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Being born intersex.

Usually, when expecting parents have decided to see with sonar technology if they are expecting a boy or girl, they are more or less certain that they know exactly what the sex of their baby will be. Preparations are made accordingly; the baby's room is decorated in pink if it is going to be a girl. If it is a boy, little toy cars, rugby or soccer balls are the gifts bought. Lots of time is spent deciding on a name, or a family name is selected according to tradition. Even if parents choose not to know the sex of their child beforehand, they still expect to have either a boy or a girl and dream of their child's future accordingly. Nobody really prepares for the event that their child may be intersex.

What is intersex?

Intersex people are born with genitalia--both external and internal--that include aspects of both sexes. While no scientific research has been carried out in any African country to establish prevalence of intersex people, anecdotal evidence points to a high number of cases in southern Africa. "Black people in Southern African have an unusually high prevalence of ovotesticular disorders of sex development (DSD), previously called true hermaphrodite and today called intersex," says Dr. Ariane Spitaels, a pediatrician and endocrinologist who sees babies and children with DSD.

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Some have an ovary on one side and a testis on the other, but more commonly one or both of these organs that produce reproductive cells is an ovotestis, with a mix of both ovary and testis tissues. In this situation, it is rare for both types of reproductive tissue to function. The external genitalia are also affected by DSD. In the period between 8 and 16 weeks after conception, as the sexual organs of the fetus are developing, the amount of testosterone produced by the testicular tissue will determine how the external genitalia will develop. Often, the external genitalia are ambiguous, neither typically female nor typically male.

Stigma and discrimination

One of the immediate challenges for parents with a baby born intersex is the confusion of not knowing what is going on. There is little, if any, guidance on how to handle the situation, and they suffer great uncertainty about the future of their child.

Parents have told a Johannesburg clinical psychologist that they would have preferred having a differently abled or HIV positive baby. The direct fear of their community's incomprehension and lack of knowledge is one of the main reasons for such a strong reaction. They feel that it would be much easier for them to explain and deal with a child who is born blind, for example.

One clinical psychologist, who has been working with the pediatric endocrinologist at Chris Hani Baragwanath Hospital in Johannesburg since 2004, says that many of the parents she sees are unemployed and economically disempowered. They live in the context in which neighbours see and hear most things and it is difficult to maintain privacy or keep a secret. They have a deep fear of other's opinions and gossip concerning their child's ambiguous genitalia.

Apart from their living conditions, there is the lack of awareness and understanding of DSD in the community. Many cultures and communities also subscribe to the belief that witchcraft is responsible for a mother having given birth to an intersex baby. It is seen as a curse, not only on the baby but also the mother. The parents themselves have difficulty explaining what the situation is.

The stigma surrounding intersex people is still so strong that many families break up as a result of such a birth. Some fathers will abandon their intersex child and the mother. There have also been cases where the mother has left the father with the baby.

What should parents do?

Dr. Spitaels explains that parents usually worry about what will happen when the child reaches puberty, what their child's sexual orientation will be, and whether the child will be able to have children of its own one day. Many parents want to "deal with it" while the baby is still very young--thinking that an operation to change the child's external genitalia will "sort out the problem."

After the initial counselling of the parents to help them come to terms with their new baby, psychologists advise that they start concentrating on the positives. Lengthy discussions about gender identity and sexual orientation become the main focus, with psychologists encouraging parents to let the children be who they are and do what they want without being constrained by gender stereotypes. The challenge lies in not letting anxiety take over and forcing the child to participate in typical traditional activities of one gender only. And this should be the case for all children, not only those born intersex.

If a girl child has interest in playing soccer or a boy wants to do more things around the house, parents need to give the child that freedom. If children are forced to live a gender role they are not happy with, they will end up being maladjusted.

The golden rule seems to be to raise the child as either a girl or a boy, but to always keep in mind that at a later age, perhaps around puberty, the child might choose to live as a different gender from the one she or he experienced in the earlier childhood years.

If we could all move beyond the boxing of ourselves and our children into a rigid female or male gender role based on our genital make up, perhaps children born intersex would not have it so hard to just be themselves. Imagine, the personal freedom of a world beyond genders!

Liesl Bjorn Theron is the director of Gender DynamiX, an organisation based in Cape Town focusing on transgender issues. Gender DynamiX provides assistance, guidance, support and mentorship to people seeking information about issues of gender identity and transitioning. Services to the trans community include referrals to medical practitioners, psychologists, legal professionals and general advice. Gender DynamiX also does public education and training about transgenderism, and works with ISOSA, the Intersex Society of South Africa. For more information, contact info@genderdynamix.org.za.

RELATED ARTICLE: Glossary

Ovary -- the female reproductive gland that regulates hormones that develop the female secondary sex characteristics (breasts, hips, etc.) and ripen eggs ready for fertilisation

Testis -- the male reproductive gland that regulates hormones that develop male secondary sex characteristics (facial hair, deep voice, Adam's apple, greater muscle mass, etc.)

Testosterone -- the sex hormone, secreted by the testes, that stimulates the development of male sex organs, secondary sexual traits, and sperm.

Genitalia -- the external sex organs which include the penis and scrotum and the vulva and the clitoris
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Title Annotation:BEYOND GENDERS
Author:Theron, Liesl Bjorn
Publication:Sister Namibia
Geographic Code:6SOUT
Date:Dec 1, 2007
Words:1117
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