LILIAN CHUDEY PRIDE Lilian Chudey Pride, “The Childless Woman's Coach”, is author of “Life Beyond Motherhood"; “Dignity of Womanhood”, and the publisher of iwriteafrica.com, an online magazine. Her books can be found on amazon.com and she can be reached on email: liliancpride@gmail.com; and lilian@iwriteafrica.com   Everyone in the world has one challenge or the other but some people’s challenges seem bigger than others, their burdens heavier to carry, and their plight, which society has labelled shameful to speak about, render their pains not politically correct as policies do not favour them.   While society may choose to look at some challenges as unspeakable, taboo or shameful, it may be important to consider that individuals who bear unsolicited burdens are daily going through grievous pains, stigmatisation, shame, and severe exclusion. The truth is, they live among us, therefore, giving deaf ears to their pains or blatantly pretending not to recognise their existence may not be the best approach.    What is intersex?  Intersex can be defined as a general term used to describe a variety of situations in which a person is born with reproductive or sexual anatomy that does not fit the boxes of “male” or “female”.   Who is an intersex individual?  This is a person born in-between a male and female gender, without clearcut gender or binary. Some of them are born with the internal organs of a female, for example, ovaries, but with a closed up vagina and protruded clitoris that are neither a clitoris nor a penis; while some have breasts but their inner selves may appear to be male. This is what makes the issue of the intersex person a secret or a matter not to be spoken of in the public because his/her condition does not conform to what society considers “normal”. This situation leaves parents and health professionals with no option than to choose or assign a gender to their precious baby and they then go ahead to raise the child according to the gender they have been assigned from birth irrespective of their peculiarity. Many of these persons have grown up to realise that they do not fit into or are not comfortable with the gender they were raised in and decide to switch gender, obviously because they are the ones who can tell what their inner body matures to be.     Is Intersex a disease, disorder or a condition?  The intersex individuals are real and are normal human beings living among us as brothers, sisters,cousins, friends, nephews, nieces, neighbours or colleagues. It is not a disease, disorder or a condition. What is clear is that they have genitals, chromosomes or reproductive organs that do not fit into a male or female binary, their genitals may not match their reproductive organs, or they may have traits of both organs at the same time; to some, these situations may be evident at birth or later in life.    Challenges  The intersex persons might face pains and regrets emanating from having surgeries without their consent. Many people in the intersex community in Africa have had surgeries during  childhood, because health professionals and parents were seeking avenues to “help” them to  align with gendered norms for male and female bodies. Because these surgeries were done at the time the person had no say, it may linger in the heart of the individual for a long time, especially growing up to notice that the gender chosen for them does not align with who they matured to become.    Listening to the interview of a young intersex Kenyan girl, Miss Monicah Mercy, I could feel her joy as she narrated the experiences of her parents' failed attempts to subject her to early childhood surgery. So many things happened at the time that stopped her parents from performing those scheduled surgeries on her as a child. Monicah has female organs internally, but her vagina is closed up. Her parents and doctors had proposed to open up the vagina in order to “help” her become a “proper” girl, but they could not continue due to some unexplained reasons. Monicah is 23 years now, doing well in academics and sports, but could not grow breasts and her inner organs like the ovaries could not grow to maturation, so, no ovulation, no menstruation and no breasts. Had they succeeded in performing the surgeries, it would have  made no sense at all. She is happy because she has a normal life and nothing to regret about.    This might not be the story of some intersex persons out there whose parents succeeded in performing several surgeries during their childhood when they had no contribution as to whether or not they wanted it.    They may harbour feelings of distrust  Hearing the president of Intersex Society of Zambia, Mr. Mphatso Sakala in an interview advocating that parents and health professionals should not make decisions for any intersex person during their childhood as it could pose a bigger problem than solution in the future left me thinking of their pains, emotional distress, confusion, exclusion, and right to decide and accept who they are.    What should health professionals do? To alleviate the challenges of the intersex individual, Mr. Sakala said that health professionals should do them the favour of pronouncing the child “intersex” at birth and writing it in their birth certificate, which will go a very long way in clearing their confusion as well as solving the problems that are waiting for the child in future. The intersex individuals have faced diverse humiliations, shame, exclusions and stigmatisation in schools, places of work, sports spaces, airports, public utilities like the conveniences to mention but these few.    In Nigeria, some intersex persons have converged to form the “Intersex Nigeria” community with or without favourable policies on their side; they are living life, contributing their own quota amidst harsh conditions and community negligence of their plights. They are creating awareness, they are doing everything to contribute to and register their relevance. I became more informed by the Intersex Nigeria group’s efforts to drive their points home for the society they are part of, to understand their plights with their thought-provoking contents on their website. These adorable individuals are loaded, they are out for business, no jokes at all. They took quality time to educate the society about the many variations of Intersex that many never knew existed.   Intersex variations

1. Androgen Insensitivity Syndrome (AIS). This is where an individual with XY chromosomes (typically male) has cells that do not respond to androgens (male hormones). This can result in a person with typically female external genitalia but internal testes instead of ovaries. 
2. Congenital Adrenal Hyperplasia (CAH). A group of genetic conditions where the adrenal gland produces a different number of steroid hormones, leading to atypical development of sex characteristics. In some cases it can lead to ambiguous genitalia in persons with XX chromosomes  (typically female). 
3. Turner Syndrome (XO). individuals with Turner Syndrome have only X chromosome (XO) instead of the typical two.
4. Klinefelter Syndrome (XXY). Individuals with an extra X chromosome (XXY) may develop characteristics such as reduced fertility, increased height, and gynecomastia (enlarged breasts). Many people with Klinefelter syndrome are not diagnosed until puberty or adulthood. 
5. Swyer Syndrome (XY Gonadal Dysgenesis). Individuals with Swyer Syndrome have XY chromosomes but are born with female external genitalia. 
6. Partial Androgen Insensitivity Syndrome (PAIS). Similar to AIS, individuals with PAIS have cells that are partially responsive to Androgens. This can result in a range of genital variations and may not always be obvious at birth. 

  Some international organisations have been supportive in awareness creation and advocacy for the intersex people. On 26th October, 2018, Amnesty International opined that the following  five (5) myths should be shattered, noting that there are millions of people around the world who have sexual characteristics that do not fit typical binary notions of male and female bodies. Many, though not all, of these people identify as intersex.    Myth 1: Everybody is either born male or female   Myth 2: Being intersex is very rare   Myth 3: Being intersex is a condition that needs to be corrected   Myth 4: Intersex people are transgender   Myth 5: No one is speaking for intersex people.   “If the topic is not discussed, when there is a de facto veil of silence, it makes it incredibly difficult for affected people to accept themselves and their body”. There is still a long way to go, but Amnesty International will keep supporting the fight for intersex people to live free of shame, stigma and pain.    How policymakers can help  People without intersex traits may think that filling school entrance forms, driver’s licence, international passports, citizenship documentation, affidavits and work related documents are something any educated person can do; that may be true because when you get to the “M” or “F” box, you know what to fix. But for the intersex person, it is a big deal, there is no box that points to who they are, they are born different, they are in-between, so, when they stand there for a while trying to solve their dilemma, do not shout out in rage, “you are wasting our time”! They are stuck, they need our support.   Many societies often recognise male and female gender to the almost ignorant or deliberate exclusion of the intersex people. The non-binary group is not represented, yet whether we like it or not, they live with us, contributing to the growth of the economy, to the wellbeing of their families, paying taxes, abiding by the laws that govern their states/nations, living life and going through various challenges like every other person.    Making policies, creating spaces for them to express their civil rights will foster equity, diversity and inclusivity. A starting point may be considering appropriate legislation by African nations to legalise the status of Africa’s intersex persons. With such legislation, it becomes easier for health professionals to indicate intersex children’s status in their birth certificates, at birth. This will rule out lingering confusion and displacement in the future. In like manner, public and private institutions will become well aware of this category of people and their rights in various aspects of documentation, recognition, inclusion and freedoms as normal members of society.    Educational authorities and educational institutions need to reflect on this matter and consider inclusion of this category in schools curricula to make awareness and knowledge of the existence of these individuals easier for public understanding and also motivate intersex individuals to attend and participate in educational activities without shame, withdrawal or exclusion.   Similarly, their rights and safety will be preserved from infancy without the trauma of being subjected to surgeries and mutilation in bids to fit them to gendered norms. Moreso, their official and confident involvement in civic roles and responsibilities like voter registration, voting, community development, political participation, will be encouraged and guaranteed.  

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