Neither girl nor boy: more and more intersex babies

A baby born with a testicle and an ovary. A penis and a vagina. It happens. And more and more often. A shock for the parents. A dilemma for the doctors: should they operate or not? What if we gave the little patients the choice?

More and more intersex babies

Every time Estrella* goes for a walk with her twins, passers-by exclaim, leaning over the stroller, "Oh, the beautiful babies! Are they girls or boys?" And each time, the question, however insignificant, capsizes her. And each time, the question, although harmless, overwhelms her, because it brings to her face the particularity of one of her sons, born with a half-male, half-female sex. "He doesn't look like a girl at all and he's dressed like a boy" she protests, showing me a photo. There's no doubt about it, 10-month-old Jeremiah* is a little guy, with his jeans, brown hair and persian eyes!

Estrella never thought she would give birth to an intersex child - it's not the kind of thing that's discussed in prenatal classes. But her pregnancy went well after four years of hoping to get pregnant. It was a success because of in vitro fertilization. "A beautiful gift of life," says the 37-year-old mother, while her twins are being looked after by her parents. Victor* was the first to show up, in perfect health. Jorge followed him just behind, with slight breathing difficulties. Nothing to worry about.

That evening, however, his partner informed him of a "small problem". The urinary meatus (the external opening of the urethra) was along the length of the penis rather than at the tip of the glans - a defect called "hypospadias", which is quite common in boys. But there was more. The physical examination revealed the presence of only one testicle. The other one must have been in the abdomen. A small operation and everything would be back in order.

Forty-eight hours later, the pediatrician asked that the baby be given a blood test "just in case". Before discharging the mother, he gave her a prescription for an endocrinology consultation the next morning at the Montreal Children's Hospital. She remembers hearing him say the word hermaphrodite, named after the mythical half-male half-female character, but didn't pay attention.

After two hellish weeks of multiple tests, the results finally came in: anatomically, Jeremiah is a boy, with a penis, a prostate and a single testicle. But genetically, he is a girl with a 46,XX karyotype. The famous lump in his belly that was first mistaken for a testicle is actually an ovary. I started to panic," says Estrella, pushing her plate away. It was like a brick had just fallen on me.

An unknown phenomenon

This strange condition has a name: intersexuality. But doctors prefer the more scientific term DSD for disorders of sex development. The body does not fit the typical definition of a man or a woman. This can be reflected in the genitalia (micropenis, enlarged clitoris, half-formed vagina), the gonads (missing ovaries or testes) or the chromosomes (XX, XY and a whole host of combinations). Sometimes, the ambiguity is not visible at birth and manifests itself at puberty (absence of menstruation, problem of pilosity). Some people do not realize it until they are adults, when they discover their infertility and the influence of the sex.

How many children are born with this unusual anatomy? The figures vary according to the criteria and the experts on gender selection. The most cautious speak of one live birth out of 10 000. The most daring, of one in 2 000. Some even put forward the figure of one in 200, taking into account the wide spectrum of variations in sexual development, which includes more than a hundred. The genome has 20 million little variations here and there that influence development. There is no way to say, Here is a man and a woman. She believes that if we were to draw up a karyotype of each human being to define the threshold of perfection of femininity and masculinity, few people would be at the extremes. There is a whole spectrum in between.

According to the medical community, which is adamant that intersex is a disease. For parents, it's a bomb that needs to be defused. All sorts of questions go through the parents heads: How will I dress him? Will he go to the girls' or boys' bathroom? What kind of future awaits him?"

In the past, these thoughts were cut short. We operated immediately. Most of the time by opting for a female sex, easier to "make".

Source: Chatelaine

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