Talk:Intersex/Archive 11

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Foundations 2 2019, Group 8b goals

1. Add to the physiology of sexual differentiation and hormones that are involved in intersex development.
2. Update the "Reparations and Justice" section because the lawsuit has since been settled for $440,000.
3. Delete incoherent sentence under the "Anti-discrimination and equal treatment" and "reparations and justice" section.

For (2) It currently reads, In the United States, the "M.C." legal case, advanced by Interact Advocates for Intersex Youth with the Southern Poverty Law Centre is still before the courts.

I added this edit to update the settlement of the lawsuit, and linked the M.C v Aaronson lawsuit to Intersex rights in the United States, which provides a more detailed description of the lawsuit.

In the United States, the M.C. v Aaronson lawsuit was " a medical malpractice case related to the informed consent for a surgery performed on the Crawford's adopted child (known as M.C.) at [Medical University of South Carolina] in April 2006". The case was eventually settled for a payment of $440,000 in 2017.

Dchnggg (talk) 01:40, 1 August 2019 (UTC)

Please sign your posts--thanks.

Is the reference provided below something you propose to add? It would be better to find a systematic review, whether or not frog-specific.

Health policy (talk) 04:27, 31 July 2019 (UTC)

References

I recommend thinking about whether or not teratogenic frogs are the best way of introducing material on intersex in non-human species. This page also summarizes material on a broad range of issues, so it is not the best place for detail. Trankuility (talk) 05:37, 31 July 2019 (UTC)

No, the reference will not be added and was meant to be a placeholder for now. Thanks for the recommendation. Will look to see if there are other areas that we can add to.

Dchnggg (talk) 01:42, 1 August 2019 (UTC)

@Mquindoy, Docwoods12, Dchnggg, and Xmrlmem: I have made for you Draft:Intersex (2019). I am unclear about the details of your class assignment, but if you four are all collaborating on making heavy changes to this article, you may like to work on a full draft article to see it come together there first. You can do things like place comments there for later review within the body of the text (see Help:Comment tags for more info). It isn't mandatory to use this though, but it may be a less overwhelming of a place to edit and discuss. Cheers! –MJL ‐Talk‐^☖ 02:12, 1 August 2019 (UTC)

We're a group of students at UCSF and will be working on this article for about a week. We do not plan on making any heavy changes to this article due to time, but will try to add to the medical classifications part on this article. We'll check it out. Thank you for the suggestion. We're new to this and trying to figure this out as we go.

Dchnggg (talk) 02:51, 1 August 2019 (UTC)

@Dchnggg: Of course! If there is anything I can do to help, then let me know. I'll leave that draft up in case you want to test out editing there or anything like that. You're free to use to use that page however you like! –MJL ‐Talk‐^☖ 04:22, 1 August 2019 (UTC)

On the M.C. case, please bear in mind that other pages, in this case Intersex human rights and Intersex rights in the United States, are likely to be better places for detailed information. Trankuility (talk) 21:19, 1 August 2019 (UTC)

Great! Thanks for the recommendation. Is it best to hyperlink the case to the other Wikipedia case which provides more details of the MC case?

Dchnggg (talk) 21:56, 1 August 2019 (UTC)

Summarization and links are helpful, yes! Trankuility (talk) 22:41, 1 August 2019 (UTC)

Apologies for the revert, It looked like they were blanking the content and I originally thought a signature was included (turns out it was a link to the talkpage), Anyway apologies for that. –Davey2010^Talk 21:09, 2 August 2019 (UTC)

Deleted extraneous lead sentence from the Anti-discrimination and equal treatment section. Xmrlmem (talk) 21:10, 2 August 2019 (UTC)

No worries!

128.218.43.241 (talk) 21:34, 2 August 2019 (UTC)

Foundations 2 2019, Group 8a peer review

For goals, group 8b was successful in providing updated information to the M.C. v. Aaronson case and in making grammatical edits by removing fragmented sentences. This helped to make the "reparations and justice" and "Anti-discrimination and equal treatment" sections more coherent. Overall, the group did a good job in cleaning up this article and updating case information. It would be helpful to add in some background information about M.C. v. Aaronson (i.e. adding in a brief description about its role in intersex rights for minors). It would be interesting to see the end results of the group's goal to add in the physiology of Intersex as well, to add in scientific information in addition to social information. Secondary sources were used appropriately in updating the M.C. v. Aaronson case. Jiangyad (talk) 06:13, 6 August 2019 (UTC)

For the M.C. v. Aaronson lawsuit, I hyperlinked the case to another Wikipedia article which provides more detailed information about its role in intersex rights for minors, but will add a brief description to provide more background.

Dchnggg (talk) 16:24, 6 August 2019 (UTC)

Orphaned references in Intersex

I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Intersex's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "theguardian.com":

• From The Guardian: Greenwald, Glenn (9 June 2013). "Edward Snowden: the whistleblower behind the NSA surveillance revelations | US news". The Guardian. Retrieved 6 March 2016.
• From Hijra (South Asia): "India recognises transgender people as third gender". The Guardian. 15 April 2014. Retrieved 15 April 2014.

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT⚡ 14:10, 12 August 2019 (UTC)

Need Different source

The opening paragraph citing the UN for defining intersex is inherently meaningless as its a biological condition and should be sourced from a scientific perspective. There are countless publications regarding intersex and human rights are irrelevant to that definition. If the source is still useful, perhaps it belongs in the human rights section, but not in the definition. To clarify, homosexuality, ethnicity or race, or blonde haired people are not defined here on Wikipedia by the UN human rights code, nor should intersex. — Preceding unsigned comment added by 61.192.112.49 (talk) 11:49, 29 September 2019 (UTC)

gender?

Surely the use of the term "gender" in this article is out of place? Using gender in place of sex is merely a fashionable, I was going to say euphemism, but I see it more as a shortcoming of the person contributing. Also it puzzles me as to exactly what is meant, sex or gender? --Damorbel (talk) 10:17, 6 November 2019 (UTC)

All the uses of "gender" in the article seemed fine to me, namely it wasn't used interchangeably with "sex". --Yhdwww (talk) 13:32, 16 November 2019 (UTC)

Sex specificity in prevalence table

I think sex specificity should be listed in third column in the prevalence table, this would clarify a lot of very confused discussion about intersex. E.g. LOCAH is essentially seen in females since males are generally asymptomatic, those with XXY Klinefelter syndrome are males etc. I think it should also be sorted in prevalence order.Maneesh (talk) 23:14, 16 December 2019 (UTC)

After adding the hypospadias entries to the prevalence table, I really think it doesn't make sense to have the genotypes listed the way they are. Some intersex traits are directly related to genotype, some are not and they don't mechanistically exclude each other. E.g. a case of an XXY male with hypospadias, Turner syndrome and classical congenital adrenal hyperplasia. We have sensible equivalence classes of those genotypes, namely 'male' and 'female' and you can see that clinical literature uses those terms. Even some of the prevalences listed in the table are misleading since they don't specify sex specificity, e.g. the table entry for Müllerian agenesis is one in "1 in 4,500–5,000 births", but the WP entry is "1 in 4,500 females". "Sex specificity" should be the second column with values of 'female','male' perhaps with an optional 'mostly' modifier and 'none'. The third column should be the existing prevalence column that also specifies 'males', 'females' or 'births', perhaps also with prose when specificity is tricky (e.g. I believe all the prevalence stats on LOCAH are for females, since males are generally asymptomatic but not necessarily so).Maneesh (talk) 18:31, 18 December 2019 (UTC)

Short description revert-warring

@Maneesh: The short descriptions that include "congenital", or something else that indicates "born with", are preferable, so Intersex is not confused with medical transition that is undertaken later in life. I have attempted to keep this in the short description but you are wholesale reverting. If I am missing some important factor, include those factors in a rewrite. It is important that the short description be very clear, especially on the points that laypeople tend to get confused with other topics, such as transgender or transsexual. - CorbieVreccan ^☊ ☼ 21:48, 8 February 2020 (UTC)

The reasoning behind the reverts was presented clearly, your version made claims about anatomy when the most prevalent intersex condition by far does not have any anatomical associations; the short description that was reverted simply did not make sense. As for congenital, yes it should definitely be put in there I"ll offer:

"An umbrella term for a diverse set of congenital conditions that result in atypical characteristics of sex-associated features in humans including hormone levels, chromosomes and anatomy."

or shorter:

"An umbrella term covering congenital conditions resulting in atypical sex-associated characteristics."

One can interpolate between those two include as much detail as desired but we *certainly* can't make claims about intersex conditions and anatomy that are in direct conflict with the most prevalent conditions described in the article.Maneesh (talk) 23:22, 8 February 2020 (UTC)

The short desc. was updated to "Uncommon congenital variations that result in non-traditionally male or female characteristics"...I have no idea what 'tradition' has to do with biology here. These characteristics are *atypical* or *infrequent*, that type of language is associated with the underlying evidence that is described in terms of clinical language. The current short desc also muddles things, some characteristics are traditional characteristics (e.g. an XX SRY-ve genotype) but for the opposite phenotype (male instead of female) some are "non-traditional" (assuming I know what that means here) like ovotestis. If it should be short it really should be "An umbrella term covering congenital conditions resulting in atypical sex-associated features or atypical sets thereof." (changed from above). That makes sense in terms of several conditions: LOCAH has androgen excess (in males and females) as the atypical sex-associated feature, ovotestis are an atypical sex-associated feature on their own, males with XX chromosomes and male bodies is an atypical set of such features thought the features (on their own) are typical.Maneesh (talk) 02:06, 15 February 2020 (UTC)

"1 in N" description of frequency

There is a point in the article where it describes the frequency of a condition as "one in 50–1000 births (0.1-0.2% in the general Caucasian population, up to 1-2% Ashkenazi Jews)". I don't think it is reasonable to summarize the frequency as "0.1‐2%", so I don't think it is reasonable to say "one in 50-1000 births": it is "one in 500-1000 births", "one in 50-100 births within a specific sub-population".

I edited once. It has been reverted.

Jmichael ll (talk) 19:47, 2 April 2020 (UTC)

Prevalences are not easy to summarize for intersex conditions since they are fairly rare, sometimes asymptomatic and estimates vary considerably across populations for all of them. If one is going to have a prevalence table, then the columns need to have values that are specified the same way to make them comparable. 1 in N is a common measure for prevalence and ranges indicate the uncertainty in the estimates. It might be appropriate to omit "Ashkenazi Jews" and replace with "some populations" since they are not the only population with high prevalence (an older publication that is still cited). LOCAH, no matter which way you slice it, has a high prevalence and accounts for about 90% of the "despite its flaws" 1.7% overall intersex prevalence that is often cited (as it is in this article). Asheknazi Jews are not a subpopulation of Caucasians. There might be some quibbling about significant figures, but that should be straightforward to solve.Maneesh (talk) 20:29, 2 April 2020 (UTC)

Maybe that entry should read more like: "one in 500–1000 births (0.1-0.2%) in the general Caucasian population, up to one in 50-100 births (1-2%) among inbred populations".

Do you know what fraction of the population is considered "inbred"? (What fraction of the total population. What fraction of the "general Caucasian" population.)

Jmichael ll (talk) 04:21, 3 April 2020 (UTC)

I know this area well enough to say that the supporting quote is not complete, Asheknazi Jews are not the only population with relatively high incidence of LOCAH, look at the New et al. link in my previous message. It is cited in 2007 in Livadas an Bothou. I think given the column heading uses "approximate" (which it must in this context) changing to 'some populations' makes the most sense to avoid over specificity or a suggestion that prevalence is presumed to be estimated precisely (it isn't, esp. since symptoms are mild). A more current take on prevalence that suggests the condition is common across ethnicities.Maneesh (talk) 06:13, 3 April 2020 (UTC)

Merge with Disorders of sex development

For your information, in a discussion Talk:Disorders of sex development#Requested move 8 April 2020 relating to the move Disorders of sex development → Differences of sex development, i tentatively suggested a merge with this article might be more appropiate. Please feel free to comment positively or negatively on that articles talk page, its not yet a correctly done merge request as I have no idea how to do one or feel fully qualified to carry this specific one out. ~ BOD ~ ^TALK 09:07, 15 April 2020 (UTC)

One of the surveys has issues.

I have a issue with in of the sources, it is the survey from Australia. A big issue is that survey was self selected which means there is a possibility that the numbers don’t accurately represent intersex people’s views. — Preceding unsigned comment added by CycoMa (talk • contribs) 21:07, 7 July 2020 (UTC)

The accuracy and scholarship of that survey bother me a lot too. The quality of the source seems very poor yet it apparently represents intersex people in Australia. I am not sure how to address this appropriately. Maneesh (talk) 20:23, 8 July 2020 (UTC)

I’m a little skeptical on whether or not these people are intersex.

I checked and nowhere did it say how to make sure if the individual had a intersex condition. It didn’t say if the participants had to submit a medical record. The only thing it stated was whether or not the answers were consistent of them having a legit intersex condition.

But there is a issue with that, many of these intersex conditions listed in the study don’t have many symptoms and individuals with these conditions are never diagnosed. So it’s hard to tell if the participants were intersex or not.

They also included conditions like PCOS and Kallman syndrome as intersex for some reason. — Preceding unsigned comment added by CycoMa (talk • contribs) 21:14, 8 July 2020 (UTC)‎

I have an issue with a specific line.

“ Research in the late 20th century led to a growing medical consensus that diverse intersex bodies are normal, but relatively rare, forms of human biology.”

What does it mean it’s normal?

It sounds like it’s saying it’s not a disorder when in reality intersex conditions do actually cause issues. CycoMa (talk) 16:45, 14 February 2020 (UTC)

I agree I don't think it is a very encyclopedic sentence. I presume the intent is to destigmatize intersex conditions but 'normal' is too non-specific. We could say that all bodies are 'normal' since most require treatment at some point but then the sentence doesn't really mean anything. Maneesh (talk) 18:29, 14 February 2020 (UTC)

Maybe it could be rewritten to say that intersex bodies are healthy, or it could specify the meaning of normal in this context. Also, from the research I've been doing lately on intersex conditions, it seems like they rarely cause health issues, as one user brought up. "Corrective" surgeries done on minors are almost always unnecessary, cosmetic, and based on social standards of the gender binary (doctors assume the child will have a better social life if their genitalia are no longer ambiguous, despite most intersex people who have undergone surgery at a young age being distressed and wishing the procedure never happened). However, intersex conditions can sometimes cause issues, to that user's point. User N/A.

My issue with is that it sounds like word play to me. You could argue that what is normal is different from person to person.

However, there is a issue with that.

“ A variety of conditions that lead to atypical development of physical sex characteristics are collectively referred to as intersex conditions.”

“ Disorders of sexual differentiation are rare congenital conditions in which a baby is born with either both male and female reproductive organs, atypical sex chromosomes or atypical appearances to their genitals. In such cases, it is not always possible to tell right away (differentiate) whether the baby is a boy or a girl. In the past, disorders of sex differentiation were given names such as intersex or hermaphroditism.”

“ The causes of DSDs that present with atypical genitalia are presented here, grouped by karyotype and mechanism. The evaluation and management of such infants are discussed separately.”

“ Disorders of sexual development (DSDs) are conditions that lead to atypical sexual development in an infant. These conditions are also referred to as differences of sexual development or disorders of sexual differentiation.”

“ Disorders of sex development is considered an endocrine emergency because many common forms of DSD (ie, congenital adrenal hyperplasia [CAH]) are associated with life-threatening electrolyte abnormalities, hypotension, and shock. In addition to the potential medical emergency, the psychological stress to the family cannot be overstated.”

“ Disorders of sexual differentiation (DSD) describe a wide range of conditions in which development of the sex organs does not occur as it normally would.”

“ group of congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical”

“ A medical condition whereby the development of chromosomal or anatomical sex is in some way atypical; an intersex condition.”

Tons of sources state that intersex is either abnormal or atypical which means. Not normal.

In contrast to one of the quotes, not all intersex conditions/DSDs necessarily require treatment (easy to go down the entries in the prevalence table and see which ones). Indeed what constitutes "treatment" (e.g. infant 'normalizing' genital surgery) is being contested right now. I think the intent of 'normal' in this context is more towards 'not requiring treatment' and many DSDs do not.Maneesh (talk) 05:40, 15 February 2020 (UTC)

Just because something doesn’t need treatment doesn’t always mean it’s normal. And just because some doesn’t need treatment doesn’t mean it’s not a disorder. Like there are plenty of disorders out there that don’t need treatment. CycoMa (talk) 14:57, 15 February 2020 (UTC)

I agree with your sentiment as does Sax (see under "IS INTERSEX n NORMAL VARIANT OR n PATHOLOGICAL CONDITION?" and "NOSOLOGICAL CONFUSION"). You can also see that 'normal' is used by other authors (Fausto-Sterling) that are currently cited in the article. I would say that your earlier claim "when in reality intersex conditions do actually cause issues" should be qualified with "can" (not all intersex conditions cause "issues" e.g. some Klinefelter males are asymptomatic, LOCAH males are generally asymptomatic etc.)Maneesh (talk) 22:39, 17 February 2020 (UTC)

Sax's definition used to be included in this Wikipedia page but it was deleted, as was my demonstration against its deletion in this talk page. Sax's definition of intersex is both a verifiable and falsifiable definition and therefore a scientific definition. The reason for Sax's definition deletion was that Sax is a "Pop Scientist!" His definition should be reintroduced, but if it is reintroduced an edit war may occur. Also, Intersex has nothing to do with LGBT, yet for some reason it is link to it.Leveni (talk) 09:22, 24 February 2020 (UTC)

It is disturbing that there would be a consensus to remove Sax's paper , it is really quite excellent and directly addresses Fausto-Sterling's popularized "tongue-in-cheek" misconceptions.Maneesh (talk) 18:52, 24 February 2020 (UTC)

"Numerous studies have shown higher rates of same sex attraction in intersex people" that is currently in the article is also a gross over-generalization. The first cite used to support that claim says what is almost the opposite, that "The scientific groundwork is insufficient to support the introduction of prenatal hormone screening or treatment for the prevention of homosexuality" and the second is about a specific intersex condition (classic CAH) which is not representative of the class of intersex people by population. I believe there no meaningful association (certainly not by prevalence) with the diverse set of intersex conditions and homosexuality. These sentences should be removed.Maneesh (talk) 04:28, 25 February 2020 (UTC)

I should correct what I've written re: classic CAH. Meyer-Bahlburg et al. is cited by Dreger et al. and it does look at non-classical CAH, not just CAH. Still, the study is "modest" and was not intended to look at the prevalence of homosexuality in intersex people (though non-classical CAH are most of them). Again, I do not see any reasonable evidence that the class of intersex people is meaningfully enriched in homosexuality.Maneesh (talk) 07:11, 26 February 2020 (UTC)

I agree. Other problems occur due to the fact that many people who participate in same sex relations would not consider themselves homosexual. Plus, many people are homosexual but not openly so. And the definition of intersex in those studies includes people that Sax's definition would not include. Leveni (talk) 06:17, 5 March 2020 (UTC)

References

How did the conversation turn into this. I’m asking because Milton purposely avoids vital facts about DSDs. In his paper he mentions Klinefelter syndrome and Turner syndrome even though there is so much evidence for why they are considered disorders. Yet he tries painting them like normal variations. — Preceding unsigned comment added by CycoMa (talk • contribs) 00:45, 15 July 2020 (UTC)

"List of conditions" table should be removed

It's largely redundant with the prevalence table, has poor summaries of the conditions, has the same problem with listing chromosomes for conditions may or may not happen with aneuploidy, has a condition for cattle etc. The following conditions should be moved into the prevalence table AFAICT: anorchia, PDMS, mosaicism and chimerism. Maneesh (talk) 18:56, 28 June 2020 (UTC)

A "chromosomes" column has now been added to this table which is completely incorrect information. E.g. congenital hyperplasia affects both XX and XY and there is nothing really stopping it from affecting any sex karyotype. This table really really should be deleted. Maneesh (talk) 05:46, 11 October 2020 (UTC)