Intersex variations

Just as people have variations in height, eye colour and skin colour, they also have natural variations in hormones, chromosomes and sexual organs. People who are intersex are born with physical sex characteristics that do not fit the stereotypical and medical definitions for female and male bodies. The term 'intersex' is an umbrella term for many forms of intersex that exist; at least 40 variations are known.¹ It is estimated that around 1.7% of the populations have intersex characteristics which means in a school of 1000, approximately 17 students may have intersex variations.²

Some people with intersex variations may be apparent at birth (e.g. if the baby’s external genitals do not appear to be typically male or female) and some may be diagnosed prenatally. Many people with intersex variations, do not find out until they start to go through puberty (or do not start puberty) and this can be very challenging for young people in a school setting particularly if RSE lessons do not acknowledge this kind of diversity. Some people do not discover they have intersex variations until they try to have children, some find out through random chance and some never find out.

The term 'intersex' is different to the term 'transgender' or 'gender diverse'. Being transgender or gender diverse is when someone's sense of being male or female is different from the sex they were assigned at birth (see Gender Diversity). Most people who have intersex variations are understood to identify with the female or male sex they were assigned at birth, while some may not. They may identify as cisgender, transgender or gender diverse.

Appropriate language

Terminology to describe intersex variations has changed over time. Medical terms such as hermaphrodite and testicular feminisation were replaced with the term Disorders of Sex Development (DSD). Although DSD is still commonly used within the medical community there has been some movement towards using the terms 'Differences of Sex Development and 'Diverse Sex Development' to acknowledge the natural diversity of sex characteristics.³

The terminology a person with intersex variations chooses to use is entirely individual. Teachers need to be aware of the sensitive nature of the terms used and seek to use affirming language by the individual concerned.^3,4

People with intersex variations may experience discrimination and stigmatisation in many settings – medical, social, legal, educational, etc.⁵ Research shows that school is a place that LGBTI young people are likely to experience harassment and discrimination⁴, but this research often focuses on young people who are same-sex attracted or transgender and does not accurately reflect the specific challenges and experiences of young people with intersex variations.

The types of harassment and discrimination that LGBTI young people may experience at school include: discriminatory language; social exclusion; deliberate use of the wrong pronouns; humiliation; rumours; online bullying; written abuse; graffiti; verbal abuse; and physical abuse.⁴ The impact of this discrimination at school can lead to:

• inability to focus in class;
• truancy;
• poor academic performance;
• self-isolation during break times for personal protection;
• missing days at school; and complete disengagement with the school system.⁶

Stigma and discrimination can have a significant impact on mental wellbeing. All school staff need to ensure that they are providing a safe environment for all of their students. Awareness and education are fundamental to ensuring intersex human rights.

• Be aware and respectful of the potential diversity within your class/school. Be mindful that just because you don’t know of any intersex young people in your school/class, does not mean that there are not any. It may be that they do not feel safe to share this at school.
• Because of natural variations in chromosomes, hormones and responses to hormones, people with intersex variations can have bodies that may be different at birth or they may develop differently as they age and go through puberty. Be mindful and acknowledge this kind of diversity in lessons on reproductive systems and puberty. Be aware that some topics may be triggers for young people and ensure that you have created a safe space with a group agreement in place.
• Try to use inclusive language. Using words that are not absolute can go a long way to helping all people to feel more included (not just people who have intersex variations). Use words like ‘most’, ‘many’ and ‘some’ instead of ‘all’ or ‘everyone’. Say words like ‘typical’ instead of ‘normal’ sex development. Regular reminders that there is a wide range of ‘normal’ helps too. For example,
  • ‘Most people with a uterus will get their period during puberty’.
  • ‘Puberty can start as young as 8 for some people, for some it may not start until 16. Most people start puberty around 10 or 11.’
  • ‘Most people will then be able to make a baby.’
  • ‘Women typically have XX sex chromosomes’.
• People with intersex variations may have had operations in early infancy and throughout childhood which can affect their physical and mental health. Medical appointments may impact attendance and engagement in school – they may require additional support and allowance for flexibility.
• Be aware that bullying, teasing and physical abuse for children and adolescents who have intersex variations can occur at schools. It is imperative that schools provide a supportive environment for these students and develop and implement policies and practices which do not tolerate teasing and bullying. Inclusive Education and Equal Opportunities Commission (Guidelines for Supporting Sexual and Gender Diversity in Schools) offer support and guidelines for this.
• Ensure that your students are aware of mental health and sexual health services that can support them:
  • school counsellor or school nurse
  • AIS Support Group Australia
  • Intersex Peer Support Australia
  • Reachout
  • Freedom Centre
• Inclusive Education has a wide range of resources to help support schools and teachers to ensure their classrooms are safe and inclusive for students and staff:
  • Inclusive schools do better: supporting sexual diversity, intersex and gender diversity in schools
  • Parent Information

• You can’t ask that: Intersex (external site) 27min video from ABC (M-rating).
• Phoebe’s story (external site) – 8.17 min video of a young person who has intersex variations.
• Let's talk about intersex (external site) 3.32 min animation
• IHRA - Intersex and education (external site)
• Teaching intersex issues: a guide for teachers in women's, gender and queer studies (external site)
• The needs of students with intersex variations (external site) - academic paper by Tiffany Jones
• 9 young people onhow they found out they are intersex (external site) - TeenVogue article
• The way we think about biological sex is wrong (external site) - Ted talk by Emily Quinn (12min 22sec)
• A guide to IDAHOBIT for teachers

There are a number of videos, books and resources listed below that offer personal stories and perspectives of intersex young people. Educators should preview all texts and videos prior to presenting them to students to determine the suitability for their students (Department of Education Policy: Use of texts in education settings). These videos should only be used by educators who know their class well and have the skills to facilitate safe and sensitive discussions and activities. Resources such as these can bring up issues for some viewers. Teachers and other staff members in the room need to be aware of protective interrupting techniques, how to deal with disclosures, and be familiar with school procedures/policies on how to refer young people who require further support.

Fact sheets/booklets/videos

You're not alone - Info for lesbian, gay, bi, trans, intersex, queer and questioning young people, Freedom Centre

Phoebe’s story – 8.17 min video of a young person who has intersex variations.

References

1. https://ihra.org.au/education/ 
2. Intersex Human Rights Australia (2013). On the number of intersex people. Retrieved from https://ihra.orga.au/16601/intersex-numbers/ 
3. Beale, Jennifer. 2018. ‘Intersex: Variations in Sex Characteristics’. O&G Magazine 20 (4): 29–31. https://www.ogmagazine.org.au/20/4-20/intersex-variations-in-sex-characteristics/ 
4. Issues paper: lesbian, gay, bisexual, trans and intersex (LGBTI) children and young people. Commissioner for Children and Young People Western Australia; 2018. Retrieved from https:// www.ccyp.wa.gov.au/media/2841/issues-paper-lgbti-childrenand-young-people-february-2018.pdf 
5. Carpenter, Morgan. 2018. ‘What Do Intersex People Need from Doctors?’ O&G Magazine 20 (4): 32–33. https://www.ogmagazine.org.au/20/4-20/what-do-intersex-people-need-from-doctors/ 
6. Alex. 2017. I’m intersex here’s what that means. Retrieved from www.minus18.org.au February 2019.