Sensitive Note

Intersex is a broad label describing variations in sex characteristics that do not fit into the male-female binary. Like anyone else, a person with any of these characteristics may identify as a man, a woman, or any other gender. Furthermore, a person’s sex characteristics may or may not influence their gender or their relationship with their gender. Different people may also prefer different terminology. Terms like disorders of sex development, differences of sex development or variations in sex characteristics are somewhat more common in medical contexts compared to the older term intersex condition, and some people prefer to use them to discuss their personal experiences. Others, however, do prefer the term intersex, especially when talking about the people with these conditions rather than the specific medical conditions themselves: Intersex activists recently won a victory with a ruling against infant genital surgeries. This book about intersex experiences is by an intersex person. The use of intersex as a noun (e.g., an intersex ) rather than an adjective (e.g., an intersex person ) when describing someone who has a difference of sex development is often considered offensive. The older term hermaphrodite is extremely offensive except when used in self-reference. As with most identity labels, it is best to ask for an individual person’s preference when referring to them. See gender ¹ ( def. ). See also sex ¹ ( def. ).

Etymology

Origin of intersex
First recorded in 1915–20; back formation from intersexual

from — Definition of intersex. (n.d.). In dictionary.com. 

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Example Sentences: intersex

“It defines the female sex without taking into account the biological specificities of intersex individuals, whose sexual characteristics present natural variations, leading to a reductive and potentially stigmatising approach,” ⁠claimed French Sports Minister Marina Ferrari.
From BBC • Mar. 31, 2026

Trying to find a cause or cure for, say, intersex conditions does not mean that people who are intersex are less worthy than those who are not.
From Slate • Sep. 25, 2025

A federal report published in January, just before President Donald Trump took office, estimated there are more than 5 million intersex Americans.
From Salon • Aug. 6, 2025

Back in 2023, Gallo was one of three subjects in Julie Cohen’s incisive documentary “Every Body,” about the intersex experience, including the ways the medical industry performs unnecessary procedures in order to “normalize” intersex people.
From Los Angeles Times • Jun. 27, 2025

My psychological makeup doesn’t accord with the essentialism popular in the intersex movement, either.
From “Middlesex: A Novel” by Jeffrey Eugenides

from — Definition of intersex. (n.d.). In dictionary.com. 

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UCLA School of Law: Williams Institute

Impact of the Executive Order Redefining Sex on Transgender, Nonbinary, and Intersex People

On January 20, 2025, President Trump signed an executive order titled, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”1 Although the executive order sweeps broadly across many areas affecting transgender, nonbinary and intersex people, a central tenet of the directive is the redefinition of the word “sex” as applied across federal programs and services to refer only to biological characteristics “at conception,” and as unchangeable.2 Redefining “sex” is something the president attempted to do in his previous term,3 particularly in the context of sex discrimination in education under Title IX,4 and had committed to doing in his second term.5 As part of his “Agenda 47” for the next four years, President Trump has also committed to working with Congress to enact a sex definition statute.6 This policy brief explores the meaning of the executive order and the potential impact for transgender, nonbinary, and intersex people.

Understanding the Scope of the Executive Order

A key function of executive orders is political messaging.7 Executive orders can have practical impacts, but there are limits on what a president can do through this medium.8 Most importantly, an executive order must be supported by an authority the president derives from the Constitution or through an express delegation from Congress.9 Additionally, their implementation is often not immediate. This is because an executive order, much like President Biden’s 2021 order regarding the meaning of “sex” for federal nondiscrimination laws,10 often takes the form of a directive to federal agencies, each of which would have to conduct internal assessments and consider actions such as rulemaking.11 This is how President Trump’s order approaches the definition of “sex” for federal agency programs and agencies.12 Notably, however, agencies under the Trump administration may also take early steps by rescinding practices or interpretations in instances where formal rulemaking is not required13 or taking actions that may encounter fewer procedural constraints.14 The president cites his authority to “regulate the conduct of employees in the executive branch” to support the order.15

Defining “Sex”

There is no universal definition of the word “sex.” The term generally refers to a collection of reproductive, hormonal, anatomical, and genetic characteristics that are commonly grouped into categories of “male” and “female” based on reproductive function.16 However, social scientists and medical professionals have long understood sex and gender as complex and intertwined concepts.17 Moreover, there is substantial variation among sex characteristics themselves, such that even for non-transgender people, categorization in a strict male/ female binary based on sex characteristics at birth does not accurately describe many Americans, such as intersex people.18 For decades, courts have recognized that given the complicated ways that “sex” manifests in society, statutes protecting against “sex” discrimination should be understood to apply to sex stereotyping,19 sexual orientation, and gender identity.20 This understanding was formally adopted into many areas of law under the Biden administration,21 which President Trump now seeks to undo. In response to what he describes as “gender ideology,” President Trump’s order lays out a sweeping redefinition of the term “sex” across many parameters of federal government that is based on a narrow subset of reproductive characteristics:

(d) “Female” means a person belonging, at conception, to the sex that produces the large reproductive cell.

(e) “Male” means a person belonging, at conception, to the sex that produces the small reproductive cell.22

The definition explicitly excludes gender, gender identity, and any other characteristics.23 The order also includes a directive to the Department of Health and Human Services to produce a standard, government-wide definition within 30 days.24

The Impact on Transgender, Nonbinary, and Intersex People

President Trump’s executive order has the potential to affect a broad range of people, including:

• Transgender people. Approximately 1.6 million individuals, or 0.6% of the U.S. population aged 13 and older, identify as transgender.25 This includes 300,100 youth aged 13 to 17 who identify as transgender.
• Nonbinary people. Approximately 1.2 million LGBTQ adults identify as nonbinary in the U.S.—11% of all LGBTQ adults.26
• Intersex people. Intersex refers to people whose sex characteristics do not fall into the typical binary categories of male and female.27 Although data are limited and further research is needed to better understand the size of the intersex population in the U.S., the best estimate to date is that intersex people comprise approximately 1.7% of the population.28 Using this estimate, the Department of Health and Human Services under President Biden estimated that as many as 5 million people in the U.S. may be intersex.29

Although the full impact of an order defining sex—or a statute to the same effect—is difficult to determine, there are a few areas of federal policy where President Trump’s executive order is clearly directed. These include nondiscrimination statutes, federally issued identity documents, prisons, and other sex-separated spaces.

• Nondiscrimination laws. The President has instructed agencies to review “laws governing sex-based rights, protections, opportunities, and accommodations” to ensure they “protect men and women as biologically distinct sexes.”30 This includes a directive to the Attorney General to “immediately issue guidance to correct” what is described as a “misapplication of the Supreme Court’s decision in Bostock v. Clayton County (2020)” to allow transgender people to participate in sex-separated spaces based on gender identity.31 
  • Many statutes enforced by federal agencies protect against sex discrimination—this includes Title VII,32 Title IX,33 Section 1557 of the Affordable Care Act,34 the Fair Housing Act,35 and even laws such as the Food and Nutrition Act of 2008 (as amended).36
  • Early in his presidency, President Biden ordered federal agencies to evaluate whether these statutes should be interpreted to apply to sexual orientation and gender identity in light of the Supreme Court’s decision in Bostock v. Clayton County.37 Many agencies complied by issuing memoranda,38 interpretations,39 guidance,40 and new regulations.41
  • The new administration seeks to reverse these interpretive documents and formally redefine these laws to exclude coverage for gender identity (and likely sexual orientation). The executive order also consistently emphasizes the administration’s assertion that nondiscrimination laws do not permit transgender people to access sex-separated spaces based on gender identity.
  • However, there are barriers that may slow down or block the implementation of these changes. For example, formal rulemaking procedures would be required to make longstanding changes to the definition of sex under these statutes, and the way that definition is enforced.42 It is also important to note that many nondiscrimination laws have been interpreted by courts to protect LGBT people,43 including access to gender-affirming bathrooms,44 and the administration’s actions cannot automatically undo those protections. Additionally, many states offer protections against discrimination in areas such as housing,45 employment,46 and public accommodations.47
• Identity documents. President Trump’s executive order addresses sex designations on federal identification documents, including passports and Global Entry cards.48
  • Passports. The federal government issues several forms of identity documents, including passports through the Department of State.49 Under President Biden, Department of State policy permitted passports to be changed upon request, allowing M, F, and X designations.50 President Trump’s executive order requires that passports “accurately reflect the holder’s sex,” as defined in the order. However, implementation of this policy would need to be determined by the Department of State, and it is yet to be seen how the agency would address the needs of transgender, nonbinary, and intersex people in light of this order. For example, the Department of State could seek to recategorize passports with X designations, revoke such passports, or honor currently existing passports for transgender, nonbinary, and intersex people while imposing new requirements for gender markers on passports in future applications or renewals.
• Federal prisons. The executive order directly addresses the placement of transgender women in prison, ordering that they be placed based on biological characteristics at birth rather than gender identity and denying gender-affirming health care.51 
  • The Federal Bureau of Prisons estimates that in January 2025, there were 1,538 transgender women and 750 transgender men in federal prisons.52
  • Under President Biden, policy guidelines permitted consideration of requests made by incarcerated transgender people to be placed based on gender identity and receive appropriate health care.53 This practice was also consistent with longstanding guidelines to prevent prison sexual abuse.54 President Trump’s order seeks to prohibit transgender prisoners from being held in facilities based on gender identity and prevent federal funding from being used for the provision of gender-affirming care in prisons.55
  • Notably, the Supreme Court has established that federal prison officials have an obligation not to act with “deliberate indifference” to the health and safety of transgender prisoners,56 which could be a barrier to the success of President Trump’s policy goal. Additionally, state laws and court decisions regarding access to health care in prisons may also serve as a barrier.57
• Sex-separated spaces. The order requires that sex-separated spaces, such as homeless shelters and intimate partner violence shelters,58 or “intimate spaces designated for women, girls or females (or for men, boys or males)” funded or operated by the federal government “are designated by sex and not identity.”0
  • Transgender people are disproportionately likely to experience homelessness. For example, a 2020 study found that 8% of transgender adults reported experiencing homelessness in the past year, compared to 3% of non-transgender LGB people and 1% of cisgender, heterosexual adults.60 Research also shows that transgender people already face substantial barriers to accessing emergency shelters, including denial of shelter access or mistreatment inside of a shelter.61
  • Studies have also found that transgender people face higher rates of intimate partner violence, compared to cisgender individuals.62
  • President Trump previously attempted to enact a rule that would bar transgender women from women’s shelters; however, that rule was quickly rolled back by the Biden administration before implementation.63The Biden administration has maintained that transgender people should be able to access federally funded emergency shelters based on gender identity.64 President Trump’s directive would reverse that yet again.
  • The broad language of the executive order could extend to any space that received federal funding and is sex-separated, particularly where individuals must change clothes or shower.

In addition to the specific areas targeted above, President Trump’s executive order broadly demands that the term “sex” be redefined across the federal government, including in forms, policies, and for the purposes of federal funding.65 This could impact several additional areas, such as bathrooms, sports participation, health care, data collection, and research.

• Bathrooms. Although bathrooms are not specifically named in the executive order, they appear to be a primary focus. The order’s purpose statement focuses on countering policies that “permit men to self-identify as women and gain access to intimate single-sex spaces and activities designed for women.”66 The order consistently reiterates a commitment to restricting single-sex spaces based on biological distinctions, which suggests that bathrooms will be a fixture of policies enacted under the order. Most directly, the order may result in restriction of bathroom access in federal government properties based on sex assigned at birth, something that President Trump has said he intends to do.67 Congress has already enacted such a restriction in Congressional buildings.0 This could also extend to other sex-separated spaces that are bathroom-adjacent, such as showers, which are addressed in the executive order,69 and locker rooms. In light of the order’s reference to use of federal funding, it is possible that the executive order could have impacts beyond federal buildings and workplaces, but that is yet to be determined.70 However, bathrooms and other government facilities are largely governed by state and local laws rather than federal laws,71 although it is possible that the federal government could attach funding restrictions regarding bathrooms to entities such as schools that receive federal funding.
• Sports participation. The executive order does not directly address participation in sports. However, the President’s order addresses the federal statutes and interpretations that apply to sports participation, such as Title IX, as well as “intimate spaces” which would likely include changing rooms. Nonetheless, changing the regulations themselves will require formal rulemaking, because existing regulations are in place which define sex in a transgender-inclusive manner for educational programs and services (although they are subject to injunctions).72 Furthermore, it is possible that a federal sports ban may come from Congress in coordination with federal executive efforts.73
• Health care. Outside of the context of federal prisons, the executive order does not address health care specifically, though it does so indirectly through its requirement that agencies rescind LGBTQ-inclusive interpretations of sex discrimination statutes and federal funding requirements.74 The Biden administration had consistently understood health nondiscrimination requirements to apply to gender identity and gender-affirming care, and that these interpretations applied to grantees.75 Although the full consequences of the executive order’s directives will be subject to procedural requirements and litigation, it is possible that funding for some health care could be disrupted or otherwise affected by policies outlined in the executive order.
• Data collection and research. President Trump’s order mandates that “agency forms that require an individual’s sex shall list male or female, and shall not request gender identity.”76 If implemented, this could make it difficult for transgender people to self-report on government forms and nearly impossible for researchers to make observations about transgender experiences using those data. The order also prohibits funds from being used to “promote gender ideology.”77 “Gender ideology” is defined broadly in the order in such a manner as to prohibit the recording of “sex” based on any factor other than reproductive biology at birth.78 Currently, federal data allow insights into transgender populations,79 and the federal government also funds research into transgender experiences.80 While the full consequences of this policy for research using gender identity data remains to be seen, this aspect of the order could result in severe restrictions on the ability of researchers to study and understand disparities, service utilization, and other experiences of transgender people.

Regardless of what actions are taken, the implementation of this order is likely to come unevenly—for example, a bathroom ban for federal buildings or employees may be possible to implement quicker if it is found to be feasible to implement without rulemaking, whereas many of the changes described above would require agencies to take actions such as formal rulemaking.81 Many of the provisions of this order, or the corresponding agency actions, will likely also face substantial litigation.82

Health Impacts of Sex Definition Laws 

In addition to the direct impacts of discrimination that may be treated as lawful under the Trump administration, a “sex” definition order could also have other downstream effects. For example, regardless of other outcomes, it is likely that there will be effects on the mental health and well-being of LGBTQ people, especially transgender, nonbinary, and intersex people most directly impacted by these policies. Research shows that anti-LGBTQ policies increase negative mental health outcomes for transgender people83 and that affirming policies, such as the ability to obtain affirming identity documents, positively influence the well-being of transgender people.84

Conclusion

President Trump’s attempt to redefine the word “sex” for the purposes of federal law to narrowly refer to certain reproductive characteristics could have a range of consequences. While the actual details and realities of implementation will take some time to understand, research shows that efforts such as these can negatively impact the mental health of transgender people. However, it is likely that the process of implementing the directives will be subject to federal procedural constraints, which means that most efforts will not be effective immediately. Furthermore, these actions will almost certainly be subject to extensive litigation, which means that the ultimate outcome is difficult to predict.

from — The Williams Institute at UCLA School of Law. (2025, January 27). Impact of the Executive Order Redefining Sex on transgender, nonbinary, and intersex People – Williams Institute. Williams Institute. Retrieved May 1, 2026

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intersex

Intersex people are those born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, “do not fit typical binary notions of male or female bodies”.^[1][2] The opposite of intersex is endosex, which describes persons born with sex characteristics that are seen as typically male or female at birth.^[3]

Sex assignment at birth usually aligns with a child’s external genitalia. The number of births with ambiguous genitals is in the range of 1:4,500–1:2,000 (0.02%–0.05%).^[4] Other conditions involve the development of atypical chromosomes, gonads, or hormones.^[5][2] The portion of the population that is intersex has been reported differently depending on which definition of intersex is used and which conditions are included. Estimates often range from 0.018% (one in 5,500 births) to 1.7%.^[5][6][7] The difference centers on whether conditions in which chromosomal sex matches a phenotypic sex which is clearly identifiable as male or female, such as late onset congenital adrenal hyperplasia (1.5 percentage points) and Klinefelter syndrome, should be counted as intersex.^[5][8] Some intersex people identify with a gender different from their assigned sex, though this is not exclusive to intersex people.^[9][10][11]

Terms used to describe intersex people are contested, and change over time and place. Intersex people were previously referred to as “hermaphrodites” or “congenital eunuchs“.^[12][13] In the 19th and 20th centuries, some medical experts devised new nomenclature in an attempt to classify the characteristics that they had observed, the first attempt to create a taxonomic classification system of intersex conditions. Intersex people were categorized as either having “true hermaphroditism“, “female pseudohermaphroditism“, or “male pseudohermaphroditism”.^[14] These terms are no longer used, and terms including the word “hermaphrodite” are considered to be misleading, stigmatizing, and scientifically specious in reference to humans.^[15] In biology, the term “hermaphrodite” is used to describe an organism that can produce both male and female gametes.^[16][17] Some people with intersex traits use the term “intersex”, and some prefer other language.^[18][19] In clinical settings, the term “disorders of sex development” (DSD) has been used since 2006,^[20] a shift in language considered controversial since its introduction.^[21][22][23]

Intersex people face stigmatization and discrimination from birth, or following the discovery of intersex traits at stages of development such as puberty.^[24] Intersex people may face infanticide, abandonment, and stigmatization from their families.^[25][26][27] Globally, some intersex infants and children, such as those with ambiguous outer genitalia, are surgically or hormonally altered to create more socially acceptable sex characteristics. This is considered controversial, with no firm evidence of favorable outcomes.^[28] Such treatments may involve sterilization. Adults, including elite female athletes, have also been subjects of such treatment.^[29][30] Increasingly, these issues are considered human rights abuses, with statements from international^[31][32] and national human rights and ethics institutions.^[33][34] Intersex organizations have also issued statements about human rights violations, including the 2013 Malta declaration of the third International Intersex Forum.^[35] In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention.^[36] In April 2015, Malta became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people.^[37][38]

There is no clear consensus definition of intersex and no clear delineation of which specific conditions qualify an individual as intersex.^[39] The World Health Organization’s International Classification of Diseases (ICD), the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), and many medical journals classify intersex traits or conditions among disorders of sex development (DSD).^[40]

In 1917, Richard Goldschmidt created the term “intersexuality” to refer to a variety of physical sex ambiguities.^[14] However, according to The SAGE Encyclopedia of LGBTQ Studies, it was not until Anne Fausto Sterling published her article “The Five Sexes: Why Male and Female Are Not Enough” in 1993 that the term reached popularity.^[41]

According to the UN Office of the High Commissioner for Human Rights:

Intersex people are born with sex characteristics (such as sexual anatomy, reproductive organs, hormonal patterns and/or chromosomal patterns) that do not fit typical binary notions of male or female bodies.^[42]

Some intersex organizations reference “intersex people” and “intersex variations or traits”^[43] while others use more medicalized language such as “people with intersex conditions”,^[44] or people “with intersex conditions or DSDs (differences of sex development)” and “children born with variations of sex anatomy”.^[45] In May 2016, interACT published a statement recognizing “increasing general understanding and acceptance of the term ‘intersex'”.^[46]

Australian sociological research on 272 “people born with atypical sex characteristics”, published in 2016, found that 60% of respondents used the term “intersex” to self-describe their sex characteristics, including people identifying themselves as intersex, describing themselves as having an intersex variation or, in smaller numbers, having an intersex condition. Respondents also commonly used diagnostic labels and referred to their sex chromosomes, with word choices depending on audience.^[10][47]

Research on 202 respondents by the Lurie Children’s Hospital, Chicago, and the AIS-DSD Support Group (now known as InterConnect Support Group)^[48] published in 2017 found that 80% of Support Group respondents “strongly liked, liked or felt neutral about intersex” as a term, while caregivers were less supportive.^[49] The hospital reported that the use of the term “disorders of sex development” may negatively affect care.^[50]

Another study by a group of children’s hospitals in the United States found that 53% of 133 parent and adolescent participants recruited at five clinics did not like the term “intersex”.^[51] Participants who were members of support groups were more likely to dislike the term.^[51] A “dsd-LIFE” study in 2020 found that around 43% of 179 participants thought the term “intersex” was bad, 20% felt neutral about the term, while 37% thought the term was good.^[52]

Historically, the term “hermaphrodite” was used in law to refer to people whose sex was in doubt. The 12th century Decretum Gratiani states that “Whether an hermaphrodite may witness a testament, depends on which sex prevails” (“Hermafroditus an ad testamentum adhiberi possit, qualitas sexus incalescentis ostendit”).^[53][54] Similarly, the 17th century English jurist and judge Edward Coke (Lord Coke), wrote in his Institutes of the Lawes of England on laws of succession stating, “Every heire is either a male, a female, or an hermaphrodite, that is both male and female. And an hermaphrodite (which is also called Androgynus) shall be heire, either as male or female, according to that type of sexe which doth prevaile.”^[55][56]

During the Victorian era, medical authors attempted to ascertain whether or not humans could be hermaphrodites, adopting a precise biological definition for the term,^[57] and making distinctions between “male pseudohermaphrodite”, “female pseudohermaphrodite” and especially “true hermaphrodite”.^[58] These terms, which reflected histology (microscopic appearance) of the gonads, are rarely used in the 2020s.^[59][60][61] Until the mid-20th century, “hermaphrodite” was used synonymously with “intersex”.^[62] Medical terminology shifted in the early 21st century, not only due to concerns about language, but also a shift to understandings based on genetics.^{[citation needed]} The term “hermaphrodite” is also controversial as it implies the existence of someone fully male and fully female.^[63] As such the term “hermaphrodite” is often seen as degrading, although many intersex activists use it as a direct form of self empowerment and critique such as in the Intersex Society of North America‘s (ISNA) first newsletter Hermaphrodites with Attitude.^[63]

The Intersex Society of North America has stated that hermaphrodites should not be confused with intersex people and that using “hermaphrodite” to refer to intersex individuals is considered to be stigmatizing and misleading.^[64]

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Estimates of the number of people who are intersex vary, depending on which conditions are counted as intersex.^[5] The now-defunct Intersex Society of North America said:

If you ask experts at medical centers how often a child is born so noticeably atypical in terms of genitalia that a specialist in sex differentiation is called in, the number comes out to about 1 in 1,500 to 1 in 2,000 births [0.07–0.05%]. But a lot more people than that are born with subtler forms of sex anatomy variations, some of which won’t show up until later in life.^[65]

Anne Fausto-Sterling et al., said in 2000 that “[a]dding the estimates of all known causes of nondimorphic sexual development suggests that approximately 1.7% of all live births do not conform to a Platonic ideal of absolute sex chromosome, gonadal, genital, and hormonal dimorphism”;^[7][6] these publications have been widely quoted by intersex activists.^[66][67][68] Of the 1.7%, 1.5% points (88% of those considered “nondimorphic sexual development” in this figure) consist of individuals with late onset congenital adrenal hyperplasia (LOCAH) which may be asymptomatic but can present after puberty and cause infertility.^[69]

Leonard Sax, in response to Fausto-Sterling, estimated that the prevalence of intersex was about 0.018% of the world’s population,^[5] discounting several conditions included in Fausto-Sterling’s estimate that included LOCAH, Klinefelter syndrome (47,XXY), Turner syndrome (45,X), the chromosomal variants of 47,XYY and 47,XXX, and vaginal agenesis. Sax reasons that in these conditions chromosomal sex is consistent with phenotypic sex and phenotype is classifiable as either male or female.^[5]

In a 2003 letter to the editor, political scientist Carrie Hull analyzed the data used by Fausto-Sterling and said the estimated intersex rate should instead have been 0.37%, due to many errors.^[70] In a response letter published simultaneously, Fausto-Sterling welcomed the additional analysis and said “I am not invested in a particular final estimate, only that there BE an estimate.”^[70] A 2018 review reported that the number of births with ambiguous genitals is in the range of 0.02% to 0.05%.^[4]

Intersex Human Rights Australia says it maintains 1.7% as its preferred upper limit “despite its flaws”, stating both that the estimate “encapsulates the entire population of people who are stigmatized—or risk stigmatization—due to innate sex characteristics”, and that Sax’s definitions exclude individuals who experience such stigma and who have helped to establish the intersex movement.^[71] According to InterACT, a major organization for intersex rights in the US, 1.7% of people have some variation of sexual development, 0.5% have atypical genitalia, and 0.05% have mixed/ambiguous genitalia.^{[72][73][74][75][a]} A study relying on a nationally representative survey conducted in Mexico between 2021 and 2022 obtained similar estimates: around 1.6% of individuals aged 15 to 64 reported being born with sex variations.^[24] A higher estimate has been found in Chile, where 2.77% of individuals aged 15 to 64 self-identify as intersex.^[78]

The following summarizes prevalences of traits that some medical experts consider to be intersex (where sex chromosome anomalies are involved, the karyotype is often summarized by the total number of chromosomes followed by the sex chromosomes present in each cell):

Notes:

From early history, societies have been aware of intersex people. Some of the earliest evidence is found in mythology: the Greek historian Diodorus Siculus wrote of the mythological Hermaphroditus in the first century BC, who was “born with a physical body which is a combination of that of a man and that of a woman”, and reputedly possessed supernatural properties.^[103] He also recounted the lives of Diophantus of Abae and Callon of Epidaurus.^[104] Ardhanarishvara, an androgynous composite form of male deity Shiva and female deity Parvati, originated in Kushan culture as far back as the first century AD.^[105] A statue depicting Ardhanarishvara is included in India’s Meenakshi Temple; this statue clearly shows both male and female bodily elements.^[106]

Hippocrates (c. 460 – c. 370 BC, Greek physician) and Galen (129 – c. 200/216 AD, Roman physician, surgeon, and philosopher) both viewed sex as a spectrum between men and women, with “many shades in between, including hermaphrodites, a perfect balance of male and female”.^[107] Pliny the Elder (AD 23/24–79), a Roman naturalist, described “those who are born of both sexes, whom we call hermaphrodites, at one time androgyni” (from the Greek andr-, “man”, and gyn-, “woman”).^[108] Augustine (354 – 430 AD), the influential Catholic theologian, wrote in The Literal Meaning of Genesis that humans were created in two sexes, despite “as happens in some births, in the case of what we call androgynes”.^[107]

In medieval and early modern European societies, Roman law, post-classical canon law, and later common law, referred to a person’s sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant.^[109] The 12th century Decretum Gratiani states, “Whether an hermaphrodite may witness a testament, depends on which sex prevails.”^{[110][54][111]} The foundation of common law, the 17th century Institutes of the Lawes of England described how a hermaphrodite could inherit “either as male or female, according to that kind of sexe which doth prevaile”.^[112][56] Legal cases have been described in canon law and elsewhere over the centuries.

In medieval Europe, people whom learned writers called “hermaphrodites“, a term which overlaps with the modern term intersex, were discussed in medical, visual, legal, and religious traditions. Some medieval anatomical theories, especially the widely circulated doctrine of the seven-celled uterus derived from pseudo-Galenic medicine, held that the position of conception within the womb could shape the sex of the child^[113]. In some versions of this model, the middle chamber was associated with the conception of a hermaphrodite^[113]. By the thirteenth and fourteenth centuries, surgeons in Italy and France claimed the authority to inspect ambiguous genital anatomy, determine which sex predominated and, in some cases, to remove or close genital tissue they viewed as contrary to a body’s natural form^[114]. These judgments could carry significant social consequences because sex classification affected marriage, inheritance, legal testimony, and eligibility for religious office. At the same time, medieval religious and alchemical writing could use the hermaphrodite in more symbolic ways: some late medieval texts employed hermaphroditic imagery to represent the union of masculine and feminine, and even described Christ in hermaphroditic terms as a way of thinking about creation^[115].

Leah DeVun’s book The Shape of Sex: Nonbinary Gender from Genesis to the Renaissance adds to this by showing that medieval ideas about hermaphrodites were not only medical or religious, but also legal and philosophical. DeVun argues that “although intersex individuals were socially and textually marginalized, ideas about nonbinary sex were central to the fundamental categories that ordered the world.”^[116] This is important because medieval writers used intersex bodies to think about what counted as male, female, human, natural, or unnatural. In a 1331 Catalan marriage case discussed by DeVun, the 14th- century surgeon Vesianus Pelegrini examined Berengaria after her husband sought an annulment on the grounds that the marriage could not be consummated. The case illustrates how medical testimony could be used by courts to determine a person’s legal and marital status^[117]. DeVun connects this development to the professionalization of surgery, arguing that surgeons’ claims to classify and “correct” sex helped enforce a binary model of male and female while also strengthening surgeons’ authority over the body^[117]. So while the medieval history of intersex was connected to symbolism, it was also tied institutions like courts, medicine, marriage, and the Church.

Some non-European societies have sex or gender systems that recognize more than the two categories of male/man and female/woman. Some of these cultures, for instance the South-Asian Hijra communities, may include intersex people in a third gender category.^[118][119] Although—according to Morgan Holmes—early Western anthropologists categorized such cultures as “primitive”, Holmes has argued that analyses of these cultures have been simplistic or romanticized and fail to take account of the ways that subjects of all categories are treated.^[120]

During the Victorian era, medical authors introduced the terms “true hermaphrodite” for an individual who has both ovarian and testicular tissue, “male pseudo-hermaphrodite” for a person with testicular tissue, but either female or ambiguous sexual anatomy, and “female pseudo-hermaphrodite” for a person with ovarian tissue, but either male or ambiguous sexual anatomy. Some later shifts in terminology have reflected advances in genetics, while other shifts are suggested to be due to pejorative associations.^[121]

The term “intersexuality” was coined by Richard Goldschmidt in 1917.^[122] The first suggestion to replace the term “hermaphrodite” with “intersex” was made by Cawadias in the 1940s.^[62]

Since the rise of modern medical science, some intersex people with ambiguous external genitalia have had their genitalia surgically modified to resemble either female or male genitals. Surgeons pinpointed intersex babies as a “social emergency” when born.^[123] An ‘optimal gender policy’, initially developed by John Money, stated that early intervention helped avoid gender identity confusion, but this lacks evidence.^[124] Early interventions have adverse consequences for psychological and physical health.^[34] Since advances in surgery have made it possible for intersex conditions to be concealed, many people are not aware of how frequently intersex conditions arise in human beings or that they occur at all.^[125]

Dialogue between what were once antagonistic groups of activists and clinicians has led to only slight changes in medical policies and how intersex patients and their families are treated in some locations.^[126] In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention.^[36] In April 2015, Malta became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people.^[37] Many civil society organizations and human rights institutions now call for an end to unnecessary “normalizing” interventions, including in the Malta declaration.^{[127][citation needed]}

Human rights institutions are placing increasing scrutiny on harmful practices and issues of discrimination against intersex people. These issues have been addressed by a rapidly increasing number of international institutions including, in 2015, the Council of Europe, the United Nations Office of the United Nations High Commissioner for Human Rights and the World Health Organization (WHO). In 2024, the United Nations Human Rights Council adopted its first resolution to protect the rights of intersex people.^[128] In 2025, the Council of Europe adopted the Recommendation on Equal Rights for Intersex Persons.^[129]

These developments have been accompanied by International Intersex Forums and increased cooperation among civil society organizations. However, the implementation, codification, and enforcement of intersex human rights in national legal systems remains slow.

Parts of this article (those related to map) need to be updated. Please help update this article to reflect recent events or newly available information. (May 2021)

Stigmatization and discrimination from birth may include infanticide, abandonment, and the stigmatization of families. The birth of an intersex child was often viewed as a curse or a sign of a witch mother, especially in parts of Africa.^[25][26] Abandonments and infanticides have been reported in Uganda,^[25] Kenya,^[130] South Asia,^[131] and China.^[27]

Infants, children and adolescents also experience “normalising” interventions on intersex people that are medically unnecessary and the pathologisation of variations in sex characteristics. In countries where the human rights of intersex people have been studied, medical interventions to modify the sex characteristics of intersex people have still taken place without the consent of the intersex person.^[132][133] Interventions have been described by human rights defenders as a violation of many rights, including (but not limited to) bodily integrity, non-discrimination, privacy, and experimentation.^[134] These interventions have frequently been performed with the consent of the intersex person’s parents, when the person is legally too young to consent. Such interventions have been criticized by the WHO, other UN bodies such as the Office of the High Commissioner for Human Rights, and an increasing number of regional and national institutions due to their adverse consequences, including trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity.^[135] The UN organizations decided that infant intervention should not be allowed, in favor of waiting for the child to mature enough to be a part of the decision-making—this allows for a decision to be made with total consent.^[136] In April 2015, Malta became the first country to outlaw surgical intervention without consent.^[37][38] In the same year, the Council of Europe became the first institution to state that intersex people have the right not to undergo sex affirmation interventions.^[66]

People born with intersex bodies are seen as different. Intersex infants, children, adolescents and adults “are often stigmatized and subjected to multiple human rights violations”, including discrimination in education, healthcare, employment, sport, and public services.^[2] Researchers have documented significant disparities in mental, physical, and sexual health when comparing intersex individuals to the general population, including higher rates of bullying, stigmatization, harassment, violence, and suicidal intention, as well as substantial barriers in the workplace.^[24] Similarly, a study from Chile estimated that intersex individuals belong to households with incomes that are substantially lower than those of endosex male individuals.^[78]

Several countries have so far explicitly protected intersex people from discrimination, with landmarks including South Africa,^[137] Australia,^[138][139] and, most comprehensively, Malta.^{[140][141][142]}

Claims for compensation and remedies for human rights abuses include the 2011 case of Christiane Völling in Germany.^[36][143] A second case was adjudicated in Chile in 2012, involving a child and his parents.^[144][145] A further successful case in Germany, taken by Michaela Raab, was reported in 2015.^[146] In the United States, the Minor Child (M.C. v Aaronson) lawsuit was “a medical malpractice case related to the informed consent for a surgery performed on the Crawford’s adopted child (known as M.C.) at [Medical University of South Carolina] in April 2006”.^[147] The case was one of the first lawsuit of its type to challenge “legal, ethical, and medical issues regarding genital-normalizing surgery” in minors, and was eventually settled out of court by the Medical University of South Carolina for $440,000 in 2017.^[148]

Access to information, medical records, peer and other counselling and support. With the rise of modern medical science in Western societies, a secrecy-based model was also adopted, in the belief that this was necessary to ensure normal physical and psychosocial development.^{[149][150][151]}

The Asia Pacific Forum of National Human Rights Institutions states that legal recognition is firstly “about intersex people who have been issued a male or a female birth certificate being able to enjoy the same legal rights as other men and women”.^[35] In some regions, obtaining any form of birth certification may be an issue. A Kenyan court case in 2014 established the right of an intersex boy, “Baby A”, to a birth certificate.^[152]

Like all individuals, some intersex individuals may be raised as a certain sex (male or female) but then identify with another later in life, while most do not.^{[153][9][154][155]} Recognition of third sex or gender classifications occurs in several countries,^{[156][157][158][159]} however, it is controversial when it becomes assumed or coercive, as is the case with some German infants.^[160][161] Sociological research in Australia, a country with a third ‘X’ sex classification, shows that 19% of people born with atypical sex characteristics selected an “X” or “other” option, while 75% of survey respondents self-described as male or female (52% as women, 23% as men), and 6% as unsure.^[10][47]

On January 20, 2025, US president Donald Trump signed Executive Order 14168, entitled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. This executive order asserts that it is the policy of the United States that there are only two sexes, male and female, and that these sexes are immutable throughout a person’s life, starting at conception.^[162] The executive order does not acknowledge the existence of, or make provision for, intersex people. According to intersex advocate Alicia Roth Weigel, this order “attempts to negate [Intersex people’s] very existence”.^[163]

Intersex conditions can be contrasted with transgender gender identities and the attached gender dysphoria a transgender person may feel, wherein their gender identity does not match their assigned sex.^{[164][165][166]} However, some people are both intersex and transgender; although intersex people by definition have variable sex characteristics that do not align with either typically male or female, this may be considered separate to an individual’s assigned gender, the way they are raised and perceived, and their internal gender identity.^[167] A 2012 clinical review paper found that between 8.5% and 20% of people with intersex variations experienced gender dysphoria.^[154] In an analysis of the use of preimplantation genetic diagnosis to eliminate intersex traits, Behrmann and Ravitsky state: “Parental choice against intersex may … conceal biases against same-sex attractedness and gender nonconformity.”^[168]

The relationship of intersex people and communities to LGBTQ communities is complex,^[169] but intersex people are often added to the LGBT acronym, resulting in the acronym LGBTI (or when also including asexual people, LGBTQIA+^[170]). Emi Koyama describes how inclusion of intersex in LGBTI can fail to address intersex-specific human rights issues, including creating false impressions “that intersex people’s rights are protected” by laws protecting LGBT people, and failing to acknowledge that many intersex people are not LGBT.^[171] Organisation Intersex International Australia states that some intersex individuals are homosexual, and some are heterosexual, but “LGBTI activism has fought for the rights of people who fall outside of expected binary sex and gender norms.”^[172][173] Julius Kaggwa of SIPD Uganda has written that, while the gay community “offers us a place of relative safety, it is also oblivious to our specific needs”.^[174] Mauro Cabral has written that transgender people and organizations “need to stop approaching intersex issues as if they were trans issues”, including use of intersex conditions and people as a means of explaining being transgender; “we can collaborate a lot with the intersex movement by making it clear how wrong that approach is.”^[175]

Heinlein‘s acclaimed 1959 “‘—All You Zombies—'” is an early intersex science fiction story, based on time travel.

An intersex character is the narrator in Jeffrey Eugenides‘ Pulitzer Prize-winning novel Middlesex.

The memoir, Born Both: An Intersex Life (Hachette Books, 2017), by intersex author and activist Hida Viloria, received strong praise from The New York Times Book Review, The Washington Post, Rolling Stone, People, and Psychology Today, was one of School Library Journal‘s 2017 Top Ten Adult Books for Teens, and was a 2018 Lambda Literary Award nominee.

Television works about intersex people and films about intersex people are scarce. The Spanish-language film XXY won the Critics’ Week grand prize at the 2007 Cannes Film Festival and the ACID/CCAS Support Award.^[176] Faking It is notable for providing both the first intersex main character in a television show,^[177] and television’s first intersex character played by an intersex actor.^[178]

Intersex peer support and advocacy organizations have existed since at least 1985, with the establishment of the Androgen Insensitivity Syndrome Support Group Australia in 1985.^[179] The Androgen Insensitivity Syndrome Support Group (UK) was established in 1988.^[180] The Intersex Society of North America (ISNA) may have been one of the first intersex civil society organizations to have been open to people regardless of diagnosis; it was active from 1993 to 2008.^[181]

Intersex Awareness Day is an internationally observed civil awareness day designed to highlight the challenges faced by intersex people, occurring annually on 26 October. It marks the first public demonstration by intersex people, which took place in Boston on 26 October 1996, outside a venue where the American Academy of Pediatrics was holding its annual conference.^[182] The commemoration day itself began in 2003^[183][184] with the establishment of a central awareness raising site by Betsy Driver and Emi Koyama.^[183] A central awareness raising site was later re-established in 2015 by Morgan Carpenter with Laura Inter of Brújula Intersexual, and support from Open Society Foundations.^[185]

Intersex Day of Remembrance, also known as Intersex Solidarity Day, is an internationally observed civil awareness day designed to highlight issues faced by intersex people, occurring annually on 8 November. The event appears to have begun on November 8, 2005, as Intersex Solidarity Day, following an invitation issued by Joëlle-Circé Laramée, then Canadian spokeswoman for Organisation Intersex International.^[186] The Organisation invited organisations and groups and individuals to show solidarity by marking the life of Herculine Barbin, or discussing intersex genital mutilation, “the violence of the binary sex and gender system” and/or “the sexism implicit within the binary construct of sex and gender”.^[186] Herculine Barbin was a French intersex person; her memoirs were published by Michel Foucault in Herculine Barbin: Being the Recently Discovered Memoirs of a Nineteenth-century French Hermaphrodite.

• 
  The intersex flag created in July 2013 by Morgan Carpenter of Intersex Human Rights Australia
•  
 
• 
  The Progress Pride Flag flag with the intersex flag, created in 2021 by Valentino Vecchietti of Intersex Equality Rights UK
•  
 
• 
  An orchid flower

The intersex flag was created in July 2013 by Morgan Carpenter of Intersex Human Rights Australia to create a flag “that is not derivative, but is yet firmly grounded in meaning”. The circle is described as “unbroken and unornamented, symbolising wholeness and completeness, and our potentialities. We are still fighting for bodily autonomy and genital integrity, and this symbolises the right to be who and how we want to be.”^[187]

In 2021, Valentino Vecchietti of Intersex Equality Rights UK redesigned the Progress Pride Flag to incorporate the intersex flag.^[188] This design added a yellow triangle with a purple circle in it to the chevron of the Progress Pride flag. It also changed the color of green to a lighter shade without adding new symbolism. Intersex Equality Rights UK posted the new flag on Instagram and Twitter.^[189][190]

Because the word “orchid” comes from the Greek word for testicle, and the orchiectomy is a common surgery performed on intersex infants, the orchid flower is a symbol of being intersex and of opposition to non-consensual genital surgery.^[191]

In Judaism, the Talmud contains extensive discussion concerning the status of two types of intersex people in Jewish law; namely, the androgynous, who exhibit both male and female external sexual organs, and the tumtum, who exhibit neither. In the 1970s and 1980s, the treatment of intersex babies started to be discussed in Orthodox Jewish medical halacha by prominent rabbinic leaders, such as Eliezer Waldenberg and Moshe Feinstein.^[192]

Erik Schinegger, Foekje Dillema, Maria José Martínez Patiño and Santhi Soundarajan were subject to adverse sex verification testing resulting in ineligibility to compete in organised competitive competition. Stanisława Walasiewicz, an athlete diagnosed posthumously with Turner syndrome was posthumously ruled ineligible to have competed.^[193]

The South African middle-distance runner Caster Semenya won 3 World Championships gold medals and 2 Olympic gold medals in the women’s 800 metres. When Semenya won gold at the 2009 World Championships, the International Association of Athletics Federations (IAAF) requested sex verification tests on the very same day. The results were not released, and Semenya was ruled eligible to compete.^[194] In 2019, new IAAF rules came into force for athletes like Semenya with certain disorders of sex development (DSDs) requiring medication to suppress testosterone levels in order to participate in 400m, 800m, and 1500m women’s events. Semenya objected to undergoing the treatment which is now mandatory. She has filed a series of legal cases to restore her ability to compete in these events without testosterone suppression, arguing that the World Athletics rules are discriminatory.^[195]

Katrina Karkazis, Rebecca Jordan-Young, Georgiann Davis and Silvia Camporesi have claimed that IAAF policies on “hyperandrogenism” in female athletes are “significantly flawed”, arguing that the policy does not protect against breaches of privacy, requires athletes to undergo unnecessary treatment in order to compete, and intensifies “gender policing”, and recommended that athletes be able to compete in accordance with their legally-recognised gender.^[196]

In April 2014, the BMJ reported that four elite women athletes with XY chromosomes and 5α-reductase 2 deficiency were subjected to sterilization and “partial clitoridectomies” in order to compete in sport. The authors noted that partial clitoridectomy was “not medically indicated” and “does not relate to real or perceived athletic ‘advantage'”.^[29] Intersex advocates^[who?] regarded this intervention as “a clearly coercive process”.^[197] In 2016, the United Nations special rapporteur on health, Dainius Pūras, criticized “current and historic” sex verification policies, describing how “a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial clitoridectomy (a form of female genital mutilation) in the absence of symptoms or health issues warranting those procedures.”^[198]

The notion of intersex individuals can be understood in the context of sexual system biology that varies across different types of organisms. Most animal species (~95%, including humans) are gonochoric, in which individuals are of either a female or male sex.^[199] Hermaphroditic species (some animals and most flowering plants^[200]) are represented by individuals that can express both sexes simultaneously or sequentially during their lifetimes.^[201] Intersex individuals in a number of gonochoric species, who express both female and male phenotypic characters to some degree,^[202] are known to exist at very low prevalences.

Although “hermaphrodite” and “intersex” have been used synonymously in humans,^{[203][pages needed]} a hermaphrodite is specifically an individual capable of producing female and male gametes.^[204] While there are reports of individuals that seemed to have the potential to produce both types of gamete,^[205] in more recent years the term hermaphrodite as applied to humans has fallen out of favor, since female and male reproductive functions have not been observed together in the same individual.^[206]

Research in the late 20th century led to a growing medical consensus that diverse intersex bodies are normal, but relatively rare, forms of human biology.^{[9][207][208][209]} Clinician and researcher Milton Diamond stresses the importance of care in the selection of language related to intersex people:

Foremost, we advocate use of the terms “typical”, “usual”, or “most frequent” where it is more common to use the term “normal”. When possible avoid expressions such as maldeveloped or undeveloped, errors of development, defective genitals, abnormal, or mistakes of nature. Emphasize that all of these conditions are biologically understandable while they are statistically uncommon.^[210]

The common pathway of sexual differentiation, where a human female has an XX chromosome pair, and a male has an XY pair, is relevant to the development of intersex conditions.

During fertilization, the sperm adds either an X (female) or a Y (male) chromosome to the X in the ovum. This determines the genetic sex of the embryo. During the first weeks of development, genetic male and female fetuses are “anatomically indistinguishable”, with primitive gonads beginning to develop during approximately the sixth week of gestation. The gonads, in a bipotential state, may develop into either testes (the male gonads) or ovaries (the female gonads), depending on the consequent events.^[211] Up until and including the seventh week, genetically female and genetically male fetuses appear identical.

At around eight weeks of gestation, the gonads of an XY embryo differentiate into functional testes, secreting testosterone. Ovarian differentiation, for XX embryos, does not occur until approximately week 12 of gestation. In typical female differentiation, the Müllerian duct system develops into the uterus, fallopian tubes, and inner third of the vagina. In males, the Müllerian duct-inhibiting hormone AMH causes this duct system to regress. Next, androgens cause the development of the Wolffian duct system, which develops into the vas deferens, seminal vesicles, and ejaculatory ducts.^[211] By birth, the typical fetus has been completely sexed male or female, meaning that the genetic sex (XY-male or XX-female) corresponds with the phenotypical sex; that is to say, genetic sex corresponds with internal and external gonads, and external appearance of the genitals.

There are a variety of symptoms that can occur. Ambiguous genitalia is the most common sign. There can be micropenis, clitoromegaly, partial labial fusion, electrolyte abnormalities, delayed or absent puberty, unexpected changes at puberty, hypospadias, labial or inguinal (groin) masses (which may turn out to be testes) in girls and undescended testes (which may turn out to be ovaries) in boys.^[212]

Ambiguous genitalia may appear as a large clitoris or as a small penis.

Because there is variation in all of the processes of the development of the sex organs, a child can be born with a sexual anatomy that is typically female or feminine in appearance with a larger-than-average clitoris (clitoral hypertrophy) or typically male or masculine in appearance with a smaller-than-average penis that is open along the underside. The appearance may be quite ambiguous, describable as female genitals (a vulva) with a very large clitoris and partially fused labia, or as male genitals with a very small penis, completely open along the midline (“hypospadic“), and empty scrotum. Fertility is variable.^{[citation needed]}

The orchidometer is a medical instrument to measure the volume of the testicles. It was developed by Swiss pediatric endocrinologist Andrea Prader. The Prader scale^[213] and Quigley scale are visual rating systems that measure genital appearance. These measurement systems were satirized in the Phall-O-Meter, created by the (now defunct) Intersex Society of North America.^{[214][215][216]}

In order to help in classification, methods other than a genitalia inspection can be performed. For instance, a karyotype display of a tissue sample may determine which of the causes of intersex is prevalent in the case. Additionally, electrolyte tests, endoscopic exam, ultrasound and hormone stimulation tests can be done.^[217]

Intersex can be divided into four categories which are: 46, XX intersex; 46, XY intersex; true gonadal intersex; and complex or undetermined intersex.^[212]

This condition used to be called “female pseudohermaphroditism“. People with this condition have female internal genitalia and karyotype (XX) and various degree of external genitalia virilization.^[218] External genitalia is masculinized congenitally when female fetus is exposed to excess androgenic environment.^[212] Hence, the chromosome of the person is of a female, the ovaries of a female, but external genitals that appear like a male. The labia fuse, and the clitoris enlarges to appear like a penis. The causes of this can be male hormones taken during pregnancy, congenital adrenal hyperplasia, male-hormone-producing tumors in the mother and aromatase deficiency.^[212]

This condition used to be called “male pseudohermaphroditism”. This is defined as incomplete masculinization of the external genitalia.^[219] Thus, the person has male chromosomes, but the external genitals are incompletely formed, ambiguous, or clearly female.^[212][220] This condition is also called 46, XY with undervirilization.^[212] 46, XY intersex has many possible causes, which can be problems with the testes and testosterone formation.^[212] Also, there can be problems with using testosterone. Some people lack the enzyme needed to convert testosterone to dihydrotestosterone, which is a cause of 5-alpha-reductase 2 deficiency.^[212] Androgen insensitivity syndrome is the most common cause of 46, XY intersex.^[212]

This condition used to be called “true hermaphroditism“. This is defined as having asymmetrical gonads with ovarian and testicular differentiation on either sides separately or combined as ovotestis.^[221] In most cases, the cause of this condition is unknown.

This is the condition of having any chromosome configurations rather than 46, XX or 46, XY intersex. This condition does not result in an imbalance between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.^[212]

There are a variety of opinions on what conditions or traits are and are not intersex, dependent on the definition of intersex that is used. Current human rights based definitions stress a broad diversity of sex characteristics that differ from expectations for male or female bodies.^[2] During 2015, the Council of Europe,^[66] the European Union Agency for Fundamental Rights^[222] and Inter-American Commission on Human Rights^[223] have called for a review of medical classifications on the basis that they presently impede enjoyment of the right to health; the Council of Europe expressed concern that “the gap between the expectations of human rights organisations of intersex people and the development of medical classifications has possibly widened over the past decade.”^{[66][222][223]}

Medical interventions take place to address physical health concerns and psychosocial risks. Both types of rationale are the subject of debate, particularly as the consequences of surgical (and many hormonal) interventions are lifelong and irreversible. Questions regarding physical health include accurately assessing risk levels, necessity, and timing. Psychosocial rationales are particularly susceptible to questions of necessity as they reflect social and cultural concerns.^{[citation needed]}

There remains no clinical consensus about an evidence base, surgical timing, necessity, type of surgical intervention, and degree of difference warranting intervention.^{[224][225][226]} Such surgeries are the subject of significant contention due to consequences that include trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity.^{[citation needed]} This includes community activism,^[121] and multiple reports by international human rights^{[31][66][35][227]} and health^[151] institutions and national ethics bodies.^[34][228]

In the cases where gonads may pose a cancer risk, as in some cases of androgen insensitivity syndrome,^[229] concern has been expressed that treatment rationales and decision-making regarding cancer risk may encapsulate decisions around a desire for surgical “normalization”.^[33]

• Feminizing and masculinizing surgeries: Surgical procedures depend on the diagnosis, and there is often a concern as to whether surgery should be performed at all. Typically, surgery is performed shortly after birth. Defenders of the practice argue that individuals must be clearly identified as male or female for them to function socially and develop “normally”. Psychosocial reasons are often stated.^[20] This is criticised by many human rights institutions, and authors. Unlike other aesthetic surgical procedures performed on infants, such as corrective surgery for a cleft lip, genital surgery may lead to negative consequences for sexual functioning in later life, or feelings of freakishness and unacceptability.^[230]
• Hormone treatment: There is widespread evidence of prenatal testing and hormone treatment to prevent or eliminate intersex traits,^[231] associated also with the problematization of sexual orientation and gender non-conformity.^[231][232]
• Psychosocial support: All stakeholders support psychosocial support. A joint international statement by participants at the Third International Intersex Forum in 2013 sought, among other demands: “Recognition that medicalization and stigmatisation of intersex people result in significant trauma and mental health concerns. In view of ensuring the bodily integrity and well-being of intersex people, autonomous non-pathologising psycho-social and peer support be available to intersex people throughout their life (as self-required), as well as to parents and/or care providers.”^[233]
• Genetic selection and terminations: The ethics of preimplantation genetic diagnosis to select against intersex traits was the subject of 11 papers in the October 2013 issue of the American Journal of Bioethics.^[234] There is widespread evidence of pregnancy terminations arising from prenatal testing, as well as prenatal hormone treatment to prevent intersex traits. Behrmann and Ravitsky find social concepts of sex, gender and sexual orientation to be “intertwined on many levels. Parental choice against intersex may thus conceal biases against same-sex attractedness and gender nonconformity.”^[168]
• Medical display. Photographs of intersex children’s genitalia are circulated in medical communities for documentary purposes, and individuals with intersex traits may be subjected to repeated genital examinations and display to medical teams. Problems associated with experiences of medical photography of intersex children have been discussed^[235] along with their ethics, control and usage.^[236][237] “The experience of being photographed has exemplified for many people with intersex conditions the powerlessness and humiliation felt during medical investigations and interventions.”^[236]
• Gender dysphoria: The DSM-5 included a change from using gender identity disorder to gender dysphoria. This revised code now specifically includes intersex people who do not identify with their sex assigned at birth and experience clinically significant distress or impairment, using the language of disorders of sex development.^[238]

• Intersex infanticide
• Intersex people and military service
• Sexual differentiation in humans
• Gynandromorphism
• Endosex

from — Wikipedia contributors. (2001, October 26). Intersex – Wikipedia. Retrieved May 1, 2026