When a baby is born, they’re assigned a biological sex — either male or female. In the vast majority of states, that information appears on the birth certificate. And while a few states have started to allow an “X” in place of the M or F, most new parents are told their child will be a boy or a girl. In reality, however, intersex traits are just as common as red hair. And while these differences may be apparent in a baby’s external genitalia, they can also impact internal organs and hormone production.
One of the most common examples is in the case of ambiguous genitalia, or intersex genitals. These are a result of a disruption in the development process, causing a newborn’s external genitalia to not match their genetic sex. This can be due to a number of different reasons, such as:
A mutation in a baby’s chromosomes is the most common cause for ambiguous genitalia. In particular, a missing X or Y chromosome can cause a baby to develop feminine features when they should have masculine ones. Other causes can include congenital adrenal hyperplasia (a condition where the adrenal glands make excess male hormones) and prenatal exposure to drugs containing testosterone or other male-producing hormones.
These issues can have a profound impact on the health of a baby. In addition to the physical problems that arise from this, the mental health and social consequences can be significant as well. For example, the child can struggle to fit in and can become withdrawn or depressed. And if they are exposed to negative gender stereotypes in school, it can lead to serious mental and emotional distress.
In some cases, immediate surgery is needed out of medical necessity to ensure that the body can function normally. However, in many cases, surgeons perform the surgeries to reinforce a child’s assigned sex and help them fit into society’s expectations of what a boy or a girl should look like. This is a highly controversial practice that human rights and advocacy groups are fighting to end.
If you are curious about what it is like to raise an intersex child, we recommend that you read the story of Jack, a transgender teen, who lives with ambiguous genitalia. You can also learn more about how to support a child who has transitioned or is living as a non-binary person by visiting the websites for the National Center for Family Building, an organization that provides education and support for families and individuals interested in LGBT parenting. Lastly, you can always contact a mental health professional who specializes in the care of transgender and gender-creative children to get more information about how to best support them.