How common is intersex?

Journal of Sex Research August 1, 2002/Scholarly Publications/Dr. Sax

A response to Anne Fausto-Sterling

Sometimes a child is born with genitalia which cannot be classified as female or male. A genetically female child (i.e., with XX chromosomes) may be born with external genitalia which appear to be those of a normal male. Or, a genetically male child (XY chromosomes) may be born with female-appearing external genitalia. In very rare cases, a child may be born with both female and male genitalia. Because these conditions are in some sense “in-between” the two sexes, they are collectively referred to as intersex.

How common is intersex? In her 1993 essay, biologist Anne Fausto-Sterling acknowledged that “it is extremely difficult to estimate the frequency of intersexuality” (Fausto-Sterling, 1993, p. 21). In this paper we will focus on establishing how often intersexual conditions occur, and what conditions should be considered intersexual.

In her most recent book, Sexing the Body: Gender Politics and the Construction of Sexuality (Fausto-Sterling, 2000), Fausto-Sterling maintains that human sexuality is best understood not as a dichotomy but as a continuum. She bases this assertion on her beliefs regarding intersex conditions. A chapter subtitled “The Sexual Continuum” begins with the case of Levi Suydam, an intersexual living in the 1840s who menstruated regularly but who also had a penis and testicles. Fausto-Sterling writes:

While male and female stand on the extreme ends of a biological con/tinuum, there are many bodies, bodies such as Suydam’s, that evidently mix together anatomical components conventionally attributed to both males and females. The implications of my argument for a sexual continuum are profound. If nature really offers us more than two sexes, then it follows that our current notions of masculinity and femininity are cultural conceits.

… Modern surgical techniques help maintain the two-sex system. Today children who are born “either/or-neither/both”–a fairly common phenomenon–usually disappear from view because doctors “correct” them right away with surgery. (Fausto-Sterling, 2000, p. 31)

Fausto-Sterling asserts that 1.7% of human births are intersex. This figure was widely quoted in the aftermath of the book’s publication. “Instead of viewing intersexuality as a genetic hiccup,” wrote Courtney Weaver for the Washington Post, “[Fausto-Sterling] points out that its frequency mandates a fresher look. In one study, intersexuality typically constitute 1.7% of a community” (Weaver, 2000). The New England Journal of Medicine applauded Fausto-Sterling’s “careful and insightful book…. She [Fausto-Sterling] points out that intersexual newborns are not rare (they may account for 1.7% of births), so a review of our attitudes about these children is overdue …” (Breedlove, 2000). “Most people believe that there are only two sex categories,” went the review in American Scientist. “Yet 17 out of every 1,000 people fail to meet our assumption that everyone is either male or female. This is the approximate incidence of intersexuals: individuals with XY chromosomes and female anatomy, XX chromosomes and male anatomy, or anatomy that is half male and half female.” (Moore, 2000, p. 545)

This reviewer assumed that Fausto-Sterling was using the term intersex in the usual way, the same way in which Fausto-Sterling herself used the term in her 1993 essay, “The Five Sexes” (Fausto-Sterling, 1993): to refer either to individuals who have XY chromosomes with predominantly female anatomy, XX chromosomes with predominantly male anatomy, or ambiguous or mixed genitalia. This assumption is reasonable, because all the case histories presented in her book Sexing the Body describe individuals who meet these criteria (Fausto-Sterling, 2000). However, as we shall see, the 1.7% statistic is based on a much broader definition of intersex.

Fausto-Sterling herself has encouraged the belief that a significant fraction of the population is neither male nor female, but intersex. In an interview with The New York Times, she said that “I did some research and we found that maybe 1 to 2 percent of all births do not fall strictly within the tight definition of all-male or all-female…. there is greater human variation than supposed … [We should] lighten up about what it means to be male or female. We should definitely lighten up on those who fall in between because there are a lot of them” (Dreifus, 2001).

IS HUMAN SEXUALITY A DICHOTOMY OR A CONTINUUM?..........To Read More....