The LGBTQIA+ community encompasses wide spectrums of sexualities and gender expressions. Among these identities are two that are often confused: intersex and nonbinary. We talked to registered nurse Mx. Francis Kuehnle and clinical psychologist Dr. Lori Lawrenz to break down the terms and the differences between them.
What does intersex mean?
According to Dr. Lori Lawrenz, a clinical psychologist specializing in Sexual Health at the Hawaii Center for Sexual and Relationship Health, intersex is an umbrella term for those with bodies that don’t fall into the binary male or female categories. There are multiple ways a person can be intersex (think: their internal sex organs, chromosomes, or external genitals).
Intersex identities are typically divided into four categories:
XY Intersex…Having male chromosomes and external genitals that either appear female or didn’t finish forming.
True Gonadal Intersex…A person with both testicular and ovarian tissue.
XX Intersex…Having the ovaries and chromosomes of a female and external genitals that appear male (think: an enlarged clitoris that looks like a penis).
Complex or undetermined intersex disorders of sexual development…Experiencing issues with the sex hormone levels or a different number of sex chromosomes.
But every intersex person has a different experience as well as traits that define who they are.
What are some common traits seen in intersex individuals?
An intersex person may experience or demonstrate:
A delayed or non-existent puberty phase.
Partial labial fusion — meaning the inner lips of the vagina are sealed together
Clitoromegaly (an enlarged clitoris)
In the past, surgeries to "correct" intersex anatomy were unfortunately common. Are they still an issue today?
Sadly, yes. According to the Human Rights Campaign, many of these non-consensual surgeries are performed in children two years old (or even younger) in an effort to adhere to societal norms.
Doctors often assign intersex children into the gender binary of male or female. But that doesn’t mean this is the gender identity they’ll grow up to identify with. The term was coined in the 1950s as doctors began to perform surgeries on intersex children to alter their anatomy. But in the 1990s, advocates began to speak up against these surgeries and provide a spotlight for the intersex community.
Clitoroplasty (repositioning or reducing the size of the clitoris)
Gonadectomy (removing the organs that would make sex hormones)
Vaginoplasty (the creation or alteration of a vagina)
Some parents choose these surgeries because they feel it's best for their child’s physical or mental health. Or fear of future judgment that their child could endure. Regardless, “this practice has been denounced by every major medical organization, and the current practice standard is to wait until the person is old enough to make an informed decision to have any surgical or medical interventions,” said Mx. Kuehnle.
Intersex advocates are at work to stop these life-threatening practices and allow intersex people to make their own choices about their bodies.
So what does nonbinary mean? And how is it different from intersex?
Nonbinary is a word used for one’s gender identity or experienced gender that falls outside of the male or female binary categories.
“For any transgender person, the sex assigned at birth doesn’t match up with their gender identity. For nonbinary people, we don't fit in the binary options presented,” Mx. Kuehnle explained.
What are some common traits of those who identify as nonbinary?
Mx. Kuehnle made it clear: “There’s no one type of way to be nonbinary, or ‘look’ nonbinary.”
In other words, nonbinary people can have any gender they feel fits them best. Also worth noting: “Nonbinary” is an umbrella term that includes a wide variety of ways to understand gender — including agender (not identifying with any gender), bigender (encompassing two genders or moving between two genders) and more.
Accordion to Dr. Lawrenz, genderqueer (rejecting traditional gender ideas and embracing fludiity in gender) and genderfluid (someone whose gender expression changes over time) are [also] ways a nonbinary person may present themselves.
What are the main differences between intersex and nonbinary identities?
Dr. Lawrenz explained that all intersex conditions are technically nonbinary, since the anatomical and sexual organs don’t fall within the binary notion of male and female. “Intersex individuals get to choose their gender identity as they evolve — and when this occurs, they may be male, female, nonbinary, genderless, or whatever gender they choose,” said Dr. Lawrenz.
The case is different when it comes to a nonbinary individual. “A nonbinary person is, more often than not, not born as an intersex individual,” said Dr. Lawrenz. “A nonbinary person is identifying their gender as falling outside of a binary standard (male or female) that’re often the societal options given to define gender.”
Why do people often confuse these two terms?
The idea of a third gender is not new when looking back at history. And the ideas of gender and sex are also not new. But they’re often seen as the same concept, when they’re anything but.
“The notion of a nonbinary gender identity can give people pause if they’re used to the notion of male and female as the gender options. Because an intersex condition involves reproductive anatomy and the biology of the body one is born with. The gender is selected by the doctor at birth,” said Dr. Lawrenz.
“The notion of intersex conditions involves many different hormonal and/or physiological presentations all of which fall outside the binary-thus by definition an intersex condition is nonbinary. A nonbinary gender identity is a different concept involving labeling your gender as consistent with your body you are living within. There is a lot of nuance.” said Dr. Lawrenz.
“Many people (especially those raised in Western cultures) grew up with the understanding that gender and sex are the same thing. Over time and with research we’ve come to realize humans are more complex than that,” said Mx. Kuehnle.
What percentage of the LGBTQIA+ community identifies as intersex or nonbinary?
1.7% of the population has an intersex trait. (According to Mx. Kuehnle, this is a “similar rate to the frequency of identical twins.”)
“…Some estimates say it’s one in every 1000 children born – About the same as being born with red hair. Some people with intersex conditions identify with the LGBTQIA+ community and some don’t – making the percentages hard to truly know,” said Dr. Lawrenz.
Intersex and nonbinary are just two of many expressions of gender and sexuality. Understanding the difference between these and other identities — within the queer community and beyond — can help us explore our own identities more deeply and better support those around us. Looking to learn more? Let's talk about the evolution of the term LGBTQIA+ throughout history and what each letter stands for.
Subscribe to Skimm Well
Sign up here to receive our wellness newsletter filled with actionable advice, expert-vetted content, product recs, and more — delivered directly to your inbox.