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Who Is An ‘Intersex’ Person? Understand That, Before Calling It A ‘Medical Emergency’

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By Vaagisha Das for Cake:

David Reimer was born biologically male but raised female due to the result of a medical procedure gone wrong. Being ill-adjusted to his state, David later transitioned to male at the early age of fifteen. Known as the John/Joan case, this was taken up as an instance of nurture versus nature, and later used to support the argument that gender identity is something that is inherent in an individual, and not something that is necessarily connected to one’s genitalia, i.e., it is unconnected to one’s sex.

Sex And Gender Are Not The Same

Sex and gender are two vastly different things. One’s sex is what an individual is born with – male or female depending on the genitalia, while gender – being a boy or a girl – is what is accordingly assigned to an individual at birth by the social order. In a society that cringes at variance, gender identity is inherently tied to one’s sex, and any deviation is sought to be ‘rectified’ as soon as possible. While some people are slowly recognizing the concept of being transgender, most are still struggling to understand that gender- and that too, unconnected with one’s sex – need not be binary.

‘Intersex’, Not ‘Hermaphrodite’

In all the confusion, the phenomenon of there being a ‘third’ sex is completely overlooked – what is contemporarily known as being intersex, i.e. when a human being has both male and female genitalia, or some variance of the same. Earlier, the term used for such individuals was ‘hermaphrodite’ (meaning fully male and female) which was grossly misleading, as this is not possible in humans. The correct term is ‘intersex’. According to the American Academy of Paediatrics, since intersex individuals are relatively rare (around 1 in 2000 babies), they are rendered ‘medical emergencies’ at the time of birth.

Image source: berlin artparasite's/Facebook
Image source: Berlin Artparasites/Facebook

Why Are Such Individuals Termed ‘Medical Emergencies’?

Society is conventionally divided in two sexes – the male and the female. This division, which exists at the core of every societal institution, also has the power to influence medical procedures, which firmly segregate between the two, and provide the courses of action to be taken, for example, female individual hits puberty at twelve, and a male individual at eighteen: medical treatments are undertaken accordingly. The ‘medical emergency’ situation arises when the sex is undecided, and consequently, the future of the child, both medically and in other areas discussed below, is called into question. In this case, the doctors apply themselves to ‘right a wrong’ – little realizing that there is no inherent error in the individual, rather surgery to alter sexual organs can harm sexual function instead.

Discrimination In Sport

This fear of the unknown seems to haunt major sports associations as well- the Olympic Association has enforced strict regulations on the testing of testosterone levels for women for fear of doping – it seems reasonable at first, until one realises that not all women are subject to it, only the ones ‘falling under suspicion’- i.e., the women who look masculine. Even after testing, if such individuals are found to be intersex, they are banned from competing on the grounds that they are not ‘real women’ and that their increased testosterone levels would give them an unfair advantage in competition- a claim found to be false, as the ‘extra’ hormone naturally present in their body does not give them an ‘extra’ advantage. Hence the controversy caused over athlete Dutee Chand (who has hyperandrogenism) following protests on the ground of her ‘not being a real woman’. This is gender discrimination, and in such cases, the only fair ground for testing would be to divide competing categories on the basis of testosterone levels, and this would be unrealistic in terms of costs and efforts involved. The lines between the ‘two’ genders are being blurred, making many uncomfortable.

Fear Of Intersex Bodies As Anomalies

In a bipolar gender paradigm, there is no simple social category for those assigned ‘intersex’- hence the doctors- and parents who think they mean well- increasingly opt for surgical corrections to bring biological sex in line with the assigned gender. This is with a view to firmly reinforce the concept of the duality of the sexes- and hence, the associated gender, according to the rigidly set social norms that strive to create increasing physical differences between men and women to ‘fit’ them into a pre-arranged system. The social order has evolved through careful policing, and anyone who is ‘different’ presents a potential threat- they could shake the entire cultural order of our society, and things would no longer make sense. Any sexual relationship that is non-heteronormative, and therefore untraditional, is often seen as bizarre, with people struggling to normalize the social order. Thus the worry about intersex individuals is this – if a male is supposed to desire a female, where does one place an intersex individual? Further, if males and females are assigned the gender boy and girl at birth, how do you assign a gender identity to an intersex human being?

‘Hermaphroditism’ Is Natural, Yet We Continue To Shun It

Our anatomy affects our existence in the social order, in terms of how we view as well as interact with others- it even affects our rights and privileges. Our anatomy, and hence the gender identity imposed on us, are reinforced so often that it almost seems natural. However, it is important to note that this rigid ordering is not in fact so. Hermaphroditism in animals is very common – these animals have both reproductive organs and are capable of self-fertilizing, hence ensuring their survival and adapting themselves to live in difficult conditions. Slugs, snails, and a number of invertebrates are capable of ‘normal’ reproduction as well through the aforementioned process. In addition to this, there are a number of animals who are capable of sequentially changing their reproductive organs. When the male in a pack of coral reef fishes dies, the largest female ‘changes’ its genitalia and naturally transforms into male. How then, does one contend that intersex humans are ‘abnormal’ and in need of surgical ‘correction’? In this case, it seems a likely conclusion to draw that we are more concerned about the dictates of human society than we are about what is naturally prevalent in it.

Gender binary is just one way of ordering the world – it is not the only way. When taken into account the spectrum of gender as well as sexualities, it would be difficult to group individuals into any one of two options society makes available to us. Why not just let people be, without trying to label them or ostracise them on the basis of such labels?

This article was originally published here on Cake.

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  1. Vasu Srivastava

    If your major argument for it is, “It’s natural”, it won’t get you anywhere near an intelligent group of people or perhaps even lawmakers and scientists. Why? Because everything that occurs in nature is by definition “natural”. But we still treat diseases or mental disorders or anomalies in human beings because we can. I won’t be surprised if within 2 decades a pill is out in the market which can cure transgenderism or the tendency to hurt yourself feeling you’re not in the right body. What will happen to the much propagated trans-activism? The so called “identity”? Most psychiatrists and neuroscientists are not believing at all that one can decide their gender, and that it’s infact biological and aligned with biological sex. If it isn’t, something is wrong. At this moment, it’s unclear if it’s a mental disorder or not. Talking about intersex, it’s termed as anamoly in medical science for obvious reasons. It’s uncommon.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

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A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

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