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Leah Bader
CAS 138T
Ben Henderson
8 April 2014
Implementing an Intersex Gender Option in the United States
As many as 1 in every 2,000 babies are born with both or ambiguous sex
characteristics (How common is intersex?). Currently, parents are forced to choose a
gender category for their newborn infants in order to satisfy federal regulations that
require every baby born to have a gender/sex (Chappell). In the 1950s and 1960s it was
proposed by Dr. John Money that gender identity in infants was determined by their
surrounding environment and the way people treated them. This was tested in the famous
John/Joan experiment run by Dr. Money. Two twin infant boys went in for a routine
circumcision at two months, but after a mechanical malfunction, one of the baby boys
external genitalia was extremely damaged. The parents, counseled by Dr. Money,
decided that the infant would undergo surgery to appear feminine and with the help of
hormones and their nurturing care, would be able to be raised as a normal girl. At first Dr.
Money reported the experiment as a success, as the girl began to grow and seemingly fit
into the conventional female gender role. Years later, David Reimer came forward and
identified himself as the object of the John/Joan case. It was discovered that Dr. Money
published very skewed results and that David was very troubled, depressed, and
sometimes suicidal while he was raised as girl. After his parents told him the truth of his
gender at the age of 14 he decided to revert back to male (Dr. Money and The Boy With
No Penis).
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This is the most famous example of attempting to raise and nurture a baby into a
particular gender role. Gender identity is much more embedded within a person and is
determined by the higher levels of exposure to hormones, like testosterone, and
androgens a fetus receives prenatally. Simply put: you cannot raise someone to be a
specific gender it is predetermined before birth. This is the problem many parents of
indeterminate sex babies are faced with at the birth of their child. Since they are forced to
decide their childs gender immediately, some of the time the parents initial guesses are
wrong and a baby they choose to identify as female will grow up possessing a male
gender identity and vice versa (Hopkins Research Shows Nature, Not Nurture,
Determines Gender). Going even further, a lot of parents decide to put their infants
through normalizing surgeries of their genitalia, in order to conform their children to
the notion of the conventional gender identity they have chosen for them. Some of these
children grow up and see this early operation as a mutilation and say that as adults,
they would have never consented to it as it just added to the complications they
experienced while trying to figure out their personal gender identities (Chappell).
This can be seen in a study conducted at the Johns Hopkins Childrens Center,
where William Reiner, a child and adolescent psychiatrist and urologist, followed 27
genetically male children who were born without a penis and were surgically made to
appear feminine. The study reported that once the children reached the age range of 5-16
years old, the majority of them subsequently reassigned themselves back to a male
identity. Consequent studies have reached similar conclusions to the point that the
scientific community is calling for a reevaluation of the practice of sex-reassignment in
children and extreme caution is urged by psychologists to parents considering a sex
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assignment surgery for their infant. Reiner states, These studies indicate that with time
and age, children may well know what their gender is, regardless of any and all
information and child-rearing to the contrary. They seem to be quite capable of telling us
who they are, and we can observe how they act and function even before they can tell
us," indicating that these children will be able to sense their own gender identity fairly
easily, maybe even as early as 5, 6, or 7 years of age (Hopkins Research Shows Nature,
Not Nurture, Determines Gender).
The proposal is that the United States would allow an indeterminate sex option on
birth certificates for parents with these ambiguous gender babies. That way the child
would be able to decide their gender identity on their own once they were old enough to
articulate their feelings. This would lead to fewer sex operations on infants that are then
reversed later in life once the child determines they identify with the opposite sex than
what their parents chose, as well as a reduction in sex assignment operations on infants
overall (Hopkins Research Shows Nature, Not Nurture, Determines Gender). After all,
attempting to choose the gender identity of an ambiguous newborn is basically a 50/50
guess and can lead to a lot of emotional distress and trauma for the individual later in life,
as can be seen from David Reimer from the John/Joan case, who committed suicide in his
thirties due to irreparable emotional damage that occurred during his childhood (Dr.
Money and The Boy With No Penis).
Germany recently implemented a similar policy in 2013. Like in the United
States, parents were forced to make a hasty decision about the gender identity of their
ambiguous newborn to satisfy federal regulation laws. The new policy allows for parents
to identify their newborns as an intermediate gender, which satisfies the federal
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regulation laws and gives the child the freedom to be able to make their own decision
later in life. While Germany is the first European country to implement a policy like this
many other countries around the world have similar options on other personal documents
for children, as well as adults (Chappell).
The third gender option policy can extend beyond birth certificates, specifically to
apply to passports. While Germany is one of the first to try to tackle the gender identity
problem with birth certificates, there are examples of multiple other countries allowing
for an intermediate gender option on their government documents, allowing the
transgender population to identify more accurately (Chappell). To start, Australia just
recently implemented in a new policy in 2013 that allowed people to list themselves as an
intermediate/intersex gender on passports without proof of a sex reassignment surgery.
Instead, an individual just needs a doctor to examine them and write an evaluation as
proof that they truly live the life of a transgender person. Identifying as a third gender as
an adult is usually associated with problems of personal freedom and encouraged by the
age old adage of being yourself, but policies pertaining to this topic could also be
helpful in remedying some logistical problems. The reason Australia implemented this
policy is because the country was having problems in that their citizens would be
detained at airports because their appearance did not reflect the gender determination on
their passport (New Passports to Allow Third Gender). The new intermediate gender
option allows the number of detained citizens to be greatly reduced, saving time and
money from trying to straighten out misunderstood situations. After all if a citizen of the
United States is detained in a foreign country, time, money, and a great deal of effort is
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put forth in an attempt to get that individual home especially if they are being detained
from a simple case of misunderstood identity.
Similarly in 2009, India and Pakistan both implemented a third gender option for
their population of hijras a cultural transgender people who are biologically men, but
are socially recognized as women. Indian voting authorities granted independent identity
to transsexuals and intersex people on voting lists, while Pakistan ordered that a third
gender be recognized when registering for the national ID card which grants most of the
societys rights and privileges from things like voting to much simpler tasks like being
able to use the internet at a cybercaf. Both of these nations implemented this policy due
to the worry that being registered with the incorrect information (being identified as male,
when an individual is socially recognized as female) would leave a person vulnerable,
misidentified, and easily excluded from participating in society, as many transgender
people in the United States are (Misra and Singh).
While the ability to personally identify as a more correct gender for transsexuals
would be helpful to reduce logistical problems as well as emotional distress, having a
large benefit, the cost would be minimal. While India and Pakistan both reprinted all the
registration forms in their countries with a third gender option (a rather expensive
process), the United States could take a different approach (Misra and Singh). In
Germany, all the forms were kept the same none were discarded and no new forms
were printed with a third gender option. Instead, Germany allows citizens to indicate their
choice for the intermediate sex by just leaving the gender section of the form blank or by
drawing a large X through the entire section, so that there was no cost to apply the new
policy, as well as allowing the policy to become effective much more quickly (Chappell).
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With new online forms, this would be a little different as often it is impossible to leave a
section blank. In the case of online technology, a third gender option would have to be
created for people to choose, but this is a minimal change in computer code on websites
that could be accomplished fairly quickly with small costs, as there is no need for
continual maintenance, just a one time change.
A budget will need to be planned initially for awareness about the policy. The
drawback of not reprinting new forms with the new gender option is that the choice will
need to be advertised so that people are informed and educated enough to know that they
have a third option they are able to choose, even if forms do not explicitly say so.
Therefore public service announcements would have to be manufactured and regularly
displayed for the first few years when the policy is implemented, so that parents of
newborns, as well as the United States transgender population are aware of their ability
to identify as an intermediate sex. This is not very expensive, in part from the large
amounts of media coverage that will no doubt cover the groundbreaking policy.
Personal freedom matters, like this, tend to get lots of media attention and the multiple
stories that will be running simultaneously and continuously after the policy has been
passed can be thought of as free publicity and will help to inform the American public
of the new policy and their new choice, reducing the number of public announcements
that would have to be created, costing less money. Also this is just an initial effort. The
announcements would only run for a few months, not continuously. This all combines to
be a very marginal cost compared to other expenses. Not only is the cost minimal, but
also it is more than likely than the LGBTA (lesbian, gay, bisexual, transgender people
and allies) community would be willing to provide some funding or coverage and
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awareness about the new policy to help educate and inform their transgender members on
their new rights.
Many people who want to identify as this third gender believe their basic human
rights and personal freedoms are being withheld from them (Nichols). The general
American public is uneducated about the amount of impact conforming to a specific
gender role can have on an individuals life, especially if they do not agree with that
gender role. People are especially uneducated about the great magnitude of detrimental
effects many individuals experience because of choices made for them about their
gender identity as infants. The need for a third gender option is still great, despite being
an overwhelmingly unknown issue, and could help reduce the trauma and emotional
distress transgender/intersex people experience daily.
The idea of implementing a third gender option for personal documents in the
United States is not particularly new many people are unaware of the entire issue. Just
last month a petition started circulating online to get the United States to legally
recognize non-binary genders and to allow for a indeterminate/intersex/unspecified
option. While the United State federal government cannot force states to create a third
gender option on state level documents, such as driver licenses, it can force states to
recognize the third gender option on federal documents. Though largely overlooked and
unnoticed by the American public, mostly due to ignorance and naivety, the small
movement to push for a third gender option in America is slowly gaining ground and
momentum and can hopefully soon be considered as a serious policy option to implement
in the contemporary United States.

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Works Cited
Chappell, Bill. "Germany Offers Third Gender Option On Birth Certificates." NPR. NPR,
Nov. 2013. Web. 07 Apr. 2014.
"Dr. Money and The Boy With No Penis." BBC News. BBC, Sept. 2005. Web. 07 Apr.
2014.
"Hopkins Research Shows Nature, Not Nurture, Determines Gender." Hopkins Medicine.
Johns Hopkins Medical Institutions, 12 May 2000. Web. 07 Apr. 2014.
"How Common Is Intersex?" Intersex Society of North America. Intersex Society of
North America, 2008. Web. 07 Apr. 2014.
Misra, Ria. "Pakistan Recognizes Third Gender." Politics Daily. N.p., 2010. Web. 07
Apr. 2014.
"New Passports Allow Third Gender." Special Broadcasting Service. Agence France-
Presse, 26 Aug. 2013. Web. 07 Apr. 2014.
Nichols, James. "White House Petitioned To Legally Recognize Non-Binary Genders."
The Huffington Post. TheHuffingtonPost.com, 19 Mar. 2014. Web. 07 Apr. 2014.
Singh, Harmeet Shah. "India's Third Gender Gets Own Identity In Voter Rolls." CNN.
Cable News Network, 12 Nov. 2009. Web. 07 Apr. 2014.