I recently attended a workshop titled All In The Family: Gender Transitions Throughout The Lifecycle and purchased the speaker’s book titled Transgender Emergence Therapeutic Guidelines for Working with Gender-Variant People and Their Families by Arlene Istar Lev, LCSW, CASAC. One of the essential facets I walked away with was gaining insight into the world of the intersex; I was pleasantly surprised to learn the number of variances in intersex and the facts I had not ever acquired throughout any part of my career as a nurse. I continue to do as much research as I can on any given subject that I cover in any of the work I do even when it crosses over into the healthcare realm. I try to gain as much insight into the latest reports and can never possibly know everything, hence the reason we have specialists working in fields that are not well understood or addressed by every practitioner.
I currently live in Jacksonville, FL where the necessary protections for human rights continues to remain in the forefront of our brains and have left those of us who believe a human rights ordinance bill is needed for the LGBT community, bewildered, at best. In trying to understand the fears of some who argue that introducing a bill for LGBT protections against discrimination would be granting the LGBT special privileges. Last year, one of the city council members mentioned it could lead to necrophilia, while others who attended the hearings and opposed the bill, argued that we would see a rise in pedophilia and bestiality.
The resistance of those opposed to this bill is difficult to grasp, and while it was overturned and did not pass the majority voting in its favor, some of us were relieved, because we could see that if the watered down version had passed, this would leave our brothers and sisters in the transgender community at risk. Even with the watered-down version that was introduced early on as an amendment to the bill, many transgender individuals were mad and felt they had been thrown to the curb by the allies and LGB who supported the amended portion to bill 2012-296, which left out Gender Identity and Expression. Those in support of the amended bill claimed that they could return at a later time and introduce a bill for Gender Identity and Expression protecting the transgender community. Equality Florida’s Executive director, Nadine Smith, warned everyone that in accepting the watered-down version of bill 296, could result in a backlash and would not necessarily guarantee, that in the future, protections for Gender Identity and Expression would pass, as what happened to the city of Orlando, Florida where citizen tried and failed for a number of years. It wasn’t until the county of Orlando introduced the bill with full protections for LGBT, that an all-inclusive bill finally passed. Who can blame the transgender community of Jacksonville for feeling the way they do?
Where does the education begin? Does it start with language? Do we need to use the current definitions in the language and insist on a broader range of adjectives, which best describe individuals in the LGBT culture? What protections are there for individuals who are at risk for discrimination and hate crimes because of their gender variances? Does it only affect the homosexual community? Could we say that in learning what we have of gender variance within a human population that the heterosexual community is also at risk for discrimination and hate crimes? What about gender variance in the heterosexual community? Some heterosexuals deviate from expressing their gender. Who are some of our transgender individuals? Have some undergone surgery? What defines someone as transgender? Why do some transgender individuals consider themselves born with a birth defect?
There are between 70 and 80 variances of intersex individuals. Some of these intersex individuals receive their sex assignment at birth, and most of them are assigned as female. The practice to perform sex assignments on intersex is changing, and the current practice is taking a shift, according to Intersex Society of North America (ISNA), it is better to wait and allow the child to determine which gender they fit more suitably; gender not determined by the parent, but determined by the child. ISNA sheds light on a paradigm which compares the way we should treat intersex as a patient-centered model opposed to prior treatments which encouraged concealing the identity and treated it as an abnormality. According to the CDC, 1 in 250 births results in intersex; the statistics still don’t include all the other variances. An internet site, Intersex Roadshow, maintained by Dr. Cary Gabriel Costello, reports that the birth rate for intersex could be put on par with the number of births born with green eyes. If this is true, it is an interesting comparison. Interesting because we seem to accept green eyes shamelessly while we marginalize intersex.
Shouldn’t a community maintain public decency towards intersex and come to recognize that there are individuals who received sex assignments at birth that misaligned them with their identities? After all, the statistics for infants born intersex are 2% of the population. What about individuals who feel disjointed from their biological sex without being intersex? We do not have any idea who is intersex and cannot possibly identify those with anatomical differences because the treatment approach was shamefully hidden by parents, family members and sometimes even from the child. Many of these individuals grew up with their sex assignments are given at birth and with most of them receiving female assigned gender status at birth (FAAB), they didn’t necessarily feel female and in these cases were wrongly assigned as such. While everyone thought they had done the right thing in assigning these children a gender, they kept it a secret from society and in many cases from the child. The reality is that not all these children grew up feeling quite the same as those of their biological sex, causing a host of psychological as well as emotional struggles and shifting the anchored pillar within the family structure from its base.
The binary world only offers two options. Should there be more than two worlds from which to choose, since it is now clear that we have birth rates of intersex 1 in 250? The question comes to mind whether or not we should continue with the old binary model of male/female or move to a gender variant model which would broaden the spectrum for many individuals.
We have a population of individuals who are transgender, transsexual, and who gender express. All deserve a place at the table with the same rights and equal opportunities as everyone else. Some of these individuals are intersex while others just feel they were born with the wrong body parts and frankly, some prefer to dress any way they please. Is it time that we should be kind and gentle towards a population of individuals who do not fit the binary world of the Westernized nation? Is the Westernized nation civil when it behaves antagonistically towards individuals who are different? Is it any wonder that some of these individuals feel they were born with a birth defect? If the truth was hidden from them, doesn’t it stand to reason they would feel it was shameful to admit that they were born this way; especially if this is how their parents and the medical establishment behaved towards their anatomical parts? How is this any different for individuals who do not feel they connect to their biological sex when the world only offers the binary model?
What about sexual orientation? We know that transgender has nothing to do with sexual orientation. We do know that transgendered individuals have a sexual orientation just as anyone else does.
Here is an illustration that might help you understand the differences in sexual orientation and how transgendered individuals aren’t any different from anyone else.
You can be a pilot and be either heterosexual, homosexual, bisexual or asexual. Insert attraction for the opposite sex; the pilot is heterosexual. Insert attraction for the same sex; the pilot is homosexual. Insert an attraction for both genders; the pilot is bisexual. Remove the sexual attraction; the pilot is asexual.
A transgender pilot could be any one of these individuals. A transgender pilot could be intersex.
All four of the pilots share a common thread which is that they fly planes, must equally meet standards of practice and competency, standards of excellence, and maintain their licenses in meeting FAA standards of policies and procedures. They have nothing in common with each other’s sexual attractions or preferences other than they frequently fly in and out of airports. Again, their sexuality has nothing to do with what they do for a living or as a hobby.
My advice to those of you reading this is to really learn this because if you are interested in wanting to have an intelligent conversation on this subject, this will help you understand that there is nothing more to these differences. It has nothing to do with lifestyle.
You might want to consider, when having a conversation with others who are walled off to anyone who does not fit the binary model, by asking these individuals why they insist homosexuality is a lifestyle? Ask them to explain to you how lifestyles between heterosexuals and homosexuals differ? Should the topic of transgender come up remind individuals that 2% of the population is intersex? While not every transgender is intersex, it still remains a critical component and is categorized under the transgender umbrella of definitions.
If you have an opportunity to help reach one human being across the spectrum of many others, remind the individual that sexual attraction has nothing to do with lifestyle and transgender gender are those individuals whose identity differs from the social expectations of their biological sex. The more we dialogue, the more likely we are to close the gap on biases and prejudices that are derived from misunderstanding differences. Debunking rhetoric is far more heroic than continuing to allow it to stand in the way of truth. We fail at tolerance when we set up barriers, preach self righteously and stop listening.
This essay is written from my own point of view, and none of which I have written holds any bearing on Lev other than mentioning her beautiful book and making the reference to the intersex variances from her book.
To learn more about Gender-Variant People and Their Families, please consider purchasing Lev’s book titled Transgender Emergence. It is an excellent read and very informative, written for therapists who are working with gender-variant people and their families, it will help some of you understand the world of gender variances. To contact Lev, please visit
The internet sites below were used for this essay and are very helpful to anyone who might be interested in learning more about gender variances.