We all know that gender is assigned at birth based on the genitals of the baby. But what happens when an Intersex Disorder makes that determination tentative, if not impossible?
A Child with DSD
Having an infant with ambiguous genitalia is not something the average person considers when awaiting the birth of a child. Outside of a few medical specialties, many doctors might not even be too familiar with Intersex conditions. If you or a loved one find yourself the parent of a child with a DSD, you may be wondering how best to announce the birth to family and friends and how to answer questions.
Broaching the subject can be difficult. It may be helpful to start with a simple, “We were as surprised as you to find out that our baby’s sex is not exactly clear to the doctors yet. Some babies are born with conditions that cause genitals to appear larger, smaller or atypical. The doctors are doing blood work and running other tests to determine the cause of the confusion. We will find out soon what is going on and what the treatment options are.”
Boy or Girl?
During the months leading up to the birth of a child, the question of whether the baby will be a boy or a girl is often the subject of much discussion and speculation. Sometimes an ultrasound or an amniocentesis can tell with a high degree of certainty which version of the proclamation, “It’s a ___!” a new parent can expect to hear in the delivery room. And yet, in approximately one out of every two thousand births, a medical condition involving the development of the reproductive system can impact the visual determination of biological sex and make this announcement problematic.
Disorders of Sex Development, a variety of developmental anomalies commonly known as Intersex Conditions, are genetically or hormonally based syndromes that affect the development of both internal and external sex organs. Once called Hermaphroditism, these disorders can cause either a retardation or overgrowth of the genitals, sometimes making it impossible to tell the sex of the baby. Additionally, a DSD can impact gender development, causing a disconnect between the genetic sex of the affected child and the child’s gender identity.
Today, those treatment options are trending away from the once-standard practice of genital surgery in infancy, which often resulted in unfavorable outcomes such as lack of sexual sensation or function or a rejection of the surgically imposed gender. Advocates for the Intersexed now recommend a wait-and-see approach that allows the affected person to have a say in the decision to surgically alter the genitals and an opportunity for self-determination of gender. Until then, experts recommend that Intersex children be raised in the gender that the medical team deems most appropriate given the particular DSD, but that the option to change genders always be available.
Several support organizations for families affected by DSD’s can be found on the web. Among them, The Intersex Society of North America, www.isna.org.