In today's society we assume that there are only two categories in sex, they are, male and female. The sex of a person is determined by the X and Y chromosomes and this is something that has been taught to us right from our school days. If two XX chromosomes come together then the sex of the person is female and if an X and Y chromosome come together then the sex of the person is male. We also assume that the body of a person can only have male or female characteristics. We have learnt in sociology classes that the gender of the person is constructed based on the male or female characteristics.
The assumptions described above are based on the premise that there are only two categories in sex, male and female. The fact that we do not even stop to consider is the fact that categorization of sex is a social creation and it is not something that exists in reality.
The case of Caster Semenya is a moot point, she is an outstanding track and field athlete who showed evidence of that right from her childhood. Caster Semenya kept winning races, but in the meantime controversy also erupted regarding her sex. Was Caster Semenya a “she” or a “he”? This was the question on which much of the controversy regarding Caster Semenya arose. The Los Angeles Times in an article, questioned the fairness of Caster Semenya competing as a woman, when it felt that she looked like a man. Another article described how Caster Semenya had been teased about her looks and abilities ever since her childhood. An Associated Press video justified the story by playing a recording of her voice thinking that everyone would hear it as if it was a male voice. Besides this, the video also showed the images of Caster Semenya's body, especially the areas around the breast, and in areas where curves would be expected on a female body. Semenya's case is a classic example to prove that sex is socially constructed.
The other articles on the Los Angeles times also brings out the most widely accepted perspectives on sex category variants. One such an article describes the concept of Intersex and also admits that there may be people who may have chromosomes that do not align with the XX female chromosome or the XY male chromosome.
The article states that specific instructions are given to hormones by chromosomes that are present in an embryo, and those instructions relate to asking the hormones to work on tissues and create the physical structure that is related to particular sex. If the hormones do not work on the tissues as instructed or if the tissues respond in a different way then things happen differently at the time of puberty for an individual.
An example for the condition described above is the 5-alpha reductase deficiency. This particular deficiency causes male children to look like females but on puberty they develop masculinity. In less developed societies with inadequate medical resources, these kind of children are raised as girls and then accepted as men at the time of puberty, 5-alpha reductase deficiency is rampant in the Dominican Republic and Papua New Guinea. This deficiency could be surgically addressed in societies with highly advanced medical resources like the US or most developed countries and in some developing countries as well. This would help keep the gender assignment of the child consistent.
The widely accepted notion about sex and gender in society classifies intersex as an anomalous condition but sociology helps us understand this condition better.
Most researchers do not accept babies being born with some conditions of Intersex. Anne-Fausto Sterling says that intersex can happen only in one 1 out of every 2000 births, with some estimates showing birth rates at 1 in 500 and some others showing the occurrence of intersex as 1 in 1000. This means that there is some degree of frequency in the occurrence of intersex births and that it happens fairly often.
Sex determines the events that a person can participate and with whom you can compete in sports and it is in sports that this issue of intersex has achieved far greater significance. In sports, issues relating to intersex are not often discussed in public. For example, the Los Angeles Times reported an incident wherein some eight female athletes had XY chromosomes, meaning that they were males but these female athletes were reinstated because physiologically they were found to be females. This form of gender testing also appears to be biased against women, because it is only women who are subject to these tests than men.
Marriage laws in Texas provide protection for marriages based on the chromosomes. This means that a females with XY chromosome can marry a female with XX chromosome, and this law has been enacted in a state where same-sex marriage is prohibited. Transsexual and Intersex couples would benefit out of this law in Texas.
These different variations in sex is part of our diverse nature as a species, but this is something that society finds it very difficult to understand. Many things vary from person to person in the human species, like for example, the color of our eyes, hair and even sexual orientation, and as like many of these variances even our biological sex also can vary. Therefore, we should recognize and accept these variances in our biological sex rather than spawn ignorance on this issue.
Cultural traditions always favor one sex over the other different sexes, and the specific traits exhibited by the sexes also show as to which sex is dominant sociologically, besides attributing meaning to these traits.
It is unfathomable to think in what way it affects us as individuals and our culture if we begin to accept the fact that there are more than two sexes in the human species. If you are not a member of a powerful or a privileged category, then how does it feel like to be a member of a non-privileged category.
Intersex individuals have formed groups in the last few years such as the Intersex Society of North America (ISNA). The group has a website, which is quiet useful and would throw light on the activities of Intersex individuals. Cheryl Chase, a founder of the ISNA is a famous figure who is widely followed on the Internet with regard to issues pertaining to Intersex individuals.
Another group is the Organization Intersex International, this group is an active group that provides an active perspective and information for those who are part of the Intersex community, or for those who want to gain a better understanding of the Intersex community.
The very thinking that sex is socially constructed and the increasing awareness about the existence of more than the male and female sex genders that we already know, indicates that there is an awakening or a social movement that seeks to provide recognition to the other sexes such as intersex and transexuals.
In this context, an interesting question posed by Cheryl Chase, an American intersex activist and founder of the ISNA needs to be answered. The question is, should sex assignment surgery be performed only when the individual is ready and able to make the choice him- or herself?
According to Judith Butler, a well-know feminist-queer theorist, intersex individuals almost always oppose unwanted surgery. Therefore, taking into consideration Judith Butler's observation most intersex individuals will not be ready to perform a sex assignment surgery primarily because they are opposed to such unwanted surgeries. As such, sex assignment surgery should be performed if and only if the individual is ready and capable of making the choice all by himself or herself. Laws should be enacted so as to make it mandatory for hospitals to seek the permission from the individual before performing any sex assignment surgery. According to Judith Butler, “intersex individuals often mourn the body they had before an unwanted normalizing surgery interfered with it”.
There are several instances where people have mourned the new bodies they had, and one such a person was Mr. Alan Finch, who had his penis and testicles removed just in order to become “Helen”. Later Alan realized that he had made a mistake. Alan Finch sued Southern Health for encouraging him to have a sex change with out providing him sufficient counseling on the issue. Alan is of the opinion that it is not possible to have a successful sex change and that those who had a sex change would have made a decision that ruined their lives as a whole.
But unlike Alan Finch, there are others who feel that it is perfectly ethical if it is a matter of last resort and if a particular person is capable of making a decision. An instance in this regard was the case of a 13-year old girl who started treatment for sex-change to become a boy. This case sparked considerable debate about the merits of gender reassignment, but family court Chief Justice Alastair Nicholson gave legal approval for the child named Alex to begin sex-change through hormone treatment. Justice Nicholson observed that Alex had developed suicidal tendencies upon puberty because of a feeling that he was having a body that was alien to him and one that he hated.
This decision was the first instance involving an intersex child in Australia. The child biologically belongs to one sex but was given legal permission to undergo sex-change mainly because of psychiatric reasons. The child felt it had an alien body and hated it to the point that he attempted to commit suicide.
In 1999, a constitutional court in Colombia restricted the rights of doctors and parents to surgically alter the genitals of children who are intersex by birth. The two cases concerned a two year old and an eight year old child. In both cases the court observed that permission from parents was invalid for conducting sex-reassignment surgery on the children. The court held that the surgery was a violation of the freedom and bodily integrity of the child, which was primarily motivated by the intolerance of the children's parents towards their wards sexual differences.
The court in Colombia also observed that the intersex people are a minority who are entitled to protection by the State against any form of discrimination. The court referenced an amicus brief provided by the ISNA, that had a 10,000 word argument, hundreds of pages of articles and books about inter-sexuality before it arrived at such a decision on the contentious issue of sex-change without prior permission from the affected party.
Genital reconstruction is not necessary but physicians perform it so that intersexed children do not suffer from psychological problems due to their intersex nature. But what finally happens is that, these surgically corrected children tend to become confused with their sexuality and this is something that would affect them much more psychologically. Therefore, genital reconstruction is not necessary.
Despite the rejection of genital reconstruction by the intersex community, the courts in the US have still not examined the legality of the issue of conducting sex-reassignment surgeries without the consent of the individual who is affected. This is in direct contrast to the courts in Colombia, that have already decided three cases on this issue of intersex of children, and has set new standards for evaluating the rights of parents to consent to sex reassignment surgery for their intersexed children. Due to pressure from ISNA, the American Bar Association has passed a resolution that recommends physicians to adopt heightened informed consent procedures adopted by the Colombian Constitutional Court.
The treatment of intersexuals has been in practice since the 1930s in the United States and the medical fraternity was under the impression that intersexed people were either truly male or female but were not fully developed in the womb. Hormone treatments and surgeries were conducted to transform the intersexed individual into a man or a woman. Prior to intersex treatments, intersex individuals were either declared as male or female based on their dominant characteristics.
Another issue that is being debated is the issue of making informed consent genuine. This debate arose because members of the medical community thought it fit to withhold information from parents of intersex children, because they felt that too much information would result in the parents questioning or rejecting the gender assignment. It is considered unreasonable to hold back information from parents or mislead them about the risks and benefits of these surgeries and as such most medical journals are demanding a honest approach from hospitals and physicians in their communication with the parents of an intersex child.
Informed consent means divulging more information to parents by physicians, more than what is being told to them currently, which would help the parents understand the status of their child more accurately. This could also help the physicians, because it would protect them from liabilities in the future if all the information is disclosed to the parent. The information that should be disclosed are, the diagnosis of the problem and its impact on the child beyond the irregular shape of the genitals, if the procedures suggested would address the biomedical and psychosocial problems that are likely to be faced by the child in the future, if the procedure is necessary for biomedical or for social reasons, if the procedure is due to a medical emergency or if that procedure can be postponed to a later date, if there is a likelihood of the surgeries being repeated again, if the surgical assignment of sex is really necessary for gender assignment, if the surgery would not guarantee that the child would grow up to the assigned gender, briefing the parents about the preliminary follow up studies that show the adverse impact that could result upon normalizing the sex of the child such as physical, emotional and sexual impacts, that surgeries conducted to normalize the sex of intersex children is a controversial subject etc. should be disclosed to the parents of the child by physicians and hospitals concerned.
A definition for intersex is something that has eluded experts, but scientists and intersexuals accept that a confusing genital or an unusual genital is grounds for believing that the child or individual is of intersex nature, but there are many forms to this nature such as having ovarian and testicular tissue, having a micro-penis in a male or oversized clitoris in a female besides discrepancies in chromosomal identity, and in situations where the chromosomes indicate one gender whereas genitals indicate another. From all this what has to be understood is that, intersex should not be viewed as a genital defect but that the current understand of of sex is defective, because that understanding of sex is a socially constructed one.