Transcript: Lesson 28 - Intersex People

Friends, welcome. In this unit we are going to be thinking about intersex people. And part of  our goal here is just to have a better understanding of what characterizes intersex people to  get a sense for the broad folks who is fit under this umbrella. And also to think about how do  

we as Christians, reflect on what it means to be intersex and to make sure that as we're  talking about and thinking about how our sexuality connects with God's story, that we are  aware of what this means for who you are, if you're if you're an intersex person, or what it  means for those of us, who are called to be the family of God together with intersex people.  And part of what we want to keep in front of our minds as we walk through this is that we are  called to be the family of God. That we, when we recognize what it means to be the family of  God, we realize it includes Jew and Gentile, male and female intersex that, that we constantly  have this danger of allowing our human identities, different dimensions of who we are, as  human beings, set us off or divide us from one another. But that part of what Jesus does, in  creating this new family is that it breaks down the barriers that we might otherwise put up.  That part of what Jesus does is he doesn't destroy those identities of Jew and Gentile or slave  and free or male and female or intersex. But part of what happens is those identities do not  ultimately define us, but that Jesus and our identity in him as someone who is loved by Him, is what ultimately defines us. And so we come together as the family of God, called to love and  care for each other in an important way, so we can show the love of Jesus to the world around us. And so in this first video, I just want to take a little bit of time to unpack and understand  what it means to use this terminology of intersex. And so this is this term is a general term  used for a variety of conditions in which a person is born with a reproductive or sexual  anatomy that doesn't seem to fit with the typical definitions of male or female. That's how the Intersex Society of North America defines what it means to be intersex. More recently, the  medical, the medical community has shifted to language of disorders of sex development.  Partly because intersex is is maybe a little bit more vague, or a little bit too confusing. The  notion here is that we want to be clear that there there's simply something that goes wrong in the process of development. So that a person who is classified as intersex or as DSD. So  there's something that that's not exactly quite normal there. Now, again, what do we mean  when we say normal part of what we have to recognize, here's when we think about the  biology of how we develop in the womb, and beyond that what makes us male and female, is  is actually a combination of factors. That includes both our chromosomal makeup, that when  we think about individuals being maybe this is a flashback to science class, but a woman a  female, typically is an X X chromosome, whereas male is X Y chromosomes. But it's not only  that these chromosomes, but it's also the fact that that part of the the, in the development  process is that the gonads of the young baby in the womb, are affected and become either  testes or ovaries, and that the external genitalia develops as well. In a normal presenting  female. You have the vagina and the clitoris, in a normal presenting male you have the  development of the penis, and that it's the external genitalia, the penis, the vagina, clitoris,  it's the internal reproductive organs, the ovaries, the testes, and these chromosomes that XX  or XY, that are all coordinating together. And that this this is a developmental process,  especially in the womb. This is something where over the course of especially the first few  months in the womb, that the baby is exposed to, to certain factors that cause development.  And so if something doesn't happen in sort of the normal sequence, there can be disruptions.  that and that's why medically speaking, these are called disorders of sex development, that  there's a recognition that sort of the normal unfolding the normal growth and development  pattern there, something goes wrong in that sequence. And so just a couple of examples of, of how this could look. Now, I should say, I'm going to give some of these examples. And these  are examples of what I would call more more noticeable and more obvious cases of disorders  of sex development, that actually, doctors play out that probably actually close to 98/99% of  people who have some sort of disorder of sex development, they, they might not even know  that this is something that they have, for example, it might surface in infertility in their life,  later on that something is not quite right internally, with the internal reproductive organs. But  it may be something that is is never really known. And so, you know, we're not talking about  here, sometimes people think, well, we talk about intersex that we're talking about. Maybe  people who have dimensions of both external genitalia, tend to think of extreme cases. But 

most folks who are diagnosed with DSD, and even many who aren't, never, you know, this is  not something that is necessarily significant dimension of their life. Like I said, For many, it  may not even be something that's fully known or recognized. But there are a small  percentage of folks for whom there are some some drastic effects, some more dramatic  effects on the development. And so let me give just a couple examples of what this can look  like. For example, you could have a person whose chromosomes are XY. In other words, that  would be the typical male chromosomes in testes. But external genitalia do not align. In other  words, there's a there's a lack of what we would typically consider normal development of the external genitalia of the penis of the testicles. And so, in cases like this, there are there's  clearly some significant external differences. And so understanding and being able to  diagnose exactly what's going on here, is important for doctors, especially during the the the  initial hours after birth. A couple of examples of how this could look what is complete  androgen insensitivity syndrome, and probably the most well known androgen is testosterone. And so if you think about part of what this name is trying to get at maybe in this in this very  technical way, is that in the womb, a typical XY, which again, would would typically be  presenting as a male, that in an XY baby in the womb, is exposed, usually to a larger amount  of testosterone. This is part of what causes the baby to development to develop with both  internal and external reproductive system as as you typically would see, but in this case, part  of what happens is that because of this insensitivity to androgen, that the baby is XY, in other  words it typically developed as a male, but ends up presenting both externally but even in  some cases internally in terms of the reproductive system, would present as female. And so  part of what you start to recognize here, if you understand the biology and if you do the  reading for this section, you see this is a really part of what does make us male and female,  typically, is this range, this this series of unfolding events in our development. Another  example would be this would be not quite as extreme because it's partial androgen  insensitivity syndrome, that there's a, that this, again, would be an XY individual who has  some sensitivity to testosterone, but but maybe not as much as a normal baby boy, that  there's a spectrum of male to female, external genitalia, that in this case, it might be difficult  for doctors initially to see if this is a child that would present and appear to have a shorter  penis or a longer clitoris. And so and some development of the of the testes would be  underdeveloped or maybe a little bit more developed. And so initial identification would would lead the doctors to say there's clearly there's some kind of disorder here things aren't exactly  as we would expect, but trying to understand exactly what's going on. that's going on would  be, would be part of what they would try to analyze and diagnose and figure out here.  Another example, is a condition called Congenital adrenal hyperplasia CAH. And then XX  persons. Again, this would be a baby who would typically develop into a female. But it  produces a spectrum of external genitalia. So again, maybe some ambiguous genitalia, in  terms of the penis, or clitoris, and some development there. And so you'll part what we  recognize here is that our biology is complex. And that, as you start to understand the  development of children, that that there is, there are a number of different places in the  process where one of these disorders of sex development can, can can crop up. And so it's  important to understand again, that, you know, when you think about somebody who is an  intersex person, there is this question of identity, if you think about how much of our identity  is tied up in being male or female, oftentimes into to have to walk through this process, and  wrestle with what wrestle with your identity and your biology. That's a big deal. That's  somebody who needs our support and loving care, not first and foremost, condemnation that  especially because we're talking here, about biology, we're not, we're not talking about the  somebody's life choices, if you will, but we're thinking about the actual biology. One other  example of this. And this is, this is something we actually see in some distinct genetic  populations around the world. In the Dominican Republic, there are a group of folks called  Guevedoches, and this is, actually there's, you can see the more technical name for it here.  But part of what that's referring to is these are actually individuals who are born and who  initially appear to be girls. And so they present that way at birth. But what's fascinating about  this, this this group is that, at puberty, when their body begins to change, what happens is  that they actually go through the process that most men go through in the womb, where 

there is the development of the external genitalia, where the testes drop down, and the penis  forms. And so, you know, these are again, individuals who, because of that, experience that  not in the womb, but experience as they go through puberty. And so part of the important  thing here, I think, for Christians is just to be just to be educated and just to realize the  complexity of the medical reality of the biological reality that people wrestle with. I don't know about you, but unfortunately, I think sometimes Christians have their heads in the sand a little bit. And we, you know, we want everything just to be simple, we want everything to be  straightforward. And because of that, we can often then leave to decide or, or, or make  intersex people feel unwanted or unwelcome. Because there's complex biological questions  that arise here. And so I think it's important that we are willing to understand the biology and  understand the the struggle it is for parents and and of children with DSD. And for the people  themselves who have to walk this journey, or they need us to be the family of God to them. I  do also want to just briefly highlight make sure it's clear this distinction between transgender  and intersex. So when you talk about a transgender person, you're typically you're talking  about somebody who doesn't have any kind of disorder in terms of their sex development  that they're biologically, it's clear that they are male or female, but that what we're talking  about what transgender transgender person is somebody whose gender identity doesn't align with their biological sex, whereas when we talk about intersex people, we're, we're talking  about people who, in terms of their actual biology, there is some ambiguity or lack of clarity,  something that has happened in the process there that has that has affected their biology.  And so with this in mind, it's it's important, I think, to think, what does the Bible say? Does the Bible Speak to intersex people? Or how should we understand people who have DSD? What  does scripture say about this? What should that lead us to and what should be pastoral care  for people who are walking that path? And so in the next couple of videos in this unit, we will  pick up those questions and and process those together. So until next time, blessings