Gender experience and satisfaction with gender allocation in adults with diverse intersex conditions (divergences of sex development, DSD)

The aims of this mixed-methods study were to: (1) describe the gender experience and level of satisfaction with gender allocation of intersex persons and (2) explore the spectrum of their gender identities. Of the 69 participants with a number of divergences of sex development (DSD), gender allocation at birth was female in 83% and male in 17%. Seventy-five per cent were satisfied with gender allocation. As adults, 81% lived in the female gender role, 12% in the male role and 7% chose other roles. Nine per cent reported gender change or reallocation. Twenty-four per cent reported an inclusive ‘mixed’ two-gender identity, including both male and female elements, and 3% reported a neither female nor male gender identity. Twenty-six per cent were highly uncertain about belonging to a specific gender, 14% received increased transgender scores on the gender identity questionnaire (GIQ). The dichotomous categorisation of gender fails to capture the gender experiences of a significant proportion of our participants. Uncertainty of belonging to the female or male gender category as well as non-binary identifications highlight the need for alternative gender categories. A reconsideration of the medical approach towards intersexuality, which is currently based on a binary categorisation, is discussed.