Intersex

Whatever list it appears on, intersex is not a gender identity. It reports how a body developed. An intersex person may be a woman, a man, non-binary, or something else, and the great majority are not transgender. The word is in this catalogue because it sits on almost every published list of gender identities, which is an error.

Why intersex keeps appearing on gender lists

Two axes are being run together. Sex characteristics are chromosomes, gonads, hormones, and anatomy. Gender identity is a person's own sense of their gender. The two interact, and a person can be unusual on one while being entirely ordinary on the other.

The confusion is old, and the medical record is partly responsible. For most of the twentieth century an intersex variation was treated as a condition to be resolved, usually surgically and usually in infancy, so the older literature is full of language about assignment and correction that reads like a claim about who somebody is. It is not one. Cisgender and Transgender describe the relation between a person's identity and the sex recorded at birth. Intersex describes the body that record was made about.

English has an antonym, which helps to hold the axes apart. Endosex describes a person born with sex characteristics seen as typically male or female, and interACT gives perisex and dyadic as alternatives to it. Its stated reason for wanting such a word is that the alternative sets intersex people against typical people, which builds a verdict into the vocabulary.

Which gender terms intersex people do use

Some gender terms are built on the variation itself. Ipsogender names an intersex person who identifies with the sex they were assigned, and Intergender names a gender shaped by being intersex. Those belong on a list of identities. The bare word intersex does not, and putting it there implies that having an intersex body is a way of having a gender.

Where the word intersex came from

Richard Goldschmidt coined intersexuality in 1917, for a range of physical sex ambiguities. The shorter noun follows from the longer one, and Merriam-Webster still defines intersex as an individual having the condition of intersexuality. According to The SAGE Encyclopedia of LGBTQ Studies, the vocabulary stayed technical until Anne Fausto-Sterling published "The Five Sexes: Why Male and Female Are Not Enough" in 1993, after which it reached general circulation.

What it displaced was hermaphrodite, the legal and medical word for centuries. The twelfth-century Decretum Gratiani held that whether a hermaphrodite might witness a testament depended on which sex prevailed. The English jurist Edward Coke wrote in his Institutes of the Lawes of England in the seventeenth century that such an heir would inherit "either as male or female, according to that type of sexe which doth prevaile". Victorian physicians built a taxonomy on the same root, sorting people into true hermaphroditism, female pseudohermaphroditism, and male pseudohermaphroditism by the microscopic appearance of the gonads. Those categories are rarely used in the 2020s. interACT records that the word is now generally taken as a slur, and that intersex people still encounter it in their own medical files. An older clinical label, congenital eunuchs, has gone the same way; the Eunuch entry carries that word's longer history.

What the intersex prevalence figures actually count

Two numbers circulate, and they are about thirty times apart. interACT gives about 1.7 per cent of people born intersex, and one baby in two thousand, or 0.05 per cent, born with genital differences that a doctor might propose changing surgically. Both rest on Anne Fausto-Sterling's review of medical literature published between 1955 and 1998, which appeared as Sexing the Body in 2000. For scale, interACT sets it against a roughly 0.3 per cent chance of having an identical twin.

The distance between them is a disagreement about what belongs inside the category, and it has names and dates on it.

Fausto-Sterling answered Hull in the same issue: "I am not invested in a particular final estimate, only that there BE an estimate." Intersex Human Rights Australia keeps 1.7 per cent as its preferred upper limit "despite its flaws", on the grounds that the wider figure covers everyone stigmatised, or at risk of stigma, because of innate sex characteristics, and that Sax's definitions exclude people who helped build the intersex movement.

Why intersex terminology is still contested

Clinical settings have used differences of sex development, abbreviated DSD, since 2006. The original expansion was disorders of sex development, and that is the objection. interACT states that many intersex people reject DSD because it carries the idea that their bodies are wrong, or are a matter for doctors to fix, and the organisation does not generally use the abbreviation. Its advocates in the United States make the comparison with homosexuality, classified as a mental disorder until 1973. interACT rejects ambiguous genitalia on a related ground, that the ambiguity belongs to the observer rather than to the body.

Preference has been measured, and the results split by who was asked. Australian sociological research on 272 people born with atypical sex characteristics, published in 2016, found 60 per cent using intersex about themselves, frequently alongside a diagnostic label, with the choice depending on the audience. Work by Lurie Children's Hospital in Chicago with the AIS-DSD Support Group, now InterConnect, covered 202 respondents in 2017: 80 per cent of support group members strongly liked, liked, or felt neutral about the word, caregivers were less supportive, and the hospital reported that using disorders of sex development may worsen care. Pulling the other way, a study across five United States clinics found 53 per cent of its 133 parent and adolescent participants disliking intersex, and the dsd-LIFE study in 2020 found 43 per cent of 179 participants calling the term bad, 20 per cent neutral, and 37 per cent good. No survey on file found a settled preference, and the split runs largely between the person described and the people around them.

How the intersex record moved from medicine to rights

The shift from a medical category to a rights category is recent and datable. Colombia's Constitutional Court restricted the ages at which surgery could be performed on intersex children in 1999. In 2011 Christiane Völling became the first intersex person known to have won damages in a case brought over non-consensual surgery. The third International Intersex Forum issued the Malta declaration in 2013. A United Nations interagency statement in May 2014 named non-medically necessary infant surgery performed without the consent of the person or the parents. In April 2015 Malta became the first country to outlaw it, followed by Portugal in 2018, Germany and Iceland in 2021, Greece in 2022, and Spain in 2023. The United Nations adopted a resolution on discrimination, violence, and harmful practices against intersex people in 2024.

The flag comes from that movement. Morgan Carpenter of Intersex Human Rights Australia designed it in 2013: a yellow field with a hollow purple circle, described as standing for bodily autonomy and wholeness.

What a national survey found about intersex lives

Population data on intersex people barely exists, which is why one study carries so much weight here. Ercio Muñoz, Melanie Saavedra and Dario Sansone worked from a Mexican household survey conducted across 2021 and 2022, the first nationally representative survey run by a national statistics office in a middle-income country to identify an LGBTQI+ population, and published the analysis in PNAS Nexus in 2025. The survey covered 44,189 people aged 15 and over, standing for 97.2 million; 608 respondents reported being born with a sex variation, a weighted 1.6 per cent of those aged 15 to 64, or about 1.3 million people.

The disparities they report are wide and run the length of a life. Childhood bullying was recalled by 26 per cent of intersex respondents against 15 per cent of endosex men and women. Harassment or violence in adulthood was reported by 20 per cent against 10 per cent of endosex men, mental health difficulties by 46 per cent against 34 per cent, and workplace rejection by 15 per cent against 6 to 7 per cent. Suicidal intention was reported by 13 per cent, against 6 per cent of endosex women and 4 per cent of endosex men. Educational attainment was lower, and barriers in healthcare settings were reported as substantial.

The authors treat the absence of data as part of what they are measuring: intersex people are missing from most official statistics, which keeps them out of the policy settings where the disparities would otherwise be addressed.