The XX Factor

“We’re All Intersex”

We learned today that Rita Wilson is prepping an HBO series based on Middlesex , Jeffrey Eugenides’ Pulitzer-winner about a girl named Callie who grows up to become a man named Cal. In a bit of fortuitous timing, Salon has posted an interview with professor Gerald N. Callahan, author of Between XX and XY , a new book about intersex people.

Intersex people are born neither male nor female; the descriptor is “an umbrella term that includes people with a tremendous number of genetic conditions, from those born with an extra X chromosome to those with overdeveloped adrenal glands.”

There are lots of interesting nuggets here-for example, Callahan’s description of biological sex as a spectrum, not a binary system. (Hence the piece’s title, “We’re all intersex.”) That’s a concept that many of us are comfortable with vis-a-vis gender identity, but applying that framework to the biological realm was a new notion to me. (Meanwhile, I’m not totally sure I buy Callahan’s assertion that gays and lesbians “can fairly easily identify with the classic binary of male and female”-though I suppose that may be true when you compare them to intersex people.)

One thread particularly struck me, given our recent conversation here on Double X about Pop, the “gender-free” Swedish tot . Callahan argues that, if people focused more on the idea that, hey, genitals are lots of fun! (and not just baby-making tools), parents and physicians might be less focused on gender-assignment surgery-which, as he notes, can have disastrous consequences if performed too early and too arbitrarily. The interviewer, Thomas Rogers, asks a perfectly logical follow-up question:

So how do you think these decisions about surgery should be made?

This idea was introduced to me by Joel Frader [professor at Northwestern’s Feinberg School of Medicine], but I think the best situation now is for the parents to be involved, for there to be a team of physicians-a surgeon, an endocrinologist, a psychiatrist-to be involved and for them to try to explain to the parents the most they can do in the most realistic way. In this world it may not be possible to raise a child without a gender, but that doesn’t mean that surgery has to be performed. The ideal situation would be that, at a later date, the child could participate directly in the decision that might involve irreversible surgery.

That sounds eminently reasonable, but I would have loved to hear more about how, practically speaking, this “ideal situation” might be accomplished. As Hanna described in her Atlantic piece about transgender children , these decisions often take place under circumstances that are far from ideal.