The biological differences between males and females develop at about 6 weeks into gestation. Before this stage male and female (XY and XX) appear the same, although genetic or chromosomal sexual differences were established at conception. The primitive duct systems are identical until the presence of male hormones triggers the development of male gonads, the differentiation of the duct systems, and the formation of external genitalia.
The sex assigned to us at birth is based on an arbitrary definition of genital size. Approximately 2% of the population is born intersexed, or with ambiguous or intermediate genitals. In the past, doctors surgically altered babies to make their bodies conform to the common dimorphic (male or female) standards. These standards allow penises as short as 2.5 cm to mark maleness, and clitorises as large as 0.9 cm to mark femaleness. Infant genital appendages between 0.9 cm and 2.5 cm are unacceptable. This is the general guideline used by mainstream medical practitioners in "managing" infants and children born with unusual genitals. At many hospitals, surgeons will remove clitoral tissue from a child born with such in-between genitals. Surgeons have also transferred tissue from other body parts to build larger penises. But there have not been any follow-up studies on these genitally altered children to determine the effects on sexual function after genital surgery.
In recent years, activists from the intersex community, anthropologists, and ethnographers have challenged these medical definitions and interventions. Outrage from activists and victims of the medical interventions have led professionals to question the practice of altering children's bodies at birth to force gender conformity. [The Intersex Society of North America (ISNA) provides a wealth of information on the current practices and need for reform.
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