Male? Female? Neither? Both?

Intersex individuals, born with both male and female physical characteristics, face problems uniquely their own

A gathering of intersex persons in Bengaluru earlier this week revealed the harassment the community faces.

They narrated stories about how hard it was to them to get admission in schools and colleges and later finding jobs.

Most said they had been abandoned by their parents or sold to the transgender community. Some said the trauma of their growing-up years had prompted them to run away.

Bengaluru has its share of intersex people. While some come out, others remain in the closet. Humiliation and fear of social prejudice is what keeps them hidden away.

Shuba Chacko, executive director, Solidarity Foundation, has been working with intersex people for over a decade.

She says they are among the least understood in the sexual minorities spectrum today.

“A majority live in the villages and small towns, where there is no concept of intersex persons, and most are ignorant about what is to be done. They find it easier to either live as male or female,” explains Shubha. Parents who have intersex children don’t have it easy either.

Most people born intersex live in isolated, with no visibility of their identity at all for years, till they find people with a similar identity. “They are most often confused about their body anatomy. I have come across people who have lived in isolated conditions for 30 years. They think they are the only one of their kind. This can increase their mental trauma many times over,” adds Shubha.

Counselling is key to minimising the mental and emotional trauma parents and intersex persons go through. Vinay Chandran, counsellor, Sahaya Helpline and Executive Director of Swabhava Trust, believes health professionals have to work long term to help intersex individuals and their parents.

“Traditional one-stop medical interventions without counselling are no longer viable or even ethical. A medical approach that looks at intersex bodies as a “problem” that needs to be solved with urgent surgery, as if it were a disease needing cure, is problematic,” says Chandran.

Edwina Pereira, child rights activist, says things get complicated when it comes to inheritance of property, admission to educational institutions, and jobs.

“While some parents accept their intersex children, others disown them. The questioning and discrimination starts within the family,” she says. With new consciousness emerging about trans rights (most educated people wrongly assume trans people and intersex people are the same), job opportunities are opening up.

“However, parental support is still minimal, and education trajectories of intersex children and teens are challenged,” she says.

‘Most need no treatment’
Dr Shaibya Saldanha, Enfold India, is a gynaecologist working with intersex people. She says an intersex individual is identified on the basis of physical differences observed.

Some differences are: underdeveloped sex organs, ambiguous sex organs where testes develop outside the body but ovaries develop inside, differences in hormonal presentation at puberty. She believes the complications for intersex people are more social than medical. “In situations where a newborn child has ‘ambiguous genitalia’, families and doctors find it difficult to assign a biological sex. We live in a world where parents or siblings of a newborn child are still asked ‘Boy or girl?’ as the first question, leading to multiple anxieties.

She answers Metrolife questions.

How do doctors address the question?
They don’t answer the question about the child’s gender and sexual identity. Genetic sex cannot be used to predict whether the child will grow up to identify as a man or woman, or even whether the child will identify as heterosexual, bisexual, homosexual or others. These are inherent at birth but only start being expressed as the child grows. Some children show typical gendered behaviour as young as two or three years while others are eight-10 before they express their own clear gender identity. A few intersex children may prefer not to be identified with any specific gender.

How is this treated medically and how expensive are the treatments?
Typically intersex children surrounded by supportive families and health professionals develop without much cause for stress. Any medical condition as a result of their intersex condition, like cancerous undescended testicles, can be addressed both by family and doctors without affecting the body or the future gender or sexual identity of the child. Most intersex people may not need any medical treatment or interference. And definitely, no treatment or surgery should be performed until the child is old enough to understand the health, body, gender, and sexuality aspects, and gives informed consent. Only life-threatening conditions need to be treated at birth or soon after diagnosis.

Who is an intersex individual?
According to the UN for LGBT Equality fact sheet, “Intersex people are born with sex characteristics (including genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies.” Between 0.05% and 1.7% of the population is born with intersex traits. An intersex person may be straight, gay, lesbian, bisexual or asexual and may identify as female, male, both or neither.

Dilemmas faced by intersex children
An intersex child can grow up like any other child, with the usual health problems and school concerns. But some problems are unique:

Parents don’t know what to fill in the sex column while registering birth.

The problem persists when they have to fill school admission forms.

Where does the child sit: with the boys or girls?

Which toilet does the child use: boys’ or girls’?

Does the child sit or stand while urinating?

Gender questions arise when uniforms are to be chosen.

These problems can result in severe bullying and teasing or isolation of the child, and also cause anxieties for the family.

Help at hand

Organizations working with intersex persons

Solidarity Foundation: 080-40990154

Enfold Proactive Health Trust: 080-25520489

Centre for Law & Policy Research (CLPR): 080-40912112

Recent meet

‘Listening to voices of intersex people’, a gathering was recently organised by Solidarity Foundation on April 10 at Ashraya Hotel, Infantry Road.

‘Let me be as I am’
Vino, 28, and is doing his Masters in Genetics. He was brought up as a girl but chose to live as a man after he started developing male characteristics. He shares his story:

“I used to dress up as a girl but as I grew older, I started undergoing many bodily changes and my body started behaving differently. I could mix better with boys than girls. When I was 14, my physical characteristics changed further. I became taller and more muscular. People started looking at me from a different perspective. My family didn’t accept me. I was put through a series of medical tests and surgeries but to no avail. I wanted to be accepted and live as an intersex person, without being forced to be someone else. I came out and declared my identity only three years ago. I feel more confident and secure now.”

‘I was sexually abused as a child’
Shaktisree Maya is in her early 20s. She had to run away from home because her parents refused to accept her. Her story: “I grew up as a confused child. I didn’t know whether I was male or female. And I was unaware of what was happening to my body. I was put through a series of tests. I am an only child and I was sexually abused as a child. I was later raped by one of my faculty members in college. I raised a complaint with the management but they refused to act on it. I had to move out because my parents refused to accept me. I got a seat in a fashion design course but discontinued because I was asked to sit separately and the faculty wouldn’t attend to me.”

‘I am male but menstruate’
Daniel Mendonca, 27, identifies as an intersex woman. She narrates her ordeal: ‘I identify as an intersex woman. If you are a woman you don’t need to dress to show the world that you are a woman. The medical field is ignorant. I discovered I was different when I was nine and a half because that’s when I got my periods. I was born as a male but some internal organs were those of a female. I had male genitals. My father almost threw me out of the house. It is my mother who took me in and raised me. My father also wanted to give me away to the transgender community. I underwent 28 major operations. I am male but I get my periods every month. I feel society needs to do away with its definition of male and female. We have to educate people to do away with gender binaries. My parents accepted me a while ago, after they understood the problem. They now educate parents with similar children. I wish to start a shelter home for LGBTIQ community to tell people they an integral part of society.”