Reversing the stigma associated with intersex children

The term hermaphrodite refers to an organism that has reproductive organs normally associated with both male and female sexes. It can also be said to be an organism that has complete or partial reproductive organs and produces gametes normally associated with both male and female sexes. Therefore, a hermaphrodite is an individual that has both […]

The term hermaphrodite refers to an organism that has reproductive organs normally associated with both male and female sexes. It can also be said to be an organism that has complete or partial reproductive organs and produces gametes normally associated with both male and female sexes. Therefore, a hermaphrodite is an individual that has both testicular and ovarian tissue present. Wikipedia defined hermaphrodite as an ovotesticular disorder of sex development. It is a medical term for an intersex condition in which an individual has some or all of the primary sex characteristics of both genders for example, a penis and a vulva.

In sexually reproductive organisms, males have organs that produce male gametes called sperm, while females have different gametes called eggs.  In sexually dimorphic organisms, each organism only has one type of reproductive organs and the population is divided into two genders. Sometimes the organisms are divided almost equally. In these cases, individuals must compete for mates. Sometimes the genders pair off equally, one male for one female. Other times one male or female breed with a large group of the other gender.

Hermaphroditism is caused by a variety of genetic conditions. In one form, a hermaphrodite or an intersex person is created when two fertilized eggs fuse together to form a zygote with two X chromosomes and a Y chromosome. Other cases of hermaphrodites are caused by mutations on the SPY gene found on the Y-chromosome which is responsible for initiating the first step in determining testicular differentiation.

In general there are three types of hermaphrodites: True hermaphrodite, male pseudo and female pseudo. The genitalia of a true hermaphrodite can vary from completely male or female to a combination of both or even ambiguous looking. Female pseudo means that a person has XX chromosomes with normal female internal organs but with masculanised genitalia, while male pseudo means that a person is with XY chromosomes. Such a person has testes which are usually hidden in the abdominal cavity with external female genitalia.

Being intersex is a naturally occurring variation in humans and not a medical problem which occurs more commonly than people realize. Although being intersex is relatively common, there is lack of awareness among the general population. The first two questions parents ask when their baby is born are “is it a girl or boy?” and “is everything OK?” In the case of hermaphrodite babies, both questions are difficult to answer even though these babies are usually perfectly healthy in all other respects as their biology does not meet our society’s traditional definitions of sex and gender.

The term hermaphrodite is generally considered a derogatory term and a lot of intersex people are faced with stigmatization having to deal with both male and female sexes as well as poverty. In Nigeria, having both sexes is considered an abomination which is hidden and kept as a family secret. The birth of such a child is normally silenced and the child is isolated from the general public either because the parents are ashamed of such a child or because they are afraid others might try to harm their child. Different kinds of traditional rituals are also being used in which their genitals are mutilated and the killing of intersex babies is still widely practiced.

Intersex medical interventions include hormonal, surgical and other medical interventions performed on an individual to modify their ambiguous genitalia and other sex characteristics for various purposes some of which include: improvement of fertility, provision of an outlet for menstruation, to improve urinary or fecal continence, to prevent or reduce urinary tract infections or obstructions, to reduce risk of cancer in gonads and to close opened wounds or exposed genital organs. These surgeries reduce the likelihood of future problems for intersex people and generally make them more accepted in the society by giving them a normal appearance.  According to the World Health Organization, at least 1 birth in 2000 is intersex. These individuals sometimes live in societies that perpetuate violence and killings by cultural, religious and traditional beliefs and practices.

Intersex people are real and face discrimination in education, employment, healthcare, sport and this has a detrimental impact on their mental and physical health as well as poverty levels.

Intersex children and adults are not only stigmatized but they are also subjected to human right violations and discriminatory treatments which include abandonment. Traditional and religious leaders can play a major role in stopping these harmful cultural practices. Community leaders need to engage in awareness education against stigmatization and call on bans on discrimination to combat stigma. This will lead to the society as a whole being more accepting of all kinds of differences.

The Wife of the President, Mrs. Aisha Buhari has been raising awareness on this issue by providing clear and consistent information that promotes understanding of intersex as a range of innate physical variations in sex characteristics in a bid to challenge misconceptions and to bring an end to stigmatization and pathologisation. She has also been discouraging parents from being ashamed of their children’s condition by making them aware that the condition is not a disease but a natural phenomenom that can be corrected via medical intervention.

Mrs. Buhari has paid for numerous intersex correction surgeries which are broadly divided into masculinizing procedures intended to make genitalia more like of those of typical males, and feminizing surgical procedures intended to make genitalia more of typical females.

In trying to overcome stigmatization against people with intersex condition, there is the need for the whole society to provide both financial and moral support to those affected and their families.  Traditional rulers can provide protection and support to them and ensure that all citizens despite their condition are treated with respect and dignity, and create awareness on the fact that the condition is not a disease and that it can be corrected.

Aisha Bunu writes from the Office of the Wife of the President