Definitions of intersex

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Various criteria have been offered for the definition of intersex, including ambiguous genitalia, atypical genitalia, and differential sexual development. Ambiguous genitalia occurs in roughly 0.05% of all births, and atypical genitalia occurs in 0.5% of all births, usually caused by masculinization or feminization during pregnancy, these conditions range from full androgen insensitivity syndrome to ovotesticular syndrome, although the definition of what constitutes "normal" genitalia is largely arbitrary.^[1]

1.7% of people are born with a disorder of sexual development as defined by the DSD consortium, such as those with Klinefelter's syndrome. The DSD was specifically made to be as inclusive to all atypical sexual development; not all conditions within the DSD effect individuals to the same extent.

There can also be a stricter definition, specifically for ambiguous DSD. This definition is restricted to those conditions in which typical chromosomal categorization patterns is inconsistent with phenotypic sex, or in which the phenotype is not easily classifiable as either male or female," with the prevalence of about 0.018%.^[2]

Most intersex activism is based around the end of unnecessary medical interventions on intersex youth which attempt to assign an arbitrary sex and gender binary, often causing physical harm with no input from the child. Intersex conditions are usually expanded to include the DSD more generally.^[3] While 0.5% of all births are born with atypical genitalia, only 0.05% of births are medically treated or considered to be "truly" ambiguous.^[4]

The exact cut-off point between male and female in an intersex context is largely arbitrary. Likewise, the definition of biological sex is also sometimes considered to be arbitrary; as an example, some individuals with XY female (SRY inactivation) may have a uterus, ovaries, and normal menstruation, and be able to achieve pregnancy.^[5][6] These individuals would be declared to be biologically female but karyotypically male. Likewise, many intersex individuals are born completely sterile, although medical interventions have been known to remove potentially fertile gonads, which makes sex determination often arbitrary. Individuals with XX male develop male genitalia but are entirely infertile due to a lack of SRY gene expression and develop a generally feminine body. This range of possibilities is further expanded by conditions which effect genital development but not hormonal or sex gene expression. Generally, most intersex advocates, as well as parts of the medical community, advocate for broadening the definitions of sexual development and the definition of intersex.^[7]