the evidence one is looking for may not be in the sample taken, even though it is present in the body. The genes of sex determination have been shown to change over time in humans over time, so even if one tested every single cell in the body, and did not find evidence of both male and female chromosomes, that could never prove sex-variant chromosomes were not present in the past. 

How people classify genitals and phenotype, however, depends on which culture they live in:  how their culture distinguishes between sexes, and how many sexes they perceive. There is no strict dividing line between male and female forms.

Science now acknowledges that human sex differentiation is best described as a spectrum of forms, in which male and female elements can overlap to any degree, most often without any visible cues or health concerns.Lunch menu (2)

 

 


Medicine vs the Intersexed

The cultural idea that there are two – and only two – sexes is deeply entrenched in the medical belief system. Medicine still defines binary sex as “normal,” and sees all intersex conditions as “disorders” or “abnormal.’ Science, on the other hand, tells us intersex conditions are at least as common as red hair or blue eyes, and that they are generally undiagnosed, unsuspected, and unproblematic – and that it is simply not possible to prove anyone is not intersexed

Science tells us it is not possible to know how many people are intersexed, because to do so you would need to biopsy every organ and test every cell in their body. Even if you did this, and found no evidence of intersexuality, that would not mean they were not intersexed in the past, because in humans, X and Y chromosomes have been observed to change over time.

Genes don’t necessarily determine genital appearance. Genitals are secondary, hormonally-based structures. There are seemingly 100% genetic “males” with normally appearing and functioning women’s bodies, and “normal males” who test as 100% genetically female. Science assumes that these people have more than one cell line, but that this has simply eluded detection, as multiple cell lines are notoriously tricky to track down.

There is a lot that is still unknown about human sex determination. When someone’s genitals don’t look the way our culture prefers, we are only able to figure out why this is so about 20% of the time.  Human sex determination turns out to be a lot more complicated – and a lot more interesting – than medical textbooks have led our doctors to believe.

Despite all the scientific evidence to the contrary, despite all the evidence of harm done, even now, the medical culture’s desire to maintain the fiction that sex is necessarily binary continues, including unconsented sex reassignment surgeries on infants and children, the deliberate withholding of medical information about a person’s intersex condition, and the erasure, shaming and stigmatization of intersex conditions.

The rationale for this has been “to prevent suicide,” apparently assuming that to have genitals that do not conform to social expectations is such a social catastrophe that no other course would ever be considered.

We suggest, instead, telling the truth – that binary sex is a cultural fiction to which not all bodies will subscribe. It should not be a matter of secrecy, stigma and shame to be born with genitals that don’t look the way our culture prefers.

Making the Cut

Science points out there is no particular reason why all genitals need to conform to our cultural preference for binary appearance, and no reason to force everyone’s parts to look the same, when it’s perfectly natural that they don’t.

In terms of biology, there is no dividing line between male and female genital forms, although medicine has chosen to create one, a danger zone for genitally non-conforming individuals that is 0.6 cm wide. This is demonstrated in the tongue-in-cheek “Phallometer,” which is based on real medical standards and expectations, with drastic, irreversible surgical consequences for infants born with culturally non-conforming genitals. 

“Normalizing” Surgeries

The medical world first experimented with “normalizing” genital surgeries on children in the 1950s. The rationale for doing these surgeries on infants and in secret, rather than respecting the bodily autonomy, sexual integrity and human rights of the child, is a long-disproven theory that gender is fluid until the age of two. The belief is that if one surgically changes the sex of a child, and then raises the child in a heteronormative environment, the child won’t know the difference, will develop a sexual attraction for the “opposite” sex to the one they were assigned, and will “know who they are supposed to marry.”

This has not worked out well for those whose bodies were altered in order to stay in line with cultural norms and expectations. The term the intersexed created and use for these surgeries is “intersex genital mutilation,” and the results have been catastrophic – physically and psychosexually.  

To surgically rearrange children’s genitals to suit the aesthetic preferences of someone else violates and interferes with the psychosexual development and bodily integrity of those children. Very often, parents of genitally non-conforming children report being pressured to accept this course of action, and that they were made to feel their children were monstrous, or freaks.

These crude attempts to reshape children’s genitals to meet cultural expectations typically tear themselves apart as the child grows, a risk that does not seem to be disclosed by doctors who perform such surgeries. This generally necessitates repeated attempts to fix the botched initial ‘repair’ for a medically non-problematic issue of having genitals that didn’t meet our culture’s rigid and unrealistic expectations for binary appearance.

Doctors typically assign a male sex and gender to a baby, if the baby’s penis looks like it will grow large enough for penetrative (and presumably heteronormative) sex. Otherwise, the standard medical approach is penile amputation, if the organ is culturally undersized. Intersex babies are generally “turned into” females, because, in medical lingo: “it’s easier to make a hole than to build a pole.”  

Parents are normally sworn to secrecy about these unconsented sex change operations, thus disrupting trust between parent and child. Or, they may be deliberately misinformed: for example told that a neonatal normalizing surgery is a “minor correction.” To be  lied to about one’s own medical information,  including being denied information about surgical alterations to one’s own gonads and genitals, obviously creates a lifelong exclusion from credible, informed, appropriate care.

Respectful Truth-telling

Surely, it is not necessary or desirable to surgically enforce genital conformation to societal norms on an entire population. The obvious alternative is respectful truth-telling. Our public health system exists to provide science-based information, choices and health care services, not to police baby’s genitals to make sure they measure up to discriminatory and unrealistic cultural preferences.

Medicine’s refusal to deal honestly or humanely with intersex conditions calls into question the basic credibility and competence of our public medical system. Since any one of us could have testicles, ovaries, a uterus or a prostate, or some combination of these – no matter what our genitals or phenotype look like – this affects us all.

Systemized, legalized discrimination

Doctors in Canada enjoy special legal protection to alter the genitals of other human beings without their consent, in order to create “normal sexual appearance.” This exclusion is made in order that doctors should not face consequences for what would in any other circumstance be recognized as aggravated assault.   

The problem with this is, of course, that “normal” is a purely subjective term, resting in the eyes of the beholder, based on the expectations and preferences of our culture. The reality is that the entire spectrum of genital forms is populated, from binary end to end. There is no “normal.”  There is only “preferred.” Thus, our doctors surgically enforce their medical culture’s preference for binary-looking genitals.

It’s not going too far to call this systematized, legalized discrimination – even persecution.  Medicine’s approach has been remarkably successful at erasing from our culture’s awareness even the fact that intersex people exist.

The United Nations Human Rights Commission has come right out and stated that intersex genital mutilation contravenes international agreements against torture, and that these surgeries constitute gross violations of one’s human rights and bodily autonomy. 

The fight for intersex rights within medicine is the fight to keep one’s perfectly healthy, if culturally non-normative looking genitals surgically unaltered, unless the person in question gives consent to such a change. The fight for intersex rights within medicine is the fight to know one’s own medical information. The fight for intersex rights within medicine is the fight for credible, inclusive care for us all, since any one of use could have mismatching sex characteristics, a fact that medicine presently is unwilling to acknowledge.  And it is the fight for the right to one’s own bodily integrity – to be able to claim and to live one’s own bodily truth, with dignity, and without secrecy or shame.


How Other Cultures See Sex

How we judge the appearance of the genitals is purely a matter of cultural agreement. Our culture sees two sexes out of a spectrum of forms, because we have chosen to see two sexes out of a spectrum of forms.

Although most people’s genitals do cluster towards the far binary ends in terms of appearance, not everyone’s genitals are going to look the way our culture idealizes and expects. This cultural insistence that human beings must be (or must appear to be) sexually binary has left no safe place in society for those who are not, and in fact, places those with a sexual difference at great risk for medical abuse and erasure.

Our culture’s attempt to categorize sex is similar to how different cultures divide up and name the spectrum of colour. The Polish language divides the color spectrum to include names for two shades each of both red and blue, which are seen as being significantly different from each other, whereas, we ignore this difference, and just call them both ”red” or “blue.”  Some cultures lump orange and red together. Some cultures do not have specific names for colors at all. Likewise, some cultures do not have words equivalent to “male” or “female” to categorize people by their anatomy.  Many cultures see more than two sexes.

Pretend for a moment that we lived in a culture that saw and named as significantly different the colors “blue” and “yellow,” but did not see “green,” except for greenish-yellow, or greenish-blue.  In this world, we might consider the area where “yellow” and “blue” overlapped to create pure “green” to be disordered, because “green” is neither wholly “blue” nor wholly “yellow.”  

Genitals, like colors, appear on a spectrum with no strict, objective-reality dividing line between them. In our culture, to be born with non-conforming genitals creates a social emergency, only because our culture insists that there must be two, and only two, sexes. Other cultures have been more realistic and inclusive.

In most cultures and time periods, sexually divergent, boundary-crossing individuals have been included, even given special status or revered. In our culture, however, intersex conditions have been hidden or erased, the individuals who have them made to feel wrong, broken, freakish – and ultimately, erased.

If other cultures have made room for, and respected the basic rights and humanity of those in the middle, we believe that our culture can, too.

 


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 be Inclusive

How all of us can 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.

Privates on parade

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.

Including the intersexed

So, how do we go about making room for the existence and the experience of the intersexed? The best way to do this is by intentionally working to undo the idea that only two sexes exist.

Watch yourself

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.  

Watch what you say

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.

Not everything belongs to “boys” or “girls”

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.

Cultural cross-training

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.

Sweden’s social experiment

Sweden has embarked on a remarkable social experiment to facilitate this cultural shift, abolishing the use of gender in schools. We think any society that prides itself on being just, diverse and inclusive  – like ours –  should do the same.

To read more about the abolition of gender in Sweden, follow these links

https://www.theguardian.com/teacher-network/2016/feb/02/swedish-schools-gender-alien-concept

Raised without Gender https://www.youtube.com/watch?v=4sPj8HhbwHs

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.

A tickbox for every sex marker

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.

Inclusive, respectful nomenclature

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 conditions. 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 conditions and individual sex differences.

In 2006, the profession renamed “intersex conditions,” 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.

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.

Include the Intersexed in 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(c) of law C-268  (LINK: http://laws-lois.justice.gc.ca/eng/acts/C-46/section-268.html ) 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

Make it legal to tell the truth

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.

Make it illegal to lie

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 condition.  

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.

“X” does not mean “I’m a target”

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.

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.

They’re called “privates” for a reason

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?