Intersex

[Tootsurly]

Bit of a thought experiment, plus curious as to how much people know about intersex conditions / DSDs.

This is slightly Black Mirror, although not totally beyond the realms of possibility. If there ever came a point where anything specifically related to being male or female required a DNA test to determine your sex before participating, what would happen to intersex people whose chromosomes didn't match their outward appearance (i.e. genotype and phenotype don't match)?

The DNA test will reveal their chromosomes and therefore biological sex.

As I understand it there are certain conditions where five areas are considered before diagnosis is made (three of which are karyotype, external genitals, gonads).

Thing is that once the diagnosis is confirmed, you have it, along with an expected path of development.

Ok, so that's one person who doesn't know about intersex conditions...

No this is right. You can be male with a dsd or female with a dsd. Intersex is a misnomer and isn't really the correct term for people with one of several different conditions.

I have no idea how it works genetically to tell you the truth. Would it be similar to conditions that have an extra chromosome like xxy ?

Do you know what the other two are? I guess hormones is one of them?

In my dystopian imagined State, cheek swabs would be taken before entry was allowed to any single-sex function, but a strip search would be rather invasive.

Perhaps people with DSDs would have to carry exemption cards or something.

They are still either male or female with a DSD; there is no 3rd sex/between the sexes

Wouldn't they just be found to be either male or female? There is no mixed sex or other human sexes other than male or female.

No, this is wrong. Well, at least it depends what you mean by "biological sex", I suppose, but I assume the PP was intending that as a "gotcha" that it's as simple as XX vs XY.

The whole point is that you can't tell someone's sex from a DNA test if they have a certain type of DSD, because that's exactly what is disordered: phenotype and genotype don't match.

Yes, you can be a male or a female with a DSD - I agree with that. And intersex is a misnomer in that sense.

That sort of thing, yes. I'm specifically thinking of 46XY complete gonadal dysgenesis, but I think there are others.

You're wrong. As pp have said, all known DSDs (don't use the term intersex, it's offensive) are specific to one or other sex. A DNA test would, and indeed does, reveal the sex of the individual. In a few cases they may get a shock, having understood themselves to be the other sex, but their DNA would still show their biological sex.

I agree, but how would they be categorised in my hypothetical example?

I assume they would be found to be male or female, yes, although there are variations such as XXY or X0.

Agree there is no mixed sex.

It would depend on why they were being categorised wouldn't it?

Everyone would have a birth certificate stating their sex, issued after their sex had been verified possibly during gestation and certainly at birth, either through observation (the vast, vast majority) or through further tests and investigations if necessary (a very small majority).

Official ID documents such as driving licences and passports would show the same sex.

No-one would be allowed to falsify their official ID.

Very simple.

So the sex of an individual is entirely their chromosomes and nothing to do with their external presentation or there internal organs?

And btw, intersex is not intrinsically offensive as a term.

In what way would it depend?

I'm talking about everyday situations, like hospital wards, toilets, single-sex social events.

That's slightly evading my question (!) but given it was hypothetical anyway I agree that would be a sensible way to manage things.

That’d be you, it seems?

A very small minority, obviously.

Sorry, trying to do three things at once.

Well it slightly hinges on what is meant by "biological sex", doesn't it?

I saw a talk by Prof Robert Winston and I believe that he said if you have an SRY gene you are male. SRY genes are usually found on the Y chromosome but in some DSDs it may not be. I think he also added functional testosterone receptors as a condition for being male - this would mean that he would classify people with CAIS as female

Very interesting. Though we are getting dangerously close to admitting that biology of phenotype is much more complicated than xx and xy!

For the 0.018% of the population with DSDs it is slightly more complicated but they are still male or female. XX and XY works for 99.9% of people

I'm certainly not going to quibble with Prof Winston. The reason for this (I think) is that foetuses are female by default, so if the SRY gene is faulty they don't (can't) become male.