How Can Biomedical Hormone Replacement Therapy Be Complex for Intersex Individuals?

How Can Biomedical Hormone Replacement Therapy Be Complex for Intersex Individuals?

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Intersexuality refers to a situation where a person is born with unclear genitalia. For instance, one may have an abnormally small penis or fused labia. Sometimes, intersex people have sex chromosomes that do not match their genitalia. Therefore, despite having clear male or female sex organs, the rest of their reproductive system may be aligned to the opposite sex.

Also known as differences in sexual development, intersexuality is treated in different ways. Typically, the parents assign a sex at birth, and the child undergoes surgery to correct the condition. Hormone replacement therapy is also an important part of treatment. Both of these corrective procedures are particularly problematic for intersex, and human rights groups often take issue with them. Here is all you need to know about the causes and treatment of intersexuality and the challenges associated with it.

What Causes Intersexuality?

A lot of factors come into play when it comes to intersexuality. For the most part, chromosomal abnormalities cause the condition. This happens where a fetus has an extra chromosome, which makes it hard to determine their sex. Even a person who has the 46 chromosomes may have chromosomal mutations that could lead to intersexuality. Sometimes, exposure to chemicals, especially agricultural pesticides, can also cause ambiguity in sex determination. Finally, excessive exposure to male hormones or tumors in the ovaries during pregnancy can lead to intersexuality.

Types of Intersexuality

XX Intersex

A chromosomal combination of XX typically means that a person is female. An XX intersex individual has female sexual characteristics, such as female chromosomes and a female reproductive system. This means that they have a normal uterus, ovaries, and fallopian tube. However, their genitalia appear to be male and can be characterized by an enlarged clitoris or bonded labia.

This condition often appears due to the exposure of an unborn female baby to a lot of male hormones. This could be because the mother ingested testosterone during her pregnancy. Ovary tumors can also lead to this condition, and a woman who gives birth to an XX Intersex baby is advised to get checked for such tumors.

XY Intersex

An XY chromosomal combination means that a person is male. However, an XY intersex person has male chromosomes and the male reproductive system, but their genital appears to be female or incompletely formed. They may not have any testes, or the tested could be ill-formed. This condition is caused by problems with the testes or due to hormonal abnormalities. For instance, one could have difficulties producing sufficient amounts of testosterone, or with using the hormone.

True Gonadal Intersex

A person with this condition displays male and female sexual characteristics, both in the reproductive system and their genitalia. For instance, they might have one testis and one ovary. Scientists have yet to determine what causes this condition, although exposure to agricultural pesticides is shown to increase the likelihood of the state.

Complex Intersex

A wide variety of factors, such as having only one X chromosome or having an extra chromosome, can cause complex intersexuality. With this condition, sexuality is usually determinate, but there could be problems with sexual development later on in life.

Treatment for Intersexuality

Most intersexual persons usually undergo surgery to correct the ambiguity. Biomedical hormone replacement therapy is also a key part of treatment. There are three main reasons why hormone replacement therapy is critical for intersex individuals who undergo surgery:

• Therapy helps a person develop desired secondary sexual characteristics, and repress unwanted ones
• Therapy helps to control adverse symptoms that would otherwise diminish a person’s quality of life, such as skin changes and heat flashes
• Therapy also helps prevent health problems brought on by hormonal abnormalities. These include salt wasting and low mineral density.

Challenges with Hormone Replacement Therapy for Intersex Individuals

One of the critical challenges that arise with hormone replacement therapy for intersex individuals is the question of assigning the wrong sex. Usually, parents will choose a sex for their child that, in their opinion, aligns the most with the baby. Sometimes, they might assign the wrong sex, but they can only realize this in retrospect. Their child may consequently develop gender identity issues in life.

A second challenge is that children may feel angry at their parents for assigning a sex to them that could end up being wrong. Usually, both the surgery and hormone replacement therapy are performed when the child is young and incapable of giving informed consent. In their adult years, they could harbor rage against the adults who chose their sex for them, even if the intentions were pure.


Hormone replacement therapy can be confusing both for parents and intersex individuals. If you need help making a choice, or deciding whether or not to go through with the procedure, seek professional advice promptly. That way, you will know the pros and cons of every choice you make. The best thing you can do for yourself or your child is to make an informed decision. Call us at 205-352-9141.

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