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“She might have the physical attributes of a woman but Jennifer Pagonis was in fact born intersex, meaning she is genetically male and has the reproductive organs to match.”[1] This was the opening sentence in a Daily Mail article titled “‘I Exist in the Gray’.” Pagonis was born with a rare genetic condition called Androgen Insensitivity Syndrome. The article explains, “Androgen insensitivity syndrome (AIS) is when a person who is genetically male (who has one X and one Y chromosome) is resistant to male hormones (called androgens). As a result, the person has some or all of the physical traits of a woman, but the genetic makeup of a man.”[2] The Intersex Society of North America further explains:

In an individual with complete AIS and karyotype 46 XY, testes develop during gestation. The fetal testes produce mullerian inhibiting hormone (MIH) and testosterone. As in typical male fetuses, the MIH causes the fetal mullerian ducts to regress, so the fetus lacks uterus, fallopian tubes, and cervix plus upper part of vagina. However, because cells fail to respond to testosterone, the genitals differentiate in the female, rather than the male pattern … The newborn AIS infant has genitals of normal female appearance, undescended or partially descended testes, and usually a short vagina with no cervix. Occasionally the vagina is nearly absent.[3]


The reality of intersex individuals is commonly presented as evidence refuting a gender binary and a universal definition of biological sex. According to an article titled “It’s Time for People to Stop Using the Social Construct of ‘Biological Sex’ to Defend Their Transmisogyny”:

Since “biological sex” is actually a social construct, those who say that it is not often have to argue about what it entails. Some say it’s based on chromosomes (of which there are many non-XX/XY combinations, as well as diversity among people with XY chromosomes), others say it’s genitals or gonads (either at birth or at the moment you’re talking about), others say it’s hormone levels (which vary widely and can be manipulated), still others say it’s secondary sex characteristics like the appearance of breasts, body hair and muscle mass (which vary even more). Some say that it’s a combination of all of them. Now, this creates a huge problem, as sex organs, secondary sex characteristics and hormone levels aren’t anywhere close to being universal to all men or women, males or females. … While it is true that gender and sex are different things, and that gender is indeed a social construct, sex isn’t the Ultimate Biological Reality that transphobes make it out to be.[4]


The implication of such arguments is that intersex individuals represent a third gender that is neither male, nor female. However, as in the argument cited above, this line of reasoning is usually extrapolated out to refute any objective and universal classification for biological sex, thus affording the possibility of a vast array of sexes. The assumption is that because intersex conditions are exceptions to the normal classifications of male and female, these individuals cannot be male or female.


According to the Intersex Society of North America, “‘Intersex’ is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.”[5] The U.S. National Library of Medicine divides intersex into 4 categories:

  • 46, XX intersex—“The person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This most often is the result of a female fetus having been exposed to excess male hormones before birth.”[6]
  • 46, XY intersex—“The person has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female. Internally, testes may be normal, malformed, or absent.”[7]
  • True gonadal intersex—“The person must have both ovarian and testicular tissue. This may be in the same gonad (an ovotestis), or the person might have 1 ovary and 1 testis. The person may have XX chromosomes, XY chromosomes, or both. The external genitals may be ambiguous or may appear to be female or male.”[8]
  • Complex or undetermined intersex—“Many chromosome configurations other than simple 46, XX or 46, XY can result in disorders of sex development. These include 45, XO (only one X chromosome), and 47, XXY, 47, XXX – both cases have an extra sex chromosome, either an X or a Y. These disorders do not result in a condition where there is discrepancy between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.”[9]


Despite the transgender community’s dependence upon intersex in their efforts to disprove the gender binary, the Intersex Society of North America readily acknowledges that “many intersex people are perfectly comfortable adopting either a male or female gender identity and are not seeking a genderless society or to label themselves as a member of a third gender class.”[10] Intersex individuals are still born male or female, even if their anatomy is not considered to be typically male or female.[11] As Darreact notes in an article at Darwinian Reactionary, “[S]ex is a functional biological norm, and individuals can deviate from this norm in many different ways. … And so, being a male isn’t whether you are XY, it is whether you are supposed to be XY; it is whether this is what would have been the biologically normal result had the process that determines sex worked as designed.”[12] The presence of the Y chromosome is supposed to trigger a whole series of events which will result in a biologically distinct male, but just because something may interfere with and distort the original design such that it does not function in the way it was intended does not negate that it was supposed to have a specific function. This is why we speak of brain damage, heart deformities, sterile sperm, and other such abnormalities by using qualifiers which indicate that something is failing to function according to its biological intent.[13] The heart remains a heart; the sperm remains a sperm, and the brain remains a brain even if they are not functioning properly. A deformed heart remains a heart, even if it is an exception to the norm. Likewise, a person’s biological sex remains male or female even if it is an exception to the norm and does not function according to its biological intent.


An analogous example is the story of Jaxon Buell who was born with a rare birth defect that occurs when the beginnings of the nervous system develop incorrectly. This condition prevented most of Jaxon’s brain from forming, leaving half his skull flat.[14] Most likely he will never be capable of talking and of walking independently.[15] Nevertheless, he remains human. Without most of a brain, he does not fit into the normal classification for humans, but the mere fact that his brain did not develop according to its biological intent does not negate his humanity. In the same way, the mere fact that sex organs may not develop according to their biological intent does not negate the individuals’ biological gender.


Despite the ambiguity of sex organs in intersex conditions, most intersex individuals are still discernably male or female. For example, in the case of 46, XX, the U.S. National Library of Medicine reports, “The person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This most often is the result of a female fetus having been exposed to excess male hormones before birth.”[16] Thus, a 46, XX individual is biologically female. A “female fetus” develops abnormal physical features because of “having been exposed to excess male hormones before birth”, but the individual remains biologically female.


Likewise, as in the case of Jennifer Pagonis, a 46, XY individual is “genetically male” but “unable to respond to the hormones that produce a male appearance.”[17] Despite the possible presence of female sex organs, these organs are not fully developed, lacking a uterus, fallopian tubes, and a cervix.[18] As such, the individual is unable to conceive or even to menstruate. The presence of female sex organs is not because the individual was biologically intended to be female. It is evident that the individual was biologically intended to be male, but the developmental process was hindered by a genetic deficiency in the X chromosome.[19] The fact that his body failed to fully mature in a biologically normal manner does not negate the fact that he is genetically male, and he was supposed to develop male genitalia. As such, a 46, XY intersex individual is biologically male, despite his appearance.


Citing the Consortium on the Management of Disorder of Sex Development’s Clinical Guidelines for the Management of Disorders of Sex Development in Childhood, the American College of Pediatricians released a statement, saying, “The norm for human design is to be conceived either male or female. Human sexuality is binary by design with the obvious purpose being the reproduction and flourishing of our species. This principle is self-evident. The exceedingly rare disorders of sex development (DSDs), including but not limited to testicular feminization and congenital adrenal hyperplasia, are all medically identifiable deviations from the sexual binary norm, and are rightly recognized as disorders of human design. Individuals with DSDs do not constitute a third sex.”[20]


Intersex conditions do not negate the reality of the male and female binary any more than mutations and defects negate any other objective reality. Likewise, the reality of intersex conditions does not prove that biological sex is merely a social construction. Biological sex exists independent of what we choose to call it. As the blogger EvolutionistX notes, “Reality doesn’t care what you call it.”[21] 

Related Paper: “Do Intersex Individuals Disprove the Gender Binary?

This article is excerpted from the book Transitioning: A Biblical Understanding of Transgenderism.

Timothy Zebell

Timothy Zebell

As a former missionary to Asia for twelve years and the author of several books, Timothy is passionate about helping people understand the relevancy of God's Word in today's world. His goals are to help Christians discern truth from error, empower Christians to speak into cultural matters with relevancy, and to help Christians capitalize on the opportunities that these matters provide for sharing the truth about God and His gospel message.
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1. Whitelocks, Sadie. “‘I Exist in the Gray’: 29-Year Old Who Looks Like a Woman but has Male Genitalia Speaks Out About Rare Intersex Condition.” The Daily Mail, April 17, 2015. Last updated April 29, 2015. Accessed May 31, 2016.

2. Ibid.

3. Intersex Society of North America. “Androgen Insensitivity Syndrome (AIS).” Accessed May 31, 2016.

4. Mey. “It’s Time for People to Stop Using the Social Construct of ‘Biological Sex’ to Defend Their Transmisogyny.” Autostraddle blog, June 5, 2014. Accessed May 25, 2016.

5. Intersex Society of North America. “What Is Intersex?” Accessed May 25, 2016.

6. Medline Plus. “Intersex.” Accessed May 25, 2016.

7. Ibid.

8. Ibid.

9. Ibid.

10. Intersex Society of North America. “Why Doesn’t ISNA Want to Eradicate Gender?” Accessed May 25, 2016.

11. Intersex Society of North America. “What’s the Difference Between Being Transgender or Transsexual and Having an Intersex Condition?” Accessed May 25, 2016.

12. Darreact. “Sex Is Not A Social Construct.” Darwinian Reaction blog, October 21, 2015. Accessed May 30, 2016.

13. Ibid.

14. “Presents Pile Up for ‘Miracle Baby’ Born Missing Most of His Brain.” CBS News, December 25, 2015. Accessed June 22, 2016.

15. Wright, David, Jackie Pou and Lauren Effron. “Florida ‘Miracle Baby’ Born Without Most of His Brain Beating the Odds.” ABC News, October 19, 2015. Accessed June 22, 2016.

16. Medline Plus. “Intersex.”

17. Whitelocks, Sadie. “‘I Exist in the Gray’: 29-Year Old Who Looks Like a Woman but has Male Genitalia Speaks Out About Rare Intersex Condition.”

18. Intersex Society of North America. “Androgen Insensitivity Syndrome (AIS).”

19. Ibid.

20. American College of Pediatricians. “Gender Ideology Harms Children.” March 21, 2016. Accessed May 25, 2016.

21. EvolutionistX. “Reality Is a Social Construct.” EvolutionistX blog, June 17, 2015. Accessed May 25, 2016.