Biology isn't a neat set of boxes. We’re taught from a young age that there are two piles: boys and girls. Pink and blue. XX and XY. But for millions of people around the globe, the reality of their physical bodies doesn't actually fit into those tiny slots. If you've ever wondered what gender is intersex, you’re asking a question that touches on medicine, identity, and the very way we define "normal."
It’s not a rare fluke.
Experts like Dr. Anne Fausto-Sterling, a professor at Brown University, have famously pointed out that about 1.7% of the population is born with intersex traits. To put that in perspective, that’s roughly the same percentage of people born with red hair. You’ve probably walked past an intersex person today at the grocery store or the gym without even knowing it.
The Difference Between Sex and Gender
Before we get into the weeds, we have to clear up some vocabulary. People often use "sex" and "gender" like they're the same thing. They aren't. Honestly, this is where most of the confusion starts when people ask what gender is intersex.
Sex is about your plumbing and your blueprints. It refers to biological attributes: chromosomes, hormone levels, internal reproductive organs, and external genitalia. Gender, on the other hand, is who you feel you are inside. It’s your social and personal identity. Intersex is a term that describes biological sex characteristics.
An intersex person might identify as a man, a woman, non-binary, or something else entirely. Their biological "intersex-ness" is the starting point, not the final destination of their gender identity.
What Does Intersex Actually Look Like?
There isn't just one way to be intersex. It's an umbrella term covering dozens of different conditions.
Sometimes it’s obvious at birth. A baby might be born with ambiguous genitalia, or features that look a bit like both male and female anatomy. Other times, it's totally invisible. You might have someone who appears female on the outside but has XY chromosomes and internal testes. Or someone with Mosaicism, where some cells in their body have XX chromosomes and others have XY.
Take Androgen Insensitivity Syndrome (AIS) for example. In many cases, a person with AIS has XY (traditionally "male") chromosomes, but their body doesn't respond to testosterone. They grow up appearing female, often only discovering their intersex status when they don't start menstruating in their teens.
Then there’s Congenital Adrenal Hyperplasia (CAH). This involves the adrenal glands producing high levels of virilizing hormones. A child with XX chromosomes might be born with an enlarged clitoris that looks more like a penis.
It's complex. It’s messy. It’s human.
Understanding What Gender is Intersex in a Medical Context
Historically, the medical community didn't handle this diversity very well. For decades, the "standard of care" was to perform "normalizing" surgeries on intersex infants. Doctors would basically take a look at a baby and decide, based on the size of the genitals, whether they should be "made" into a boy or a girl.
This was often done without the parents really understanding the long-term consequences.
The idea was that if you fixed the body early, the child would grow up with a "normal" gender identity. But biology doesn't work like a Lego set. Many of these individuals grew up to feel a deep sense of betrayal. They suffered from chronic pain, loss of sexual sensation, and a gender identity that didn't match the body a surgeon chose for them.
Groups like InterACT (Advocates for Intersex Youth) have been fighting for years to end these non-consensual surgeries. They argue that unless a procedure is medically necessary—like making sure a baby can urinate safely—it should be delayed until the person is old enough to decide for themselves.
Is Intersex a Third Gender?
In some cultures, yes. In others, not really.
If you look at the Hijra in India or the Muxe in Mexico, there are long-standing social roles for people who don't fit the male/female binary. However, in most Western legal systems, we’re still catching up. Some countries and several U.S. states now allow an "X" marker on birth certificates or passports.
But here is the kicker: being intersex doesn't automatically mean you are a third gender.
Most intersex people identify as either men or women. They just happen to have a biological history that is more complex than the average person. If you ask an intersex man what his gender is, he’ll say "I’m a man." The fact that he might have been born with XXY chromosomes (Klinefelter syndrome) is just a part of his medical record, not his identity.
Why the "DSD" Label is Controversial
If you go into a hospital today, you might not hear the word intersex. Doctors often use the term Disorders of Sex Development (DSD).
Some people like this term. They feel it’s more clinical and accurate. They see their condition as a medical issue that needs management, like diabetes or asthma.
Others hate it.
They argue that "disorder" implies that something is broken. They prefer "intersex" because it frames their body as a natural variation of human biology. It’s a debate that’s still raging in medical journals and support groups. There isn't a single "correct" answer, but listening to how an individual describes themselves is usually the best way to go.
The Role of Hormones and Puberty
Puberty is often the "aha!" moment for intersex individuals who didn't know they were different. Imagine being a 14-year-old girl and suddenly your voice starts dropping and you're growing facial hair. Or being a boy and developing breast tissue.
This happens because the body’s internal hormonal "engine" might be sending different signals than the external appearance suggests.
A condition called 5-alpha reductase deficiency is a fascinating example. In certain parts of the Dominican Republic, some children are born appearing female, but when they hit puberty, they undergo a massive surge of testosterone, their bodies masculinize, and they begin living as men. They are locally known as guevedoces—which literally translates to "penis at twelve."
In that specific culture, the community accepts this transition as a natural part of life. It shows that our understanding of what gender is intersex is largely shaped by the culture we live in.
Common Myths and Misconceptions
Let's bust a few myths while we're at it.
- Intersex is not the same as being transgender. A transgender person usually has a "standard" male or female body but a gender identity that doesn't match it. An intersex person has a body that doesn't fit standard definitions of male or female from the start. (Though, yes, a person can be both intersex and trans).
- It’s not "hermaphroditism." That’s an outdated, stigmatizing, and biologically inaccurate term when applied to humans. Don't use it.
- It’s not always a disability. Many intersex people live perfectly healthy, long lives. Some conditions might require hormone replacement therapy or monitoring for specific health risks (like certain types of cancer), but many don't require any "treatment" at all.
Moving Toward Better Support
The shift in the last decade has been toward transparency.
Psychologists now emphasize the importance of being honest with intersex children about their bodies. Hiding someone's medical history creates shame. When kids grow up knowing the truth—that their body is just one way a human body can be—they tend to have much better mental health outcomes.
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Resources like the AIS-DSD Support Network provide a space for families to connect. They offer a place where parents can realize their child isn't "weird" or "broken." They’re just part of the 1.7%.
Practical Steps for Inclusion
If you want to be an ally or just a decent human being, it’s not that hard.
- Respect privacy. You wouldn't ask a stranger about their genitals or their chromosome count. Don't do it to intersex people.
- Use the language they use. If someone calls themselves intersex, use that. If they prefer the name of their specific condition (like Turner Syndrome), use that.
- Support bodily autonomy. Advocate for policies that prevent unnecessary cosmetic surgeries on infants.
- Educate others. When you hear someone say there are "only two sexes," you can gently point out that biology is actually a spectrum.
Understanding what gender is intersex requires letting go of the need for perfect categories. Nature doesn't draw hard lines; humans do. By acknowledging the reality of intersex bodies, we aren't "redefining" sex; we're finally just describing it accurately.
The next time you see a form that only offers "Male" or "Female," remember that for millions of people, neither of those boxes tells the whole story.
Actionable Next Steps
- Read "Middlesex" by Jeffrey Eugenides for a fictional but deeply researched look at the intersex experience.
- Visit the InterACT website to learn about current legislative efforts to protect intersex rights.
- If you are a medical professional, look into the updated guidelines for gender-affirming care that prioritizes patient consent over traditional "normalization."
- Check your own biases. Ask yourself why a body that doesn't fit the binary feels "wrong" to you, and consider how that perspective affects the people living in those bodies.