I

I — The I in LGBTQIA+ is for INTERSEX.

INTERSECTIONAL, INTERSECTIONALITY — The understanding that no one axis of oppression can be regarded separately from all of the others.

Intersectionality as a term was coined by Black feminist and legal scholar Kimberlé Crenshaw in her 1989 piece “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics”; but as a concept, intersectionality has been a hallmark of Black feminism since at least the 1800s.

All of our identities and perceived identities interact and determine how much structural power we have, but these are context dependent and there is no clear hierarchy of these categories. It’s complex, not simple.

“Intersectional” is not shorthand for “inclusive.” A conference panel is not “intersectional” for having people of multiple genders, sexualities, races, and economic backgrounds speaking on it: it’s diverse. A second panel made up entirely of straight, white, cis, wealthy men is as intersectional as the first: the intersections of those privileges gives those men vast institutional power and an amplified voice which is assumed to be legitimate.

Intersectionality has gathered a morally righteous tone. “Intersectional feminism” is a term often used, to mean a feminist approach which acknowledges the intersections of oppression; that womanhood is not a single experience; and women of color, trans women, queer women, poor women, and disabled women suffer more misogyny, compounded with their other marginalizations. It might be pedantic but I’d gently remind “intersectional feminists” that “white feminism” is intersectional too: feminist movements led by white women who fail to account for racism and misogynoir are a perfect example of the intersection of race and gender, and the way white privilege operates to position the white experience as universal.

INTERSEX — One of several contested terms to describe someone born with a combination of physical characteristics typically associated with exclusively maleness or femaleness (e.g., chromosomes, genitalia, and gonads).

There are multiple traits which could manifest as an “intersex condition”; for example, androgen insensitivity syndrome (AIS), which prevents the body from responding to androgen (testosterone), and Swyer syndrome, which is the presence of testes and a uterus. Both syndromes can lead to people having a phenotype (external appearance, in these cases of genitals or gonads) which does not “match” their sex chromosomes.

There is no single, universally agreed upon definition of intersex, and it is not a universally accepted term. Other terms, all contested, include “disorder of sex development (DSD)” and “hermaphrodite.”

Intersex activism and communities are not monolithic. There are multiple stakeholders (intersex people, the parents of intersex children who are making medical decisions for them, and medical experts on intersexuality), and intersex activists disagree on how to, or whether to, collaborate with the medical establishment. Medicalization and pathologization are avenues to medical care and civil rights, but they also bolster assumptions about deviance from the gender/sex binary as a “disorder,” with the implication that it can be medically rectified so the patient might live as closely as possible within the gender/sex binary.

Statistics on intersexuality are fraught because there is no widely used single definition. The most frequently used statistic is that 1 in 2,000 people are born with intersex traits, though this has been criticized by intersex activists such as Peggy Cadet. Data on intersexuality is also tricky because it either relies on reporting from doctors (rather than patients) whose patients might not even know they have intersex traits; or on patients’ self-reporting, which is better, but only patients with social capital are able to seek out information and communities (and therefore research projects) on intersexuality. Georgiann Davis, an intersex researcher (both intersex, and a researcher on intersexuality) discusses this in her 2015 book Contesting Intersex.

Intersex people are likely to face medical neglect and lies, be labeled as “abnormalities” and imbued with stigma, and may suffer non-consensual and medically unnecessary surgery or intervention: removal of undescended testes, or circumcision to create a vagina. Often the medical opinion is that the patient is better off not knowing about their intersex condition, despite the ethical implications for the patient’s bodily autonomy and informed consent.

It is common practice for parents of intersex children to be presented with an intersex diagnosis as though it is an immediate medical emergency, and a “state of exception” is created. Doctors can then suggest medically unnecessary surgery to “correct” the intersex characteristics so the patient is more closely aligned with a binary sex/gender, and the responsibility for this decision is placed with the parents and based on guilt, instead of lying with the doctor and the usual due diligence required for consenting to surgery, especially to a medically unnecessary surgery. For parents who are not familiar with intersexuality, or a non-essentialist understanding of sex and gender, the intersex condition is positioned as an urgent threat to the child’s wellbeing.

DSD language is preferred by the medical establishment, which implicitly sees intersex conditions as abnormalities to be fixed. “Intersex” language instead positions intersex conditions as a natural biological variation.

One oppressive dynamic facing intersex people is the insider/Outsider binary in research, which places legitimacy with the voices of “experts” on intersexuality who are not themselves intersex, while intersex patients are positioned as “subjects” (objects) rather than people with valuable lived experiences, never mind their own research qualifications. The patient is denied agency and their experience is considered to cast doubt on their objectivity, while the non-intersex researcher is ostensibly objective and untainted by bias.

The medicalization of intersex perpetuates medical authority over intersex bodies (Katrina Karkazis). The primary stakeholder on issues about intersexuality must be intersex people, not their non-intersex doctors. Non-intersex “experts” might have something to offer to scholarship around intersexuality, but more often than not their contributions are insensitive and paternalistic, and they treat intersex people like a problem that needs to be fixed.

Intersex status is not relevant to gender identity and sexuality: the same as non-intersex people, intersex people can be any gender or sexuality. Some intersex people are trans.

Why is I part of LGBTQIA+? Because there is a shared denial of agency and “normalcy” over our bodies, and a shared failure to fit into hegemonic binaries of sex. Intersex is a “problem” because it challenges the gender binary and its biological essentialism.

Similarly to trans people, intersex people face stigma and difficulty accessing services, especially medical services, in a way which prioritizes their agency rather than treats them like an object of intrigue. Likewise, both intersex and trans people tend to develop a highly specialized knowledge of their conditions, regardless of their interest in medicine as a field, because their doctors are often under-informed and making medical decisions based on stigma and misconception, and are gatekeepers to proper medical care. The patient then must carefully toe the line between gently informing the doctor, and undermining the doctor’s credibility as the “expert” lest they feel insulted and deny care entirely.

There are medical and social shared struggles between intersex people and trans people; it’s useful to make these connections, but we shouldn’t conflate them.

The goals of intersex activism today are, again, not monolithic, but include: the elimination of medically unnecessary surgeries; interrupting stigma, silence, and shame surrounding intersex bodies; collaborating with medical allies; building community within intersex organizations; addressing inequalities within intersex communities, and including more diverse voices; and amplifying the voices of, and validating the experiences of, intersex children.

Intersexuality is not a sexual orientation, despite sounding similar to homosexuality, bisexuality, heterosexuality, and so on.

INVERT, INVERSION — A late 19th-century psychology term for homosexual.

Havelock Ellis coined the concept of the “invert” in his 1897 work Sexual Inversion. Ellis argued that homosexuality was a congenital condition, which he called “sexual inversion”: a physical or psychological state whereby the invert was possessed of a female soul in a male body (gay men), or a male soul in a female body (lesbians). Gender characteristics were aligned with sexual preferences and behavior. This is an interesting early example of how heterosexuality was seen to be more fundamental than a fixed biological sex.

This conceptualization and pathologization of queer people as inverts in the “wrong” gender is one example of the longstanding link between cis LGBQ+ people and trans people. Any attempts to culturally separate homosexuality and transness (or sexuality and gender identity) ignore the shared pathology and cultural history of all non-heterosexual and all transgender people.

INVISIBILITY — Lack of representation. Incredulity about your existence.