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OVERVIEW According to the highest estimates (Fausto-Sterling et. al., 2000) perhaps 1 percent of live to disguise their sexual ambiguity. Other sources (Leonard Sax, 2002) create a narrower definition of "true intersexual conditions" and estimate the incidence as far lower, at approximately 0.018%. In typical " with a small protuberance in the middle, and the Urethra behind the protuberance. If the fetus has testes, and if the testes produce testosterone, and if the cells of the genitals respond to the testosterone, the outer urogenital folds swell and fuse in the midline to produce the scrotum; the protuberance grows larger and straighter to form the penis; the inner urogenital swellings grow, wrap around the penis, and fuse in the midline to form the penile urethra. Because there is variation in all of these processes, a child can be born with a Sexual Anatomy that is typically female, or feminine in appearance with a larger than average Clitoris ; or typically male, masculine in appearance with a smaller than average Penis that is open along the underside. The appearance may be quite ambiguous, describable as female genitals with a very large clitoris and partially fused labia, or as male genitals with a very small penis, completely open along the midline (" Hypospadic "), and empty scrotum. There are dozens of named medical conditions that may lead to intersex anatomy. Fertility is variable. The distinctions "male pseudohermaphrodite", "female pseudohermaphrodite" and especially "true hermaphrodite" are vestiges of 19th century thinking that placed "true sex" in the Histology (microscopic appearance) of the Gonad s. The common habit in the 21st century of elevating the role of the Sex Chromosomes above all other factors when determining gender may be analogous to the older habit of finding "true" sex in the gonads. Though high school biology teaches that men have XY and women XX chromosomes, in fact there are quite a few other possible combinations such as Turner syndrome XO , Metafemale syndrome XXX , Klinefelter's syndrome XXY , Jacob's syndrome XYY , Mosaicism XO/XY , de la Chapelle syndrome XX Male , Swyer syndrome XY Female , and there are many other individuals who do not follow the typical patterns (such as individuals with four or even more sex chromosomes). Thus, people nowadays may be more likely to look towards the sex chromosomes than, for example, the histology of the gonads. However, according to researcher Eric Vilain at the University Of California, Los Angeles , "the biology of gender is far more complicated than XX or XY chromosomes". Many different criteria have been proposed, and there is little consensus.[http://www.isna.org/faq/what_is_intersex BIOLOGICAL CAUSES OF INTERSEXUALITY Typical males have sex chromosomes XY and typical females XX. One biological definition of a male child is the presence of a Y chromosome. This definition has sometimes been used for sex determination at sports events, but it caused much confusion because it does not always apply. The most common cause of sexual ambiguity is Congenital Adrenal Hyperplasia , an endocrine disorder in which the Adrenal Gland s produce abnormally high levels of virilizing hormones. In genetic females, this leads to an appearance that may be slightly masculinized (large clitoris) to quite masculine. In many cases individuals are neither XX nor XY:
In Persistent Mullerian Duct Syndrome the child has XY chromosomes typical of a male. The child has a male body and an internal uterus and fallopian tubes because his body did not produce Mullerian Inhibiting Factor during fetal development. The following further XY cases leads to intersexuality:
Excessive ''in utero'' exposure to androgens may lead to intersexuality in XX cases:
A similar phenomenon occurs in cases where a cow brings two fraternal twins, one male and one female, to term. Because (unlike humans) such twins share hormones via their placental blood interface with the mother cow, male hormones produced in the body of the fetal bull find their way into the body of the fetal cow and masculinize her brain. The result is a Freemartin (unconventional heifer), a cow that will eventually try to mount other cows the way that a bull would. In XX Male Syndrome (also called De La Chapelle Syndrome ) the resulting child is usually a phenotypically normal male, but without sperm production. This syndrome is sometimes the result of an abnormal interchange of the SRY region from a Y chromosome to an X. CHIMERISM According to the ''New England Journal of Medicine'', vol 338, p 166, physicians in the Western General Hospital of Edinburgh have reported on a child with a penis, one testicle, and an ovary and fallopian tube instead of a second testicle. Some of this child's body cells are XY (male), and some are XX (female). The child was conceived as the result of In-vitro Fertilization , and it appears most likely that two embryos, a male embryo and a female embryo, fused before or soon after embryos were transferred to the mother's uterus. This kind of condition, where there is more than one set of Cell Line s with different sets of chromosomes making up the body is known as Chimerism . This kind of Tetraploid chimerism can also occur naturally, without in-vitro fertilization (see ''New England Journal of Medicine'', vol 346, p 1545). Not all cases of Chimerism involve intersexuality, however. There have been about 40 known cases worldwide of humans reproducing naturally and producing offspring with absolutely no genetic similarities between mother and child. Discovery Health Channel has produced a documentary on two families and their issues in dealing with chimerism. It was called " I Am My Own Twin ." INTERSEXUALS IN SOCIETY Intersexual individuals are treated in different ways by different cultures. In some cultures intersexuals were included in larger " Third Gender " or gender-blending social roles along with other individuals. In most societies, intersexed individuals have been expected to select one sex, and conform to its Gender Role . Since the rise of modern medical science in Western societies, intersexuals with ambiguous external genitalia have had their genitalia surgically modified to resemble either male or female genitals. But there are increasing calls for recognition of the various degrees of intersexuality as healthy variations which should not be subject to correction. Some have attacked the common Western practice of performing corrective surgery on the genitals of intersexuals as a Western cultural equivalent of Female Genital Mutilation . Despite the attacks on the practice, most of the medical profession still supports it. Others have claimed that the talk about third sexes represents an ideological agenda to deride gender as a social construct whereas they believe gender is a biological reality. Corrective surgery is generally not necessary for protection of life or health, but purely for aesthetic or social purposes. Unlike other aesthetic surgical procedures performed on infants, such as corrective surgery for a Cleft Palate , genital surgery may lead to negative consequences for sexual functioning in later life (such as loss of sensation in the genitals) which would have been avoided without the surgery; in other cases negative consequences may be avoided by surgery. Defenders of the practice argue that it is necessary for individuals to be clearly identified as male or female in order for them to function socially. However, many intersex individuals have resented the medical intervention, and some have been so discontented with their surgically assigned gender as to opt for Sexual Reassignment Surgery later in life. The writer Anne Fausto-Sterling Coined the words ''herm'' (for hermaphrodite), ''merm'' (for an intersex person that most closely resembles a male), and ''ferm'' (for an intersex person that most closely resembles a female), and proposed that these be recognized as sexes along with male and female. However, her use was "tongue-in-cheek"; she no longer advocates these terms even as a rhetorical device. SEE ALSO Conditions:
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