We no longer speak of (human) hermaphroditism or pseudo-hermaphroditism but of intersex. Intersex people are born with sex characteristics that do not fit traditional definitions of male or female. Definition, causes, signs: discovery.
“Intersex people are born with sex characteristics that do not fit traditional definitions of male or female,” says the UN. We talked for a long time of hermaphroditismtrue and pseudo-hermaphroditism for humans which are however not medical terms to express intersex. This medical term defines people whose sexual characteristics do not fit into one of the two “normal” boxes typical: feminine and masculine. The point with Nicolas Morel-Journel, urologist and specialist in genital reconstruction surgeries at the University Hospital of Lyon.
What does hermaphrodite mean in humans?
“We no longer speak of hermaphroditism or pseudo-hermaphroditism. The notion of intersex is now the one we use for the so-called “intersex” people concerned. It’s a more respectful term and which truly encompasses all concerned, which is ultimately not the case with the word hermaphroditism”, explains Nicolas Morel-Journel, urologist, specializing in sex reassignment surgeries. “It’s a very broad concept that goes from people who have moderate hormonal disruption Has people who are born with XY cells and XX cells” he explains. According to the Office of the United Nations High Commissioner for Human Rights, “intersex people are born with sex characteristics that do not fit traditional definitions of male or female“.
What are the causes ?
Multifactorial, the causes of intersex are still poorly understood. “What is certain is that certain anomalies have exploded over the last 30 or 40 years. Because we are tracking them more but also probably for environmental reasons such as organic pollutants, pesticides, heavy metals etc…” The mother may also have been exposed to endocrine disruptors during pregnancy such as phytoestrogens, phthalatesto the bisphenols… The genetic factor also plays a role. “There is therefore no single and certain cause of intersex” summarizes the urological surgeon.
What are the signs of hermaphroditism?
A person can be discovered to be intersex From birth in the case of anatomical variations of the genital organs or in childhood, adolescence or even in adulthood. “There are as many signs of intersex as there are intersex people” explains our expert. “It can range from small hormonal abnormality which we will not realize until late in the course of investigations for infertility and which manifests itself only by a low body hair in a boy for example – until, another example, the presence of ath penis visible at birth in a little girl“, notes Nicolas Morel-Journel. Variations in sexual characteristics can be genital, gonadal and chromosomal. “In cases of true hermaphroditism, case extremely rarethere are XX cells and XY cells. The child does not have two genitalia but may have both gonads, a testicle and an ovary“explains our expert.
Can we reproduce when we are hermaphrodites?
“Very often, intersex people are infertile or have poor fertility” emphasizes the urologist. It is important to think about this question before an operation which can affect fertility, whether the patient is pubescent or not. There are several ways to preserve fertility: freezing of oocytes, spermatozoa. For prepubescent boys, it will be a question of preserving the germinal stem cells. “And even if it is still about experimentation, we cannot predict the progress of science in 20 years. We may be able to multiply germ cells in vitro” imagine the doctor who advises to preserve fertility when possible.
What treatment for hermaphrodites?
In addition to psychological support, “on the medical level, the care of intersex people is based on hormonal treatments and reconstructive surgeries (breast prostheses, mastectomy, reconstruction of the genital apparatus)”, lists Nicolas Morel-Journal. “In numerous countries, surgeries are performed on intersex children and other repeated treatments to try to change their sexual characteristics or their appearance. In addition to causing them physical, psychological and emotional suffering, these procedures violate their rights.” writes the UN. Should sex reassignment operations be performed or not on children who are too young to choose but should be operated on so that they conform to male or female “norms”? In any case, the question is no longer a taboo. The legislator has also seized on it in the law of August 2, 2021 relating to bioethics. Despite a call for good practices and advances such as the postponement of the mention of sex in civil status, the law does not prohibit surgeries on babies, who however are not able to choose.
Thank you to Dr Nicolas Morel-Journel, urologist and specialist in genital reconstruction surgeries at the University Hospital of Lyon.
Sources:
The bioethics law regulates the situation of intersex children. Dalloz News. September 13, 2021.