Intersex
What is it?
Intersex is a state where a newborn’s sex orgrans has
anatomic characteristics of both sexes, making it
impossible to identify the sex of the baby from its
outward appearance. Sometimes, the genetic sex (as
indicated by chromosomes) may not match the appearance of
the sex organs.
Who gets it?
Intersex affects one in every 2,000 births.
What causes it?
Intersex may be caused by any abnormality in
chromosomes or sex hormones, or in the unborn baby's
response to the hormones. The condition can also be caused
by congenital adrenal hyperplasia, a disease that blocks
the infant’s metabolism and can cause a range of symptoms,
including abnormal sex organs.
What are the symptoms?
An infant with an intersex state can be classified as a
true hermaphrodite, a female pseudohermaphrodite, or a
male pseudohermaphrodite. A true hermaphrodite is born
with both ovaries and testicles and has mixed male and
female sex organs. This condition is extremely rare. A
female pseudohermaphrodite is a genetic female with
external sex organs that look like a penis. A male
pseudohermaphrodite is a genetic male with external sex
organs that fail to develop normally. Intersex males may
have testes and a female-like vulva, or a very small
penis.
How is it diagnosed?
When doctors are uncertain about a newborn's sex, a
specialist in infant hormonal problems is usually
consulted as soon as possible. The specialist may perform
an ultrasound to locate a uterus behind the bladder and
determine if there is a cervix or uterine canal. Blood
tests can check the levels of sex hormones in the baby's
blood, and chromosome analysis (called karyotyping) can
determine sex. Explorative surgery or a biopsy of
reproductive tissue may also be necessary.
What is the treatment?
Treatment of intersex states is controversial.
Traditional treatment assigns sex according to test
results, the potential for the child to identify with a
sex, and the ease of genital surgery to make the organs
look more normal. Treatment may then include
reconstructive surgery followed by hormone therapy. Babies
born with congenital adrenal hyperplasia can be treated
with cortisone-type drugs and sometimes surgery. The
American Academy of Pediatrics states that these children
can be raised successfully as members of either sex, and
recommends surgery within the first 15 months of life.
Some people are critical of this approach, including
intersex adults who were operated on as children. The
remolded genitals do not function sexually and can be the
source of lifelong pain. They suggest that surgery be
delayed until the patient can make informed choices about
surgery and intervention.
Self-care tips
Counseling should be given to the entire family of an
intersex newborn, and should also be provided to the child
when he or she is old enough.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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