What is intersexuality? Definition, causes and types
Until a few years ago it was considered as a disorder to intersexuality, that is, the fact of having intermediate sexual characteristics between those that are typical in men and those that are in women.
Today the conception of what intersexuality is changing as knowledge of human biology expands and awareness of the diversity of sex and gender increases.
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What is intersexuality?
The term "intersexuality" refers to a series of variations in the organs and sexual characteristics, both anatomically and genetically, that make the person have both male and female characteristics simultaneously. These variations can affect chromosomes, hormones, genitalia and / or secondary sex traits, like the distribution of muscles and fat.
The result of the variations produced by intersexuality is the ambiguity of the sexual anatomy or the discrepancy between the genotype and the phenotype. In short, we can say that intersex people are born without all the physical characteristics typically female or male. Furthermore, since this does not have to be manifested externally, it can also occur only in genes, not all intersex people know that they are.
From the biological sciences, intersexuality is currently conceived as a set of disorders or variations in sexual development . The second conception is increasingly generalized, less stigmatizing for intersex people.
Although in many cases it has been medicalized, the truth is that intersexuality is not usually a danger for survival, although in some cases it does involve risk of pain and infertility and may cause discomfort with regard to sexual identity.
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Synonymous with "hermaphrodite"?
Previously Intersex people were known as "hermaphrodites" but today this term is considered derogatory: hermaphroditism consists of the simultaneous presence of male and female reproductive organs that occurs in some species of animals and plants.
In the Europe of antiquity and the Middle Ages people who had ambiguous sexual characteristics were considered hermaphrodites . The law of these societies affirmed that they should be considered men or women according to the predominant external features. To a large extent, this conception has remained up to the present.
During the twentieth century the term "intersexuality", coined by the geneticist Richard Golschmidt in 1917, replaced "hermaphroditism" in this type of case. Medical advances during the past century allowed surgical and hormonal interventions will be popularized to alter the anatomy of intersex people so that their bodies were more similar to the male or female prototype.
However, the dubious efficacy and risks of these treatments, which are often practiced without consent in minors, have contributed to the emergence of movements that defend the rights of intersex people.
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Causes and types of intersexuality
There are many possible causes of intersexuality that cause different variations in genotype and phenotype. These causes can be divided into four main categories based on their most defining characteristics.
1. Intersexuality 46, XX (with virilization)
In these cases the chromosomes of the person correspond to those that are typical in women, but their external genitalia are those of a male. Even though in intersexuality 46, XX the person has a uterus , the exhibition to high levels of masculine hormones during the fetal development, produced by several possible causes, cause that the clítoris and the vaginal lips are developed like a penis.
The most common cause of this type of intersexuality is the congenital adrenal hyperplasia , consisting of defects in the adrenal glands that cause excessive secretion of androgens, as well as deficit of cortisol and other hormones. This alteration can influence menstruation and hair growth, but in severe cases it can also affect heart rhythm or blood levels of sodium and potassium.
The presence of ovarian tumors and the consumption of male hormones during pregnancy by the mother can also cause intersexuality with virilization.
2. Intersexuality 46, XY (with subvirilization)
The intersexuality 46, XY consists of the presence of male chromosomes and female external genitalia or ambiguous. In this type of intersexuality the normal development of the male phenotype from the inhibition of female characteristics does not come to completion.
The most common cause of intersexuality with subvirilization is the androgen insensitivity syndrome ; in these cases the organism is resistant to male hormones, necessary for the development of the gonads and the rest of the male sexual characteristics.
Malformations in the testicles and the deficient production of testosterone are also frequent causes of intersexuality 46, XY.
3. True gonadal intersex
This type of intersexuality occurs when the person has simultaneously ovaries and testicles , either completely or incompletely. Formerly these variations were known as "true hermaphroditism", in contrast to the terms "female pseudohermaphroditism" and "male pseudohermaphroditism" that were used for intersexuality XX and XY, respectively.
In true gonadal intersexuality the external genitalia can be masculine, feminine or intermediate, and chromosomes XX, XY or both can be presented at the same time. The cause of these variations is unknown.
4. Complex or indeterminate intersexuality
We speak of complex or indeterminate intersexuality when sexual development is altered there is no inconsistency between the genotype and the phenotype . Among other aspects, the sex hormones or the number of chromosomes may be affected.
For example, cases in which there are two X chromosomes (47, XXY or 47, XXX) and in which there is only one X chromosome (45, XO) would be included in this category.