I have started a new category specifically devoted to my graduate school assignments in clinical mental health counseling. Given that I am writing so much for grad school, I feel it's both useful and maybe even helpful to post that work on my blog.
I am sort of in low power mode, still, so not much curation this time.
Anyway, here is my most recent essay on how my life would be if I had been born intersex.
I hope you enjoy it.
Thanks for tuning in.
Week Five Discussion MAIN POST - A - Gender - intersex
COUN-6215-18 - Lifespan
Instructor - Dr. Kristin Page
Years ago, I read the Pulitzer Prize winning novel Middlesex
by Jeffrey Eugenides, and it became one of my top five all-time favorite
novels. Though it is a multi-generation-sweeping tale of Greek emigration to
America, entrepreneurship in Detroit in the 1950s, and the American civil
rights movements of the ‘50s and ‘60s, it is also the story of Calliope (Cal),
an intersex youth reaching maturation when the Detroit riots of 1967 made the
news (Eugenides, 2002). Though cis-gendered Eugenides has taken some criticism
for writing outside of his lived experience, the novel touched my heart like it
did for so many others. As any reader might, I wondered what my life would be
like had I been born intersex as I followed Calliope’s (Cal’s) journey of
self-discovery.
American culture does not honor and respect the intersex
(formerly known as hermaphrodites) as do other cultures. It is well known that
indigenous cultures viewed these people as “two-spirit” and often revered them
as shaman. In the mountains of the Dominican Republic, those born with
5-alpha-reductase are so common that they are called “guevedoces,” as Deborah
Blum (1997) described in her wonderful book Sex on the Brain. These
children are socialized as “conditional” girls until puberty when they either
remain girls or are re-socialized as boys. Because of this acceptance and
commonality, the transition is much less traumatic for the “sisters who would
have been born brothers” (pp. 31-32). However, in America, nearly all intersex
people are not as accepted and well-socialized and experience trauma,
compounded by the rarity of and lack of understanding about their condition.
Disorders of Sex Development (DSDs) are rare: one in every 1400
births, though one-two in every hundred when including subtle variations
(Broderick & Blewitt, 2025, p. 317). Though DSD has become a common term
for such births, many people – especially those born that way – prefer the term
intersex as it does not include the word “disorder” in the definition, which
has a negative connotation. Furthermore, the word “normal” derives from the
root for carpenter’s square, I.e. “straight,” and “abnormal” derives from the
word meaning “monstrous,” cementing in the roots of our conceptual language the
binary of normal versus monstrous (Fraction & Zdarsky, 2015). Because of
this deeply-rooted mindset to enforce normality and castigate all else as
monstrous, biological considerations aside, most Western cultures have divided
gender into a strict binary, even when views of that either/or have not
remained static and seem obsolete. As Cordelia Fine (2010) reminds readers in
the book Delusions of Gender, stereotypical gender definitions are often
arbitrary as evidenced by the association of pink for girls and blue for boys
that has only been in force since the 1950s. From the Nineteenth Century until
about the midpoint of the Twentieth, boys were more often clothed in pink and
red as sign of strength, vitality, or zeal whereas blue was seen as demur and
delicate, and so it was a common color for girls (pp. 207-208). As I am a
cis-gender man who likes to wear pink and would not want to be viewed as
monstrous, I reject all these concepts of gender and sexuality that oppress
people, which is easy with my male, white privilege, not so much for intersex people.
And so, because intersex people are not accepted and are instead misunderstood,
pathologized, and stigmatized, I would likely have severe trauma if I had been
born that way; however, changes in awareness of and support for intersex by
caregivers and clinicians as well as better use of safe online forums may have
helped me or any intersex person to develop a strong sense of gender identity
and to avoid being surgically mutilated at a young age.
Intersex Gender Development
Had I been born intersex, I would be a rare and special
individual given that experts recently estimate only 1.7 percent of the world
population are “born with intersex traits” (OHCHR, 2025). This definition given
by Anne Fausto-Sterling in 1993 included conditions many clinicians do not
recognize as intersex, such as Klinefelter syndrome among others. To retain the
integrity of meaning for the term “intersex,” scientists have argued
restricting it to conditions in which chromosomal (or genotypic) and phenotypic
sex (physical and biological characteristics of sex) are not aligned. With this
more precise definition only 0.018% of the world population would be intersex
(Sax, 2002, p.174). Assuming no changes in prevalence, in Fausto-Sterling’s
over-estimation as written in her famous essay that would place intersex
population at about 95 million of the 5.6 billion world population in 1993 and
thus 138 million of today’s 8.1 billion people; using the more precise
estimation, the intersex population would be only one million in 1993 and
nearly 1.5 million today.
Given how rare intersex children are (outside of those villages
in the Dominican Republic), as an intersex person, my development may well have
been fraught with abuse and trauma. Often intersex infants and very young
children are subjected to “nonconsensual, medically unnecessary interventions”
to conform their bodies to one of the binary sex types (Medina & Mahowald,
2021). In some cases if the medical procedure aligns with how the child’s
gender would develop without alteration, then less harm is done; however, in
most cases, these mutilations go against how the child might otherwise develop
and might be irreversible. Though some statutes and guidance prohibit these
procedures, there’s still a lack of education for health professionals that
would help them in respecting the rights of people with intersex traits (Medina
& Mahowald, 2021). Because of the rarity of the condition
and the stigma surrounding these traits, there is a lack of data
as many intersex people choose to hide the truth about themselves. These issues
could have ruined my natural development as a human being as I would be
confused about who I am biologically and in terms of gender ans identity as
well as unable to truly be open who I think I am. Without guidance and support
from parents, medical professionals, teachers, etc., I would likely have
experienced significant trauma. Even if the surgery decision was right, and I
would feel my biology aligned with my gender as I grew up, I would still carry
the scars (emotional and physical) of surgery to which I did not consent and
could not have consented at my age. And if they guessed wrong? I would face a
difficult path to align biology and gender and would likely be traumatized for
life.
Intersex Identity Development
Even when “corrective” surgery is not performed on young
children, many intersex people face difficulties in thriving or even surviving.
Around the world, intersex people are killed as infants. Nearly all face
discrimination that influence education, medical care, and/or legal
rights/recognition (OHCHR, 2025). The Stephanides family socialized young
Calliope (Callie) as a girl in the novel Middlesex, she is not subjected
to coercive surgery as an infant or young child. Still, Callie faces identity
confusion in her attraction to her female best friend as an adolescent and
experiences trauma as a runaway teenager. The novel does have a somewhat happy
ending as Cal (formerly Calliope) is later in life able to live as a male
(biologically and in terms of identity) and as a heterosexual (Eugenides,
2002). Regardless of whether my life course followed the character of
Callie/Cal or a different course, my identity development would have been a
confusing process and one probably stunted by the need to hide the truth about
myself from everyone outside of my family (and maybe from some of them, too).
Though Cal faced a somewhat easier time with her family than many intersex
people, she (he) runs away rather than undergoing a forced sex-reassignment
surgery at the age of fourteen. Cal survives to find fulfillment and somewhat
of a normal life as an adult, though many intersex people are not as fortunate.
Despite the controversy surrounding the nature-nurture debate in the
development of identity (Broderick & Blewitt, 2025, p. 320), socialization
plays a key role in development. However, nearly all people with intersex
traits experience stressful environments and threats to their well-being
growing up due to most of them being gender non-conforming persons,
experiencing high rates of self-harm and suicidal ideation (Broderick &
Blewitt, 2025, p. 350). Had I been born intersex, I would need extensive
therapy just to feel comfortable in my identity (or even to find it) let alone
to process and heal from all the trauma I would have experienced.
Biological and Social Impacts on
Development
Biologically, there is an argument among experts on what
qualifies as intersex and thus how biology impacts development. Anne
Fausto-Sterling argued in her 1993 article for a higher number of intersex
people worldwide to support the claim that human sexuality is a continuum not a
dichotomy. Despite re-defining her numbers as much lower by redacting the
number of conditions qualifying as intersex, in the article “How Common is
Intersex? A Response to Anne Fausto-Sterling,” author Leonard Sax rejected
Fausto-Sterling’s social constructionist views as “not helpful for clinicians,
patients, and families” depriving the term intersex of any “clinically useful
meaning” (Sax, 2002, p.177). Like Sax, Broderick & Blewitt (2025) restrict
intersex to four conditions: 5-Alpha Reductase Deficiency (ambiguous genital
organs), Androgen Insensitivity Syndrome (feminized genitalia), Congenital
Adrenal Hyperplasia (masculinized genitals), Swyer Syndrome (sex reversal)
(Broderick & Blewitt, 2025, p. 318). Like much of the American culture at
large and many other world cultures, Sax appears prejudiced against
Fausto-Sterling’s claim that “all combinations of sexual anatomy must be considered
normal” and that intersex children are “blessed or lucky” (Sax, 2002, p.177).
The cultural resistance to see intersex biology as “normal” but rather as
abnormal (which means “monstrous,” remember) would impact my development
negatively and severely as it does most people born with one of these four
biological conditions.
Socially, allies are vital for people’s healthy socialization.
Sociometric divisions demonstrate the need for peer acceptance, which has been
shown to have strong positive influence on a child’s development. However,
intersex people are not accepted and are instead misunderstood, pathologized,
and stigmatized.
These social oppressions can be mitigated by caregivers who can
“support the shit out of them” (intersex people) as Astle et. al. (2024) argue
in an article of the same name published in the journal Sexuality and
Culture. Advocacy groups like interACT (Advocates for Intersex Youth) can
“break the silence” around intersex topics, helping youth feel seen, heard, and
accepted as well as to “disrupt the systems of oppression that harm intersex
individuals” (p. 2143). Based in social cognitive theories, Astle et. al.
(2024) argue for normalizing messages, open communication, and adult support
for intersex youth: a message of “I am natural and nothing is wrong with me”
can combat shame (p. 2147). Caregivers like those described by Astle et. al.
(2024) are not the only vital participants in the social survival of intersex
youth. Connor & Atkinson (2021) discuss the importance of EPs (educational
psychologists) in an article in the Educational Psychology in Practice
journal. The authors found a lack of established support for children and young
people in the United Kingdom schools studied, and the need for EPs to be
advocates for human rights for intersex youth (p. 199). Both articles highlight
deficiencies in socialization and acceptance of intersex youth in the culture
at large and by professionals in schools; however, acceptance in healthy peer
relationships is also vital as Broderick & Blewitt (2025) make clear from
pages 334-350 of The Life Span: Human Development for Helping Professionals
text, and peer acceptance for intersex youth is virtually non-existent. But
schools can only do so much and serve so many. These days much of peer interaction
takes place outside of schools in online spaces for all LGBTQIA+ people who
journey through life transitions of identity construction. In an article
published in the Journal of the Association for Information Science &
Technology, Jia et al. (2024) found that online forums can be safe spaces
(safer than traditional school environments) for LGBTQIA+ youth (including
intersex) facing transition challenges, helping participants to construct a new
sense of sense and meaning with identity out of “people’s new realities” (p.
39). As technological reshapes how socialization happens in all world cultures,
America in particular, further research is needed to better understand the
function and benefit of such online communities.
Summary
Given what is known about the experiences of intersex people,
the fictional Cal Stephanides of Middlesex had an easier time forming a
gender identity than many who are born with an intersex condition. Most
cultures are not as set up to support intersex youth as a few villages in the
Dominican Republic where it is more common than in the rest of the world, in
which 99.8% of humans are NOT born intersex (Sax, 2002, p.177). Greater
awareness and acceptance of intersex people is needed to save them from being misunderstood,
pathologized, and stigmatized. Even the language is important in keeping with
the more accepting term intersex, than the classification as Disorders of Sex
Development (DSDs), which includes the negatively connotative word “disorder,”
a problem much like the long-standing classification of “homosexuality” as a
mental illness in the Diagnostic and Statistical Manual of Mental Disorders.
Had I been born intersex, I would be a very rare individual and
yet would likely have severe trauma and might have been surgically-altered at
an age when I would have been too young to consent, a mutilation that would
severely limit if not ruin my biological, gender, and identity development for
years to come if not forever. And yet, the world is changing, and there is room
for optimism for intersex to develop safely and avoid the high rates of
self-harm and suicide among those born with the four main biological traits of
the condition. Advocacy groups like interACT can fight the oppression and
spread awareness: with awareness comes understanding and thus acceptance.
Online forums can also be safe spaces for identity development for all LGBTQIA+
youth, including intersex. But more needs to be done to safeguard intersex
youth from being seen by the culture at large as the true root meaning of
“abnormal”: monstrous.
Postscript
I didn’t fit into this post a mention of the very wonderful book
Gender Queer, one of the most frequently banned books in America since
its publication. Though not specifically about intersex, the struggles of Maia
Kobabe to find identity and especially gender identity are very similar. I
highly recommend this graphic novel for anyone who may work with anyone in the
LBGTQIA+ community: https://redgoldsparkspress.com/projects/6926504.
References
https://research.ebsco.com/linkprocessor/plink?id=4c926726-9d89-3923-8cdb-74b2d0ea3ffe.
Blum, D. (1997). Sex on the Brain. Penguin Books.
Broderick, P. C., & Blewitt, P. (2025). The life span:
Human development for helping professionals (6th ed.). Pearson Education.
Connor, J., & Atkinson, C. (2021). Educational
psychologists’ experiences of supporting intersex children and young people. Educational
Psychology in Practice, 37(2), 187–201.
https://doi.org/10.1080/02667363.2021.1890548.
https://research.ebsco.com/linkprocessor/plink?id=a7a0d3ca-ad4e-30be-9d88-65d94d4924f7.
Eugenides, J. (2002). Middlesex. Farrar, Straus, and
Giroux.
Fine, C. (2010). Delusions of Gender. Norton Publishing.
Fraction, M. & Zdarsky, C. (2015). Sex Criminals,
(12). Image Comics.
Jia, R. M., Du, J. T., & Zhao, Y. (2024). Interaction with
peers online: LGBTQIA+ individuals’ information seeking and meaning-making
during the life transitions of identity construction. Journal of the
Association for Information Science & Technology, 75(1), 24–42.
https://doi.org/10.1002/asi.24837.
https://research.ebsco.com/linkprocessor/plink?id=0a2fc3c7-3cf2-3f00-ab44-18d3a7a435fe.
Medina, C. & Mahowald, L. (2021, October 26). Key issues
facing people with Intersex traits. The Center for American Progress.
https://www.americanprogress.org/article/key-issues-facing-people-intersex-traits/
Office of the High Commissioner for Human Rights (OHCHR).
(2025). Intersex people: OHCHR and the human rights of LGBTI people.
https://www.ohchr.org/en/sexual-orientation-and-gender-identity/intersex-people
Sax, L. (2002). How Common is Intersex? A Response to Anne
Fausto-Sterling. Journal of Sex Research, 39(3), 174. https://doi.org/10.1080/00224490209552139
https://research.ebsco.com/linkprocessor/plink?id=5f741b35-3d0a-3108-95ce-318e454b0aa6
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- Days ago: MOM = 3648 days ago & DAD = 302 days ago
- New note - On 1807.06, I ceased daily transmission of my Hey Mom feature after three years of daily conversations. I post Hey Mom blog entries on special occasions. I post the days since ("Days Ago") count on my blog each day, and now I have a second count for Days since my Dad died on August 28, 2024. I am now in the same time zone as Google! So, when I post at 10:10 a.m. PDT to coincide with the time of Mom's death, I am now actually posting late, so it's really 1:10 p.m. EDT. But I will continue to use the time stamp of 10:10 a.m. to remember the time of her death and sometimes 13:40 EDT for the time of Dad's death. The blog entry numbering in the title has changed to reflect total Sense of Doubt posts since I began the blog on 0705.04, which include Hey Mom posts, Daily Bowie posts, and Sense of Doubt posts. Hey Mom posts will still be numbered sequentially. New Hey Mom posts will use the same format as all the other Hey Mom posts; all other posts will feature this format seen here.
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