Is this Intersex condition realistic & sensitive?

[cavitycollector]

Hello. I am writing a comic, and in the comic there is a man who is meant to be intersex. I have done as much research as I could find into different Intersex experiences and though I’ve seen none that are identical to his, based on what I’ve read think it is possible? I think I probably have an okay enough grasp of the actual science behind it, but in terms of his personal experiences I’m not sure.

He is a man in his late 20s. He currently has notable breasts, a deep voice, a lot of body hair, and is very heavyweight. For his backstory so far I have written: He was born in the 1990’s with male appearing genitalia, and was assigned male at birth due to this. He was raised as a boy, but during childhood he began to experience negative symptoms such as fatigue, weightloss, muscle weakness, and early development of body hair and odor (precocious adrenarche). He was seen by a doctor who determined he was actually female, and his parents not knowing what direction to go with hormone therapy let him choose. He chooses estrogen for a female puberty because he has always behaved femininely and been bullied for this, so he believes this might be the answer. (He also starts other treatments for the other symptoms of congenital adrenal hyperplasia) Once he begins this therapy and transition develops breasts, he realizes he doesn’t want to continue with female hormones and asks to be socialized as male again and to start male hormone treatments instead.

Throughout this, his parents would be trying to do what is right while completely out of their element, and there would be some conflict about the difficulty of resocializing as female and then male again. they would not really understand and slightly resent losing their son, and then again not understand and be both frustrated by the switch and also relieved to have their son back. In adulthood his parents do not acknowledge his technical female sex, they just desire normalcy.

My main concern is the parents, doctors, and character himself choosing a female puberty at first. I have no idea if that is realistic, especially for the 90s. Most of the experiences I’ve read even when the child is ”biologically the opposite sex”, they continue being raised as their AGAB with or without their consent. I know this experience would be unusual in that way, but I don’t see why it wouldn’t be possible. I feel some parents may justify it because it is technically their “true sex” and therefore bioessentialism states they must be raised as their “true sex”. These parents would have been willing to go either way and believe whatever their son seemed to lean towards due to their complete ignorance on the subject.

If you believe this is unrealistic, what other ways could I come about having an intersex character with these adult physical traits, who identifies as male, and is fully accepted as such by his family, who have been shown to NOT be accepting of transgender people, just him due to it being a “real medical problem”.

Comments

[melannen]

I am not sure about the hormone therapy questions - I suspect it would depend a *lot* on when and where he was, and also exactly what doctors he was going to - but I think it's very unlikely even today that any doctor would look at a child with unambiguous male gentalia and no obvious dysphoria and say they were "actually female" regardless of their genes or hormones, doctors tend to go with genitals if asked to make a call. If their genitals are in some way ambiguous, with CAH they would likely have been tagged as intersex at birth, and decisions about how to socialize them would have been made with the parents then (and possibly revisited later). In my understanding of CAH, XX people with CAH are very unlikely to have unambiguous male genitals anyway.

I'd advise you to tread carefully regardless if you want to go in that direction; the question of treating children with hormones is a *really* hot-button issue politically right now in many countries and you could end up telling a story that was harmful to real-life people dealing with serious threats if you weren't very, very careful.

Anyway, if all you need is a dude who is intersex, has complicated gender feelings about it, and has bodacious bosoms, I would probably go with Klinefelter's syndrome. Most people with Klinefelter's are raised cis male and many are not aware of their condition until puberty or later if at all, and breast development (gynecomastia) is a common symptom. (Although if you don't need him to have a lifelong intersex condition, gynecomastia happens in cis males not infrequently too, due to a variety of things. And many heavyweight men develop nice boobs without any medical condition.)

[cavitycollector]

With the doctor saying “Actually female” what I mean is not that he would up and say “Oh well you have XX therefore I will call you she now!” I just mean “He is biologically considered female, so thats why these issues have arisen.”, which is completely medically accurate and says nothing about how the doctor actually perceives the kid. My character would be presenting with gender dysphoria symptoms, because he does feel ostracized from masculinity and wants to be allowed to present femininely. (As an adult he wears mostly womens clothing and does makeup, etc. because thats how he feels most comfortable.) i’d call him genderqueer but, he doesn’t identify that way so I wont.

However, despite what I just said. After further research to fact-check your reply, I did find more information that clarified some things that had become fuzzy between researching the different forms of CAH and I see yeah my proposition is not good.

I already researched Klinefelter's and originally when I created him that WAS the disorder I had in the back of my mind, but comically the issue with that is that Klinefelter’s doesn’t seem to result in breasts as obvious as my character has, same goes for him being heavyweight not being enough. (I’m not talking cartoon crazy big bazonkers, they're just realistic for a woman of his size.)

I am still considering the possibility of changing the backstory up to fit closer to one of the CAH subtypes, or finding another way to fit estrogen therapy in there to result in larger breasts. His backstory is very malleable in that regard, the only necessary elements are

1. He develops the previously listed secondary sexual characteristics.


2. He goes through this process in a way that would not necessarily upset transphobic parents.


3. Preferably he remains identifying as a femme cis man. But that ones a little flexible.

Finally, on the political sensitivity note; I am quite aware of this issue. This plot is in no way central to the story, this character has a sister who is protagonist and whose gender and sex is the only one explored in the comic. It may not even come up once in the entire story. It’s simply that in writing and understanding this character, these details are important to me. I am not content to leave this gaping hole in my world with a lack of reasoning for why he looks the way he does and why he has the relationship with his family that he does. ¯\_(ツ)_/¯

[melannen]

Gynecomastia can give men breast development well into average female range! If you combine that with volume from fat and or muscle they could certainly be more than enough for your purposes. (They won't necessarily look like cartoon boobs but real cis women's usually don't either.)

If he actively likes looking femme he could also certainly have gotten them on purpose through either self-administered hormones or somewhat illicit implants, and then lied and told his parents it was the medical condition. There's a long history of people of all gender identities, including cis male, doing that for various reasons. He'd need connections in queer communities probably to know how but he could also be keeping all of that very secret.

The specific narrative of getting prescribed feminizing hormones during puberty and then changing his mind is not only really, really unlikely but it's right out of modern transphobes' most paranoid fantasies. If you're in a place where you need to ask for a sensitivity read on that you should probably stay very far away from it.

I'd also add if he's not a main character and the precise configuration of his body and its history isn't a plot point you might not actually need all the medical details up front - it sounds like a lot of this is about presenting a contrast with the main character's story? You really only need to know what the MC knows (which may not be a lot - parents are often very secretive about intersex kids.)

[pauraque]

I don't have the knowledge to answer your intersex-specific questions, but one thing I can say is that you do not want to be using terms like "actually"/"technically"/"biologically"/"true sex" when what you are talking about is a person's genes. Genetic sex is not more actual, technical, biological, or true than other sex characteristics, and that framing is transphobic. (If you have your fictional characters speaking ignorantly because they don't know any better, that's fine, but you as the author should know they're being ignorant.)

[cavitycollector]

In some parts I am using purposefully ignorant language to fit the characters and in others I am using the terms provided by the medical documents I have been crawling through to understand what the hell it is I’m writing. I myself am trans, I know the way to use proper terminology. Talking about complex intersex biology is still outside of my regular wheelhouse.

edit: after rereading this post which was originally written when I was running on 40 hours of no sleep, I realize I used a lot more of this terminology than I recalled. I think I turned off the part of my brain that thought about these things and just started using the exact same terminology I was reading off the medical documents because I could trust it would at least be readable lol.

[lilacsigil]

He was seen by a doctor who determined he was actually female

How and why did the doctor determine this? It's very unlikely that an intersex child in the 90s would be allowed to choose either male or female puberty, particularly as you've set up a framework of his parents and doctor being very set on what his "real" sex is.

[cavitycollector]

Due to the symptoms he would be exhibiting, a genital examination would be conducted. With the specific subtype I was attempting to pull from, the genitals become quite obviously abnormal after infancy, and that combined with a blood test for the hormone deficiency would narrow down exactly what subtype and what chromosomes the character had. After further research replying to a different comment, I have gotten some things cleared up on CAH subtypes I do realize this is not possible but not for the reasons you have brought up. (with the actual subtypes now as I understand it, he would either have to have a subtype that gives him standard female genitalia & late diagnosis, or ambiguous genitalia & early diagnosis, due to the life threatening complications only present in the second case.)

I set up that framework as a suggestion for how it might work in the setting, not as the setting itself. That was one way my brain provided to rationalize it, I admit a shabby one but that is why I came here; because I knew what I was writing was shabby.

To be quite honest I’m not sure why I wrote that specific line you quoted the way I did, I had not slept for 40 hours when I wrote it. If I rewrote it now I’d have been much clearer.

[lilacsigil]

Yeah, I think it might be a good idea to do a bit more reading about intersex experiences and medicalisation before starting with the medical determination.

[cavitycollector]

i assumed the medical determination would be easiest to start with researching as a good baseline since its something that is diagnosed and therefore has criteria i can understand and build off of. but i suppose not. lesson learned. this is my first time trying to write any of the stories i made in my head down and i never went to school so i dont really know how youre meant to research.

[lilacsigil]

Asking questions and realising your approach is not right is definitely part of research! One of the reasons I enjoy communities like this is seeing everyone's different sources and approaches, and now you have more ideas about what you need to find out.


This is an article about the basics of research for writers and what to do with that research.
https://www.thefussylibrarian.com/newswire/for-authors/2024/03/15/research-for-fiction-writers

[yalovetz]

I would seriously rethink writing an intersex character, given the way you currently talk about intersex people. You've called intersex variations "disorders", referred to intersex people's genitals as "abnormal", and seem to have done most of your research by looking at pathologising medical information, which is problematic given how frequently intersex people are seriously traumatised by the medical establishment. Try reading up on the subject using resources from intersex-led organisations and researchers, such as OII.

[cavitycollector]

ive been looking at pathologizing medical information because i need specific info on specific intersex conditions, which none of the intersex run foundation pages ive gone over have covered as in depth as medical journals do. and perhaps I am using outdated over medicalized language and I apologize for that, but most of these are terms I’ve heard my intersex friends use to describe themselves so I assumed those ones were fine. I read several articles and blog posts of strangers personal accounts about living as intersex too, but none of them ever corrected any of the language so i didn't get that there either.

I filled in the blanks of things i hadn't heard before with what the papers were telling me, and used my knowledge of how doctors treat “biological sex” for flavor in certain places to fit the setting. I 100% admit, i haven't done as much research into the broader societal issues of intersexuality as would be required to write this character, I'm fully aware!!! thats why this is a WIP!

so far the reason I only relied on a few personal experiences and medical documents was because i went “oh, ill just figure out what condition he has first so i can cross reference that while i read through the lived experience literature!” and fell down a confusing rabbithole that made me rethink the whole character and im now just trying to wrap my head around that so i can get back to the cultural research.

I’m in the earliest stages of research and i thought popping in here to get some feedback on this rough draft of a possible origin for the character design i created and fell in love with years ago, using as much of the medical knowledge i could gather to be accurate; would be helpful to push me along so i could get back to the sociological research. this is my first time posting so maybe i misunderstood the culture here.

i probably shouldn’t have used the word sensitive in the title since that isnt quite my goal yet, it was more like “is it completely out of touch?” than “is it perfectly modern and correct?” i will be working on correcting my offensive language. i already planned to read those things, i just got distracted with this.