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Medicalisation and health impacts

Each trait can come with health and  issues. Each trait has a typical age of diagnosis, typical treatment and typical sex registration as female or male.

Sex registration is based on physical appearance. If sex is uncertain, doctors apply a set of rules to make a decision,  expected outcomes from surgeries to make genitals more masculine. This often leads to female registration and feminising surgeries, on the basis that it is  to “make a hole but you can’t build a pole”. Early surgery may not align with the child’s future wishes.

People with  have a trait that affects how their adrenal glands produce certain hormones. They may have trouble regulating salt levels, and babies may have genital differences.

Girls with congenital adrenal hyperplasia and boys with “hypospadias” frequently undergo early surgeries to make their genitals fit . Children with traits associated with XY chromosomes may have variable genital appearance at birth, and surgery in line with sex registration.

Infant girls are thought to need a vagina, while boys undergo surgeries to fit a “functional” requirement of standing to urinate. Early surgeries frequently require revisions later in life.

Women and others with Turner (45,X0) syndrome have fewer than the typical number of sex chromosomes. People with this trait have a higher risk of .��

Boys and other children with Klinefelter (XXY) syndrome – where someone has three sex chromosomes, compared to the usual two – can experience . They may benefit from access to learning supports, as well as support to make decisions about hormonal replacement and fertility from the age of puberty.

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Language has changed over time

The term intersex has its origins in medicine in the 1920s. In the 1990s, people with lived experience of intersex traits adopted the term as  their own advocacy groups.��

Many people start with the medicalised  by doctors and parents.

People who know their diagnosis use many . It’s up to individuals to decide what feels right, whether that means talking about having an intersex variation, a difference in sex development, or a medical condition.

Sometimes, people use different terms in different situations, to avoid misconceptions or build a sense of belonging with others. But often, shame, stigma and people not  mean they don’t speak about variations at all.

Clinical terms also change and shift. Even  on what should be included in the clinical concept of “differences of sex development”.��

It’s different to being transgender

People with innate variations of sex characteristics may identify as lesbian, gay, bisexual, trans or non-binary, or may be heterosexual and identify with female or male sex registered at birth.

But intersex is often conflated with being transgender. Sometimes this is a product of simplistic and unhelpful media .��

Sometimes this is the product of institutional policies. For example, many women and girls with a Y chromosome, registered female at birth and  in public hospitals without their consent, are now being  they are “biological males” and don’t belong in women’s spaces.

Sometimes this is a product of  errors in Australian federal guidelines, which have  intersex as people who “identify as neither male nor female”. This impacts passports, health records and other government documents.

In 2020, the Australian Bureau of Statistics  better practices for government data. Its standard detaches variations of sex characteristics from classifications of sex and gender. But federal and some state governments have been slow to implement this change.��

Harmful medical experiences, stigma, misinformation and lack of transparency have all made it hard to talk about being intersex, difficult to access safe, informed and accessible services, and hard to  on the experiences and needs of adults with innate variations. This needs to change.