[Clinical Notes] More on the 'Identifying as intersex' dilemma
First, a note from Dr Margarita Holmes: I first started this column to provide a more clinical perspective to problems that our Two Pronged format is less suited to. Mr Baer then suggested I expand this column’s remit to include answering the sort of letters that require much more psychological training and sometimes even internship in an institute of higher learning. An example is the letter below, a continuation of the previous Clinical Notes.
Dear Dr Holmes:
[To summarize from Clinical Notes: Identifying as intersex] I am a 38-year old intersex person (Partial Androgen Insensitivity Syndrome) masquerading as a lesbian to avoid more confusion... I am a type of person who won't easily put my foot forward, maybe because I always put it in my head that I need to conceal my genetic condition… I have a lover of 4 years, Susan, who met another lesbian, Cora (who is) much more financially stable but old enough to be her mother. We broke up.
I discovered that Susan is nurturing another relationship with Cora. Our relationship got a lot worse… In October 2014, we called it quits.
We got back together, except now we don’t live together. She stays in our rented apartment in the city near her workplace; I in a house in Bulacan from a loan from PAG-IBIG fund near my small business.
In December Susan moved near Cora's place. Her sister lives with her. Cora seduced her family with money and presents, and stays a few hours at the new apartment. Then she goes home because to her own place which she shares with her GF of 15 years....
Susan and I still meet at least once a month. She helps me financially when needed; reminding me that I am still the one she wants to be with in the future.
Is she really sincere about her words? Am I being too gullible? Everyday my feeling of loneliness and self pity grows. I even managed to stay at home alone during Christmas and New Year's when everyone was celebrating.
Do I need to move on and leave all things linked to her? What about my feelings and our future plans?
Please forgive me for taking much longer to answer this letter (part 2 of Clinical Notes] Identifying as intersex) than I had originally estimated.
You see, initially, I saw your problem as mainly a relationship problem, common among people of any gender or orientation. I consulted 3 of the LGBTIQ experts in Philippines – University of Hong Kong Professor Dr Brenda Alegre, UP Diliman Professor Eric Manalastas and UP Tacloban Professor Pierce Docena – and they, too, felt as I did.
They – and ahem, I – are essentially correct. The situation you are in, vis a vis Susan and Cora, is fraught with infidelity, subterfuge. And the inevitable insecurity and vulnerability that follows IS a relationship problem. It happens to all people of all genders and sexual orientations.
However, while that is essentially true, it is just as true that being intersexed is part of who you are and I cannot help feeling that has had an impact on your relationship with Susan.
But hindi rin, eh (but that is not really the case either). It is not really being intersexed that is the issue, rather, it is how you seem to think being intersexed is a liability.
Look, I won’t lie to you. Being intersexed, and thus part of a sexual minority, can be damn difficult. In many ways, it can be even more difficult than being “merely” gay or “merely” lesbian, because it is not necessarily a factor a potential partner would know without either being told beforehand or realizing for herself once you are undressed.
That fact could make you even more vulnerable (to being outed, etc.) than other sexual minorities. In that sense, you are 100% spot on in being cautious when getting involved in relationships. In many senses, cautious (but not fearful) is a good quality to possess when deciding whether to get close to another person or not.
But you seem to feel being intersexed is even more of a liability than that. One of your first statements about yourself in your letter is: “I am a 38-year old intersex person ( Partial Androgen Insensitivity Syndrome) masquerading as a Lesbian to avoid more confusion... I am a type of person who won't easily put my foot forward maybe because I always put it on my head that I need to conceal my Genetic condition (italics mine).”
You describe yourself as needing to “conceal” your genetic condition, but did you ever ask yourself why you really need to do that, Angela? Who said you had to hide being intersexed? You don’t need to shout it from the rooftops – no one needs to shout anything about their sexual orientation or gender identity or anything else about them from the rooftops if they don't want to – BUT being intersexed is nothing to apologize for – least of all to your lover/s.
You are not masquerading as a lesbian, Angela. You are a lesbian – a person whose gender identity is female and whose sexual orientation is also female.
And I am not saying this in the hokey-rose-colored-wearing-glasses-a-Pollyanna-skipping-along-a-bed-of-roses-might-wear-as-she-tralalas-“You-can-be-anyone-you-want-to-be”- way either.
There is absolutely no doubt that prenatal sex hormones (and thus biology) play a big role in both gender and sexuality in everyone. In your particular case, your biology did not follow the typical female pattern. Well, so what, right?
All this means is that your body did not follow the typical female pattern. It’s no big deal…except to anyone who wants it to be...and, alas, anyone who has been taught (whether verbally or non verbally) that it is. There is a movement for Intersex rights that insists that intersex cases are differences, not disorders, because there is nothing inherently pathological about being intersexed. There is no reason an intersexed person cannot live a perfectly normal life.” I agree with this movement’s position entirely.
In fact, I also agree entirely with Dr. Lehmiller, our Harvard professor and sex researcher, and author of The Psychology of Human Sexuality (NY: Wiley 2013) who says that: "…while both situations of 5αRD and AIS involve biological males with XY chromosomes and testes whose bodies do not get the full effect of androgen exposure, one of these cases usually results in a female identity (AIS) and the other in a male identity (5αRD).1
“That is probably because in AIS the entire body (inc the brain) is not responsive to androgen (male sex hormone) which means the brain doesn’t get a chance to be masculinized..…(suggesting) that gender identity is ‘hardwired’ into the brain.”
In other words, dearest Angel, there is no doubt you are a person whose gender identifies as female and loves other females; the way Susan, Cora, and possibly Cora’s girlfriend of 15 years does.
Just because you are intersexed doesn’t mean you are less able to insist on the kind of love you want or less able to chart your own course. Once you yourself believe that, it will be easier to either get Susan believe it or leave her if she doesn’t.
All the best,
*1(5αRD) stands for five-alpha-reductase-deficiency which occurs when a biologically male fetus has insufficient levels of the enzyme 5-alpha-reductase, resulting in a feminized genital appearance, even if male gonads are present internally. When testosterone production increases almost exponentially (puberty), the bodies of people with 5αRD masculinize and most switch from a female to male gender identity.