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Is it a boy or a girl? We don€™t know!
Sex Determination and Intersex
Ziggy
June 23rd, 2007
€œIs it a boy or girl?"
€œWe don€™t know!€
While not what a mother really wants to hear, it does happen.
The majority of babies have a biological sex that is typically and obviously male or female. For most people that means they have either a penis or vagina. However, that is not always the case. In fact, about 1 in 2000 children are born with atypical sex characteristics, or about 150,000 people in the USA, and perhaps 2.5 million people world-wide.
How can this happen? How can a baby not be obviously male or female?
It all starts in the womb. The fetus is sex neutral until about the 7th week. Until that time, the sex organs, or gonads, are identical in both future males and females. Starting about the 7th week, sex determination starts. By the 9th to 12th weeks, the genitals start to differentiate. Sex determination is based on a lot of factors, with some understood by scientists and some not.
Once the gonads start to differentiate, hormones produced by them impact the reproductive organs and genital development. Because of the complexity of the process, variations happen, resulting in people who may have an atypical phenotype (visual appearance of the genitals) or even atypical reproductive organs.
For example, some males have a penis so small (micro-penis), it can look like a vagina. Likewise, the clitoris€™ of some females are so large, they look like a penis. There are also males with testicles that haven€™t descended (and are thus invisible), females with no ovaries, and even situations where both reproductive organs exist in one person (ovotestes).
These variations continue at the chromosonal level. Some males have a female karotype of 46, XX and some females have a male karotype of 46, XY. Even at the genetic level there are differences. For example, some females have the €˜male€™ SRY gene. In short, while we may have an image of a typical male or female, many of us are not the same, and perhaps don't even know it.
Olympic Committees became aware of genetic variations the hard way. In 1968, a sex determination test used was based on karotypes and then in 1992 based on detection of the SRY gene. Unfortunately, in both cases, women were falsely identified as men and vice versa, due to their sex reversal conditions. These tests were abolished in the 1998 Olympics.
According to the Intersex Society of North America (ISNA), there are about 17 different intersex conditions. Except for one (Congenital Adrenal Hyperplasia), all others are non life-threatening. From studies done, most if not all intersex people grow up having healthy physical and emotional lives, and are not ostracized by society. As such, it is highly recommended that no decisions be made regarding surgery or hormone therapy except by the individuals themselves, once they are capable of making such decisions.
Unfortunately, this is not always the case. Many doctors still follow the Optimum Gender of Rearing system developed by John Money of John Hopkin€™s University in the 1950s. That system assumes that gender can be nurtured. Practically, it encourages doctors to make a decision at birth to reverse the gender of children born with genitalia that do not represent their biological sex. This is done through surgery before 18 months.
The most famous case of this is referred to as John/Joan. Because of a botched circumcision resulting in a very small penis, David Reimer€™s doctor decided to reverse his sex through surgery, hormone therapy, psychological support, and encouragement of parental nurturing. Money used David€™s case as an example of success and proof of his theories. When David found out about his past, he reverted back to a male, getting surgery to undo what had been done before. David committed suicide at 38 after significant pschological trauma throughout his life. Those against Money€™s nurture theories use this an example of why they were wrong.
So, if your doctor says €œWe don€™t know if your child is a boy or girl€, don€™t be distraught. Be happy. You have a healthy and very natural child, like many others with an intersex condition around the world and perhaps even in your own community. And remember, evidence shows your child will grow up and be a happy adult, just as others have done before.
Is it a boy or a girl? We don€™t know!
Sex Determination and Intersex
Ziggy
June 23rd, 2007
€œIs it a boy or girl?"
€œWe don€™t know!€
While not what a mother really wants to hear, it does happen.
The majority of babies have a biological sex that is typically and obviously male or female. For most people that means they have either a penis or vagina. However, that is not always the case. In fact, about 1 in 2000 children are born with atypical sex characteristics, or about 150,000 people in the USA, and perhaps 2.5 million people world-wide.
How can this happen? How can a baby not be obviously male or female?
It all starts in the womb. The fetus is sex neutral until about the 7th week. Until that time, the sex organs, or gonads, are identical in both future males and females. Starting about the 7th week, sex determination starts. By the 9th to 12th weeks, the genitals start to differentiate. Sex determination is based on a lot of factors, with some understood by scientists and some not.
Once the gonads start to differentiate, hormones produced by them impact the reproductive organs and genital development. Because of the complexity of the process, variations happen, resulting in people who may have an atypical phenotype (visual appearance of the genitals) or even atypical reproductive organs.
For example, some males have a penis so small (micro-penis), it can look like a vagina. Likewise, the clitoris€™ of some females are so large, they look like a penis. There are also males with testicles that haven€™t descended (and are thus invisible), females with no ovaries, and even situations where both reproductive organs exist in one person (ovotestes).
These variations continue at the chromosonal level. Some males have a female karotype of 46, XX and some females have a male karotype of 46, XY. Even at the genetic level there are differences. For example, some females have the €˜male€™ SRY gene. In short, while we may have an image of a typical male or female, many of us are not the same, and perhaps don't even know it.
Olympic Committees became aware of genetic variations the hard way. In 1968, a sex determination test used was based on karotypes and then in 1992 based on detection of the SRY gene. Unfortunately, in both cases, women were falsely identified as men and vice versa, due to their sex reversal conditions. These tests were abolished in the 1998 Olympics.
According to the Intersex Society of North America (ISNA), there are about 17 different intersex conditions. Except for one (Congenital Adrenal Hyperplasia), all others are non life-threatening. From studies done, most if not all intersex people grow up having healthy physical and emotional lives, and are not ostracized by society. As such, it is highly recommended that no decisions be made regarding surgery or hormone therapy except by the individuals themselves, once they are capable of making such decisions.
Unfortunately, this is not always the case. Many doctors still follow the Optimum Gender of Rearing system developed by John Money of John Hopkin€™s University in the 1950s. That system assumes that gender can be nurtured. Practically, it encourages doctors to make a decision at birth to reverse the gender of children born with genitalia that do not represent their biological sex. This is done through surgery before 18 months.
The most famous case of this is referred to as John/Joan. Because of a botched circumcision resulting in a very small penis, David Reimer€™s doctor decided to reverse his sex through surgery, hormone therapy, psychological support, and encouragement of parental nurturing. Money used David€™s case as an example of success and proof of his theories. When David found out about his past, he reverted back to a male, getting surgery to undo what had been done before. David committed suicide at 38 after significant pschological trauma throughout his life. Those against Money€™s nurture theories use this an example of why they were wrong.
So, if your doctor says €œWe don€™t know if your child is a boy or girl€, don€™t be distraught. Be happy. You have a healthy and very natural child, like many others with an intersex condition around the world and perhaps even in your own community. And remember, evidence shows your child will grow up and be a happy adult, just as others have done before.
to 'make?' him into a girl 
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