Intersex

Intersex is an umbrella term for a variety of congenital conditions where a person’s chromosomes, sex glands or anatomy does not develop in a typical manner. Thus, the biological sex of an intersex person cannot be clearly defined as either male or female at birth, but instead exhibits variations that are inconsistent with the norm in one or several ways.

In countries with comprehensive healthcare, including Sweden, intersex persons are often laid subject to treatment while infants, before they are old enough to give consent themselves. There are situations when this is medically justified, such as hormone treatments for congenital adrenal hyperplasia (CAH). But intersex infants are sometimes provided surgery to make them comply with the binary gender norm, according to which all people are (and should be) either a man or a woman (see also dichotomy). And this is done even in cases where such a procedure is not medically justified. The surgery can lead to extensive scarring and numbness.

Legally, the medical practice in this area is largely unregulated and only rests on the formulation in the Swedish Patient Safety Act that all medical treatments and procedures must be based on ‘science and proven experience’. However, there is a scientific controversy regarding the benefit of these procedures. Colombia, Malta and Chile are the only countries in the world that have outlawed cosmetically or socially motivated surgery performed on children with intersex variations. In the new ethical guidelines for healthcare in Finland, doctors are recommended not to perform surgery on infants unless it is medically justified.

Quite often, the sex a person has been assigned through medical intervention turns out not to agree with the person’s gender identity. When this happens in Sweden, the person is referred to an investigation similar to that required for trans persons who wish to undergo sex-corrective treatment – despite the fact that the situation at hand is rather a matter of correcting a medical mistreatment.

Intersex is also called DSD, an acronym that has traditionally stood for disorder of sex development. This medical term has been subject to criticism, from intersex persons among others, as it is based on a normative understanding of sex and gender. Instead, the acronym can be taken to stand for diverse sex development or differences in sex development.