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“When babies are forming, there’s a very complex series of things that has to happen for them to be born with absolutely typical genitals,” says Daniel Metzger, a paediatric endocrinologist at BC Children’s Hospital in Vancouver.
“It’s like a big chain reaction and anywhere it breaks can disrupt things downstream.” There are more than a dozen intersex conditions—the majority are genetic while some are caused by atypical cell division.
In many cases, hormones affect a child’s development in utero.
For example, a child may not have a free-flowing urinary opening.
Yet being intersex is almost as common as having red hair, affecting nearly two percent of the population.
These differences in sexual development may be in chromosomes, internal organs or genitals.
There’s research on how people with certain conditions identify on the gender spectrum, which can help guide decision-making.
For example, 95 percent of genetic females with CAH who were raised as girls identify as female.