“Is it a Boy or a Girl?”

Intersex Babies: Who They Are and What They Need From Us

by Trish Garner

 

Throughout any pregnancy there’s one question that people keep asking. Some parents find out before the birth, others wait for the surprise. Either way, I’m sure most imagine they will find out for sure on the day of the birth. But, in some cases, when the health team hold up your baby, they won’t know whether to say ‘It’s a boy’ or ‘It’s a girl’.

 

Usually, when medical staff make this kind of declaration, they’re basically going on the presence or absence of a penis. But sometimes it’s not that black and white. Some babies are born with mixed sexual characteristics and this likely means that the baby has an ‘intersex’ condition. Intersexuality refers to multiple conditions, hormonal or chromosomal, that blur the physical sex of a person (not all of which show up at birth).

 

Undoubtedly this is a scary situation for new parents. One which you may feel very unprepared for. A lot of things will be racing through your mind. The important thing is not to act in haste and fear; this situation is actually reasonably common. It’s hard to say exactly how common but estimates of the appearance of what’s called “ambiguous genitalia” put it at 1 in 1500 to 1 in 1000 births.(1) Originally, the term “hermaphrodite” was used to describe this condition but the medical establishment has now adopted the use of Disorder of Sex Development as the official diagnosis. However, many people with lived experience and their allies and advocates generally prefer the term “intersex.”

 

This terminology won’t really be helpful to you in those initial moments. What your baby needs from you is the same as any other baby – lots of love and reassurance. You will be expected to make some decisions about the medical care of your baby but you don’t have to make them right away. Unless, of course, your baby has an immediate medical problem that requires treatment, but most intersex children are healthy. So give yourself the time to ask lots of questions of your medical professionals. Here are some useful ones to start off with:

 

  • Can we wait until my child can make the decisions about optional medicines (like hormones) and procedures (like surgeries)?
    • Until very recently, you may not have even known that your baby was intersex. Medical staff would have whisked your baby away in the name of an emergency and surgically altered your baby’s genitalia without your knowledge or consent. Thankfully, that doesn’t happen in most hospitals now – it’s recognized that surgery often leaves people with little or no genital sensation or functionality – but make sure you or a support person always remain with your baby. Letting your child have a say in what happens to their body is vital and involves waiting until they are old enough to understand the implications of their condition and their options. Delaying the surgery will not harm the child in any way.

 

  • Which gender assignment do you think my child should be given right now?
    • Our society is structured around people fitting neatly into two boxes – boy or girl – so you may want to make an initial gender assignment. Your doctor can give advice based on medical evidence but there are no certainties your child will not change their original gender assignment later in life, though it doesn’t happen often.
      • Would you please give me a referral to a mental health professional who specializes in gender issues and birth anomalies?
        • Feeling a range of emotions, from fear and guilt to confusion and joy, is an entirely natural response to this situation. Seeking counseling for you and your family is a great way to get support. You can also ask if the medical centre has a support group for parents of intersex babies.

       

      More information and support can be found through the Intersex Society of North America (www.isna.org), and there is a Handbook for Parents that can be downloaded at www.dsdguidelines.org.

       

      Above all, remember this is still a joyful occasion – you’ve just become a parent – and that shouldn’t be overwhelmed by this issue. Enjoy your baby in those first few hours, do all the things you were planning to do, and, most importantly, hold your baby tight and tell them how much they are loved.

      1. Intersex Society of North America. “How Common is Intersex?” http://www.isna.org.

       

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      Trish Garner is a parent of three wonderful children: twins plus one more.

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