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The Intersex Thread

Quasirandom 🚫

Okay, this has come up several times recently, so in honor of the approach of Intersex Awareness Day, on the 26th, a central thread to talk about it. Content warning: long wall of text. Tl,dr at the end.

Disclosure: I am not intersex. I have two relatives (one by marriage) who are. I am close enough friends to four other intersex people that they've disclosed significant medical details about their condition, and I volunteer with a support group for intersex kids. I keep myself current with medical research and with political & social issues important to the intersex community. (If there's anyone here who is intersex or has better firsthand knowledge, please chime in. I'll try to be a good ally.)

Definitions: A person is intersex when they have sexual organs that developed in some way different from typical male or typical female. There are many, many possible differences, and so many intersex conditions. The medical term was, for a long time, hermaphroditism, even though this is a different use of the term from the way biologists use it. It is now considered offensive to call anyone intersex a hermaphrodite β€” offensive not quite on the level of nigger, but approaching it. (This is why the SOL tag drives me to fits β€” there are stories with true hermaphrodites, and it's appropriate for those, but there's nothing else for tagging intersex characters and readers want to be warned about that.) The prefered medical technical term is Differences of Sexual Development, or DSD. Most intersex people use the term intersex.

Numbers: Because of the stigma intersex conditions have, hard numbers are hard to come by. Estimates vary significantly. The best we have is that around 1 in 200, or 0.5%, are born with some sort of intersex condition. The two largest types are having an unusually enlarged clitoris and having a urethra that does not exit the end of a penis. These are relatively minor, and there is continued debate over whether to classify them as intersex conditions. Even if we put those aside, all other conditions come to around 1 in 1000, or 0.1% of the population. In the United States, that's over 30,000 people.

This is not a trivial number of people. Trivializing them as insignificant is not respectful.

A lot of energy gets expended, often generating more heat than light, debating whether certain people are "really male" or "really female". One commonly asserted guideline is, ignoring the fringe cases of chromosome duplication, whether the 23rd chromosome pair is XX or XY. This is a horrible, HORRIBLE guideline. Here's why:

Sexual development is not controlled at the chromosome level, but at the gene level. As of three years ago (the last time I deep-dived this), we've identified at least a dozen genes responsible for different aspects of how sexual organs develop, a handful of which are the most important. Not all of them are in the 23rd pair, not even of that most important handful. (Or usually there β€” that genes jump chromosomes is yet another complication.) IF all of the relevant genes are pulling in synch AND a person develops as "typical male" or "typical female", THEN and only then is XY/XX a reasonable shorthand for what sex, genetically, someone is. This does not hold true for a large proportion of intersex conditions.

To give one broad example: Early on, embryos grow proto-sex-organs that later, in the fetus, can (assuming everything works as designed) develop as male or female. So there's a cliteropenis that can either stay small and become a clitoris or grow large and become a penis. There are proto-gonads that can develop into either ovaries or testes. There's a proto-uterus that can either grow into a uterus + fallopian tubes or wither away. (Yes, all you dudes out there: at one point, every single one of you started growing a uterus. Most of you stopped well before you were born, but you had one.)

The genes that control most of the development of internal sex organs are different from the ones that control development of external genitalia. Which means you can have typical male internal anatomy and typical female external anatomy (with testes that never migrated out of the body cavity into a scrotum) β€” regardless of whether the person is XY or XX. The most common cause of this is Androgen Insensitivity Syndrome (AIS). Complete AIS results in external anatomy that is typical female, Partial AIS in anatomy that is somewhere between typical male and typical female. (FWIW, which is not very much, most but by no means all people with AIS are XY.)

tl,dr: Biological sex is not a binary. It is clear for most people, the overwhelming majority in fact. But between them, there is a continuum of anatomical and genetic possibilities, and insisting on binary terminology for people in that continuum is not rational.

Dominions Son 🚫

@Quasirandom

and insisting on binary terminology for people in that continuum is not rational.

Binary terminology is all we have in the English language.

Making up your own terminology and demanding other people use it on penalty being expelled from school/losing their job/facing legal penalties is neither rational nor reasonable.

Replies:   Quasirandom
Quasirandom 🚫
Updated:

@Dominions Son

Making up terminology is entirely rational and reasonable. Letting the folk process work out a consensus change is as well. Advocating for the one you (or better yet, people with skin in the game) prefer is as well.

Enforcement is, as you say, not.

Insisting that those with skin in the game use inaccurate terminology to describe themselves also is not.

Replies:   Dominions Son
Dominions Son 🚫
Updated:

@Quasirandom

Making up terminology is entirely rational and reasonable.

Yes, it is. Getting something to the point of sufficient general acceptance that you can say it has become part of the language is something that can happen quickly, or it can take generations.

Demanding other people use your made up terminology or face social/legal/employment penalties is not.

Insisting that those with skin in the game use inaccurate terminology to describe themselves also is not.

I don't care how they describe themselves. I only care when they try to control how I describe them.

Replies:   Quasirandom
Quasirandom 🚫

@Dominions Son

I don't care how they describe themselves

I am glad to hear that.

What about trying to change laws and regulations that describe them inaccurately? (This has nothing to do with what language YOU use. What language LAWS use.) For example, what about intersex athletes in sports that insist that sex is a binary?

Replies:   Dominions Son  Remus2  joyR
Dominions Son 🚫

@Quasirandom

What about trying to change laws and regulations that describe them inaccurately?

Fine, if they do it through the legislative process. No, I don't think trying to use the courts to force such a change is legitimate.

For example, what about intersex athletes in sports that insist that sex is a binary?

Sports is a more complex issue.

US anti-discrimination laws explicitly allow sex segregated sports, because most women can't competed physically with men on the same field*.

Unfortunately, accommodations for the intersex in sports has gotten tied up with the issue of m>f transsexuals competing in women's sports.

I don't have any idea what the right answer is, but you will get a lot of push-back from women athletes and TERFs if legal changes for the intersex in sports opens women's sports to those born unambiguously biologically male.

*This is what Congress decided, don't put that on me.

Replies:   Quasirandom
Quasirandom 🚫

@Dominions Son

Fine, if they do it through the legislative process. No, I don't think trying to use the courts to force such a change is legitimate.

I'd like to make a subtle distinction here. There are couple different ways to use the courts to create change. Using them to enforce behaviors not legislated is, yes, a big problem. Using courts to expose the need for legislative action is not.

This latter was a significant tactic of, for example, the Civil Rights Movement: in this case, by breaking unjust laws and making the courts enforce them, activists highlighted the need to change them.

Replies:   Dominions Son
Dominions Son 🚫

@Quasirandom

Using courts to expose the need for legislative action is not.

Suing to block discriminatory laws is not a problem.

Using courts to reinterpret laws to the way you want them to read without going through the legislative process is a problem.

Remus2 🚫
Updated:

@Quasirandom

What about trying to change laws and regulations that describe them inaccurately? (This has nothing to do with what language YOU use. What language LAWS use.) For example, what about intersex athletes in sports that insist that sex is a binary?

For the vast majority of people, sex/gender is in fact binary. If 1 out of a 100 people insist they receive different treatment, how is that fair to the other 99 people.

Further, if a male replete with the biological benifit of more muscle mass denser bone structure were to compete with a biological female in weight lifting, which of them is more likely to lose?

True intersex people are rare. Therein is the problem.

Let's look at right handed verses left handed people. By your logic, every product out there should have left handed variants available for the same cost. That's not going to happen anytime soon because it's not a viable solution.

Replies:   Quasirandom
Quasirandom 🚫

@Remus2

By and large, intersex people (especially the activists I've talked with) do not desire different treatment. They desire having the fact that their bodies are different be acknowledged and accounted for in a way that is fair to all.

They also desire not having their concerns be dismissed just because of relative rarity.

Whether a commercial product is available for special needs is not a concern for law. It is a matter of business. When I was growing up, there were separate designs of scissors for lefties and righties. If there are enough people willing to pay for something, someone will make it.

Replies:   Remus2
Remus2 🚫

@Quasirandom

By and large, intersex people (especially the activists I've talked with) do not desire different treatment. They desire having the fact that their bodies are different be acknowledged and accounted for in a way that is fair to all.

They also desire not having their concerns be dismissed just because of relative rarity.

The problem here as I see it, is the concept of "fair." There is nothing about life that is fair. I am one of those lefties you spoke of, I don't ask that everything be catered to me. Instead I adapt to reality. Using spiral notebooks in reverse for instance. The spine is faced to the right, in effect writing backwards in page order, back to front.
Adapting is exactly what they should do, instead of insisting the majority of people adapt to them instead.

joyR 🚫

@Quasirandom

For example, what about intersex athletes in sports that insist that sex is a binary?

That is actually simple. Currently we have, for example, mens gymnastics and women's gymnastics, just add intersex gymnastics, for those who are neither women nor men.

Replies:   awnlee jawking  Keet
awnlee jawking 🚫

@joyR

That is actually simple.

Not really. Like disabled Olympics, you'd need a range of events to be relatively fair to those with similar testosterone levels. And we've seen how that works, with Tanni Grey-Thompson always winning the event that seems tailor-made for her to the disadvantage of her competitors.

AJ

Keet 🚫

@joyR

That is actually simple. Currently we have, for example, mens gymnastics and women's gymnastics, just add intersex gymnastics, for those who are neither women nor men.

Not gonna work, every one of those thinks they are unique, or at least in a separate sub-group. Most of them don't want to be put in a box "male", "female", or "intersex".

Replies:   joyR
joyR 🚫

@Keet

Not gonna work, every one of those thinks they are unique, or at least in a separate sub-group. Most of them don't want to be put in a box "male", "female", or "intersex".

Of course it wouldn't work. :) It is a simple solution though.

But to be fair the existing male/female groups in sport should also be split. We need separate groups for straight, lesbian, gay, bisexual etc, that makes it both simple and fair to all.

:)

Replies:   Keet  awnlee jawking
Keet 🚫

@joyR

But to be fair the existing male/female groups in sport should also be split. We need separate groups for straight, lesbian, gay, bisexual etc, that makes it both simple and fair to all.

Split them up so far that everyone is their own group. Everyone is a winner!

Replies:   awnlee jawking
awnlee jawking 🚫

@Keet

Split them up so far that everyone is their own group. Everyone is a winner!

And that's far better than participation trophies!

AJ

awnlee jawking 🚫

@joyR

But to be fair the existing male/female groups in sport should also be split.

Surely that discriminates against the gender-fluid, who are liable to change gender part way through an event ;-)

AJ

Replies:   Dominions Son  joyR
Dominions Son 🚫

@awnlee jawking

gender-fluid

That sounds terribly messy.

joyR 🚫

@awnlee jawking

Surely that discriminates against the gender-fluid, who are liable to change gender part way through an event ;-)

Being disqualified for ending a race a different gender from the one they started as means they are then in the wrong race. That solves that problem.

Consider how it would advance world peace. Many of the countries who hardly medal in the olympics are also countries whose culture and or religion is intolerant of such issues. If they actively welcomed sexual and gender diversity they could substantially increase their medal count.

:)

Also, do you want to buy a flying pig?

richardshagrin 🚫

@joyR

do you want to buy a flying pig?

Do pigs using parachutes count? The 82nd and One hundred and worst divisions both have a lot of guys who qualify as pigs.

Replies:   joyR
joyR 🚫

@richardshagrin

"Bomber" Harris (AOC Bomber Command) voiced his objection to using his aircraft to drop parachutists... "They don't explode on impact."

Dominions Son 🚫

@joyR

Also, do you want to buy a flying pig?

With sufficient thrust, pigs fly just fine. However, this is not necessarily a good idea. It is hard to be sure where they are going to land, and it could be dangerous sitting under them as they fly overhead.

awnlee jawking 🚫

@joyR

Also, do you want to buy a flying pig?

Can I also buy a bridge for it to fly under?

AJ

Replies:   Dominions Son
Dominions Son 🚫

@awnlee jawking

Can I also buy a bridge for it to fly under?

Why would you want a pig to fly under a bridge. Wouldn't it be more likely to fly over the bridge?

Replies:   awnlee jawking
awnlee jawking 🚫

@Dominions Son

Why would you want a pig to fly under a bridge.

There's more kudos to flying a Tiger Moth under Tower Bridge than over it. I'm sure a pig would enjoy the same experience ;-)

AJ

Replies:   joyR
joyR 🚫

@awnlee jawking

There's more kudos to flying a Tiger Moth under Tower Bridge than over it. I'm sure a pig would enjoy the same experience ;-)

For ultimate kudos the pig would have to be going full boar...

Keet 🚫

@Quasirandom

binary terminology for people in that continuum is not rational.

For computers it's all there is :D

Replies:   LupusDei
LupusDei 🚫

@Keet

For computers it's all there is :D

Indeed I sometimes think the word be richer place today if trits had been adopted for computing over bits. Both are almost equally efficient mathematically. Depending on the implementation fuzzy logic could be much cheaper and easier. And it would much easier to argue against those with binary "moral" logic.

awnlee jawking 🚫

@Quasirandom

Caster Semenya seemed pretty adamant about wanting to live the life of a normal women, albeit with an obvious restriction. I don't understand why anyone would want to adopt nomenclature that gives precedence to what they are rather than who they are.

If that's what intersex people are asking for, that might be okay. But it could put pressure on those who don't want to be publicly outed.

AJ

Replies:   Quasirandom
Quasirandom 🚫

@awnlee jawking

Not pressuring those who do not wish to be out is a big concern. Of my two relatives, one is public about his condition because he believes this will help remove the stigma; the other, it is disclosed only to her immediate family and partners on a need-to-know basis (er, and caretakers when very young). Both are valid decisions, and should be accounted for.

Vincent Berg 🚫

@Quasirandom

Actually, the older XX/XY dichotomy has weakened over the years as medical experts have gained more evidence. There are other options, as many of these cases result from mixed genetics (ex: XYX or XXY). This can occur naturally, but a notable exception is the case of the 'absorbed twin', where part of someone's body contains different DNA than the rest of their body. It's not common, but it has be proven to be the case.

Typically the XYX variant is mostly from a random mutation (one-off), though there are other sources which produce different results.

Replies:   Quasirandom
Quasirandom 🚫

@Vincent Berg

I didn't mention triplication because it's a very rare conditionβ€”less than 1:20,000 IIRC. Most DSDs have other, single-gene causes (or sometimes a couple genes).

Quasirandom 🚫

@Quasirandom

And as a reminder, today is Intersex Awareness Day. So now you know.

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