What It’s Like To Be Born With Female Pseudohermaphroditism
My name is Thomas, and I was born with a condition called female pseudohermaphroditism. My condition means that while I was born with normal-looking male genitals, I also had a functioning female set of internal reproductive organs.
After a doctor encouraged me to intentionally cause myself harm because, as they were concerned, “people like you should not exist”, I decided to write this article to educate, inspire, and inform those who are curious about my intersex condition.
This condition is what caused my external genitals looked more like those of a boy than those of a girl. However, it wasn’t until I got my period as an adolescent that I realized there was anything unusual about my body. My breasts developed at puberty (although not very much) and I had male pattern facial hair. While nothing seemed out of place on my body, something felt different inside. I felt sick to my stomach and thought that perhaps something was wrong with me. I tried hard to ignore these feelings but they became acutely overwhelming during my senior year in high school.
I finally went to see a doctor who simply labeled me as transgender and suggested that I seek counseling. I began struggling with severe depression and anxiety. Based on the doctors advice, I sought counseling to help me cope with what life threw at me.
My entire life, most people thought that my external appearance was either female or ambiguous. Overall, I’ve come to terms with my body and how it looks and functions. If I could go back in time and tell my teenage self one thing, it would be that you’re beautiful just as you are. Although my body might not be typical, it is mine and I love it just as much as anyone else loves theirs.
Today, many people assume they have a good understanding of what being transgender means because they’ve seen popular media like I Am Jazz or Transparent. But those shows don’t tell you how it feels to be different, or how you’ll react when someone says something rude about your appearance. They don’t show you how hard it can be to find love when all anyone sees is someone who is different. They certainly don’t show you what it’s like to be raised by parents who think their child is the gender they perceive them to be. But, these are all things I’ve experienced firsthand.
What are some common questions on what it’s like to be born with female pseudohermaphroditism? In particular, people mostly bombard me with questions about my genitals. I can’t believe how comfortable they are asking me about my genitals, though some of it comes from a place of genuine curiosity. These questions include:
- How big is your penis?
It is rather small in size, according to my doctors.
- Do you have a vagina?
I do, in the sense that there is a vaginal cavity, though it is covered in skin and therefore I cannot accept vaginal penetration. I should note that it is entirely possible for someone to be born with either a penis, a vagina, neither, or a combination of both. My genitals look [mostly] similar to that of a pre-pubescent natural male.
- How do you have sex?
I am fully capable of having sex the same as anyone else who has a functioning penis.
- Can you have children?
I have been told that I am totally infertile, and I have never been able to produce a pregnancy with any sexual partner. I cannot become pregnant without medical assistance, nor do I wish to.
- Can you ejaculate?
Kind of, but the amount of fluid that is excreted (if any) is minimal and doesn’t contain semen.
- What happens when you urinate?
I urinate through my penis, like a typical male.
- Do you get your period?
I do, but it is very irregular, and occasionally it skips a month. The blood exits my body through my penis, which is sometimes painful and irritating.
- Can you get an erection?
I can! This was not affected by hormone replacement therapy, but everyone’s experience is different.
- Have you thought about changing your name?
No, I actually like being a woman named Thomas. Everyone knows me as a female, and it has always been this way. It has worked for me my entire life, so why change it?
- Are you transgender?
According to my doctors, because I identify with my birth gender (female), so in my case, they have labeled me a cisgender female. I have met with several therapists who agree that I am not transgender and do not have gender identity disorder. My underlying problem is a birth defect, not a psychological condition.
- What is your sexual orientation?
I am solely attracted to females. Although I dislike putting a label on my sexuality, for the purposes of this article, I identify as lesbian.
- How has your condition affected your romantic relationships?
Because I am open and honest about my condition, the women whom I have been romantically involved with have been very accepting of my condition.
- Have you considered getting surgery?
Until sometime in my 40’s, I sought out surgical intervention. After speaking with several specialists in the field of transgender health, and more recently, doctors who specialize in intersex conditions, they have advised against me getting surgery because I have a much higher risk of complications. To be honest, my problem lies with society and it’s unnecessary binary interpretation of sex and gender, which are unrelated. Everyone who knows me is aware of my condition, and it has never been an issue.
I have been asked these and many other questions by doctors and medical students for many years, so these questions are surprisingly not invasive to me at all. In fact, I am more than happy to answer these questions for those who are genuinely curious.
If I haven’t already answered your question here, please ask it in the comments section below.
With all of this information, I’m not suggesting that having an intersex condition is a blessing. I have had female friends of mine tell me that I’m lucky that I don’t have to sit when I urinate. Unfortunately, we are still living in a society with strict gender rules and expectations, and that can be emotionally painful—particularly if your body doesn’t fit neatly into one of two categories; male or female. However, as many of us learned in biology class: every cell in our body has a sex chromosome (either XX or XY), which can lead to differences in physical development during puberty.
For example, women tend to have wider hips than men because they have more estrogen; while men tend to have more muscle mass because they have more testosterone. As a result, there are people who are born with bodies that fall somewhere between male and female. For example, some people are born with XXY chromosomes instead of XY; others may develop both ovarian and testicular tissue; others may develop either fully functional set of genitalia, or sometimes no genitalia at all, such as a medical condition known as penile agenesis. It is also possible for a female to be born without a vagina, a medical condition known as vaginal agenesis.
If someone is born with both ovarian and testicular tissue (which happens when an embryo develops both male and female gonads), then it’s possible for them to produce both eggs and sperm at once. This can cause them to develop ambiguous genitalia—which may require surgery or hormone treatment later on in life for their own comfort. These conditions aren’t common but they can and do happen.
Because these conditions often go undiagnosed until well after birth, it can be difficult to determine how much of a role socialization plays in their upbringing. Is it nature? Or nurture? And how does that affect how we treat them?
In my case, my doctors determined that I was born with ovotestes and assigned me hermaphrodite at birth based on my external anatomy—I developed in a very androgynous way throughout childhood due to a hormonal imbalance.
When I hit puberty, my body changed rapidly and uncontrollably—and no one could tell me why. By 13 years old, I had grown several inches taller than all of my friends; by 14 years old, hair had started growing all over my face and body. It was around this time that my father tried to amend my birth certificate to say male (it has said intersex since birth), and sent me away to an all-boys boarding school. At 16 years old, I was finally diagnosed with female pseudohermaphroditism. Until that time in my life, I grew up never knowing anything about my condition.
My father repeatedly told me that I was going to grow up and be a man, or else. I thought very seriously about committing suicide, often, because I knew that I was really female. I feared my father, and I what he might have been truly capable of; for my father, his entire identity centered around his child being male, no matter what the cost.
My mother has maintained that she was never told about my diagnosis, though it was likely that my father would have known. This uncertainty of who knew what and when causes a lot of unnecessary friction in my relationship with my family.
I’m now 42 years old and unlike most girls my age, my breasts are still continuing to develop, though my body has retained its original hourglass shape. On a daily basis, I deal with unwanted attention from both strangers and acquaintances—some of whom assume that I must be gay or transgender just because of how I look. The truth is, being born with female pseudohermaphroditism hasn’t stopped me from leading a happy, fulfilling life—I’ve just had to work harder to prove myself in order to earn respect from others.
I prefer female pronouns (she/her) and am generally considered a cisgender woman. I absolutely hate it when someone refers to me as a male, or uses he/him pronouns. All of my friends, including the ones who have seen me fully naked, accept me as a cisgender female, and have been absolutely amazing and accepting.
There are many doctors who believe that intersex people are stupid. They think we don’t understand our own bodies, so they tell us how we should feel about them and how we need to identify ourselves. I was told that the only way I could ever identify myself was by having surgery on my genitals when I turned eighteen years old. Doctors thought that since my genitalia looked male, then there must be something wrong with me mentally, despite having a well-documented IQ of 178.
Even though doctors thought they knew better than me what my body should look like, I was never offered an apology for being forced into a decade of unnecessary psychotherapy as a child, in which multiple therapists tried to convince me that I was a male because my father put enormous pressure on them to do so.
When I turned 18, I again asked for help and was told by a therapist that, “[I was] simply confused about my gender identity.” This same therapist told me that, “[I] don’t know what it’s like to grow up as a woman, so I can never empathize with a woman fully.”
The truth is, it’s a lot harder to grow up as an intersex person than most people realize—especially if you were born with female pseudohermaphroditism. For one thing, my childhood wasn’t nearly as typical as many people assume. Yes, I liked playing with dolls because they were pretty and nice and clean-smelling (and also because every little girl does), but no more than any other little girl did. In fact, growing up in the 1980s meant I had far fewer opportunities to play dress-up or paint my nails or spend time at beauty salons than girls do today. My favorite toys weren’t Barbie dolls; they were fire trucks!
I had a really easy time making friends with other girls my age because they thought it was cool that I was so girly. I used to go and spend time at my female friends houses when we were little, and I would try on their clothes and play. Sometimes, we would even try on makeup! They assumed I was gay, they stood up against bullies for me throughout my school years, and accepted me into their social circles.
The truth is, I have identified as female my entire life, and was fully accepted as such, despite the opinions of some who disagreed. Growing up, it was hard for me to explain myself and make people understand what I was going through. Even though gender is a social construct, you’d be surprised how many people still believe that you are born a certain way or that being trans or intersex is somehow a mental illness, a sexual fetish, or an addiction.
Society tends to define real women based on narrow ideals and body standards, which made me feel bad about myself when I didn’t fit into society’s definition of a woman. I remember feeling that I wasn’t truly loved because no one could accept me for who I am. It took years before I found out exactly why I felt so different from other girls. In kindergarten, they started noticing that something was off with my anatomy. My teachers would ask if I was sure that I was a girl and when I said yes, they would suggest that I go play with the other girls.
I was raised as a girl and lived as one, literally my entire life, with the exception of when I went away to summer camp. Summer camp was really hard for me because I had a very androgynous appearance and my body didn’t look like everyone else’s. I was accepted, and genuinely felt as if I belonged, but feeling as if I didn’t truly belong to either gender caused me a lot of emotional turmoil. At the time, I had two forms of gender dysphoria (one due to being intersex, and one due to being incorrectly labeled as male at summer camp), it was a constant struggle trying to figure out how I fit into society or who I truly was.
Later on in life, being intersex definitely affected my romantic relationships. When I came out as a lesbian at age 16, I was sure that most people would think I just wanted attention or was confused about my sexuality. My mom told me that once I lost my virginity, it would all make sense and I would figure it out on my own. At age 20, I lost my virginity to a female friend; it was a wonderful and memorable experience, but it did not help me to understand who I truly was.
Looking back on my teenage experience, I can now say that almost everyone I came out to was very accepting and non-judgmental. That said, coming out as queer has always been a little scary. Even today it’s hard to know how other people will react and whether or not they will judge me for being born intersex, especially when you have female pseudohermaphroditism. For example, although all of my friends and all of family members know about my condition, there are those who I’ve only known for a short period of time whom I haven’t told yet.
I’ve always identified as a lesbian. Some of my past relationships were short and others were longer, but now I’m currently happily married to another woman; we both identify as cisgender lesbian women. The fact that I have male-like genitals has never really been a problem for either of us. My wife Amelia and I simply accept it for how it is, and how it has been my entire life. When we have sex it just feels natural and enjoyable, and it does not feel scary or strange at all.
Despite what others may assume, I’m not bothered or embarrassed by having male-looking genitalia. While I may be biologically intersex, I am female in my gender identity, and I always felt like a girl on every possible level as far back as my earliest memories. While surgery is possible for someone with my condition, I have always been scared of going through it because of how invasive it was. Historically, the surgeons have been disrespectful towards me because I don’t embody the stereotypical transgender patient that they are accustomed to working with, and most doctors refuse to take me on as a patient because they lack adequate training in the complexities of intersex conditions.
I clearly remember trying to convince my doctor to prescribe me female hormones ate age 19. While my doctor agreed that this would be an obvious and necessary course of treatment, according to WPATH guidelines, my doctor needed letters from two different psychotherapists who did not know each other, and had both seen me on a regular basis for over a year.
These guidelines are patently discriminatory against anyone who does not, in the therapists opinion, pass as their gender. Under them, an intersex or transgender person is repeatedly denied care or hormones entirely because oftentimes they do not meet the unrealistic expectations of therapists. The logic is baffling: people are only deemed truly in need of care if they can pass full-time as their gender identity. Unsurprisingly, these guidelines have been widely criticized by a vast number of gender diverse individuals as well as gender-affirming physicians and organizations.
Many intersex and transgender patients are frustrated with WPATH, as their guidelines prevent most patients from getting the medical care they need. This is exactly what I was worried about when my doctor required letters from therapists that met WPATH guidelines — namely that it could be used as a weapon against me at any time, and on a handful of occasions, I was denied access to care simply for being a lesbian. WPATH Standards of Care have no medical or scientific value, are based on bias, and should not be enforced or relied upon, because they endanger trans patients lives by denying them life-saving treatment.
A lifelong friend of mine who became a gynecologist, was acutely aware of my situation offered to help me transition. She discussed my options, and informed me that WPATH may require her licensing board to take action against her if she prescribed hormones for me. While she was willing and eager to prescribe them for me, understandably, she couldn’t take that risk with her career. She gave me the name of a doctor she knew who would write me a prescription so I could legally receive HRT. After 6 months on HRT, both my physical and mental health improved drastically.
It should be noted that gender identity has nothing to do with gender assignment—it’s all about how you feel. Therefore, gender is not binary. Instead, we multiple categories: masculine, feminine, non-binary, and agender. While some people are assigned male at birth and others female, it doesn’t mean they have to identify as such.
The medical community, even today, is still reluctant to accept a patient who is gender diverse, let alone one who has condition such as mine. They often try and persuade patients like me into having Gender Reassignment Surgery. I completely understand why they do that, and for some intersex or transgender people, it is a life-saving necessity! For me, I simply wanted medical care to treat my underlying condition. The guidelines published by WPATH are grossly outdated and prevented me from getting medical care that I needed.
Gender identity has nothing at all to do with sexual orientation. Sexual orientation is all about who you find sexually attractive; a person may identify as a certain gender and be attracted to others based on their gender.
My gender identity doesn’t dictate my sexual orientation. I identify as a homosexual female, but that’s not because I was born with male-looking genitalia, or because I have female pseudohermaphroditism—it just means I identify as a woman who is exclusively attracted to women. I’ve spent most of my life feeling like there was something wrong with me because of how I was born and how people reacted to it when they found out.
I can only begin to imagine how hard it must be for people who identify in even more atypical ways. I’ve often felt pressured by society into feeling like something was wrong with me, but I have come to accept that is just how I was born. I’m simply not ready to undergo major surgery, and it’s unlikely that I will ever will be ready. While I will need and desire to continue to take female hormones, I don’t plan on having any gender-related surgeries. The truth is that I don’t see the need for surgery as I am fully comfortable with the way my body looks, and functions. My body works perfectly fine as it is, and just like everyone else, we all deserve to be accepted for whatever gender we choose to identify as.
Disclaimer: This is NOT medical advice, it is only an account of my personal experience. The information provided in this article is for educational and informational purposes only and solely for your own use.
The header image used in this piece is the Intersex Pride Flag, and is Public Domain.
The pictures of me waere taken in 2022.
The article itself was inspired by recent events in my life, which convinced me to simply give up on trying to get surgeons to provide me with a very basic procedure that would reduce chronic pain in my genitals. After trying to get a simple office procedure approved since age 19 (I’m now turning 43), I’ve decided to give up and move on with my life. The article was written shortly after I posted this tweet.
How Masturbation Helped Me Accept Myself as an Intersex Lesbian | A Debate On Intersex | XX Male Syndrome | Growing Up Transgender | Thursday FACTS – Transgender History (Pt1) Let’s start at the beginning… | Thursday FACTS – Trans gender History (Pt2) | Intersex Awareness Day | Mapping the Lived Experiences of Intersex/Variations of Sex Characteristics in Ireland | Key Issues Facing People With Intersex Traits | Intersex | Boy or girl? People Probably Have No Idea How Many Other Variations Babies Are Born With. A Brief Medical Exploration Of Intersex.
Great post. Thanks for sharing
You are welcome! Thank you for reading!
This was so interesting. Thank you for being so candid about your journey in life. You answered a few questions I had, or things I didn’t really understand.
Hey Patricia! I’m so glad I could help! My wife and I decided that it would be productive to write this article about my condition in hopes that it would help educate people to better understand intersex conditions, and specifically how my condition has affected my life. I have always been open and honest about my condition with my friends, my family, and with the doctors involved in my medical care. Thank you for your lovely comment! ❤️
UPDATE: I finally received an apology from the hospital administration for the way a doctor mistreated me several months ago. Apparently, if the doctor labels you as transgender (I’m intersex and lesbian, not transgender), it takes numerous complaints from patients. If I were a heterosexual and cisgender person, it would only have taken one complaint for action to be taken.
The American medical system is so fucked up!
I wrote this piece with the help of my wife; we are both intersex women trying to educate people in intersex and transgender topics. It was my goal to share this information to help spread acceptance, awareness, and understanding of LBGTQ people. Thank you for being an amazing grandparent! ❤️
A fantastic article: very accessible, open and heartfelt. Well done!
Thank you very much. Of course, I’m open to questions.
Thank you for sharing this, Thomas. It’s a really interesting and insightful read x
Thank you so very much for being so amazing, accepting, and open-minded! ❤️