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07 September 2009

96 000 South Africans may be intersexed

Many babies are born with genitals that are ambiguous. In fact, there are thought to be at least 96 000 intersex people in the country.

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The Caster Semenya issue focused the world's attention on the fact that the definition of someone's sex isn't always clear. Intersex SA explores this issue, and what it means.

When a baby is born, the customary first question everyone wants answered is whether the newborn is a boy or a girl.

The answer to this question is generally sought by looking between the baby’s legs and seeing whether a phallus is discernible, and at the prominence of the phallus.

On the face of it, this is straight-forward. In practice, however, far more people than is generally realised are born with genitals which are ambiguous. Such people are the majority of the intersexed, people whose physical sexual differentiation from development in the womb onwards is not typical. In such cases, there is no really straightforward answer to the “is it a boy or is it a girl” question.

SA has high incidence of intersex babies
It is estimated that around one in 50 is born with some degree of non-typical sexual differentiation, though the degree of variance from what is typical is relatively small in most of these cases. The incidence of intersex babies is particularly high in South Africa: it is though that out of a total South African population of around 48-million, some 96,000 or more South Africans are intersexed to a marked degree. Mostly, the intersexed are born with genitals which are ambiguous to some degree. In one in 500 babies the variance is significantly atypical.

The possession as a phallus as the common-sense criterion for classifying the sex of a new-born baby is not in fact straight-forward. This is because of the way in which sexual differentiation takes place in the womb.

A matter of size
The very same body of tissue in the embryo develops into a penis in undisputed and typical male infants, and into a clitoris in typical and undisputed female infants, and whether a phallus is deemed to be a penis or a clitoris is largely a matter of size.

In the case of infants with ambiguous genitalia, it is the length of the phallus which, in the context of the standard protocol of treatment, determines whether surgery is imposed. It is usually not considered to be an option for the infant to be left to develop without the imposition of what is in effect cosmetic surgery - surgery which does damage, and which is not required for the preservation of the physical health and life of the baby.

The Phall-O-Meter shown above, designed and produced in around 1997 by Kiira Triea, an intersexed activist in the US, illustrates the way in which standard practice classifies sex and decides whether or not to impose genital surgery on infants born with ambiguous genitals.

It is basically a measuring-rule (which, having been produced in the US, is in inches). What it measures is the stretched length of a baby’s phallus.

Should the stretched length of the phallus be no more than 0.9 cm, it is considered to be an acceptable clitoris and the baby is classified as a girl. Where the stretched length is greater than 2.5 cm (about the size of one digit of an adult’s thumb), the phallus is deemed to be an acceptable penis, and the baby is classified as a boy.

However, when the stretched length of the phallus is between 0.9 and 2.5 cm, panic spreads, alarm bells ring, medical staff run around on a state of panic, a socio-cultural state of emergency is declared, scalpels are sharpened and used, the unacceptably ambiguous phallus is cut off or cut down to an acceptable size, and the baby is classified as a girl.

It is not that the little body or the little phallus constitutes a danger to the baby’s health or life. Quite to the contrary. The surgical intervention typically leads to years of further surgery to seek to repair damage done by the scalpel and made worse by growth.

Typically, the long-term psychological impact of all of this on the non-consenting patient is major and highly negative. As the American sociologist Susan Kessler observes, the imposition of surgery in this way is not for the preservation of the infant’s health, but rather to protect the surrounding culture from the infant’s subversive little intersexed body.

(This is an edited version of an article published courtesy of Intersex SA, September 2009)

Visit the website of Engender here.
Visit the website of Intersex South Africa here.

Read more:
What is gender identity?
Development of sexual identity

 
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