Introduction

Things used to be so simple. Fifty years ago, grandmothers asserted that girls were made of "sugar and spice, and everything nice" while little boys were made of "snips and snails and puppy dog tails." But what happens when a child is born with a mixture of sugar and spice as well as snails and puppy dog's tails? A recent media explosion (such as a feature on "60 Minutes") has shined the light on what is commonly being referred to as "intersexed" people -- a term used to describe a set of medical conditions that features congenital anomaly of the reproductive and sexual system. That is, intersexed people are born with sex chromosomes, external genitalia or an internal reproductive system that are not considered "standard" for either a male or female. Sadly this condition is real, and unfortunately the victims find themselves in both a physiological and a political battle. Besides any visible abnormalities, these individuals often are sterile, lacking either a complete male or female reproductive system. Additionally, many individuals in the gay and lesbian community are holding up the hands of intersexed people in an effort to say: "Look, we are like them. We were born this way." However, scientific evidence is becoming available that demonstrates intersexed people are vastly different from homosexuals.  

While the term intersexed is not yet found in most current medical dictionaries (e.g., the second edition of the acclaimed Stedman's Concise Medical Dictionary), hermaphroditism is. This term -- used prior to the politically correct era -- is defined as the presence in one individual of both ovarian and testicular tissue (1993, p. 461). Current estimates indicate that 1 in 2,000-3,000 persons are born with what has been termed "non-standard gender." Of these, only small percentages are classified as true hermaphrodites. These children, frequently sterile, are born to unsuspecting parents whose hopes and dreams often are crushed as the confusion and reality of the situation sets in. Many times in these cases, a gender-identity team from a hospital is employed to further determine the actual sex of the child. Adolescents with abnormal sexual differentiation present a unique challenge to their healthcare providers -- should the child be surgically altered to be a male or a female? In the past, this lifelong decision generally was made immediately after birth. And any necessary surgery was performed for cosmetic reasons, the result being that the function of the genitals was compromised. Today, clinicians are rethinking recommended protocols.

Sex Chromosomes

Men and women share 22 pairs of chromosomes; only one set is different (there are two X chromosomes in women, and an X and a Y in men). People with true hermaphroditism -- an extremely rare condition -- usually have chromatin-positive nuclei [containing the X chromosome, or Barr bodyBH], and 80% of them have a 46-XX chromosome constitution (Moore and Persuad, 1993, p. 292). As such, they generally are reared as females. Male and female pseudohermaphroditism also occurs, resulting in abnormal gonadal appearance as well as androgen insensitivity syndrome (sometimes referred to as testicular feminization). Research conducted over the past forty years indicates that the Y chromosome causes many of these conditions. In 1989, the testis-determining gene SRY (which stands for sex-determining region) was identified. To be effective, SRY must be expressed at a particular time and in a specific location during development. In the absence of expression of the SRY gene, testes do not form, the result being that the same region later differentiates into an ovary. Current evidence suggests that the SRY gene acts principally as a switch, and that the genes necessary for guiding subsequent events are present in other areas of the Y chromosome as well as elsewhere in the genome, such as chromosome 9.

 In 1999, a team of scientists from Melbourne, Australia, discovered that some genetically male children are born with female sex organs. The researchers observed that genetically male children that were born without a gene known as DMRT1, failed to form testes (Smith et al., p. 602). This particular gene is located on Chromosome 9, which means that both men and women possess copies of it. However, researchers discovered that the gene is regulated differently in men and women. They found that the gene was expressed in high levels in the developing testes, but in low levels in the ovaries. They believe that females born with testes may have an extra copy of the DMRT1 gene.

Sex determination in mammals is controlled not just by SRY and DMRT1. Various transcription factors, some of which we have yet to identify, also can lead to variations in sexual organs. Thus, we see that alterations of the normal sex determining genes frequently result in humans that possess both male and female characteristics. This information provides compelling evidence that the intersexed condition is the result of mutated genes.

Reaching a Middle Ground

Traditional practice at the birth of a child with ambiguous gender involved the parents making a decision (usually coached by medical practitioners), which sometimes included the use of incomplete communication of facts about the infant's condition and a recommendation of early surgical intervention to make a "definitive" sex and gender assignment. Today we have DNA testing and internal-imaging tools (such as MRIs) that can better determine both what the sexual chromosomes of the individual are, and what internal reproductive organs are present. Children should not be surgically assigned a sex until clinicians know for sure what their gender is. As we are now finding out, early surgical intervention may not always be what is best for the child. Parents (and other adults involved in the counseling process) should encourage intersexed individuals to undergo genetic testing to determine what sexual chromosomes and internal organs are present. Christians must not be prejudiced against intersexed people just because they are physically different, but instead must express genuine concern and sympathy.

Conclusion

In the beginning, God created humans male and female (Genesis 1:27). Today, however, we know that individuals are born who possess both male and female reproductive tissues. As Christians, we must tear down the veil of shame and secrecy, and deal with issues such as these that current societal conditions have placed squarely on our doorstep. Intersexed people are people with souls -- as well as people who may one day want to marry and rear children. As each day brings new ethical dilemmas, we must strive to look at them within the scope of God's Word. And that Word -- not human opinion -- must remain the criterion against which every new development is to be measured. While the homosexual community envelopes the intersexed with open arms and calls for Americans to look at people that are "born with gender issues," we must not forget that scientific evidence establishes that these abnormalities are a result of humanity's mutated gene pool. Through the years, the sex-determining genes -- such as SRY and DMRT1 -- have mutated as the result of people's exposure to harmful chemicals like DDT, asbestos, thallidomide, Agent Orange, etc. Christians must be compassionate toward intersexed people, but at the same time must not allow society to return toward the ways of Sodom and Gomorrah by advocating that intersexuality proves that homosexuals are simply "born that way."

References

McDonough, James T. Jr., ed. (1994) Stedman's Concise Medical Dictionary (Philadelphia, PA: Williams & Wilkins), second edition.

Moore, Keith L, and T.V.N. Persaud (1993), The Developing Human: Clinically Oriented Embryology (Philadelphia, PA: W.B. Saunders).

Smith, Craig A., Peter J. McClive, Patrick S. Western, Kirsty J. Reed, and Andrew H. Sinclair (1999), "Conservation of a Sex-Determining Gene," Nature, 402:601-602, December 9.

(Brad Harrub earned his Ph.D. degree in anatomy and neurobiology from the College of Medicine at the University of Tennessee in Memphis. He is a member of the Society for Neuroscience, and was listed in the 2001-2002 edition of Who's Who Among Scientists and Researchers. Dr. Harrub is the author or co-author of numerous scientific articles published in refereed science journals, and the book Diamonds in the Rough: Nuggets of Truth from God's Word. He is a popular speaker on Christian evidences at lectureships, youth rallies, etc. Currently, he serves as the Director of Scientific Information at Apologetics Press and as associate editor of Reason & Revelation, a monthly journal on Christian evidences. He and his wife Melinda attend the Eastern Meadows Church of Christ in Montgomery, Alabama. They have two sons, Will and Reese.)