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It is the beginning of a new year.  

I often get ideas for new diaries from comments left in past diaries.  And sometimes I am reminded that I need to touch base with the beginning material in this course of study once again…because there are always new students joining in.

So the following is going to be boring for some of you but it will be, one hopes, enlightening to others.

bigjacbigjacbigjac commented in a recent diary:

'L'esbian
'G'ay
'B'isexual
'T'ransgender
'T'ranssexual
'T'wo-spirited
'Q'ueer
'Q'uestioning
'I'ntersex
'A'sexual
'A'lly
The terms I'm not clear on are:

transsexual,
(how is that different from transgender?)

two-spirited

queer
(how is that different from lesbian or gay?)

intersex

I think I understand the others.

But, 
if you write a diary,
 carefully explaining all those terms,
 that might be a reliable reference.

First, transsexual.  Now I have seen people claim that it is a term which should no longer be used because it is politically incorrect.  I have no idea where such an idea would come from.

My comment in response to bigjacbigjacbigjac has been edited into the following:

Not all transgender people are transsexual.

Transgender people are folks whose gender identity or presentation is not that which is generally associated with the sex they were assigned at birth.    Transgender is also an umbrella term used to describe most, if not all, gender non-conforming people.

Transsexual people actually go through the process to change their body morphology to their desired sex...or wish to do so (this extra phrase is included to acknowledge that not all transsexual people have the financial wherewithal to pursue such a process and that some are precluded from doing so for medical reasons).  A person can be transgender without the desire to do that.

Two-spirit

Some transgender people believe they are both man and woman.  They often adopt the term two-spirit, borrowing from First Nations people.

Some transgender people believe they are neither man nor woman, but something new and different.  They sometimes use the term gender-queer to describe this new state.

Queer

Queer is also more of a political term.  Many gay and lesbian people try to own the term, but not all queers are gay or lesbian.There are heterosexual people who also claim to be queer, especially people in the kink community. I think it is used partially in search for solidarity, but it is not in favor among all LGBT people.

Transgender and transsexual are conditions of being different which are generally expressed in one's brain, not on the body.  But we understand that the brain is part of the body as well.

Intersex

Intersex people, on the other hand, have chromosomal or physiological abnormalities that pit their bodies against the standard binary sex classifications that aver that XX is female and XY is male and that's all there is.  There are many variations of intersex, which I try to cover below.

In reality there are XX males (de la Chapelle syndrome) and XY females (Swyer's syndrome) and people who are XXY (Klinefelter's syndrome), XXX and XYY (neither of which generally have physical abnormality) and XXXY, XXYY and mosaics and even XO (Turner's syndrome, with a missing sex chromosome).

de la Chapelle syndrome was characterized in 1972 by a researcher with that name.

Usually it is caused by unequal crossing over between X and Y chromosomes during meiosis in the father, which results in the X chromosome containing the normally-male SRY gene.
This syndrome occurs in approximately four or five of every 100,000 births.

Individuals with the syndrome have very small testes and are invariably sterile, have varying degrees of gynecomastia, but no Mullerian tissue (the tissue which develops into fallopian tubes. uterus, and cervix in females).  Some research indicates that XX males are not stereotypically feminine, although facial hair growth is usually poor and they have diminished libido.

Swyer syndrome is also known as XY gonadal dysgenesis.  It is often caused by a mutation on the SRY region on the Y-chromosome.  Swyer syndrome is present in approximately 1 in 30,000 births.

The person is externally female with streak gonads (the gonads are mainly composed of non-functioning fibrous material), and left untreated, will not experience puberty. Such gonads are typically surgically removed and a typical medical treatment would include hormone replacement therapy with female hormones.
People with Swyer syndrome generally present as normal girls until they fail to go through puberty.  If the streak-gonads are not removed, there is an high threat of cancer.

Klinefelter's syndrome. also known as 47,XXY is a genetic disorder in which there is at least one extra X chromosome.  It occurs because of an error during meiosis I.  Because of the presence of a Y chromosome people with the syndrome are generally classified as males.  The syndrome is present in about 1 in 500 live male births.

Many people with the syndrome will not display symptoms.  If symptoms do appear, it usually happens at puberty.  Symptoms include reduced function of the gonads, including reduced fertility.

Because they do not produce as much testosterone as other boys, XXY males have a less muscular body than other boys, less facial and body hair, broader hips, gynocomastia, weaker bones, and lessened energy.  When they reach adulthood, they may display a lanky, youthful build with some degree of gynocomastia.  Affected males are often infertile.

The condition can also result in some cognitive developmental impairment.  Language learning and reading ability may be affected.  They may also have deficits in executive functions:  planning, working memory, attention, problem solving, verbal reasoning, inhibition, mental flexibility, task switching, and monitoring of actions.

Triple X syndrome (aka trisomy X) are females with an extra X chromosome.   The condition occurs during the formation of the ovum and sperm (either the oocyte or the sperm cell has an extra X).  The syndrome occurs in 1 in 1000 female births.  There is no difference physically between people with Triple-X and the rest of the female population.

The vast number of Triple-X females are never diagnosed, so symptoms of people with the condition are difficult to generalize.  But symptoms may include tall stature, small head, epicanthal folds at the inner corners of the eyes, delayed development of certain motor skills, speech and language, learning disabilities such as dyslexia, and/or weak muscle tone.  Girls with Triple-X are also at increased risk for delayed language development, EEG abnormalities, motor-coordination problems, auditory-processing disorders, and scoliosis.  They are also more likely to present with personality and psychological disorders and low self-esteem.  They may suffer from anxiety and may be very shy.  They are at risk for poor academic performance and may need special education.  They tend to do better after leaving school.

XYY males also do not display any phenotypical abnormality.  It is estimated that 97% of XYY males never know they have the abnormality, which is estimated to occur in 1 in 1000 male births.  The syndrome occurs as a random event during sperm formation.

The main symptom is increased growth velocity from early childhood.  XYY  males generally end up 3 inches taller than would otherwise be expected.  In fact increased height is evident in all three sex chromosome trisomies (XXX, XXY and XYY).  The IQs of XYY boys in newborn screening programs tended to be lower than their siblings, but on a par with the general population.  At one time it was thought that XYY males tended to criminal behavior, but that has been debunked.

XXXY syndrome results in males with two extra X chromosomes.  It is estimated to occur in 1 out of every 50,000 "male" births.

I suggest you watch the movie XXXY.  No, I implore you to do so.

XXYY syndrome is estimated to affect as many as 1 in every 18,000 males.  It usually occurs as a random event during the production of eggs and sperm, either with both egg and sperm having an extra sex chromosome or a sperm carrying three sex chromosomes.

Sufferers generally have some difficulty with speech and language development and learning disabilities, especially reading problems, are common.  Affected boys are better at math and skills involving spacial awareness. but may have coordination difficulties.  They have a higher than average risk of ADHD, mood disorders (including anxiety and bipolar disorders), and autism spectrum disorders.

Men with this condition tend to be taller than other men their age, tend to develop a tremor in adolescence which worsens with age, have dental problems, and are at risk for peripheral vascular disease as they age, which may result in deep vein thrombosis.  They are also likely to have flat feet, elbow abnormalities, allergies, asthma, type 2 diabetes, seizures, and congenital heart defects.

Turner syndrome (45,X) most commonly presents as the total absence of one of the sex chromosomes.  This occurs in between 1 in 2000 and 1 in 5000 phenotypic females.  In 3/4 of cases, the inactivated X comes from the father.

Females with Turner's syndrome tend to be short (averaging 4'7"), have a broad chest, low hairline, low-set ears, and webbed necks.  Girls with Turner's experience gonadal dysfunction, which results in amenorrhea and sterility.  They are also prone to congenital heart disease, hypothyroidism, diabetes, vision and hearing problems, and autoimmune diseases.  One third of Turner's women have kidney disorders.  Due to inadequate production of estrogen, they are also subject to osteoporosis.

Turner's females also have difficulties with visuospacial, mathematical, and memory tasks.

Additionally 1 in 20,000 individuals inherits Androgen Insensitivity Syndrome (AIS), in which the body's cells are unable to respond to androgen (male hormones).  An individual with complete AIS and 46XY karotype develops testes during gestation, which in turn produce mullerian inhibiting hormone, which causes the mullerian ducts to regress, so the fetus lacks a uterus, fallopian tubes, cervix,  and upper vagina.  But because the body otherwise fails to react to testosterone, the rest of the genitals differentiate in a female pattern.  Thus the newborn has genitals that appear to be female in every respect as the testes are generally undescended or only partially descended.  Occasionally the vagina may be nearly absent.  

These individuals are clearly girls at birth.  At puberty the pituitary gland signals the testes to produce testosterone, some of which the body converts back into estrogen, but this may cause delayed breast growth.  Women with AIS also do not menstruate and are not fertile.  Most also have no pubic or underarm hair.

If the condition is discovered during infancy, the testes are generally removed because, they say, of the risk of cancer.  Intersex advocates suggest that the choice of procedure should be offered to the individual at an older age so that the girl can choose for herself.  Vaginoplasty is also often performed so that the girl can have sexual intercourse with a partner having an average size penis.  Intersex advocates also think this should not be done without informed consent, including the opportunity to speak with AIS women about their sexual experiences and surgery.

AIS is a genetic defect located on the X chromosome, so XX children of carriers are also carriers, while the XY-children have a 1/2 chance of having AIS.

It is a complicated subject.  But it happens much more often than people comprehend.  Most people do not know their karotype...but are more than willing to define make as XY and female as XX anyway.  That is done in spite of the fact that, if you have been keeping track, we have about 1 in 400 live births falling into one of these intersex categories.

Discovery television produced this documentary in 2000:  

Is it a boy or a girl?

Originally posted to TransAction on Tue Jan 01, 2013 at 03:30 PM PST.

Also republished by LGBT Kos Community.

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