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)?

Yes, an extension of the Guthrie test would be great.

But in the interim it feels like there is an opportunity to use existing protocols (with a tweak to training) for early indication of some of the more complex conditions. 5-ARD could also be picked up at this stage as it would flag as an absence of uterus and of penis/scrotum too.

Maybe sonographers are already doing this at the 20 week scan in some countries?

Children with 5-ard who develop a strong female identity are offered gonadectomy/œstrogen/vaginoplasty. Whilst, for me, this is right on the edge of acceptability, it does fit with my rough and ready paradigm of "DSDs can choose: the rest of us should lump it".

In principal, I kind of agree that it's right up against the line on the right side of acceptability. The BBC article that I linked upthread mentions that there will be a small number of children (biological males) who will make a decision to take female hormones, have their testicles and penis removed and an approximation of a vagina created. However, for me it's still a no ethically. The child's sense of who they are is based on pre-puberty. When the testosterone surge kicks in at puberty, this will all change. Their body shape, their aggression and libido levels etc. Left without intervention, their body will catch up as a natural adult male. Although obviously it would be very difficult emotionally, they deserve to go through puberty for the benefit of their future health. Removing their testicles will remove this possibility. (If someone has CAIS or Swyer that's different as puberty is not possible anyway). It's a case of First Do No Harm. The endocrine system is going to balance itself much better without intervention.

Unfortunately the conflation with gender identity kicks in here, as does lots of misinformation. For example many people seem to think it's possible to go through the puberty of the opposite sex. It's not. There's either puberty or no puberty. Cross sex hormones will just create a mimicry of opposite-sex puberty. Biological males on oestrogen won't get wider pelvis bones (they'll get fat distribution on their hips) or start ovulating. Biological females on testosterone won't get a wider larynx (they'll get longer vocal chords in the same sized space, hence the distinctive "rasp") or start producing sperm.

Also biological males with 5-ARD are at risk of coercion by people who want to use them. For example there may be someone who is talent-spotted for women's boxing, who parades around with male coaches in a way that wouldn't normally be seen in a Muslim society (women don't normally ride around on the shoulders of men, for example), who then goes on to talk about facial feminisation surgery. It's difficult to see whether this person might have been pressured into this pathway or is fully complicit. Obviously such a person doesn't belong in women's boxing but the boundary between victim and perpetrator isn't necessarily clear, depending on how it all unfolded and how young the boxer was when it did.

Thank you for coming on here to share your perspective. I do not like the fact that congenital conditions are used to defend positions related to identity.

We need to learn how to talk like everyone is listening. I think your thread showed us, that we never know who is talking - until we ask them.

Social media platforms like this one, have presented us with a myriad of opinions, augmented and echoed so that we feel the need to shout back so our voices and opinions are not dismissed.

Much disinformation that is shared and we are invited to learn more, but it seems, the more we learn, the less it is understood. We need to learn to communicate with people who hold different opinions to ours... this is the only way forward.

Ps my sympathy drops of a cliff for any boxer (or runner, or footballer) who knows that they are obfuscating the truth when competing in women's sports.

FWIW, I agree with Caster that nobody should be forced into taking testosterone suppressants in order to compete. However, Caster and I are on opposite pages regarding which sex category biological males with 5-ARD should compete in.

@BonfireLady

Biological males on oestrogen won't get wider pelvis bones (they'll get fat distribution on their hips) or start ovulating. Biological females on testosterone won't get a wider larynx (they'll get longer vocal chords in the same sized space, hence the distinctive "rasp") or start producing sperm.

Whilst it's true that cross-sex gamete production is impossible, I understood that skeletal feminisation is possible if the exposure is started at a young-enough age.

But there's the rub. Changing a child, who knows nothing of what they are choosing, into a different person. How can anyone think it's ethical?

There is a reason athletic scouts looked for 5-ARD cases in specific countries because in countries with good obstetric care these boys are identified shortly after birth and their sex recorded correctly,

Boys and girls have different height and weight charts from birth, not just from puberty, so while hormonal intervention may alter the expected growth trajectory it won’t change nearly as much as trans people like to assume it does.

Paediatric MtF transitioners tend to be tall and thin (similar effect happens in prematurely castrated mammals). Quite a few former MtF ‘trans kids’ are catwalk models.

CAIS individuals (male genotype, female-seeming phenotype) are also taller than biological females. It’s because one of the genes for male height is on the Y chromosome and doesn’t need testosterone to activate it (and conversely, giving testosterone to female teenagers does not give them male height because they don’t have that Y chromosome gene).

XXY men tend to be tall even by male standards.

Yes, and even if the birth paperwork mistake wasn’t noted until the child was 4-5 or 12-13 families in developed countries are more likely to have had the paperwork annotated/revised than families in poorer countries.

Unscrupulous sports scouts specifically need 5ARD boys who have never had their paperwork corrected.

from the NHS: average height for XXY men (Klinefelter Syndrome) is 6ft 2 (average height for UK men is 5ft 9 to 5ft 10, depending on the year they were born)

www.mangen.co.uk/wp-content/uploads/2018/07/Klinefelter-Syndrome.pdf

Haven’t rtft but DSDs often need to be taken on a case by case basis imho. Some XY people (a small percentage) will have female bodies except for internal organs. Chimeras can have cells some of which are XX and some XY. These are very rare so need to assess individually.
Other DSDs are more commonplace, eg Kleinfelters XXY, so easier to make a grouping as male (though they can still affect people somewhat differently).

Paediatric MtF transitioners tend to be tall and thin (similar effect happens in prematurely castrated mammals). Quite a few former MtF ‘trans kids’ are catwalk models.

The same increased height was noted in castrati singers - boys castrated before puberty to preserve their high-pitched singing voices.

I think so, broadly. Why do you ask?

I did not know until puberty (or lack thereof). It would definitely have been huge helpful to have known earlier. It wouldn't have changed the medical/physical reality, but would have dramatically improved the psychological trauma as treatment could have taken place at the appropriate time as opposed to significantly belatedly when compared with my peers.

I don’t think anyone here would disagree that early diagnosis and sympathetic medical intervention (delayed until the child can consent wherever practical, eg surgical intervention that is cosmetic rather than necessary for continence) along with appropriate psychological support should be made available to all children born with DSDs, and that where sex has been recorded erroneously paperwork amendments should be a simple process, free of charge.

The issue with Caster and Khelife, and indeed trans-identifying men who participate in women's sports, is that they can't win in male sports. This isn't a matter of "we're women, let us play", it's more, "we can't win in men's sports and that's unfair, so let us win in women's sports".

There is no way I have ever been able to go for a run as a fun thing to do or to keep fit, probably due to genetic reasons that I won't go into. I would love to have that kind of energy, but it's never going to happen. I accept it. These men don't accept that they are mediocre so they steal from women.

I'm curious as to what I've said that's circular. I don't mean that to be argumentative, but if I have been unclear or if I need to adjust my own knowledge of the related biology then it would be useful to know.

I hadn't really expected there to be so many very knowledgeable people on here - I'm far more used to coming across comments from people who know nothing other than the usual uninformed cliches about hermaphroditisim etc, so I was perhaps a bit prejudiced in my expectations!

I'd be interested to know what people think of this article.

@Tootsurly thank you for answering that. It's a very personal question and I can't imagine any of that time was easy.

Whilst it's true that cross-sex gamete production is impossible, I understood that skeletal feminisation is possible if the exposure is started at a young-enough age

That's interesting. I would struggle to believe this happens. Unfortunately the amount of misinformation (and disinformation) that's out there really doesn't help. It's a shame we can't magically pull Emma Hilton into the thread to address that one. She was sooooooo good at answering all the questions during the Olympics.

@MyrtleStrumpet I fully agree re their entitlement. It's appalling that mediocre males with 5-ARD get celebrated as brilliant females.

@ChaChaChooey well said.

You need to RTFT. You might learn something,

Nonsense. Sex is defined by gamete type and this is consistent across all higher plants and animals.

Thank you. I assume you're saying this from a position of having studied this area?

All the TRAs in the intersex group are of course jumping up and down with glee having read it.

I'm curious as to what I've said that's circular.

TBF, I accidentally did it myself. I asked you if you knew at birth or "at puberty" about your DSD. Which makes me a bit of an idiot... given I'd just been talking about lack of puberty on exactly this subject i.e. in Swyer (and CAIS). Thank you for taking my numpty comment in good faith.

I will RTFT and pull out what didn't make sense from my POV. Others have already called some of it out.

I don't profess to have a full working knowledge of DSDs. I just learned a shit load during the Olympics because it was such a door opener of a topic. Watching males with 5-ARD punch women in the face, with the president of the IOC auditioning for some kind of Gaslighter of the Year competition was next level dystopia. It was a peak peaking opportunity to call out some of the utter madness that much of the world is still wrapped in. Thankfully several big GB Olympic names stepped out of the shadows to call it out publicly e.g. Barry McGuigan, Nicola Adams, Mark Forster and Matthew Pinsent. Obviously Sharron Davies and Martina Navratilova had been doing so before this too.

I hadn't really expected there to be so many very knowledgeable people on here - I'm far more used to coming across comments from people who know nothing other than the usual uninformed cliches about hermaphroditisim etc, so I was perhaps a bit prejudiced in my expectations!

There's a lot of knowledge on this board. There's also a lot of caution and sceptism. Especially around Swyer in particular. Nobody knows who anyone is online so prejudice is part of the deal.

It may be convenient, but that doesn't stop it being true.

Are you in the US? (A PP mentioned that it's not considered offensive there)

There seem to be some differences between the UK and US on terms that are considered offensive. I think I'm right that retard and retarded aren't offensive terms in the US when talking about people with learning difficulties. They very much are here.

Well I just assumed you meant "at the time you would ordinarily have gone through puberty" or "at the time your peers were going through puberty".

ETA: Why scepticism around Swyer's in particular?