Babies who are intersex may have noticeable differences in their genitalia — or they may not. Sometimes, intersex traits affect internal organs or hormone production and are not apparent until puberty or at all.

If you’re a new parent, it can be scary to hear anything unexpected from a doctor after your baby is born. But intersex traits occur naturally, and being intersex is not a disease or condition that affects a baby’s physical health.

When a baby is born, they’re assigned a sex based on their external genitals. You may even have learned your baby’s sex before birth in a similar way.

But it can actually be a bit more complicated than that.

Sometimes, a baby can have genitalia with some male characteristics and some female characteristics. Alternatively, some people may be born with a mix of male and female sex characteristics (such as a uterus and testicles) that can’t be seen on the outside.

When someone doesn’t fall exactly into the “male” or “female” sex designation, the term “intersex” may be used.

The term “intersex” isn’t new, and it isn’t political in and of itself. It is becoming a more widely recognizable term, but a lot of people still don’t understand it.

This is a popular question for Google searches, but it might not be the best one to ask.

Keep in mind that people who are intersex are your co-workers, friends, neighbors, and classmates — in other words, you’ve likely interacted with someone who is intersex and had no idea. That’s because they look like anyone else you meet.

It’s true that a baby who has intersex traits will sometimes have noticeable differences in their genitalia.

Here are some possibilities:

  • a clitoris that’s larger than expected
  • a penis that’s smaller than expected
  • no vaginal opening
  • a penis without a urethra opening at the tip (the opening might instead be on the underside)
  • labia that are closed or otherwise resemble a scrotum
  • a scrotum that is empty and resembles labia

But in some cases, the baby’s genitalia might look completely male or completely female. In other words, they may have male anatomy on the outside but female anatomy on the inside or vice versa.

A child’s intersex status might not become obvious until puberty, when their body produces more of a hormone that is not expected according to their assigned sex.

They might not experience certain expected puberty milestones, such as a deepening voice or growing breasts. Or they might experience changes that are characteristic of the sex you think of as the “opposite.”

In these cases, a person who had more male sex characteristics as a child might look “more feminine” after puberty, according to a society that has been slow to reject the traditional binary system. Or a person who “looked female” as a child might start to look more stereotypically male as a teenager.

Sometimes, a person might not learn that they have intersex traits until even later, such as if they have difficulty having children and consult specialists to find out why. It’s even possible to have intersex traits and never know it.

Regardless, a person doesn’t “become” intersex. They are born that way, whether it’s clear at birth or not clear until later.

The term “intersex” does not describe one particular characteristic. There are many different varieties — it’s a spectrum.

If you’re a new parent trying to figure all this out, know that there’s nothing you did or didn’t do to “make” your baby intersex.

For example, you might have learned in sex ed that people are born with sex chromosomes. Generally, people assigned female at birth have two X chromosomes, and people assigned male at birth have one X and one Y chromosome.

But did you know that some people are born with other combinations? For example:

These variations can happen randomly and spontaneously during conception. Sometimes they’re due to egg cells, and sometimes they’re due to sperm cells. Other factors can also contribute to variations.

And chromosomal variations sometimes result in traits that might be labeled as intersex.

Intersex is not a disease, and it can’t be “cured.” So in that sense, there’s no treatment.

Some people might experience health conditions related to intersex anatomy that need to be addressed. For example, if you have a uterus but no uterine opening, you might have painful menstrual cycles in which the blood doesn’t exit your body. In this case, you may want to have surgery to create an opening.

But this isn’t “treating intersex” — it is treating a closed uterus.

So, what about your baby, who might not have the expected genitalia?

Do you ‘choose a sex’?

The short answer: Unless your child also has a health condition (such as if urine is not properly flowing out of their body), you don’t need to do anything in terms of medical intervention.

Your doctor may recommend surgery to make the genitalia look more typically male or typically female. Doctors in the United States have been doing this since at least the 1930s — especially performing clitoral surgery when a baby has a large clitoris and the parents intend to raise the child as a girl.

But this can lead to all sorts of questions:

  • What if my child later identifies with a sex other than the one I chose for them?
  • What if I have a surgeon remove my child’s micropenis but later learn during their puberty that they produce a dominant amount of male hormones?
  • What if my child resents my decision and wishes I had left everything as it was when they were born?
  • What if I opt not to do surgery, and my child later wishes I had done the “obvious” surgery when it was less complicated/memorable?

All of these questions are more commonly stated as, “What if I make the wrong choice?” And this worry can weigh heavily on you as a parent.

This is why it’s crucial to talk with counselors familiar with intersex, social workers, a variety of medical professionals, trusted friends and family, and people who have intersex traits themselves.

For many parents who find out that their baby is intersex, fears about their child’s future acceptance, relationships, and self-esteem are front and center.

You may have questions like “Will my child be able to go to sleepovers?” and “What if others make fun of them in gym class locker rooms?”

These are natural worries that show your love and concern for your little one. But you don’t have to go it alone. There are resources available that can help.

In addition to firsthand accounts from intersex people, helpful resources include:

You can also ask your doctor to connect you with a counselor or social worker who can recommend support groups in your area.

Remember: There is no shame in having a child with intersex traits or in being intersex yourself. Until society is completely aligned with this view, your child may have some challenges ahead. But with a strong support system that includes you, your child can thrive into adolescence and beyond.