For those that didn't read it the first time around:
There are a number - over a hundred - of medical conditions we call "Intersex". That is, neither wholly male, nor wholly female.
This is not a philosophical issue, or a religious issue, it's a biological issue, capable of being examined and proven by objective tests.
Most - 98.3% in fact - people are normally male, or normally female. No doubts, no ambiguities. And of the 1.7% who are Intersexed, most are asymptomatic, and never know - unless they go to a fertility clinic, or have a gene test taken for health reasons. You could be one of them.
But for 1 in 1000 - yes, that common - it's not asymptomatic at all.
AIS - androgen insensitivity syndrome. This feminises a masculine body. There are degrees - partial AIS 1 leads to a male body with hypogonadism, undeveloped genitalia, and probably some other feminisation too. Complete AIS (CAIS) results in a female body. Miss Teen America 1991 had CAIS. Women with CAIS universally have a female gender identity - more on that later.
CAH - congenital adrenal hyperplasia. This masculinises a feminine body. Again, there are degrees. Only 1 in 10 have a male gender identity, despite somewhat masculinised genitalia.
Kleinfelter - usually 47xxy rather than 46xy (male) or 46xx (female), though 48xxyy etc and combinations are also possible. These people usually look male, with male gender identities. But some don't, and some have even given birth.
Turner syndrome - 45x - has been explained before.
Swyer sundrome - 46xy, but with a complete female reproductive system, except for the gonads. They can give birth, but only as surrogate mothers.
There are 46xy women who have given birth in the normal way. There are 46xx men who have fathered children. There are mosaics, people with both 46xx and 46xy chromosomes in different parts of their bodies. Or 45x/46xy, or 47xxy/46xx, or 47xxy/46xy, and so on.
It gets worse though. It has been common medical practice to surgically alter newborn babies with unusual genitalia so they look "normal". This means that some normal baby boys whose male organ was deemed too small were castrated, and surgically altered to look female. Many only were told later in life - usually after they'd seen a psychiatrist because they thought they were transsexual. They looked female, but their gender identity was always male.
But that's not all. There are several rare conditions, such as 5ARD and 17BHDD that cause a natural sex change. Those born with 5ARD or 17BHDD look like little girls, regardless of their chromosomes. But half masculinise at puberty, the genitals change shape, and some can even father children. For 2/3 of them, this is a wonderful relief, gender identity is usually male. But for the rest, it's a descent into nightmare, and a medical emergency.
OK, that's Intersex - but what about Transsexuality? Isn't that just a mental illness, curable with therapy or drugs or something?
No. Transsexuality is a form of Intersex, one where the brain, rather than other parts of the body, is affected. In fact, other parts of the body are often affected too, though the only area of the brain that matters is the lymbic nucleus, the parts that deal with emotions, instincts, body map, ovulation and so on.
This has been known since 1996, as the result of autopsies on the brains of transsexual people. We've known that male and female brains differ structurally for even longer, but the results from 1996 show that transsexuals have cross-gendered brains, just as some intersexed people have cross-gendered genitalia or chromosomes. We can now use Functional Magnetic Resonance Imaging (fMRI) to show this on people who aren't dead. Which is a distinct advantage to the people concerned.
See:
Zhou JN, Hofman MA, Gooren LJ, Swaab DF. A sex difference in the human brain and its relation to transsexuality. Nature (1995) 378:68–70.
http://www.nature.com/nature/journal.../378068a0.html
Kruijver FP, Zhou JN, Pool CW, Hofman MA, Gooren LJ, Swaab DF. Male–to–female transsexuals have female neuron numbers in a limbic nucleus. J Clin Endocrinol Metab (2000) 85:2034–2041.
Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus -- Kruijver et al. 85 (5): 2034 -- Journal of Clinical Endocrinology & Metabolism
And many other papers on the subject.
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