Biology is messy. We’re taught in third grade that there are two boxes: male and female. You get an X and a Y, or two Xs, and that’s the end of the story. But nature doesn't always read the textbook. When people ask are intersex people male or female, they’re usually looking for a simple "yes" or "no" that doesn't actually exist in the real world of clinical medicine and human genetics.
It's about 1.7% of the population. That’s the figure often cited by experts like Dr. Anne Fausto-Sterling, a professor at Brown University. To put that in perspective, it’s roughly the same number of people born with red hair. You wouldn’t say red hair is a "myth" or a "glitch," right? It’s just a variation. Intersex is an umbrella term for people born with reproductive or sexual anatomy that doesn’t fit the typical definitions of "female" or "male." Sometimes it’s chromosomal. Sometimes it’s hormonal. Sometimes the outside doesn't match the inside.
Breaking down the "either/or" trap
So, let's get into the weeds. If you’re looking at a person with Androgen Insensitivity Syndrome (AIS), they might have XY chromosomes—which we usually associate with being male—but their body doesn’t respond to androgens. The result? They are often born with a vagina and labia, and they’re usually raised as girls. They might not even know they’re intersex until they hit puberty and don’t start a period.
In this case, are intersex people male or female? Biologically, they have elements of both. Legally and socially, they might be female. But their DNA says something else entirely. It’s a spectrum, not a binary toggle switch.
Medical professionals, particularly those following the guidelines from the Intersex Society of North America (ISNA) and more recent frameworks from organizations like interACT, have moved away from trying to "fix" these variations with surgery at birth. Why? Because you can’t look at a baby and know how their brain will develop or how they will identify later. You just can’t.
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The Chromosomal Roulette
We all know XX and XY. But what about XXY? That’s Klinefelter syndrome. Or just a single X? That’s Turner syndrome. These individuals have traits that are distinct. A person with Klinefelter might have lower testosterone levels and develop breast tissue, but they generally identify as male.
Then you have Congenital Adrenal Hyperplasia (CAH). This is where the adrenal glands produce an excess of androgens. A child with XX chromosomes might be born with ambiguous genitalia. Historically, doctors would perform "normalizing" surgeries. Honestly, it was pretty traumatic for a lot of people. The Intersex Community has been vocal about the fact that these surgeries were often done for the comfort of the parents and doctors rather than the health of the child.
It's not just about the parts
If we only look at genitals, we miss the whole picture. Biology involves:
- Chromosomes (the DNA blueprint)
- Gonads (ovaries or testes)
- Hormones (estrogen, testosterone, etc.)
- Internal reproductive organs (the uterus or prostate)
- External genitalia
An intersex person might have three of these "male" and two of them "female." Or they might have a mosaic—where some cells in their body are XX and some are XY. This isn't science fiction. It’s human biology.
Why the question "Are intersex people male or female" is so complicated
Most intersex people are assigned a sex at birth—either male or female—and they live their lives as that gender. Many are perfectly comfortable with that. But for others, that assignment feels like a mistake because it doesn't align with their internal experience.
The medical community used the term "Disorders of Sex Development" (DSD) for a long time. Some doctors still use it. Many advocates hate it. They feel "disorder" implies something is broken. They prefer "variation." It’s a huge point of contention in the medical world right now.
Real-world impact of the binary
Think about sports. You've probably seen the headlines about Caster Semenya or Dutee Chand. These athletes have naturally occurring variations in their biology that result in higher testosterone levels. The world of sports wants a clean line. They want to say, "If you have this much testosterone, you're a man." But if that person has lived their entire life as a woman, has a female reproductive system, and identifies as a woman, where do they fit?
The International Association of Athletics Federations (IAAF) has struggled with this for years. It shows that our social categories (male/female) are often too small to hold the reality of human diversity.
The legal shift
Some countries are starting to catch up. Germany, Australia, and several U.S. states now allow for an "X" marker on birth certificates or passports. This acknowledges that forcing someone into a "male" or "female" box when their biology is intersex isn't always accurate.
But let's be real: most of the world isn't there yet. Most systems require you to pick one. This creates a massive headache for intersex people when it comes to healthcare, insurance, and even just traveling.
Common misconceptions that need to go away
First off, being intersex is not the same thing as being transgender. They overlap sometimes, sure, but they’re fundamentally different. Transgender is about gender identity—who you know yourself to be. Intersex is about biological traits—how your body is built. An intersex person can be trans, but most identify as the sex they were raised as.
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Secondly, intersex people are not "hermaphrodites." That term is considered outdated and offensive. It’s also biologically inaccurate for humans. In biology, a true hermaphrodite is an organism that has fully functional male and female reproductive systems—like some snails or worms. Humans don't work like that.
Thirdly, it’s not always "obvious." You could be sitting next to an intersex person on the bus and never know. You could be intersex and not know it until you try to have kids and find out you have internal testes instead of ovaries.
Navigating the medical landscape
If you or someone you love is intersex, the most important thing is finding a provider who understands "patient-centered care." This means moving away from the "emergency" mindset of the 1950s. Being intersex is rarely a medical emergency.
Doctors like those at the Lurie Children’s Hospital of Chicago have started implementing multidisciplinary teams. These teams include endocrinologists, urologists, and psychologists who work together. The goal isn't to "fix" the person, but to ensure they’re healthy and have the support they need to make their own decisions about their body when they’re old enough.
The role of ethics
Bioethicists are increasingly arguing that cosmetic genital surgeries on infants should be banned. The United Nations has even labeled these procedures as a violation of human rights in some reports. The logic is simple: if the surgery isn't life-saving, wait until the person can consent.
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Actionable insights for moving forward
If you’re trying to navigate this topic, whether for personal reasons or just to be a better human, here’s how to handle it:
- Respect the terminology. If someone tells you they are intersex, don't ask about their "parts." That’s weird. Just use the language they use for themselves.
- Acknowledge the nuance. Stop looking for a binary answer to a non-binary biological reality. Are intersex people male or female? The answer is "it depends on the individual."
- Support bodily autonomy. Advocate for policies that protect intersex children from unnecessary, non-consensual surgeries. Organizations like interACT are great resources for this.
- Update your mental map. Recognize that sex is a spectrum. We have "male-typical" and "female-typical," but there’s a whole lot of beautiful space in between.
- Seek specialized care. If you are intersex, don't settle for a GP who is confused by your labs. Look for specialists at major university hospitals who have experience with DSD or intersex variations.
The conversation is changing fast. What we thought we knew about sex and gender twenty years ago is being rewritten by better science and the lived experiences of millions of people. It’s okay to be confused at first—biology is complex—but the move toward accepting that complexity is a win for everyone.
Find reputable support networks. Connect with groups like the AIS-DSD Support Group or the Intersex Justice Project. These communities offer real-world advice that you won't find in a medical textbook. Information is power, but community is what actually helps people thrive in a world that’s still obsessed with boxes.