The UNAIDS Terminology Guidelines define an intersex person as “an individual with both male and female biological attributes (primary and secondary sexual characteristics).” “Intersex” encompasses a number of biological circumstances, including everything from ambiguous genitalia to differences at the hormonal and chromosomal level. Estimates for the incidence of intersexuality range from as low as 1 in 2000 births, to 1 in 500 births in South Africa. The causes of intersexuality are as diverse as intersex people themselves.
Intersexuality challenges prevailing notions about binary sex—male and female—and thus often incites stigma and discrimination. There is a lot of misunderstanding around intersexuality, especially in its more visible forms, and many intersex people will experience discrimination and humiliation within their communities and within the healthcare system. Infants born with ambiguous genitalia are often assigned a sex at birth and have their anatomy surgically altered to match that sex. Many intersex people will grapple with the results of this surgery later in life.
Unfortunately, very little research has been done in South Africa on intersex people, and thus not much is known about their vulnerability to HIV, STIs, TB, and other diseases, or about their susceptibility to discrimination and stigma. There is a desperate need for more research about intersex people, and current efforts to reduce violence, stigma, and discrimination against LGBTI people need to substantively address the needs of intersex people.