사용자:Jjw/연습장

2013년 국제 간성 포럼 참가자

간성(間性) 또는 인터섹스(intersex)는 염색체, 생식샘, 성 호르몬, 성기 등에서 전형적인 남성이나 여성의 신체 정의에 규정되지 않는 성징을 가진 사람이다. 유엔 인권 고등판무관 사무소는 남녀로 구분되는 전형적 이분법에 들어맞지 않는 신체"를 지닌 사람으로 정의하였다.[1][2]

출생시 성 지정은 일반적으로 신생아의 성적 표현형을 보고 판단한다. 대개는 전형적인 성징을 통하여 성별을 확인할 수 있지만 대략 0.02 % - 0.05 % 정도의 신생아는 성징이 뚜렷하지 않다.[3] 염색체의 조합, 생식샘의 발달, 호르몬의 분비 등의 조건이 이러한 모호한 성징의 원인이 될 수 있다.[4][5] 이 때문에 남아 또는 여아로 신고되었으나 자라면서 스스로가 갖추는 성정체성은 지정된 성과 반대인 경우도 있다. 그러나 당사자를 보는 사회적 시각은 대개 출생시 신고된 성을 기준으로 한다.[6][7][8] 신생아가 간성으로 신고되는 빈도는 누가 어떤 기준으로 판단하였는 지에 따라 다르게 나타난다. 미국의 성과학자 앤 파우스토-스털링과 그의 공저자는 "비동질 성징 발달"이 출산 아동의 1.7 % 정도라고 추정하였다.[9][10] 미국의 가정의학 전문가 레오나드 색스는 표현된 성징이 남녀 어느 쪽이든 분명한 경우를 제외하면 간성의 비율은 약 0.018 % 정도라고 보고하였다.[4][11][12]

어디까지를 간성으로 볼 것인 지에 대한 기준은 시대와 지역에 따라 다르다. 과거에는 자웅동체, 선천적 거세자 등으로 분류되기도 하였다.[13][14] 19세기와 20세기 의료계 일각에서는 성징의 발달 정도를 기준으로 참남녀한몸, 여성 우세 거짓남녀한몸, 남성 우세 거짓남녀한몸 등의 분류 체계를 세우기도 하였다.[15] 그러나 오늘날 이러한 분류는 더 이상 사용되지 않는다. 과학적 연구 결과에 부합하지 않고 간성을 남녀 이분법의 기준에 따라 꿰어 맞추는 것은 오해의 소지가 다분하기 때문이다.[16] 생물학에서 일반적으로 자웅동체는 한 개체가 암수의 생식기관 모두를 가지고 다음 세대를 재생산하는 경우를 뜻하기 때문에 간성을 그렇게 부르는 것은 적절하지 않다.[17][18] 당사자들 가운데 일부는 다른 어떤 것을 연상할 수 있는 비유적 표현보다 그저 간성, 인터섹스로 불리길 원한다.[19] 의료계에서는 2006년 이후 성발달 장애라는 용어가 쓰인다.[20][21][22][23]

간성은 출생 직후부터 성장 과정에서 사회적 낙인을 경험하며 특히 사춘기를 힘겹게 보낸다. 일부 지역에서 간성으로 출생한 신생아는 영아 살해의 대상이 되기도 하며 버려지거나 가족들 마저 백안시 하는 경우가 있다.[24][25][26] 한편 아이가 보다 사회적으로 인정받는 성징을 갖추도록 하기 위해 외과적 수술을 하거나 호르몬 요법으로 치료하는 경우도 있지만 이 경우도 본인 보다는 가족이 받을 사회적 시선을 의식한 것이라는 논란이 있다.[27] 이러한 의학적 처치는 종종 불임수술을 동반한다. 여성 육상 선수로 성장한 성인에게도 이러한 의료 행위가 이루어진 사례가 있다.[28][29] 점차 신장되고 있는 인권 의식으로 간성에 대한 의료적 처치가 온당한 것인지 논란이 되고 있다.[30][31] 이를 바탕으로 국제적인 간성 권리가 제창되었다.[32][33] 국제 간성 포럼은 2013년 몰타에서 제3차 국제 포럼을 열고 이를 인권 침해로 선언하였다.[34] 2011년 독일의 크리스티안 뵐링은 외과적 수술에 의한 인권 침해 소송에서 승리한 최초의 간성인이 되었다.[35] 2015년 4월 몰타는 본인의 동의 없는 간성에 대한 의료적 처치를 인권 침해로 적시하는 법률을 제정하였다.[36][37]

용어편집

간성과 간성인에 대한 명확한 정의는 마련되어 있지 않다.[38] 세계보건기구국제질병분류, 미국의 정신질환 진단 및 통계 편람, 그리고 다수의 의학 학술지는 간성을 성발달 장애로 기술한다.[39] 이 때문에 일반적으로 성발달 장애가 곧 간성으로 인식되고 있다.[1]

어원과 정의편집

1917년 독일계 미국 유전학자 리처드 골드슈미츠는 이분법적 양성 가운데 하나로 분류하기 어려운 다양한 사례를 묶어 간성성(영어: intersexuality, 인터섹슈얼리티)로 정의하였다.[15] 그러나 《LGBTQ 연구를 위한 SAGE 백과》에서는 앤 파우스토-스털링이 1993년 발표한 《다섯 개의 성: 왜 남녀로는 부족한가》이후 간성이 널리 알려진 용어가 되었다고 설명하고 있다.[40]

 
벨기에의 모델 안 가비 오딜은 널리 알려진 간성인이다. 성염색체는 XY형이지만 안드로겐 무감응 증후군으로 남성 성징이 발달하지 않았다.

유엔 인권 고등판무관 사무소는 간성을 다음과 같이 정의하고 있다.

간성인은 성기, 생식샘, 염색체 등의 이유로 남녀 이분적인 성별의 전형적 구분에 들어맞지 않는 신체로 태어난 사람으로 광범위한 다양성을 포괄한다.[2]

용례와 반응편집

간성 기구들 가운데 일부는 "간성인" 또는 "간성 다양성", "간성적 특성"과 같은 용어를 사용한다.[41] 한편 의료계에서는 "간성 특징을 보이는 사람"과 같은 용어를 쓰고 있으며[42], 성발달 장애와 같은 용어나 "해부학적 성별 다양성을 지닌 아동"과 같은 용어도 사용된다.[43] 2016년 5월 인권 운동 단체인 인터액트는 "해당 용어로 '간성'을 택하는 경우가 일반화 되고 있다"고 발표하였다.[44]

2016년 272명의 "비전형적 성별로 태어난 사람"을 대상으로 한 오스트레일리아의 연구에서 당사자들의 60%가 자신들을 지칭하는 용어로 간성을 지지하였다.[7][45]

시카고의 루리 어린이 병원에서 실시하여 202명이 응답한 조사는[46] 2017년 발표되었는데, 응답자의 80%가 자신들을 지칭하는 용어로 간성을 선호하였다.[47] 병원측은 의학계 용어인 "성발달 장애"는 당사자들에 대한 부정적 선입견을 심어줄 수 있다고 지적하였다.[48]

미국의 다른 어린이 병원에서 133명의 부모를 대상으로 한 조사에서도 53%가 간성을 선호하였지만 조사에 참여한 진료소 가운데 5개소의 는 "간성"의 사용에 부정적 태도를 보였다.[49] 2020년 당사자 179명을 대상으로 한 조사에서는 43%가 부정적 반응을 20%가 중립적 반응을 보여 당사자들 안에서도 "간성"이라는 용어에 대한 호불호가 나뉘는 것을 보여 주었다.[50]

남녀한몸편집

유럽에서는 과거 남녀의 성별이 불분명한 경우를 "남녀한몸"(hermaphrodite)이라고 표현하였다. 12세기 《그라티아누스 교령집》은 다음과 같이 정의하고 있다.[51][52]

  • 라틴어: Hermafroditus an ad testamentum adhiberi possit, qualitas sexus incalescentis ostendit
  • 한국어 번역: 증인의 입증으로 두 성징이 모두 보이는 경우를 남녀한몸이라 할 수 있다.

이와 비슷하게 17세기 잉글랜드의 법학자 에드워드 코크는 《잉글랜드 법률 연구》에서 "남녀의 성징을 모두 보이는 사람을 남녀한몸(양성인)이라고 한다"고 정의하였다.[53][54]

빅토리아 시대 의학서의 저자들 역시 성징의 발현을 기준으로 남녀한몸을 설명하였고[55] 성징이 모호하지만 어느 한쪽이 우세하면 남성형 거짓남녀한몸, 여성형 거짓남녀한몸과 같은 용어로 불렀고 두 성별의 성징이 모두 나타난 경우는 참남녀한몸으로 구분하였다.[56] 성징을 기준으로 하는 조직학적 구분은 오늘날 더 이상 사용되지 않지만[57][58][59], "간성"이 정의된 후인 20세기 중반까지도 관용적으로 사용되었다.[60]

북아메리카 간성 협회는 오해와 혼동의 소지가 많은 용어인 "남녀한몸" 대신 "간성"으로 표현해 줄 것을 권고하고 있다.[61]

한국어에는 비슷한 연원을 가진 "어지자지"가 있지만[62] 특별한 경우가 아니면 사용되지 않는다.

분포편집

간성인의 수는 각 나라의 간성에 대한 판정 기준이 달라 명확히 파악하기 어렵다.[4] 북아메리카 간성 협회는 다음과 같이 간성인의 분포를 파악하고 있다.

의료 기관에 성징이 분명하지 않은 아동의 출생 비율을 문의하면 1천5백 명 또는 2천명 가운데 한명이라고 응답한다.(0.07–0.05%) 그러나 그 보다 많은 경우의 다양한 스펙트럼이 존재하고 살아가다 나중에야 스스로 알게 되는 경우도 있다.[63]

앤 파우스토-스털링 연구팀은 2000년 "성염색체, 생식샘, 성징, 호르몬 동질이상 등의 알려진 모든 경우를 포함하면 이분법적이지 않은 성발달은 약 1.7 %로 추정된다"고 발표하였다.[10][9] 이 발표는 간성 활동가들이 폭넓게 인용하고 있다.[64][65][66] 파우스토-스털링 팀이 발표한 1.7 % 가운데 88%에 해당하는 전체 인구의 1.5%는 후발성 선천 부신 과다형성에 의한 것이다.[67] 선천 부신 과다형성은 신생아 1만4천명 당 1 명 꼴로 보고되어 있고 호르몬 불균형으로 여아의 성징이 불분명해지고 자라면서 남성과 비슷한 변성기를 겪는다.[68]

이와 대조적으로 레오나르드 색스는 간성 비율을 전체 인구의 0.018 %로 추정한다.[4] 그는 성적 표현형이 비교적 뚜렷한 선천적 부신과다형성증, 클라인펠터 증후군, 터너 증후군, 47,XYY 형 및 47,XXX 등의 염색체 이상은 간성에서 제외하였다.[4]

2003년 캐리 훌은 파우스토-스털링의 데이타를 분석하여 오류를 제거하면 보다 엄밀하게 간성으로 정의할 수 있는 경우는 0.37 %라고 발표하였다.[69] 이에 대해 파우스토-스털링은 자신의 연구 결과는 추정치일 뿐이므로 추가적인 연구와 논의를 환영한다는 입장을 밝혔다.[69] 2018년 발표된 신생아 중 간성 비율은 0.02 % 에서 0.05 % 정도이다.[3]

그러나 1.7%라는 수치는 간성 인권 운동에서 여정히 중요하게 언급되는데 간성 당사자들은 성이분법적 시각으로 자신들을 우선 구분하려는 편견이 낮은 인구 비율 발표에 개입하였다고 생각한다.[70]

간성의 원인별 유병률은 다음과 같다.

간성의 원인별 유병률
유형 성적 표현형 대략적 유병률
후발성 선천 부신 과다형성 (비정형성) 여성
(남성의 경우 증상 없음)[71]
0.1–0.2%[72]
요도밑열림증 남성 0.01%–0.5%[73]
클라인펠터 증후군 남성 0.1–0.2%[74]
XXX 증후군 여성 0.1%[75]
터너 증후군 여성 0.04%[76]
뮐러관 무발생 여성 0.022%[77]
질자궁수종 여성 0.02%[78]
45,X/46,XY 모자이크형 남성 0.015%[79]
XYY 증후군 남성 0.0142%[80]
선천 부신 과다형성 (정형성) 없음 (여아의 남성화)[72][67] 0.01–0.02%[67]
XXYY 증후군 남성 0.0025%–0.0055%[81]
XX 남성 증후군 남성 0.005%[82]
난정소성발달장애 없음 0.005%[83]
스와이어 증후군(XY 여성 증후군) 여성[84] 0.0013%[85]
안드로겐 무감응 증후군 유전적 남성[86]
(표현형은 남녀 모두 있음)
0.001%[87]
원인 불명 특발성 없음 0.0009%[88]
산모의 호르몬 이상 등에 의한 특발성 없음 불분명
5알파-환원효소 2 결핍증 남성 불분명
생식샘 모자이크형 없음 불분명
방향화효소 과다 증후군 없음 불분명
무고환증 남성 불분명
지속성 뮐러관 증후군 남성 불분명

유병률은 지역에 따라 다르게 나타날 수 있다. 5알파-환원효소 2 결핍증은 다른 지역에서는 매우 드문 경우이지만 도미니카 공화국의 라스 살리나스 지역에서는 비교적 흔하게 나타나는데 간성에 대한 사회적 태도가 영향을 미친 것으로 보인다.[89] 이 지역에서는 12 내지 13 가구 당 한 명 이상의 남성이 해당 유전자를 보유하고 있어 90 명 가운데 1 명 꼴의 유병률을 보인다.[90]

History편집

 
Hermaphroditus in a wall painting from Herculaneum (first half of the 1st century AD)
 
A Chola statue depicting Ardhanarishvara, a Hermaphroditus form of Shiva.

From early history, societies have been aware of intersex people. Some of the earliest evidence is found in mythology: the Greek historian Diodorus Siculus wrote of the mythological Hermaphroditus in the first century BC, who was "born with a physical body which is a combination of that of a man and that of a woman", and reputedly possessed supernatural properties.[91] He also recounted the lives of Diophantus of Abae and Callon of Epidaurus.[92] Ardhanarishvara, an androgynous composite form of male deity Shiva and female deity Parvati, originated in Kushan culture as far back as the first century AD.[93] A statue depicting Ardhanarishvara is included in India's Meenakshi Temple; this statue clearly shows both male and female bodily elements.[94]

Hippocrates (c. 460c. 370 BC Greek physician) and Galen (129 – c. 200/216 AD Roman physician, surgeon and philosopher) both viewed sex as a spectrum between men and women, with "many shades in between, including hermaphrodites, a perfect balance of male and female".[95] Pliny the Elder (AD 23/24–79) the Roman naturalist described "those who are born of both sexes, whom we call hermaphrodites, at one time androgyni" (from the Greek 틀:Transliteration, "man," and 틀:Transliteration, "woman").[96] Augustine (354 – 28 August 430 AD) the influential Catholic theologian wrote in The Literal Meaning of Genesis that humans were created in two sexes, despite "as happens in some births, in the case of what we call androgynes".[95]

In medieval and early modern European societies, Roman law, post-classical canon law, and later common law, referred to a person's sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant.[97] The 12th century Decretum Gratiani states that "Whether an hermaphrodite may witness a testament, depends on which sex prevails".[98][99][100] The foundation of common law, the 17th Century Institutes of the Lawes of England described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile."[101][54] Legal cases have been described in canon law and elsewhere over the centuries.

Some non-European societies have sex or gender systems that recognize more than the two categories of male/man and female/woman. Some of these cultures, for instance the South-Asian Hijra communities, may include intersex people in a third gender category.[102][103] Although–according to Morgan Holmes–early Western anthropologists categorized such cultures "primitive," Holmes has argued that analyses of these cultures have been simplistic or romanticized and fail to take account of the ways that subjects of all categories are treated.[104]

During the Victorian era, medical authors introduced the terms "true hermaphrodite" for an individual who has both ovarian and testicular tissue, "male pseudo-hermaphrodite" for a person with testicular tissue, but either female or ambiguous sexual anatomy, and "female pseudo-hermaphrodite" for a person with ovarian tissue, but either male or ambiguous sexual anatomy. Some later shifts in terminology have reflected advances in genetics, while other shifts are suggested to be due to pejorative associations.[105]

The term "intersexuality" was coined by Richard Goldschmidt in 1917.[106] The first suggestion to replace the term "hermaphrodite" with "intersex" was made by Cawadias in the 1940s.[60]

Since the rise of modern medical science, some intersex people with ambiguous external genitalia have had their genitalia surgically modified to resemble either female or male genitals. Surgeons pinpointed intersex babies as a "social emergency" when born.[107] An 'optimal gender policy', initially developed by John Money, stated that early intervention helped avoid gender identity confusion, but this lacks evidence.[108] Early interventions have adverse consequences for psychological and physical health.[33] Since advances in surgery have made it possible for intersex conditions to be concealed, many people are not aware of how frequently intersex conditions arise in human beings or that they occur at all.[109]

Dialogue between what were once antagonistic groups of activists and clinicians has led to only slight changes in medical policies and how intersex patients and their families are treated in some locations.[110] In 2011, Christiane Völling became the first intersex person known to have successfully sued for damages in a case brought for non-consensual surgical intervention.[35] In April 2015, Malta became the first country to outlaw non-consensual medical interventions to modify sex anatomy, including that of intersex people.[36] Many civil society organizations and human rights institutions now call for an end to unnecessary "normalizing" interventions, including in the Malta declaration.[111][1]

Human rights and legal issues편집

 
Intersex activists on a boat at Utrecht Canal Pride in the Netherlands on June 16, 2018

Human rights institutions are placing increasing scrutiny on harmful practices and issues of discrimination against intersex people. These issues have been addressed by a rapidly increasing number of international institutions including, in 2015, the Council of Europe, the United Nations Office of the United Nations High Commissioner for Human Rights and the World Health Organization (WHO). These developments have been accompanied by International Intersex Forums and increased cooperation amongst civil society organizations. However, the implementation, codification, and enforcement of intersex human rights in national legal systems remains slow.

Physical integrity and bodily autonomy편집

 
  Legal prohibition of non-consensual medical interventions
  Regulatory suspension of non-consensual medical interventions

Stigmatization and discrimination from birth may include infanticide, abandonment, and the stigmatization of families. The birth of an intersex child was often viewed as a curse or a sign of a witch mother, especially in parts of Africa.[24][25] Abandonments and infanticides have been reported in Uganda,[24] Kenya,[112] South Asia,[113] and China.[26]

Infants, children and adolescents also experience "normalising" interventions on intersex persons that are medically unnecessary and the pathologisation of variations in sex characteristics. In countries where the human rights of intersex people have been studied, medical interventions to modify the sex characteristics of intersex people have still taken place without the consent of the intersex person.[114][115] Interventions have been described by human rights defenders as a violation of many rights, including (but not limited to) bodily integrity, non-discrimination, privacy, and experimentation.[116] These interventions have frequently been performed with the consent of the intersex person's parents, when the person is legally too young to consent. Such interventions have been criticized by the WHO, other UN bodies such as the Office of the High Commissioner for Human Rights, and an increasing number of regional and national institutions due to their adverse consequences, including trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity.[1] The UN organizations decided that infant intervention should not be allowed, in favor of waiting for the child to mature enough to be a part of the decision-making – this allows for a decision to be made with total consent.[117] In April 2015, Malta became the first country to outlaw surgical intervention without consent.[36][37] In the same year, the Council of Europe became the first institution to state that intersex people have the right not to undergo sex affirmation interventions.[64]

Anti-discrimination and equal treatment편집

 
  Explicit protection on grounds of sex characteristics
  Explicit protection on grounds of intersex status
  Explicit protection on grounds of intersex within attribute of sex

People born with intersex bodies are seen as different. Intersex infants, children, adolescents and adults "are often stigmatized and subjected to multiple human rights violations", including discrimination in education, healthcare, employment, sport, and public services.[2] Several countries have so far explicitly protected intersex people from discrimination, with landmarks including South Africa,[118] Australia,[119][120] and, most comprehensively, Malta.[121][122][123]

Remedies and claims for compensation편집

Claims for compensation and remedies for human rights abuses include the 2011 case of Christiane Völling in Germany.[35][124] A second case was adjudicated in Chile in 2012, involving a child and his parents.[125][126] A further successful case in Germany, taken by Michaela Raab, was reported in 2015.[127] In the United States, the Minor Child (M.C. v Aaronson) lawsuit was "a medical malpractice case related to the informed consent for a surgery performed on the Crawford's adopted child (known as M.C.) at [Medical University of South Carolina] in April 2006".[128] The case was one of the first lawsuit of its kind to challenge "legal, ethical, and medical issues regarding genital-normalizing surgery" in minors, and was eventually settled out of court by the Medical University of South Carolina for $440,000 in 2017.[129]

Information and support편집

Access to information, medical records, peer and other counselling and support. With the rise of modern medical science in Western societies, a secrecy-based model was also adopted, in the belief that this was necessary to ensure normal physical and psychosocial development.[130][131][132]

Legal recognition편집

The Asia Pacific Forum of National Human Rights Institutions states that legal recognition is firstly "about intersex people who have been issued a male or a female birth certificate being able to enjoy the same legal rights as other men and women."[34] In some regions, obtaining any form of birth certification may be an issue. A Kenyan court case in 2014 established the right of an intersex boy, "Baby A", to a birth certificate.[133]

Like all individuals, some intersex individuals may be raised as a certain sex (male or female) but then identify with another later in life, while most do not.[134][6][135][136] Recognition of third sex or gender classifications occurs in several countries,[137][138][139][140] However, it is controversial when it becomes assumed or coercive, as is the case with some German infants.[141][142] Sociological research in Australia, a country with a third 'X' sex classification, shows that 19% of people born with atypical sex characteristics selected an "X" or "other" option, while 75% of survey respondents self-described as male or female (52% as women, 23% as men), and 6% as unsure.[7][45]

LGBT and LGBTI편집

 
U.S. intersex activist Pidgeon Pagonis
 
ILGA conference 2018, group photo to mark Intersex Awareness Day

Intersex conditions can be contrasted with transgender gender identities and the attached gender dysphoria a transgender person may feel, wherein their gender identity does not match their assigned sex.[143][144][145] However, some people are both intersex and transgender; though intersex people by definition have variable sex characteristics that do not align with either typically male or female, this may be considered separate to an individual's assigned gender, the way they are raised and perceived, and their internal gender identity.[146] A 2012 clinical review paper found that between 8.5% and 20% of people with intersex variations experienced gender dysphoria.[135] In an analysis of the use of preimplantation genetic diagnosis to eliminate intersex traits, Behrmann and Ravitsky state: "Parental choice against intersex may ... conceal biases against same-sex attractedness and gender nonconformity."[147]

The relationship of intersex people and communities to LGBTQ communities is complex,[148] but intersex people are often added to the LGBT acronym, resulting in the acronym LGBTI. Emi Koyama describes how inclusion of intersex in LGBTI can fail to address intersex-specific human rights issues, including creating false impressions "that intersex people's rights are protected" by laws protecting LGBT people, and failing to acknowledge that many intersex people are not LGBT.[149] Organisation Intersex International Australia states that some intersex individuals are homosexual, and some are heterosexual, but "LGBTI activism has fought for the rights of people who fall outside of expected binary sex and gender norms."[150][151] Julius Kaggwa of SIPD Uganda has written that, while the gay community "offers us a place of relative safety, it is also oblivious to our specific needs".[152] Mauro Cabral has written that transgender people and organizations "need to stop approaching intersex issues as if they were trans issues", including use of intersex conditions and people as a means of explaining being transgender; "we can collaborate a lot with the intersex movement by making it clear how wrong that approach is".[153]

In society편집

 
Kristi Bruce after shooting the documentary XXXY, 2000

Fiction, literature and media편집

An intersex character is the narrator in Jeffrey Eugenides' Pulitzer Prize-winning novel Middlesex.

The memoir, Born Both: An Intersex Life (Hachette Books, 2017), by intersex author and activist Hida Viloria, received strong praise from The New York Times Book Review, The Washington Post, Rolling Stone, People Magazine, and Psychology Today, was one of School Library Journal's 2017 Top Ten Adult Books for Teens, and was a 2018 Lambda Literary Award nominee.

Television works about intersex and films about intersex are scarce. The Spanish-language film XXY won the Critics' Week grand prize at the 2007 Cannes Film Festival and the ACID/CCAS Support Award.[154] Faking It is notable for providing both the first intersex main character in a television show,[155] and television's first intersex character played by an intersex actor.[156]

Civil society institutions편집

Intersex peer support and advocacy organizations have existed since at least 1985, with the establishment of the Androgen Insensitivity Syndrome Support Group Australia in 1985.[157] The Androgen Insensitivity Syndrome Support Group (UK) was established in 1988.[158] The Intersex Society of North America (ISNA) may have been one of the first intersex civil society organizations to have been open to people regardless of diagnosis; it was active from 1993 to 2008.[159]

Events편집

Intersex Awareness Day is an internationally observed civil awareness day designed to highlight the challenges faced by intersex people, occurring annually on 26 October. It marks the first public demonstration by intersex people, which took place in Boston on 26 October 1996, outside a venue where the American Academy of Pediatrics was holding its annual conference.[160]

Intersex Day of Remembrance, also known as Intersex Solidarity Day, is an internationally observed civil awareness day designed to highlight issues faced by intersex people, occurring annually on 8 November. It marks the birthday of Herculine Barbin, a French intersex person whose memoirs were later published by Michel Foucault in Herculine Barbin: Being the Recently Discovered Memoirs of a Nineteenth-century French Hermaphrodite.

Flag편집

 
Intersex flag

The intersex flag was created in July 2013 by Morgan Carpenter of Intersex Human Rights Australia to create a flag "that is not derivative, but is yet firmly grounded in meaning". The circle is described as "unbroken and unornamented, symbolising wholeness and completeness, and our potentialities. We are still fighting for bodily autonomy and genital integrity, and this symbolises the right to be who and how we want to be."[161]

Religion편집

In Judaism, the Talmud contains extensive discussion concerning the status of two types of intersex people in Jewish law; namely, the androgynous, who exhibit both male and female external sexual organs, and the 틀:Transliteration, who exhibit neither. In the 1970s and 1980s, the treatment of intersex babies started to be discussed in Orthodox Jewish medical halacha by prominent rabbinic leaders, such as Eliezer Waldenberg and Moshe Feinstein.[162]

Sport편집

Erik Schinegger, Foekje Dillema, Maria José Martínez-Patiño and Santhi Soundarajan were subject to adverse sex verification testing resulting in ineligibility to compete in organised competitive competition. Stanisława Walasiewicz was posthumously ruled ineligible to have competed.[163]

The South African middle-distance runner Caster Semenya won gold at the World Championships in the women's 800 metres and won silver in the 2012 Summer Olympics. When Semenya won gold in the World Championships, the International Association of Athletics Federations (IAAF) requested sex verification tests. The results were not released. Semenya was ruled eligible to compete.[164]

Katrina Karkazis, Rebecca Jordan-Young, Georgiann Davis and Silvia Camporesi have claimed that IAAF policies on "hyperandrogenism" in female athletes are "significantly flawed", arguing that the policy does not protect against breaches of privacy, requires athletes to undergo unnecessary treatment in order to compete, and intensifies "gender policing", and recommended that athletes be able to compete in accordance with their legally-recognised gender.[165]

In April 2014, the BMJ reported that four elite women athletes with XY chromosomes and 5-ARD were subjected to sterilization and "partial clitoridectomies" in order to compete in sport. The authors noted that partial clitoridectomy was "not medically indicated" and "does not relate to real or perceived athletic 'advantage'."[28] Intersex advocates[누가?] regarded this intervention as "a clearly coercive process".[166] In 2016, the United Nations Special Rapporteur on health, Dainius Pūras, criticized "current and historic" sex verification policies, describing how "a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial clitoridectomy (a form of female genital mutilation) in the absence of symptoms or health issues warranting those procedures."[167]

Biology편집

The notion of intersex individuals can be understood in the context of sexual system biology that varies across different types of organisms. Most animal species (~95%, including humans) are gonochoric, in which individuals are of either a female or male sex.[168] Hermaphroditic species (some animals and most flowering plants[169]) are represented by individuals that can express both sexes simultaneously or sequentially during their lifetimes.[170] Intersex individuals in a number of gonochoric species, who express both female and male phenotypic characters to some degree,[171] are known to exist at very low prevalences.

Although "hermaphrodite" and "intersex" have been used synonymously in humans,[172]틀:Pages needed a hermaphrodite is specifically an individual capable of producing female and male gametes.[173] While there are reports of individuals that seemed to have the potential to produce both types of gamete,[174] in more recent years the term hermaphrodite as applied to humans has fallen out of favor, since female and male reproductive functions have not been observed together in the same individual.[175]

Medical편집

Research in the late 20th century led to a growing medical consensus that diverse intersex bodies are normal, but relatively rare, forms of human biology.[6][176][177][178] Clinician and researcher Milton Diamond stresses the importance of care in the selection of language related to intersex people:

Foremost, we advocate use of the terms "typical", "usual", or "most frequent" where it is more common to use the term "normal." When possible avoid expressions like maldeveloped or undeveloped, errors of development, defective genitals, abnormal, or mistakes of nature. Emphasize that all of these conditions are biologically understandable while they are statistically uncommon.[179]

Medical classifications편집

Sexual differentiation편집

The common pathway of sexual differentiation, where a productive human female has an XX chromosome pair, and a productive male has an XY pair, is relevant to the development of intersex conditions.

During fertilization, the sperm adds either an X (female) or a Y (male) chromosome to the X in the ovum. This determines the genetic sex of the embryo. During the first weeks of development, genetic male and female fetuses are "anatomically indistinguishable", with primitive gonads beginning to develop during approximately the sixth week of gestation. The gonads, in a bipotential state, may develop into either testes (the male gonads) or ovaries (the female gonads), depending on the consequent events.[180] Up until and including the seventh week, genetically female and genetically male fetuses appear identical.

At around eight weeks of gestation, the gonads of an XY embryo differentiate into functional testes, secreting testosterone. Ovarian differentiation, for XX embryos, does not occur until approximately week 12 of gestation. In typical female differentiation, the Müllerian duct system develops into the uterus, Fallopian tubes, and inner third of the vagina. In males, the Müllerian duct-inhibiting hormone MIH causes this duct system to regress. Next, androgens cause the development of the Wolffian duct system, which develops into the vas deferens, seminal vesicles, and ejaculatory ducts.[180] By birth, the typical fetus has been completely sexed male or female, meaning that the genetic sex (XY-male or XX-female) corresponds with the phenotypical sex; that is to say, genetic sex corresponds with internal and external gonads, and external appearance of the genitals.

Signs편집

There are a variety of symptoms that can occur. Ambiguous genitalia is the most common sign. There can be micropenis, clitoromegaly, partial labial fusion, electrolyte abnormalities, delayed or absent puberty, unexpected changes at puberty, hypospadias, labial or inguinal (groin) masses (which may turn out to be testes) in girls and undescended testes (which may turn out to be ovaries) in boys.[181]

Ambiguous genitalia편집

Ambiguous genitalia may appear as a large clitoris or as a small penis.

 
The Quigley scale is a method for describing genital development in AIS.

Because there is variation in all of the processes of the development of the sex organs, a child can be born with a sexual anatomy that is typically female or feminine in appearance with a larger-than-average clitoris (clitoral hypertrophy) or typically male or masculine in appearance with a smaller-than-average penis that is open along the underside. The appearance may be quite ambiguous, describable as female genitals with a very large clitoris and partially fused labia, or as male genitals with a very small penis, completely open along the midline ("hypospadic"), and empty scrotum. Fertility is variable. [출처 필요]

Measurement systems for ambiguous genitalia편집

The orchidometer is a medical instrument to measure the volume of the testicles. It was developed by Swiss pediatric endocrinologist Andrea Prader. The Prader scale[182] and Quigley scale are visual rating systems that measure genital appearance. These measurement systems were satirized in the Phall-O-Meter, created by the (now defunct) Intersex Society of North America.[183][184][185]

Other signs편집

In order to help in classification, methods other than a genitalia inspection can be performed. For instance, a karyotype display of a tissue sample may determine which of the causes of intersex is prevalent in the case. Additionally, electrolyte tests, endoscopic exam, ultrasound and hormone stimulation tests can be done.[186]

Causes편집

Intersex can be divided into four categories which are: 46, XX intersex; 46, XY intersex; true gonadal intersex; and complex or undetermined intersex.[181]

46, XX intersex편집

This condition used to be called "female pseudohermaphroditism". Persons with this condition have female internal genitalia and karyotype (XX) and various degree of external genitalia virilization.[187] External genitalia is masculinized congenitally when female fetus is exposed to excess androgenic environment.[181] Hence, the chromosome of the person is of a woman, the ovaries of a woman, but external genitals that appear like a male. The labia fuse, and the clitoris enlarges to appear like a penis. The causes of this can be male hormones taken during pregnancy, congenital adrenal hyperplasia, male-hormone-producing tumors in the mother and aromatase deficiency.[181]

46, XY intersex편집

This condition used to be called "male pseudohermaphroditism". This is defined as incomplete masculinization of the external genitalia.[188] Thus, the person has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female.[181][189] This condition is also called 46, XY with undervirilization.[181] 46, XY intersex has many possible causes, which can be problems with the testes and testosterone formation.[181] Also, there can be problems with using testosterone. Some people lack the enzyme needed to convert testosterone to dihydrotestosterone, which is a cause of 5-alpha-reductase deficiency.[181] Androgen insensitivity syndrome is the most common cause of 46, XY intersex.[181]

True gonadal intersex편집

This condition used to be called "true hermaphroditism". This is defined as having asymmetrical gonads with ovarian and testicular differentiation on either sides separately or combined as ovotestis.[190] In most cases, the cause of this condition is unknown.

Complex or undetermined intersex편집

This is the condition of having any chromosome configurations rather than 46, XX or 46, XY intersex. This condition does not result in an imbalance between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.[181]

Conditions편집

There are a variety of opinions on what conditions or traits are and are not intersex, dependent on the definition of intersex that is used. Current human rights based definitions stress a broad diversity of sex characteristics that differ from expectations for male or female bodies.[2] During 2015, the Council of Europe,[64] the European Union Agency for Fundamental Rights[191] and Inter-American Commission on Human Rights[192] have called for a review of medical classifications on the basis that they presently impede enjoyment of the right to health; the Council of Europe expressed concern that "the gap between the expectations of human rights organisations of intersex people and the development of medical classifications has possibly widened over the past decade".[64][191][192]

Medical interventions편집

 
Hong Kong intersex activist Small Luk

Rationales편집

Medical interventions take place to address physical health concerns and psychosocial risks. Both types of rationale are the subject of debate, particularly as the consequences of surgical (and many hormonal) interventions are lifelong and irreversible. Questions regarding physical health include accurately assessing risk levels, necessity, and timing. Psychosocial rationales are particularly susceptible to questions of necessity as they reflect social and cultural concerns.

There remains no clinical consensus about an evidence base, surgical timing, necessity, type of surgical intervention, and degree of difference warranting intervention.[193][194][195] Such surgeries are the subject of significant contention due to consequences that include trauma, impact on sexual function and sensation, and violation of rights to physical and mental integrity.[1] This includes community activism,[105] and multiple reports by international human rights[30][64][34][196] and health[132] institutions and national ethics bodies.[33][197]

In the cases where gonads may pose a cancer risk, as in some cases of androgen insensitivity syndrome,[198] concern has been expressed that treatment rationales and decision-making regarding cancer risk may encapsulate decisions around a desire for surgical "normalization".[32]

Types편집

  • Feminizing and masculinizing surgeries: Surgical procedures depend on the diagnosis, and there is often a concern as to whether surgery should be performed at all. Typically, surgery is performed shortly after birth. Defenders of the practice argue that individuals must be clearly identified as male or female for them to function socially and develop "normally". Psychosocial reasons are often stated.[20] This is criticised by many human rights institutions, and authors. Unlike other aesthetic surgical procedures performed on infants, such as corrective surgery for a cleft lip, genital surgery may lead to negative consequences for sexual functioning in later life, or feelings of freakishness and unacceptability.[199]
  • Hormone treatment: There is widespread evidence of prenatal testing and hormone treatment to prevent or eliminate intersex traits,[200] associated also with the problematization of sexual orientation and gender non-conformity.[200][201]
  • Psychosocial support: All stakeholders support psychosocial support. A joint international statement by participants at the Third International Intersex Forum in 2013 sought, amongst other demands: "Recognition that medicalization and stigmatisation of intersex people result in significant trauma and mental health concerns. In view of ensuring the bodily integrity and well-being of intersex people, autonomous non-pathologising psycho-social and peer support be available to intersex people throughout their life (as self-required), as well as to parents and/or care providers."틀:Quote without source
  • Genetic selection and terminations: The ethics of preimplantation genetic diagnosis to select against intersex traits was the subject of 11 papers in the October 2013 issue of the American Journal of Bioethics.[202] There is widespread evidence of pregnancy terminations arising from prenatal testing, as well as prenatal hormone treatment to prevent intersex traits. Behrmann and Ravitsky find social concepts of sex, gender and sexual orientation to be "intertwined on many levels. Parental choice against intersex may thus conceal biases against same-sex attractedness and gender nonconformity."[147]
  • Medical display. Photographs of intersex children's genitalia are circulated in medical communities for documentary purposes, and individuals with intersex traits may be subjected to repeated genital examinations and display to medical teams. Problems associated with experiences of medical photography of intersex children have been discussed[203] along with their ethics, control and usage.[204][205] "The experience of being photographed has exemplified for many people with intersex conditions the powerlessness and humiliation felt during medical investigations and interventions".[204]
  • Gender dysphoria: The DSM-5 included a change from using gender identity disorder to gender dysphoria. This revised code now specifically includes intersex people who do not identify with their sex assigned at birth and experience clinically significant distress or impairment, using the language of disorders of sex development.[206]

See also편집

References편집

  1. UN Committee against Torture; UN Committee on the Rights of the Child; UN Committee on the Rights of People with Disabilities; UN Subcommittee on Prevention of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment; Juan Méndez, Special Rapporteur on torture and other cruel inhuman or degrading treatment or punishment; Dainius Pῡras Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health; Dubravka Šimonoviæ, Special Rapporteur on violence against women its causes and consequences; Marta Santos Pais, Special Representative of the UN Secretary-General on Violence against Children; African Commission on Human and Peoples' Rights; Council of Europe Commissioner for Human Rights; Inter-American Commission on Human Rights (2016년 10월 24일), “Intersex Awareness Day – Wednesday 26 October. End violence and harmful medical practices on intersex children and adults, UN and regional experts urge”, 《Office of the High Commissioner for Human Rights 
  2. “Free & Equal Campaign Fact Sheet: Intersex” (PDF). United Nations Office of the High Commissioner for Human Rights. 2015. 4 March 2016에 원본 문서 (PDF)에서 보존된 문서. 28 March 2016에 확인함. 
  3. Selma Feldman Witchel (2018). “Disorders of Sex Development”. 《Best Practice & Research. Clinical Obstetrics & Gynaecology》 48: 90–102. doi:10.1016/j.bpobgyn.2017.11.005. ISSN 1521-6934. PMC 5866176. PMID 29503125. The estimated frequency of genital ambiguity is reported to be in the range of 1:2000-1:4500 
  4. Sax, Leonard (August 2002). “How common is intersex? a response to Anne Fausto-Sterling”. 《Journal of Sex Research》 39 (3): 174–178. doi:10.1080/00224490209552139. ISSN 0022-4499. PMID 12476264. 2021년 4월 24일에 원본 문서에서 보존된 문서.  Alt URL
  5. United Nations; Office of the High Commissioner for Human Rights (2015). 《Free & Equal Campaign Fact Sheet: Intersex》 (PDF). 2016년 3월 4일에 원본 문서 (PDF)에서 보존된 문서. 
  6. Alice Domurat Dreger (2001). 《Hermaphrodites and the Medical Invention of Sex》. USA: Harvard University Press. ISBN 978-0-674-00189-3. 
  7. “New publication "Intersex: Stories and Statistics from Australia". 《Organisation Intersex International Australia》. 3 February 2016. 29 August 2016에 원본 문서에서 보존된 문서. 18 August 2016에 확인함. 
  8. “Intersex population figures”. Intersex Human Rights Australia. 2013년 9월 28일. 2021년 1월 1일에 확인함. 
  9. Fausto-Sterling, Anne (2000). 《Sexing the Body: Gender Politics and the Construction of Sexuality》. Basic Books. 53쪽. ISBN 978-0-465-07714-4. 
  10. Blackless, Melanie; Charuvastra, Anthony; Derryck, Amanda; Fausto-Sterling, Anne; Lauzanne, Karl; Lee, Ellen (March 2000). “How sexually dimorphic are we? Review and synthesis”. 《American Journal of Human Biology》 12 (2): 151–166. doi:10.1002/(SICI)1520-6300(200003/04)12:2<151::AID-AJHB1>3.0.CO;2-F. ISSN 1520-6300. PMID 11534012. 
  11. “How Common is Intersex? An Explanation of the Stats.”. Intersex Campaign for Equality. 2015년 4월 1일. 2021년 1월 1일에 확인함. 
  12. Ripley, Amanda (2005년 2월 27일). “Who Says A Woman Can't Be Einstein?”. 《Time》 (Time.com). 2008년 8월 1일에 원본 문서에서 보존된 문서. 2008년 12월 29일에 확인함. 
  13. Mason H.J. (1978). “Favorinus' Disorder: Reifenstein's Syndrome in Antiquity?”. 《Janus》 66 (1–2–3): 1–13. PMID 11610651. 
  14. Nguyễn Khắc Thuần (1998), Việt sử giai thoại (History of Vietnam's tales), vol. 8, Vietnam Education Publishing House, p. 55
  15. Zucker, Kenneth J.; Bradley, Susan J.; Sullivan, Claire B. Lowry (March 1992). “Gender Identity Disorder in Children”. 《Annual Review of Sex Research》 3 (1): 73–120. doi:10.1080/10532528.1992.10559876. ISSN 1053-2528. 
  16. Dreger, Alice D.; Chase, Cheryl; Sousa, Aron; Gruppuso, Phillip A.; Frader, Joel (2005년 8월 18일). “Changing the Nomenclature/Taxonomy for Intersex: A Scientific and Clinical Rationale”. 《Journal of Pediatric Endocrinology and Metabolism》 18 (8): 729–33. doi:10.1515/JPEM.2005.18.8.729. PMID 16200837. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 2월 5일에 확인함. 
  17. Kilman, Richard (2016년 4월 14일). 《Encyclopedia of Evolutionary Biology》. Elsevier Science. ISBN 9780128004265. 
  18. Avise, John; Nicholson, Trudy (2011년 3월 15일). 《Hermaphroditism》. Columbia University Press. 1–7쪽. ISBN 9780231527156. 
  19. Preves, Sharon E. (2003). 《Intersex and identity : the contested self》. New Brunswick, N.J.: Rutgers University Press. ISBN 0-8135-3228-0. OCLC 50334056. 
  20. Houk, C. P.; Hughes, I. A.; Ahmed, S. F.; Lee, P. A.; Writing Committee for the International Intersex Consensus Conference Participants (August 2006). “Summary of Consensus Statement on Intersex Disorders and Their Management”. 《Pediatrics》 118 (2): 753–757. doi:10.1542/peds.2006-0737. ISSN 0031-4005. PMID 16882833. 
  21. Davis, Georgiann (2015년 9월 11일). 《Contesting Intersex: The Dubious Diagnosis》. New York University Press. 87–89쪽. ISBN 978-1479887040. 
  22. Holmes, Morgan (September 2011). “The Intersex Enchiridion: Naming and Knowledge”. 《Somatechnics》 1 (2): 388–411. doi:10.3366/soma.2011.0026. ISSN 2044-0138. 
  23. Beh, Hazel; Diamond, Milton (July 27, 2006). “Variations of Sex Development Instead of Disorders of Sex Development [sic]”. 《ADC Online》. August 21, 2008에 원본 문서에서 보존된 문서. March 15, 2021에 확인함. 
  24. Civil Society Coalition on Human Rights and Constitutional Law; Human Rights Awareness and Promotion Forum; Rainbow Health Foundation; Sexual Minorities Uganda; Support Initiative for Persons with Congenital Disorders (2014). “Uganda Report of Violations based on Sex Determination, Gender Identity, and Sexual Orientation”. 3 May 2015에 원본 문서에서 보존된 문서. 15 May 2017에 확인함. 
  25. Grady, Helen; Soy, Anne ( 4 May 2017). “The midwife who saved intersex babies”. 《BBC World Service, Kenya》. 15 May 2017에 원본 문서에서 보존된 문서. 
  26. Beyond the Boundary – Knowing and Concerns Intersex (October 2015). “Intersex report from Hong Kong China, and for the UN Committee Against Torture: the Convention against Torture and Other Cruel Inhuman or Degrading Treatment or Punishment”. 26 March 2017에 원본 문서에서 보존된 문서. 
  27. Submission 88 to the Australian Senate inquiry on the involuntary or coerced sterilisation of people with disabilities in Australia Archived 23 September 2015 - 웨이백 머신. , Australasian Paediatric Endocrine Group (APEG), 27 June 2013
  28. Jordan-Young, R. M.; Sonksen, P. H.; Karkazis, K. (April 2014). “Sex, health, and athletes”. 《BMJ》 348 (apr28 9): –2926–g2926. doi:10.1136/bmj.g2926. ISSN 1756-1833. PMID 24776640. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 12월 11일에 확인함. 
  29. Macur, Juliet ( 6 October 2014). “Fighting for the Body She Was Born With”. 《The New York Times》. 12 January 2015에 원본 문서에서 보존된 문서. 9 February 2015에 확인함. 
  30. Report of the UN Special Rapporteur on Torture Archived 29 April 2019 - 웨이백 머신. , Office of the UN High Commissioner for Human Rights, February 2013.
  31. Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement Archived 11 July 2015 - 웨이백 머신. , World Health Organization, May 2014.
  32. 《Involuntary or coerced sterilisation of intersex people in Australia》. 《Australian Senate》 (Canberra: Senate of Australia Community Affairs References Committee). 2013. ISBN 978-1-74229-917-4. 23 September 2015에 원본 문서에서 보존된 문서. 
  33. Swiss National Advisory Commission on Biomedical Ethics NEK-CNE (November 2012). 《On the management of differences of sex development. Ethical issues relating to "intersexuality".Opinion No. 20/2012》 (PDF). 2012. Berne. 23 April 2015에 원본 문서 (PDF)에서 보존된 문서. 24 July 2018에 확인함. 
  34. Asia Pacific Forum of National Human Rights Institutions (June 2016). 《Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics》. ISBN 978-0-9942513-7-4. 15 January 2017에 원본 문서에서 보존된 문서. 
  35. International Commission of Jurists. “In re Völling, Regional Court Cologne, Germany (6 February 2008)”. 5 January 2016에 원본 문서에서 보존된 문서. 27 December 2015에 확인함. 
  36. Reuters (2015년 4월 1일). “Surgery and Sterilization Scrapped in Malta's Benchmark LGBTI Law”. 《The New York Times》. 2015년 4월 4일에 원본 문서에서 보존된 문서. 2020년 8월 29일에 확인함. 
  37. “Malta passes law outlawing forced surgical intervention on intersex minors”. 《Star Observer》. 2 April 2015. 14 August 2015에 원본 문서에서 보존된 문서. 
  38. Dreger, A. D.; Herndon, A. M. (2009년 1월 1일). “PROGRESS AND POLITICS IN THE INTERSEX RIGHTS MOVEMENT: Feminist Theory in Action”. 《GLQ: A Journal of Lesbian and Gay Studies》 15 (2): 199–224. doi:10.1215/10642684-2008-134. In our experience some clinicians have played a sort of moving target game whereby their definition of intersex changes from venue to venue, or moment to moment. We end up spending a remarkable amount of time just trying to agree on which diagnoses (and thus which people) count in the conversation we’re trying to have. This does not usually seem to be a purposeful attempt to stall or derail conversation (although that does sometimes result); rather it seems to stem from a lack of systematic consideration of what the term might mean. For example, some want to call intersex only those born with visibly ambiguous genitalia, or only those who have had a particularly unusual mix of prenatal sex hormones. 
  39. Jordan-Young RM, Sönksen PH, Karkazis K (April 2014). “Sex, health, and athletes”. 《BMJ》 348: g2926. doi:10.1136/bmj.g2926. PMID 24776640. 
  40. Goldberg, Abbie E. (2016년 5월 10일). 《The SAGE Encyclopedia of LGBTQ Studies》 (영어). SAGE Publications. 614쪽. ISBN 978-1-4833-7129-0. 
  41. Welcome to OII Australia – we promote human rights and bodily autonomy for intersex people, and provide information, education and peer support Archived 31 October 2014 - 웨이백 머신. , Intersex Human Rights Australia, 4 April 2004
  42. Answers to Your Questions About Individuals With Intersex Conditions Archived 31 October 2014 - 웨이백 머신. , American Psychological Association, 2006.
  43. Advocates for Informed Choice Archived 11 August 2011 - 웨이백 머신. , Advocates for Informed Choice, undated, retrieved 19 September 2014
  44. interACT (May 2016). “interACT Statement on Intersex Terminology”. 《Interact Advocates for Intersex Youth》. 8 June 2016에 원본 문서에서 보존된 문서. 30 May 2016에 확인함. 
  45. Jones, Tiffany; Hart, Bonnie; Carpenter, Morgan; Ansara, Gavi; Leonard, William; Lucke, Jayne (2016). 《Intersex: Stories and Statistics from Australia》 (PDF). Cambridge, UK: Open Book Publishers. ISBN 978-1-78374-208-0. 2016년 9월 14일에 원본 문서 (PDF)에서 보존된 문서. 2016년 2월 2일에 확인함. 
  46. “InterConnect Support - Support Embrace Educate Network”. 2021년 4월 9일에 확인함. 
  47. Johnson, Emilie K.; Rosoklija, Ilina; Finlayso, Courtney; Chen, Diane; Yerkes, Elizabeth B.; Madonna, Mary Beth; Holl, Jane L.; Baratz, Arlene B.; Davis, Georgiann; Cheng, Earl Y. (May 2017). “Attitudes towards "disorders of sex development" nomenclature among affected individuals”. 《Journal of Pediatric Urology》 13 (6): 608.e1–608.e8. doi:10.1016/j.jpurol.2017.03.035. ISSN 1477-5131. PMID 28545802. 
  48. Newswise (11 May 2017). “Term "Disorders of Sex Development" May Have Negative Impact”. 《Newswise》. 15 May 2017에 원본 문서에서 보존된 문서. 11 May 2017에 확인함. 
  49. D'Oro Anthony; Rosoklija Ilina; Jacobson Deborah L.; Finlayson Courtney; Chen Diane; Tu Duong D.; Austin Paul F.; Karaviti Lefkothea P.; Gunn Sheila K.; Nahata Leena; Kapa Hillary M. (2020). “Patients' and Caregivers' Attitudes toward 'Disorders of Sex Development' Nomenclature”. 《Journal of Urology》 204 (4): 835–842. doi:10.1097/JU.0000000000001076. PMID 32302259. 2020년 10월 20일에 원본 문서에서 보존된 문서. 2020년 7월 4일에 확인함. 
  50. Bennecke, Elena; Köhler, Birgit; Roehle, Robert; Thyen, Ute; Gehrmann, Katharina; Lee, Peter; Nordenström, Anna; Cohen-Kettenis, Peggy; Bouvattier, Claire; Wiesemann, Claudia (2020년 1월 27일). “Disorders or Differences of Sex Development? Views of Affected Individuals on DSD Terminology”. 《The Journal of Sex Research》 58 (4): 522–531. doi:10.1080/00224499.2019.1703130. PMID 31985272. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 7월 4일에 확인함. 
  51. Decretum Gratiani, C. 4, q. 2 et 3, c. 3
  52. “Decretum Gratiani (Kirchenrechtssammlung)”. 《Bayerische StaatsBibliothek (Bavarian State Library)》. 2009년 2월 5일. 2016년 12월 20일에 원본 문서에서 보존된 문서. 
  53. E Coke, The First Part of the Institutes of the Laws of England, Institutes 8.a. (1st Am. Ed. 1812).
  54. Greenberg, Julie (1999). “Defining Male and Female: Intersexuality and the Collision Between Law and Biology”. 《Arizona Law Review》 41: 277–278. SSRN 896307. 
  55. Reis, Elizabeth (2009). 《Bodies in Doubt: An American History of Intersex》. Baltimore: Johns Hopkins University Press. 55–81쪽. ISBN 978-0-8018-9155-7. 
  56. Molina B Dayal, MD, MPH, Assistant Professor, Fertility and IVF Center, Division of Reproductive Endocrinology and Infertility, Medical Faculty Associates, George Washington University distinguishes what 'true hermaphroditism' encompasses in their study of Ovotestis. Found here: “Ovotesticular Disorder of Sexual Development”. 31 December 2007에 원본 문서에서 보존된 문서. 2 January 2008에 확인함. 
  57. W. S. Alexander M.D., O. D. Beresford M.D., M.R.C.P. (1953) wrote extensively about 'female pseudohermaphrodite' origins in utera, in his paper "Masculinization of Ovarian Origin, published An International Journal of Obstetrics and Gynaecology Volume 60 Issue 2 pp. 252–258, April 1953.
  58. Am J Psychiatry 164:1499–1505, October 2007: Noted Mayo Clinic researchers J.M. Bostwick, MD, and Kari A Martin MD in A Man's Brain in an Ambiguous Body: A Case of Mistaken Gender wrote of the distinctions in male pseudohermaphrodite condition.
  59. Langman, Jan; Thomas Sadler (2006). 《Langman's medical embryology》. Hagerstown, MD: Lippincott Williams & Wilkins. 252쪽. ISBN 978-0-7817-9485-5. 
  60. Cawadias, A. P. (1943) Hermaphoditus the Human Intersex, London, Heinemann Medical Books Ltd.
  61. “Is a person who is intersex a hermaphrodite? | Intersex Society of North America”. Isna.org. 1 July 2013에 원본 문서에서 보존된 문서. 5 July 2013에 확인함. 
  62. 어지자지 - 국립국어원 표준국어대사전
  63. “How common is intersex? | Intersex Society of North America”. Isna.org. 22 August 2009에 원본 문서에서 보존된 문서. 21 August 2009에 확인함. 
  64. Council of Europe; Commissioner for Human Rights (April 2015), 《Human rights and intersex people, Issue Paper》, 6 January 2016에 원본 문서에서 보존된 문서, 29 August 2020에 확인함 
  65. “On the number of intersex people”. Organisation Intersex International Australia. 28 September 2013. 4 July 2015에 원본 문서에서 보존된 문서. 4 July 2015에 확인함. 
  66. Chaleyer, Rani (10 March 2015). “Intersex: the 'I' in 'LGBTI'. Special Broadcasting Service. 5 July 2015에 원본 문서에서 보존된 문서. 4 July 2015에 확인함. 
  67. Merke DP, Auchus RJ (September 2020). “Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency”. 《The New England Journal of Medicine》 383 (13): 1248–1261. doi:10.1056/NEJMra1909786. PMID 32966723. 
  68. 선청성 부신과다형성증, 서울아산병원
  69. Hull, Carrie L.; Fausto-Sterling, Anne (2003). “Letter to the Editor”. 《American Journal of Human Biology》 (영어) 15 (1): 112–116. doi:10.1002/ajhb.10122. ISSN 1520-6300. PMID 12552585. 
  70. “Intersex population figures”. 2013년 9월 28일. 2021년 4월 17일에 확인함. 
  71. Witchel, Selma Feldman; Azziz, Ricardo (2010). “Nonclassic Congenital Adrenal Hyperplasia”. 《International Journal of Pediatric Endocrinology》 2010: 625105. doi:10.1155/2010/625105. PMC 2910408. PMID 20671993. 
  72. Speiser PW, Arlt W, Auchus RJ, Baskin LS, Conway GS, Merke DP, Meyer-Bahlburg HF, Miller WL, Murad MH, Oberfield SE, White PC (November 2018). “Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline”. 《The Journal of Clinical Endocrinology and Metabolism》 103 (11): 4043–4088. doi:10.1210/jc.2018-01865. PMC 6456929. PMID 30272171. 
  73. Springer, A.; van den Heijkant, M.; Baumann, S. (June 2016). “Worldwide prevalence of hypospadias”. 《Journal of Pediatric Urology》 12 (3): 152.e1–152.e7. doi:10.1016/j.jpurol.2015.12.002. PMID 26810252. 
  74. “Klinefelter syndrome Genetic and Rare Diseases Information Center (GARD) – an NCATS Program”. 《rarediseases.info.nih.gov》. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 12월 19일에 확인함. 
  75. Wigby, Kristen; D'Epagnier, Cheryl; Howell, Susan; Reicks, Amy; Wilson, Rebecca; Cordeiro, Lisa; Tartaglia, Nicole (November 2016). “Expanding the phenotype of Triple X syndrome: A comparison of prenatal versus postnatal diagnosis”. 《American Journal of Medical Genetics Part A》 170 (11): 2870–2881. doi:10.1002/ajmg.a.37688. PMC 6501572. PMID 27644018. 
  76. Reference, Genetics Home. “Turner syndrome”. 《Genetics Home Reference》. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 12월 19일에 확인함. 
  77. Morcel, Karine; Camborieux, Laure; Guerrier, Daniel (2007). “Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome”. 《Orphanet Journal of Rare Diseases》 2 (1): 13. doi:10.1186/1750-1172-2-13. PMC 1832178. PMID 17359527. 
  78. “Urology Care Foundation – What is Vaginal Agenesis?”. 《www.urologyhealth.org》. 2019년 1월 4일에 원본 문서에서 보존된 문서. 2018년 1월 21일에 확인함. 
  79. Mohammadpour Lashkari, F.; Sadighi Gilani, M. A.; Ghaheri, A.; Zamanian, M. R.; Borjian Boroujeni, P.; Mohseni Meybodi, A.; Sabbaghian, M. (June 2018). “Clinical aspects of 49 infertile males with 45,X/46,XY mosaicism karyotype: A case series”. 《Andrologia》 50 (5): e13009. doi:10.1111/and.13009. PMID 29527714. Chromosomal analysis plays an important role in the DSD determination. 45,X/46,XY mosaicism is a rare karyotype, and its prevalence is about 1.5 in 10,000 newborns. 
  80. Stochholm, Kirstine; Juul, Svend; Gravholt, Claus H (2010). “Diagnosis and mortality in 47,XYY persons: a registry study”. 《Orphanet Journal of Rare Diseases》 5 (1): 15. doi:10.1186/1750-1172-5-15. PMC 2889887. PMID 20509956. 
  81. Tartaglia, Nicole; Ayari, Natalie; Howell, Susan; D'Epagnier, Cheryl; Zeitler, Philip (June 2011). “48,XXYY, 48,XXXY and 49,XXXXY syndromes: not just variants of Klinefelter syndrome”. 《Acta Paediatrica》 100 (6): 851–860. doi:10.1111/j.1651-2227.2011.02235.x. PMC 3314712. PMID 21342258. 
  82. “46,XX testicular disorder of sex development”. 《Genetics Home Reference》. 2019년 5월 17일에 원본 문서에서 보존된 문서. 2019년 12월 24일에 확인함. 
  83. “Ovotesticular Disorder of Sex Development”. 《NORD (National Organization for Rare Disorders)》. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 12월 21일에 확인함. 
  84. 《Yen and Jaffe's reproductive endocrinology : physiology, pathophysiology, and clinical management》 7판. Elsevier/Saunders. 2013년 9월 13일. ISBN 9781455727582. phenotypically, pure XY GD individuals are unambiguously phenotypic females (previously known as Swyer syndrome) but usually internally possess hypoplastic müllerian structures. 
  85. Reference, Genetics Home. “Swyer syndrome”. 《Genetics Home Reference》. 2019년 12월 16일에 원본 문서에서 보존된 문서. 2019년 12월 21일에 확인함. 
  86. Sinnecker, G. H. G.; Hiort, O.; Nitsche, E. M.; Holterhus, P.-M.; Kruse, K.; Group, German Collaborative Intersex Study (1996년 6월 29일). “Functional assessment and clinical classification of androgen sensitivity in patients with mutations of the androgen receptor gene”. 《European Journal of Pediatrics》 156 (1): 7–14. doi:10.1007/s004310050542. PMID 9007482. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 2월 5일에 확인함. In the genetic male, mutations of the androgen receptor (AR) gene cause phenotypes ranging from female to subfertile male. 
  87. Boehmer, Annemie L. M.; Brüggenwirth, Hennie; van Assendelft, Cissy; Otten, Barto J.; Verleun-Mooijman, Marja C. T.; Niermeijer, Martinus F.; Brunner, Han G.; Rouwé, Catrienus W.; Waelkens, J. J.; Oostdijk, Wilma; Kleijer, Wim J.; van der Kwast, Theo H.; de Vroede, Monique A.; Drop, Stenvert L. S. (September 2001). “Genotype Phenotype in Families with Androgen Insensitivity Syndrome”. 《The Journal of Clinical Endocrinology & Metabolism》 86 (9): 4151–4160. doi:10.1210/jcem.86.9.7825. PMID 11549642. 
  88. Anne Fausto-Sterling (2000). 《Sexing the Body: Gender Politics and the Construction of Sexuality》. New York: Basic Books. 
  89. Mosley, Michael (20 September 2015). “The extraordinary case of the Guevedoces”. 《BBC News》 (BBC News). 23 September 2015에 원본 문서에서 보존된 문서. 23 September 2015에 확인함. 
  90. Imperato-McGinley, Julianne; Guerrero, Luis; Gautier, Teofilo; Peterson, Ralph Edward (December 1974). “Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism”. 《Science》 186 (4170): 1213–1215. Bibcode:1974Sci...186.1213I. doi:10.1126/science.186.4170.1213. PMID 4432067. 
  91. Diodorus Siculus (1935). 《Library of History (Book IV)》. Loeb Classical Library Volumes 303 and 340. C H Oldfather (trans.). Cambridge, MA: Harvard University Press. 27 September 2008에 원본 문서에서 보존된 문서. 
  92. Markantes, Georgios; Deligeoroglou, Efthimios; Armeni, Anastasia; Vasileiou, Vasiliki; Damoulari, Christina; Mandrapilia, Angelina; Kosmopoulou, Fotini; Keramisanou, Varvara; Georgakopoulou, Danai; Creatsas, George; Georgopoulos, Neoklis (2015년 7월 10일). “Callo: The first known case of ambiguous genitalia to be surgically repaired in the history of Medicine, described by Diodorus Siculus”. 《Hormones》 14 (3): 459–461. doi:10.14310/horm.2002.1608. PMID 26188239. 
  93. Swami., Parmeshwaranand (2004). 《Encyclopaedia of the Śaivism》 1판. New Delhi: Sarup & Sons. ISBN 978-8176254274. OCLC 54930404. 
  94. Shankar, Gopi (March–April 2015). “The Many Genders of Old India”. 《The Gay & Lesbian Review Worldwide》 22: 24–26 – ProQuest 경유. 
  95. DeVun, Leah (June 2018). “Heavenly hermaphrodites: sexual difference at the beginning and end of time”. 《Postmedieval》 9 (2): 132–146. doi:10.1057/s41280-018-0080-8. ISSN 2040-5960. 
  96. Pliny, Natural History 7.34: gignuntur et utriusque sexus quos hermaphroditos vocamus, olim androgynos vocatos; Veronique Dasen, "Multiple Births in Graeco-Roman Antiquity," Oxford Journal of Archaeology 16.1 (1997), p. 61.
  97. Lynn E. Roller, "The Ideology of the Eunuch Priest," Gender & History 9.3 (1997), p. 558.
  98. Decretum Gratiani, C. 4, q. 2 et 3, c. 3
  99. “Decretum Gratiani (Kirchenrechtssammlung)”. 《Bayerische StaatsBibliothek (Bavarian State Library)》. 5 February 2009. 20 December 2016에 원본 문서에서 보존된 문서. 
  100. Raming, Ida; Macy, Gary; Bernard J, Cook (2004). 《A History of Women and Ordination》. Scarecrow Press. 113쪽. 
  101. E Coke, The First Part of the Institutes of the Laws of England, Institutes 8.a. (1st Am. Ed. 1812) (16th European ed. 1812).
  102. “India's Third Gender Rises Again”. 《Sapiens》. Wenner-Gren Foundation for Anthropological Research. 2019년 9월 26일. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 4월 26일에 확인함. 
  103. “Hijra: India's third gender claims its place in law”. 《The Guardian》. 2014년 4월 16일. 2017년 4월 15일에 원본 문서에서 보존된 문서. 2020년 4월 26일에 확인함. 
  104. Holmes, Morgan (July 2004). “Locating Third Sexes” (PDF). 《Transformations Journal》 (8). ISSN 1444-3775. 2017년 4월 16일에 원본 문서 (PDF)에서 보존된 문서. 2014년 12월 28일에 확인함. 
  105. 《Intersex Issues in the International Classification of Diseases: a revision》 (PDF). Mauro Cabral, Morgan Carpenter (eds.). 2014. 11 August 2016에 원본 문서 (PDF)에서 보존된 문서. 
  106. Goldschmidt, R. (1917), “Intersexuality and the endocrine aspect of sex”, 《Endocrinology》 1 (4): 433–456, doi:10.1210/endo-1-4-433, 2020년 8월 29일에 원본 문서에서 보존된 문서, 2019년 7월 4일에 확인함. 
  107. Coran, Arnold G.; Polley, Theodore Z. (July 1991). “Surgical management of ambiguous genitalia in the infant and child”. 《Journal of Pediatric Surgery》 26 (7): 812–820. CiteSeerX 10.1.1.628.4867. doi:10.1016/0022-3468(91)90146-K. PMID 1895191. 
  108. Hughes, I A; Houk, C; Ahmed, S F; Lee, P A; LWPES1/ESPE2 Consensus Group (June 2005). “Consensus statement on management of intersex disorders”. 《Archives of Disease in Childhood》 91 (7): 554–563. doi:10.1136/adc.2006.098319. ISSN 0003-9888. PMC 2082839. PMID 16624884. 
  109. Alice Domurat Dreger (May 1998). “"Ambiguous Sex"--or Ambivalent Medicine?”. 《The Hastings Center Report》 28 (3): 24–35. doi:10.2307/3528648. JSTOR 3528648. PMID 9669179. 
  110. Dreger, Alice ( 3 April 2015). “Malta Bans Surgery on Intersex Children”. 《The Stranger SLOG》. 18 July 2015에 원본 문서에서 보존된 문서. 
  111. 《Public statement by the third international intersex forum》. Malta. 2 December 2013. 24 November 2016에 원본 문서에서 보존된 문서. 
  112. Odero, Joseph (23 December 2015). “Intersex in Kenya: Held captive, beaten, hacked. Dead.”. 《76 CRIMES》. 25 April 2016에 원본 문서에서 보존된 문서. 1 October 2016에 확인함. 
  113. Warne, Garry L.; Raza, Jamal (September 2008). “Disorders of sex development (DSDs), their presentation and management in different cultures”. 《Reviews in Endocrine and Metabolic Disorders》 9 (3): 227–236. CiteSeerX 10.1.1.469.9016. doi:10.1007/s11154-008-9084-2. ISSN 1389-9155. PMID 18633712. 
  114. Ghattas, Dan Christian; Heinrich-Böll-Stiftung (2013). 《Human Rights between the Sexes A preliminary study on the life situations of inter*individuals》 (PDF). Berlin: Heinrich-Böll-Stiftung. ISBN 978-3-86928-107-0. 23 September 2015에 원본 문서 (PDF)에서 보존된 문서. 
  115. "Intersex", Radio Netherlands Archives, April 21, 2004”. 2004년 4월 21일. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 4월 16일에 확인함. 
  116. Carpenter, Morgan (December 2018). “Intersex Variations, Human Rights, and the International Classification of Diseases”. 《Health and Human Rights》 20 (2): 205–214. PMC 6293350. PMID 30568414. 
  117. Greenberg, Julie A. (June 2017). “Legal, ethical, and human rights considerations for physicians treating children with atypical or ambiguous genitalia”. 《Seminars in Perinatology》 41 (4): 252–255. doi:10.1053/j.semperi.2017.03.012. PMID 28478089. 
  118. Government Gazette Archived 9 June 2011 - 웨이백 머신. , Republic of South Africa, Vol. 487, Cape Town, 11 January 2006.
  119. Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013, No. 98, 2013 Archived 6 October 2014 - 웨이백 머신. , ComLaw, C2013A00098, 2013.
  120. On the historic passing of the Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013 Archived 6 October 2014 - 웨이백 머신. , Organisation Intersex International Australia, 25 June 2013.
  121. Malta (April 2015), 《Gender Identity, Gender Expression and Sex Characteristics Act: Final version》, 2015년 7월 5일에 원본 문서에서 보존된 문서, 2015년 7월 4일에 확인함 
  122. OII Europe ( 1 April 2015). “OII-Europe applauds Malta's Gender Identity, Gender Expression and Sex Characteristics Act. This is a landmark case for intersex rights within European law reform”. 22 May 2015에 원본 문서에서 보존된 문서. 3 July 2015에 확인함. 
  123. Transgender Europe ( 1 April 2015). 《Malta Adopts Ground-breaking Trans and Intersex Law – TGEU Press Release》. 3 November 2016에 원본 문서에서 보존된 문서. 4 July 2015에 확인함. 
  124. Zwischengeschlecht (12 August 2009). “Christiane Völling: Hermaphrodite wins damage claim over removal of reproductive organs”. 5 July 2015에 원본 문서에서 보존된 문서. 20 July 2015에 확인함. 
  125. “Condenan al H. de Talca por error al determinar sexo de bebé”. 《diario.latercera.com》 (스페인어). 15 February 2017에 원본 문서에서 보존된 문서. 15 February 2017에 확인함. 
  126. García, Gabriela (20 June 2013). “Identidad forzada”. 《www.paula.cl》 (스페인어). 15 February 2017에 원본 문서에서 보존된 문서. 
  127. Zwischengeschlecht (17 December 2015). “Nuremberg Hermaphrodite Lawsuit: Michaela "Micha" Raab Wins Damages and Compensation for Intersex Genital Mutilations!”. 11 May 2016에 원본 문서에서 보존된 문서. 21 December 2015에 확인함. 
  128. “M.C. V. AARONSON”. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 8월 1일에 확인함. 
  129. Dutta, Anatol; Pintens, Walter (2018년 9월 12일), “Private International Law Aspects of Intersex”, 《The Legal Status of Intersex Persons》 (Intersentia), 415–426쪽, doi:10.1017/9781780687704.026, ISBN 9781780687704 
  130. Holmes, Morgan. “Is Growing up in Silence Better Than Growing up Different?”. 《Intersex Society of North America》. 5 March 2016에 원본 문서에서 보존된 문서. 
  131. Intersex Society of North America. “What's wrong with the way intersex has traditionally been treated?”. 26 June 2014에 원본 문서에서 보존된 문서. 
  132. World Health Organization (2015). 《Sexual health, human rights and the law》. Geneva: World Health Organization. ISBN 9789241564984. 
  133. “Kenya takes step toward recognizing intersex people in landmark ruling”. 《Reuters》. 5 December 2014. 24 September 2015에 원본 문서에서 보존된 문서. 
  134. Money, John; Ehrhardt, Anke A. (1972). 《Man & Woman Boy & Girl. Differentiation and dimorphism of gender identity from conception to maturity》. USA: The Johns Hopkins University Press. ISBN 978-0-8018-1405-1. 
  135. Furtado P. S.; 외. (2012). “Gender dysphoria associated with disorders of sex development”. 《Nat. Rev. Urol.》 9 (11): 620–627. doi:10.1038/nrurol.2012.182. PMID 23045263. 
  136. Marañón, Gregorio (1929). 《Los estados intersexuales en la especie humana》. Madrid: Morata. 
  137. “Australian Government Guidelines on the Recognition of Sex and Gender, 30 May 2013”. 1 July 2015에 원본 문서에서 보존된 문서. 6 October 2014에 확인함. 
  138. Holme, Ingrid (2008). “Hearing People's Own Stories”. 《Science as Culture》 17 (3): 341–344. doi:10.1080/09505430802280784. 
  139. “New Zealand Passports - Information about Changing Sex / Gender Identity”. 23 September 2014에 원본 문서에서 보존된 문서. 6 October 2014에 확인함. 
  140. Third sex option on birth certificates Archived 10 October 2014 - 웨이백 머신. , Deutsche Welle, 1 November 2013.
  141. "Intersex: Third Gender in Germany" (Spiegel, Huff Post, Guardian, …): Silly Season Fantasies vs. Reality of Genital Mutilations”. 《Stop IGM》. 2013년 11월 1일. 2021년 3월 15일에 확인함. 
  142. Sham package for Intersex: Leaving sex entry open is not an option Archived 29 August 2014 - 웨이백 머신. , OII Europe, 15 February 2013
  143. Rupprecht, Marlene (2013년 9월 6일). “Children's right to physical integrity”. Parliamentary Assembly of the Council of Europe. 2013년 12월 26일에 원본 문서에서 보존된 문서. 2021년 1월 1일에 확인함. 
  144. “Trans? Intersex? Explained!”. interACT. October 18, 2014에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  145. “Basic differences between intersex and trans”. Organisation Intersex International Australia. 3 June 2011. 4 September 2014에 원본 문서에서 보존된 문서. 10 July 2013에 확인함. 
  146. “The marks on our bodies”. 《Intersex Day》. October 25, 2015. April 5, 2016에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  147. Behrmann, Jason; Ravitsky, Vardit (October 2013). “Queer Liberation, Not Elimination: Why Selecting Against Intersex is Not "Straight" Forward”. 《The American Journal of Bioethics》 13 (10): 39–41. doi:10.1080/15265161.2013.828131. ISSN 1526-5161. PMID 24024805. 
  148. Dreger, Alice ( 4 May 2015). “Reasons to Add and Reasons NOT to Add "I" (Intersex) to LGBT in Healthcare” (PDF). Association of American Medical Colleges. 9 June 2016에 원본 문서 (PDF)에서 보존된 문서. 18 May 2016에 확인함. 
  149. Koyama, Emi. “Adding the "I": Does Intersex Belong in the LGBT Movement?”. 《Intersex Initiative》. 17 May 2016에 원본 문서에서 보존된 문서. 18 May 2016에 확인함. 
  150. “Intersex for allies”. 21 November 2012. 7 June 2016에 원본 문서에서 보존된 문서. 18 May 2016에 확인함. 
  151. Busby, Cec (2014년 6월 1일). “OII RELEASES NEW RESOURCE ON INTERSEX ISSUES”. Intersex Human Rights Australia. 2014년 6월 6일에 원본 문서에서 보존된 문서. 2021년 1월 1일에 확인함. 
  152. Kaggwa, Julius (19 September 2016). “I'm an intersex Ugandan – life has never felt more dangerous”. 《The Guardian》. ISSN 0261-3077. 6 October 2016에 원본 문서에서 보존된 문서. 3 October 2016에 확인함. 
  153. “IAD2016: A Message from Mauro Cabral”. Global Action for Trans Equality. October 26, 2016. November 3, 2016에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  154. Leffler, Rebecca (26 May 2007). “Critics Week grand prize to 'XXY'. 《The Hollywood Reporter》. 30 September 2007에 원본 문서에서 보존된 문서. 12 February 2017에 확인함. 
  155. Peitzman, Louis (September 23, 2014). “Meet television's groundbreaking intersex character”. BuzzFeed News. May 29, 2016에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  156. Avery, Dan (April 1, 2016). "Faking It" Breaks New Ground With First Intersex Actor To Play Intersex Character On TV”. 《NewNowNext》. Logo TV. April 5, 2016에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  157. Androgen Insensitivity Syndrome Support Group Australia; Briffa, Anthony (22 January 2003). “Discrimination against People affected by Intersex Conditions: Submission to NSW Government” (PDF). 11 March 2016에 원본 문서 (PDF)에서 보존된 문서. 16 May 2016에 확인함. 
  158. “Androgen Insensitivity Syndrome Support Group (AISSG)”. 21 January 2016에 원본 문서에서 보존된 문서. 16 May 2016에 확인함. 
  159. “Dear ISNA Friends and Supporters”. 2008. 19 May 2016에 원본 문서에서 보존된 문서. 16 May 2016에 확인함. 
  160. “When Max Beck and Morgan Holmes went to Boston”. 《Intersex Day》. October 17, 2015. October 20, 2015에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  161. An intersex flag, Intersex Human Rights Australia, 5 July 2013
  162. Schifrin, Dan (September 19, 2014). “Stanford prof: Talmudic rabbis were into analyzing sexuality”. 《Jewish News of Northern California》. October 10, 2014에 원본 문서에서 보존된 문서. January 1, 2021에 확인함. 
  163. Klaudia Snochowska-Gonzales. “Walasiewicz była kobietą (Walasiewicz Was a Woman)”. 《Gazeta Wyborcza》 (폴란드어) 190 (14 August 2004): 8. 2020년 5월 14일에 원본 문서에서 보존된 문서. 2006년 5월 31일에 확인함. 
  164. Cooky, Cheryl; Shari L. Dworkin (Feb 2013). “Policing the Boundaries of Sex: A Critical Examination of Gender Verification and the Caster Semenya Controversy”. 《Journal of Sex Research》 50 (2): 103–111. doi:10.1080/00224499.2012.725488. PMID 23320629. 
  165. Karkazis, Katrina; Jordan-Young, Rebecca; Davis, Georgiann; Camporesi, Silvia (July 2012). “Out of Bounds? A Critique of the New Policies on Hyperandrogenism in Elite Female Athletes”. 《The American Journal of Bioethics》 12 (7): 3–16. doi:10.1080/15265161.2012.680533. ISSN 1526-5161. PMC 5152729. PMID 22694023. 
  166. “UN Human Rights Council: resolution, statement and side event, "The time has come". Organisation Intersex International Australia. 11 September 2014. 30 September 2014에 원본 문서에서 보존된 문서. 28 September 2014에 확인함. 
  167. Pūras, Dainius; Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health ( 4 April 2016), 《Sport and healthy lifestyles and the right to health. Report A/HRC/32/33》, United Nations, 15 December 2016에 원본 문서에서 보존된 문서 
  168. Muyle, A.; Marais, G. (2016). 〈Mating Systems in Plants, Genome Evolution and〉. 《Encyclopedia of Evolutionary Biology》. 480–492쪽. doi:10.1016/B978-0-12-800049-6.00320-6. ISBN 9780128004265. 
  169. Christopher, Dorothy A.; Mitchell, Randall J.; Trapnell, Dorset W.; Smallwood, Patrick A.; Semski, Wendy R.; Karron, Jeffrey D. (August 2019). “Hermaphroditism promotes mate diversity in flowering plants”. 《American Journal of Botany》 106 (8): 1131–1136. doi:10.1002/ajb2.1336. PMC 6852098. PMID 31403705. 
  170. Auld, J.R.; Jarne, P. (2016). 〈Sex and Recombination in Snails〉. Kliman, Richard M. 《Sex and Recombination in Snails》. 《Encyclopedia of Evolutionary Biology》. 49–60쪽. doi:10.1016/B978-0-12-800049-6.00149-9. ISBN 9780128004265. 
  171. Fusco, Giuseppe; Minelli, Alessandro (2019년 10월 10일). 《The Biology of Reproduction》 (영어). Cambridge University Press. 116쪽. ISBN 978-1-108-49985-9. 
  172. Dreger, Alice Domurat (1998). 《Hermaphrodites and the medical invention of sex》. Cambridge, Mass.: Harvard University Press. ISBN 9780674001893. 
  173. Ross, L.; Blackmon, H. (2016). “Sex Determination”. 《Encyclopedia of Evolutionary Biology》: 81–88. doi:10.1016/B978-0-12-800049-6.00146-3. ISBN 9780128004265. 
  174. Krob, G.; Braun, A.; Kuhnle, U. (January 1994). “True hermaphroditism: Geographical distribution, clinical findings, chromosomes and gonadal histology”. 《European Journal of Pediatrics》 153 (1): 2–10. doi:10.1007/BF02000779. PMID 8313919. 
  175. Rosenfield, Kevin A. (2018), 〈Hermaphrodite〉, Vonk, Jennifer; Shackelford, Todd, 《Encyclopedia of Animal Cognition and Behavior》, Cham: Springer International Publishing, 1–2쪽, doi:10.1007/978-3-319-47829-6_329-1, ISBN 978-3-319-47829-6, 2021년 4월 27일에 확인함 

    The term "hermaphrodite" has sometimes been used to refer to humans whose biological sex is ambiguous. This usage has fallen out of favor and in any case was technically incorrect. The essential characteristic of hermaphrodites is the ability to reproduce as both male and female. No such case has been identified in any human

  176. Zderic, Stephen (2002). 《Pediatric gender assignment : a critical reappraisal; [proceedings from a conference ... in Dallas in the spring of 1999 which was entitled "pediatric gender assignment – a critical reappraisal"]》. New York, NY [u.a.]: Kluwer Acad. / Plenum Publ. ISBN 978-0306467592. 
  177. Frader, J.; Alderson, P.; Asch, A.; Aspinall, C.; Davis, D.; Dreger, A.; Edwards, J.; Feder, E. K.; Frank, A.; Hedley, L. A.; Kittay, E.; Marsh, J.; Miller, P. S.; Mouradian, W.; Nelson, H.; Parens, E. (May 2004). “Health care professionals and intersex conditions”. 《Arch. Pediatr. Adolesc. Med.》 158 (5): 426–8. CiteSeerX 10.1.1.572.1572. doi:10.1001/archpedi.158.5.426. PMID 15123472. 
  178. Wiesemann, Claudia; Ude-Koeller, Susanne; Sinnecker, Gernot H. G.; Thyen, Ute (2009년 10월 20일). “Ethical principles and recommendations for the medical management of differences of sex development (DSD)/intersex in children and adolescents” (PDF). 《European Journal of Pediatrics》 169 (6): 671–679. doi:10.1007/s00431-009-1086-x. PMC 2859219. PMID 19841941. 2020년 8월 29일에 원본 문서 (PDF)에서 보존된 문서. 2013년 9월 6일에 확인함. 
  179. Diamond, Milton; H. Keith Sigmundson (1997). “Management of intersexuality: Guidelines for dealing with individuals with ambiguous genitalia”. 《Archives of Pediatrics and Adolescent Medicine》 June. 8 February 2007에 원본 문서에서 보존된 문서. 8 April 2007에 확인함. 
  180. Kolodny, Robert C.; Masters, William H.; Johnson, Virginia E. (1979). 《Textbook of Sexual Medicine》 1판. Boston: Little, Brown and Company. ISBN 978-0-316-50154-5. 
  181. “Intersex: MedlinePlus Medical Encyclopedia”. 《medlineplus.gov》. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2019년 3월 25일에 확인함. 
  182. Diamond, Milton; Linda, Watson (2004). “Androgen insensitivity syndrome and Klinefelter's syndrome: sex and gender considerations”. 《Child Adolesc Psychiatric Clin N Am》 (13). 623–640면. 1 July 2013에 원본 문서에서 보존된 문서. 
  183. Forrester, John (2009). “The psychology of the sexual–reproductive–gender system” (PDF). 《Wellcome History》 (42): 13–15. 2020년 8월 29일에 원본 문서 (PDF)에서 보존된 문서. 2018년 6월 26일에 확인함. 
  184. Marchal, Joseph (2010년 7월 3일). “Bodies Bound for Circumcision and Baptism: An Intersex Critique and the Interpretation of Galatians”. 《Theology & Sexuality》 16 (2): 163–182. doi:10.1558/tse.v16i2.163. ISSN 1355-8358. 
  185. García López, Daniel J (March 2015). “La intersexualidad en el discurso médico-jurídico”. 《Eunomía》 (8): 54–70. ISSN 2253-6655. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2018년 6월 26일에 확인함. 
  186. Baylis, Françoise; Borgerson, Kirstin; Hoffmaster, Barry; Sherwin, Susan (2011년 10월 6일). 《Health Care Ethics in Canada》. Cengage Learning. ISBN 9780176504649. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 5월 28일에 확인함. 
  187. Kamijo, H.; Narita, O. (November 1997). “[Female pseudohermaphroditism]”. 《Nihon Rinsho. Japanese Journal of Clinical Medicine》 55 (11): 2925–2929. ISSN 0047-1852. PMID 9396289. 
  188. Migeon, C. J. (July 1980). “Male pseudohermaphroditism”. 《Annales d'Endocrinologie》 41 (4): 311–343. ISSN 0003-4266. PMID 7011168. 
  189. Fernández-Cancio, Mónica; Camats, Núria; Flück, Christa E.; Zalewski, Adam; Dick, Bernhard; Frey, Brigitte M.; Monné, Raquel; Torán, Núria; Audí, Laura (2018년 4월 29일). “Mechanism of the Dual Activities of Human CYP17A1 and Binding to Anti-Prostate Cancer Drug Abiraterone Revealed by a Novel V366M Mutation Causing 17,20 Lyase Deficiency”. 《Pharmaceuticals》 11 (2): 37. doi:10.3390/ph11020037. PMC 6027421. PMID 29710837. 
  190. Iqbal, Muhammad Zafar; Jam, Mazhar Rafee; Saleem, Muhammad; Ahmad, Mushtaq (2011년 7월 30일). “True Hermaphrodite: A Case Report”. 《APSP Journal of Case Reports》 2 (2): 16. ISSN 2218-8185. PMC 3418019. PMID 22953283. 
  191. European Union Agency for Fundamental Rights (April 2015), 《The fundamental rights situation of intersex people》 (PDF), 5 March 2016에 원본 문서 (PDF)에서 보존된 문서, 3 January 2016에 확인함 
  192. Comisión Interamericana de Derechos Humanos (12 November 2015), 《Violencia contra Personas Lesbianas, Gays, Bisexuales, Trans e Intersex en América》 (PDF) (스페인어), Comisión Interamericana de Derechos Humanos, 7 January 2016에 원본 문서 (PDF)에서 보존된 문서 
  193. Lee, Peter A.; Nordenström, Anna; Houk, Christopher P.; Ahmed, S. Faisal; Auchus, Richard; Baratz, Arlene; Baratz Dalke, Katharine; Liao, Lih-Mei; Lin-Su, Karen; Looijenga, Leendert H.J.; Mazur, Tom; Meyer-Bahlburg, Heino F.L.; Mouriquand, Pierre; Quigley, Charmian A.; Sandberg, David E.; Vilain, Eric; Witchel, Selma; and the Global DSD Update Consortium (2016년 1월 28일). “Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care”. 《Hormone Research in Paediatrics》 85 (3): 158–180. doi:10.1159/000442975. ISSN 1663-2818. PMID 26820577. 
  194. Mouriquand, Pierre D. E.; Gorduza, Daniela Brindusa; Gay, Claire-Lise; Meyer-Bahlburg, Heino F. L.; Baker, Linda; Baskin, Laurence S.; Bouvattier, Claire; Braga, Luis H.; Caldamone, Anthony C.; Duranteau, Lise; El Ghoneimi, Alaa; Hensle, Terry W.; Hoebeke, Piet; Kaefer, Martin; Kalfa, Nicolas; Kolon, Thomas F.; Manzoni, Gianantonio; Mure, Pierre-Yves; Nordenskjöld, Agneta; Pippi Salle, J. L.; Poppas, Dix Phillip; Ransley, Philip G.; Rink, Richard C.; Rodrigo, Romao; Sann, Léon; Schober, Justine; Sibai, Hisham; Wisniewski, Amy; Wolffenbuttel, Katja P.; Lee, Peter (2016). “Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how?”. 《Journal of Pediatric Urology》 12 (3): 139–149. doi:10.1016/j.jpurol.2016.04.001. ISSN 1477-5131. PMID 27132944. 
  195. Creighton, Sarah M.; Michala, Lina; Mushtaq, Imran; Yaron, Michal (2014년 1월 2일). “Childhood surgery for ambiguous genitalia: glimpses of practice changes or more of the same?” (PDF). 《Psychology and Sexuality》 5 (1): 34–43. doi:10.1080/19419899.2013.831214. ISSN 1941-9899. 2018년 7월 19일에 원본 문서 (PDF)에서 보존된 문서. 2019년 1월 13일에 확인함. 
  196. Comisión Interamericana de Derechos Humanos (12 November 2015), 《Violencia contra Personas Lesbianas, Gays, Bisexuales, Trans e Intersex en América》 (PDF), Comisión Interamericana de Derechos Humanos, 7 January 2016에 원본 문서 (PDF)에서 보존된 문서 
  197. German Ethics Council (February 2012). 《Intersexuality, Opinion》. ISBN 978-3-941957-50-3. 21 April 2017에 원본 문서에서 보존된 문서. 25 January 2020에 확인함. 
  198. Cools, Martine; Koen van Aerde; Anne-Marie Kersemaekers; Marjan Boter; Stenvert L. S Drop; Katja P. Wolffenbuttel; Ewout W. Steyerberg; J. Wolter Oosterhuis; Leendert H. J. Looijenga (September 2005). “Morphological and Immunohistochemical Differences between Gonadal Maturation Delay and Early Germ Cell Neoplasia in Patients with Undervirilization Syndromes”. 《J. Clin. Endocrinol. Metab.》 90 (9): 5295–5303. doi:10.1210/jc.2005-0139. PMID 15998778. 
  199. Intersex Society of North America (24 May 2006). What evidence is there that you can grow up psychologically healthy with intersex genitals (without "normalizing" surgeries)? Archived 8 December 2006 - 웨이백 머신. . Retrieved 25 November 2006.
  200. Bioethics Forum blog – Preventing Homosexuality (and Uppity Women) in the Womb? Archived 2 April 2016 - 웨이백 머신. , Alice Dreger, Ellen K. Feder, Anne Tamar-Mattis (2010), at Hastings Center Bioethics Blog, retrieved 18 May 2012.
  201. Meyer-Bahlburg, HFL (1990). “Will prenatal hormone treatment prevent homosexuality?”. 《Journal of Child and Adolescent Psychopharmacology》 1 (4): 279–283. doi:10.1089/cap.1990.1.279. 
  202. “American Journal of Bioethics, 13:10, 51–53. Retrieved 11 September 2013”. 11 October 2014에 원본 문서에서 보존된 문서. 6 October 2014에 확인함. 
  203. Preves, Sharon (2003). 《Intersex and Identity, the Contested Self》. Rutgers. ISBN 0-8135-3229-9.  p. 72.
  204. Creighton, Sarah; Alderson, J; Brown, S; Minto, Cathy (2002). “Medical photography: ethics, consent and the intersex patient”. 《BJU International》 89 (1): 67–71. doi:10.1046/j.1464-410X.2002.02558.x. PMID 11849163.  p. 70.
  205. Dreger, Alice Domurat (2000). “Jarring Bodies: Thoughts on the Display of Unusual Anatomies”. 《Perspectives in Biology and Medicine》 43 (2): 161–172. doi:10.1353/pbm.2000.0002. ISSN 1529-8795. PMID 10804583. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 2월 5일에 확인함. 
  206. Kraus, Cynthia (May 2015). “Classifying Intersex in DSM-5: Critical Reflections on Gender Dysphoria”. 《Archives of Sexual Behavior》 44 (5): 1147–1163. doi:10.1007/s10508-015-0550-0. ISSN 0004-0002. PMID 25944182. 2020년 8월 29일에 원본 문서에서 보존된 문서. 2020년 2월 5일에 확인함. 

Bibliography편집

External links편집

  위키미디어 공용에 Jjw/연습장 관련 미디어 분류가 있습니다.

외부 동영상
  " What It's Like To Be Intersex", Lizz Warner, BuzzFeed