Anatomy, biology, physiology and brain chemistry are complex components that mesh, forming sexual behavior and desire. A broad array of psycho-social and cultural influences also impact human sexuality.
Heterosexuals are those attracted to the opposite sex. Homosexuality is the romantic and sexual attraction to members of the same sex. Transgender people gender-identify with the sex opposite their birth designation. Transgenderism is the result of biology and brain development, not personal choice.
Many people are born with traits not fully understood or explained. Most lesbian, gay, bisexual and transgender (LGBT) individuals have normal X and Y pairing, yet are gender-nonconforming.
Birth-assigned or Biological Sex: Male, Female, Other (third sex)
At birth, children are assigned a biological sex based on their genital anatomy and chromosomes, except when the anatomy is ambiguous. This means the child’s external anatomy is not clearly male or female and the gender is termed intersex.
The Intersex Society of North America reports in about 1:2000 births a child is born with external genital anatomy unusual enough that a specialist in sex differential must be consulted to accurately determine the sex. Intersex is not a new diagnosis. It has been evident throughout history. Stories have been told and written through the ages of individuals who are part male and part female, hermaphrodites. Intersex is not about sexual orientation (feeling male or female), it is a developmental variant.
Most genital abnormalities are not intersex issues because the anatomy is clearly male or female, not ambiguous. Often, the differences are treatable with surgical interventions. For example, 1:1000 female children are born without a vagina. In 1:770-2000 male births, the urethral urinary outlet is misplaced (hypospadias) and surgical correction is needed.
Most transgender people are clearly male or female anatomically, but gender-identify with the sex opposite their designation at birth. In some cultures, the acceptance of a non-male/non-female gender identity is common. The third sex term is used. For more than a decade, India passport applications have listed three gender options. Two years ago, the Supreme Court of India recognized a third gender, acknowledging the designation as a civil rights issue.
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Betty Kuffel, MD