This document provides information about intersex individuals and conditions through a series of slides. It defines what constitutes intersex genitalia at birth and lists statistics on the frequency of various intersex-related conditions. Specific conditions like congenital adrenal hyperplasia, Klinefelter syndrome, and Swyer syndrome are explained. It discusses the discredited medical case of David Reimer and ethics around intersex treatment. Recommended books and resources for further information are also provided.

2. Important Note!
Some transphobic language and human
anatomy revolving around the genitalia
will be spoken about for the sole
purpose of educating others. This
powerpoint is being made with the sole
purpose to educate others. You’re free
to step out at any time, no hard feelings


3. An intersex person is someone who was deemed
to not have “clearly male” or “clearly female”
genitalia at the moment of birth. What’s defined as
“clearly male” is the penis NOT being shorter than
a specific length. What’s defined as “clearly
female” is the clitoris NOT being longer than a
specific length.
If the child has a “mixture” of genitalia (testicles
and a vagina as an example) then they are deemed
“intersex”

4. © http://www.isna.org/faq/frequency
•Not XX and not XY: 1 in 1,666 births
•Klinefelter (XXY): 1 in 1,000 births
•Androgen insensitivity syndrome: 1 in 13,000 births
•Partial androgen insensitivity syndrome: 1in 130,000 births
•Classical congenital adrenal hyperplasia: 1 in 13,000 births
•Late onset adrenal hyperplasia: 1 in 66 individuals
•Ovotestes: 1 in 83,000 births
•Hypospadias (urethral opening in perineum or along penile shaft): 1 in 2,000
births
•Hypospadias (urethral opening between corona and tip of glans penis): 1 in 770
births
•Total # of “non traditional” births: 1 in 100 births
•Total # of people receiving surgery to “normalize” genital appearance: 1-2 in
1,000 births

5. The term “hermaphrodite” is a dated term in the
medical community. In reality, no human is capable
of being a hermaphrodite. Animals that are
hermaphrodites have both female and male genitalia
AND can get themselves pregnant. Humans that
exhibit both male and female genitalia can NOT get
themselves pregnant.

7. Specific Conditions
The following slides covers some of the “big”
conditions that fall into the intersex
umbrella. Some conditions vary from
person to person, depending on the
individual’s biology and chemistry.

8. A person born with male chromosomes (XY), but
female genitalia. Extremely rare, occurs in 1 in
300,000 people on average. Typically these people
do not have their ovaries develop and surgery is
recommended to remove them to prevent cancer.
Their sex organs are not functional as sex organs.
© http://ghr.nlm.nih.gov/condition/swyer-syndrome
© http://www.isna.org/faq/conditions/swyer

9. A female who has typically has high levels of androgens within
their blood (a "male" hormone), mixed/irregular menstruation, and
possibly have small cysts on their ovaries. The eggs a woman has
does not have enough hormones for the eggs to fully mature. This
syndrome typically affects a woman's: menstrual cycle, ability to
have children, hormones, heart, blood vessels, and their
appearance (such as having a large amount of body hair). Between
1-10 and 1-20 women are thought to experience this that are of
childbearing age. It can occur in girls as young as 11 years old.
© http://www.womenshealth.gov/publications/our-publications/fact-sheet/
polycystic-ovary-syndrome.html

11. Female humans are typically made up of 46 XX
chromosomes. A person with Turner Syndrome
typically has 45 XX chromosomes. Female traits
normally develop (breasts, hip widens, waist thins,
etc…) but typically are underdeveloped.
© http://www.isna.org/faq/conditions/turner

12. Appears in XY (male) individuals, PAIS tends to have
“ambiguous” genitalia (an enlarged clitoris or a small
penis). PAIS is the suggested cause for infertility in
some males.
© http://www.isna.org/faq/conditions/pais

14. Congenital Adrenal Hyperplasia (CAH) is the most prevalent cause of intersex
among people with XX (Female) chromosomes. About 1 in 10,000 to 18,000
children are born with CAH, but it does not cause intersex in those with XY
(Male) chromosomes, so the prevalence of CAH-related intersex is about 1 in
20,000 to 1 in 36,000.
Those born with XX chromosomes affected by CAH typically have enlarged
clitorises, or will have their clitoris resemble a penis, due to having a
“broken” genetic recipe that causes the adrenal glands (located on top of the
kidneys found in the lower back) to make abnormally high levels of
hormones.
CAH can also cause “typically male” features to occur within XX individuals
(thick body hair, deepening of the voice, etc…).
Those with XY chromosomes that are affected by CAH can cause boys to
have their puberty earlier than other boys. This can cause them to be shorter
than the average man and cause strong sexual urges and thoughts prior to
puberty.
© http://www.isna.org/faq/conditions/cah

15. Males born with Klinfelter Syndrome typically have an
extra X chromosomne, resulting in theirs being (XXY).
Klinefelter is quite common, occurring in 1/500 to
1/1,000 male births.
Testies in males affected with Klinefelter Syndrome
are typically smaller than average and their
ejaculation produces no sperm. Some other potential
affects are that they may developed breasts and may
not develop a lot of body hair. Taking extra
testosterone can help the individual to grow thicker
body hair.
© http://www.isna.org/faq/conditions/klinefelter

17. David Reimer was born an identical (non-intersex) twin boy in
1965. When David was 8 months old, David and his brother each
had a minor medical problem involving his penis, and a doctor
decided to treat the problem with circumcision. The doctor
accidentally cut off all of David’s penis. At the advice of a
psychologist, David’s parents agreed to have him “sex
reassigned” and made into a girl via surgical, hormonal, and
psychological .
For many years, the psychologist (John Money) claimed that
David (known in the interim as “Brenda”) turned out to be a “real”
girl with a female gender identity. Money used this case to
bolster his approach to intersex, one that relies on the
assumption that gender identity is all about nurture (upbringing),
not nature (inborn traits), and that gender assignment is the key
to treating all children with atypical sex anatomies.
TO BE CONTINUED….

18. Money as lying. He knew Brenda was never happy as a
girl, and he knew that as soon as David found out what
happened to him, David reassumed the social identity
of a boy.
The case of David Reimer has been used by the
proponents of the “gender is inborn” (nature) theory as
proof that they are right. What we can predict with a
good degree of certainty is that children who are
treated with shame, secrecy, and lies will suffer at the
hands of medical providers who may think they have
the best of intentions and the best of theories.
© http://www.isna.org/faq/reimer

19. •CAH (Congenital Adrenal Hyperplasia): Those with CAH have
problems making their own cortisone, the hormone that’s
responsible for responding to stress. Another possible issue is the
body is unable to properly regulate the amount of salt within the
body. Mental health issues can also arise from a child with CAH.
•Gonadal Tumors: Children with XY chromosomes are at higher
risk than those with XX chromosomal make up.
•Osteoporosis: testosterone and estrogen are important for
mainting healthy adult bones. If at any time your gonads (sex
organs) are removed or aren’t present from birth, one should
seriously consider hormone replacement therapy to help keep
healthy and strong bones.
© http://www.isna.org/

21. Ethics and Intersex (International Library of
Ethics, Law, and the New Medicine)
by Sharon E. Sytsma (Editor)
This collection of 21 articles is designed to
serve as a state-of-the art reference book for
intersexuals, their parents, health care
professionals, ethics committee members, and
anyone interested in problems associated with
intersexuality. It fills an important need
because of its uniqueness as an
interdisciplinary effort, bringing together not
just urologists and endocrinologists, but
gynecologists, psychiatrists, psychologists,
lawyers, theologians, gender theorists, medical
historians, and philosophers. Most contributors
are well-known experts on intersexuality in
their respective fields. The book is also unique
in that it is also an international effort, including
authors from England, the Netherlands,
Germany, Australia, India, Canada and the
United States.

22. Intersex and Identity by Sharon
Preves
In Intersex and Identity: The Contested
Self, sociologist Sharon Preves
explores how people with intersex
conditions experience and cope with
being labeled sexual deviants in a
society that demands sexual
conformity. By demonstrating how
intersexed people manage and create
their own identities, often in conflict with
their medical diagnosis, Preves shows
that medical intervention into
intersexuality often creates, rather than
mitigates, the stigma these people
suffer.

23. Fools for Love by Lisa Lees
Carys has never willingly worn a dress and
Jami, who has, is intersexed. Teenage love
is never easy, but for Carys and Jami love
is an often terrifying journey in self-discovery
and trust.
Carys, a senior, meets home-schooled
Jami at a week-long Arts
Camp where she is clowning (as a tramp
named Lovelorn) and
Jami is helping teach a photography
course. Carys is immediately attracted to
Jami and boldly sets out to determine if the
interest might be mutual. Jami surprises
herself by telling Carys that she is
intersexed, and so begins a sometimes
very emotional process of figuring out what
it would mean for Carys and Jami to be in
love, and eventually to make love. They
continue to see each other when the Arts
Camp ends, becoming involved in each
other’s activities and interests.

24. For more books….
For more books, please go to this website!
http://www.isna.org/books

26. For more information
If you are interested in learning more about
intersex individuals, please visit this
website (http://www.isna.org/). It’s a
community dedicated to spreading
information about the intersex individuals.