Intersex. What is Intersex? Examples of DSD History Examples of intersex condition Treatment /Hormonal induction of Puberty Surgery % Of Intersex Opting to Change Sex Support from medical professionals should include Conclusion. What is Intersex?.
Has a female external appearance despite a 46XY karyotype and undecendedtestes; a condition termed "testicular feminization" in the past.
Androgen insensitivity syndrome (AIS) is when a person who is genetically male (has one X and one Y chromosome) is resistant to male hormones called androgens. As a result, the person has some or all of the physical characteristics of a woman, despite having partial fusion of the outer vaginal lips.
5-alpha-reductase deficiency (5-ARD) is an autosomal recessive intersex condition caused by a mutation of the 5-alpha reductase type 2 gene. Normal function 5-alpha-reductase is an enzyme that converts testosterone...
The presence of Y chromosome confers a high risk of neoplastic transformation in dysgenetic gonads. The neoplastic development in these patients is associated with the presence of Y chromosome and intra abdominal location of the abnormal gonad.
(MGD) refers to individuals who usually have a differentiated gonad on one side and a streak gonad or streak testis on the other side. A differential diagnosis between the TH and MGD has important clinical implications for gender assignment and the decision for early gonadectomy.
(46,XY CGD) is characterized by a 46,XY karyotype, normal female external genitalia, completely undeveloped (”streak”) gonads, no sperm production, and presence of normal Müllerian structures.
It was first assumed that children are psychosexually neutral at birth. Until a publication of a studied came out that suggested prenatal brain exposure to sex hormones determines gender development.
In the 1950s, the well known psychologist John Money and his co-workers at the John Hopkins University Hospital in Baltimore were the first to conduct follow up studies on intersex patients. Because, in their work, gender largely seemed to follow the gender of rearing, they concluded that gender assignment and rearing, and not the chromosomal, gonadal or genital sex, was the best predictor of adult gender identity. (Cohen-Kettenis, P .2005 (1)
First sex-dimorphic brain nuclei were found in animals and humans as a consequence, prenatal exposure of the brain to androgens was increasingly put forward as a factor in gender identity development. Second several studies on neuroendocrine effects on gender-atypical behaviors, traits, preferences and activities. In these studies evidence was found of an influence of sex steroids on a wide range of behaviors. . (Cohen-Kettenis, P .2005 (3)
Third, studies were carried out on the long-term out-come of gender identity in individuals with various intersex conditions. For example a baby boy, one of a pair of twins, lost his penis during circumcision. Along the lines of the optimal gender policy, the boy was reassigned as a girl at 15 months. Regrettably, the child turned out to be increasingly unhappy as a girl. At 14, she was informed that she had been born a boy. From that moment on she resumed the male role. In this case, biology seemed to clearly determine gender identity. This outcome seemed to be in line with a number of follow –up studies among intersex patients, in particular 5a-reductase-2 deficiency.
(Cohen-Kettenis, P .2005 (4)
The percentage of gender changes varies depending on the condition. This may imply that prenatal androgen exposure of the brain is more important for gender development than has long been believed. (Cohen-Kettenis, P .2005 (8)
True hermaphrodites have both male and female organs, often because of abnormal chromosomes. ”Ferms”(female pseudoherma-phrodites) are genetic females who’s sex organs were masculinizes through prenatal exposure to testosterone. ”Merms ” are genetic males who failed to produce the necessary hormones or whose tissue failed to respond to them.
(Sillars, 1998 P 10-11)
The results are often bizarre and produce lives filled with emotional upheaval depression and debilitating side effects from years of drug treatment and surgeries, according to the Intersex Society of North America (ISNA), a group witch objects to surgical reassignment of infants. At the age of 12, reports one member, ”My body began to go haywire. My hips spread and my voice began to break. My breasts grew, and so did my facial hair, "Some genetic females have been raised as boys because of the presence of male genitals, only to start menstruating at age 13.
(Sillars, 1998 P 10-11)
A study took 250 patients raised as females. Out of the 250, 32 had male assessment at birth, but 28 were reassigned within the first 19 months. At the follow up 9.2% experienced problems related to gender identity. However, only 1.6% made gender changes.
Out of 99 cases (55 assigned females and 44 assigned males) 9 of them decided to change gender later in life.6 Changed from male to female. In 3 of the cases the child had female assignment at birth, but were than reassigned and then raised as boys.3 other cases were female to malechanges.1 child had a male assignment at birth, but was reassigned as femalelater.
Providing accurate information to the patient/family
Be aware and acknowledge important biological determinants
To minimize psychological distress, patients /family should
Be told exactly what will be done and why.Support from medical professionals should include
(Cohen-Kettenis, P .2005)
From the beginning you’re reared according to your anatomy and your genitals. The intersexes, the people who don’t always speak out, have feelings and are humans too.
We as people have lived life in accordance to labels, but it isn’t fair to live life as being labeled some thing more or less than you really are. If were all unique as individuals wouldn’t that be consider normal anyway?
Living with (DSD), some Adolescence start to experience side effects during puberty that normal adolescence might not. They spend time in hospitals having surgery, hormonal treatment, and suffer with depression. They sometimes seem lost and confused.
However, rearing a child as middle sex may cause psychological damage. It is best to raise a child with one sex or the other, but not both.
(Cohen-Kettenis, P .2005)