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Sex assignment
 | This article needs more reliable medical references for verification or relies too heavily on primary sources. (June 2023) |  |
Sex assignment (also known as gender assignment[1][2]) is the discernment of an infant's sex, typically made at birth based on an examination of the baby's external genitalia by a healthcare provider such as a midwife, nurse, or physician.[3] In the vast majority of cases (99.95%), sex is assigned unambiguously at birth. However, in about 1 in 2000 births, the baby's genitalia may not clearly indicate male or female, necessitating additional diagnostic steps, and deferring sex assignment.[4][5]
In most countries the healthcare provider's determination, along with other details of the birth, is by law recorded on an official document and submitted to the government for later issuance of a birth certificate and for other legal purposes.[6]
The prevalence of intersex conditions, where a baby's sex characteristics do not conform strictly to typical definitions of male or female, ranges between 0.018% and 1.7%.[7][8][9] While some intersex conditions result in genital ambiguity (approximately 0.02% to 0.05% of births[4]), others present genitalia that are distinctly male or female, which may delay the recognition of an intersex condition until later in life.[10][11]
Societally and medically, it is generally assumed that a person's gender identity will align with the sex assigned at birth, making them cisgender. However, for a minority, assigned sex and gender identity do not coincide, leading to transgender identity experiences. When assigning sex to intersex individuals, some healthcare providers may consider the gender identity that most people with a similar intersex condition develop, although such assignments may be revised as the individual matures.[2][12]
The use of surgical or hormonal interventions to reinforce sex assignments in intersex individuals without informed consent is considered a violation of human rights, according to the Office of the United Nations High Commissioner for Human Rights.[13][2][14][15]
- ^ "gender assignment". APA Dictionary of Psychology. American Psychological Association. Archived from the original on 6 June 2023. Retrieved 6 June 2023.
- ^ a b c American Psychiatric Association, ed. (2022). Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, text revision ed.). Washington, DC: American Psychiatric Association. p. 511. ISBN 978-0-89042-575-6.
- ^ Rathus SA, Nevid JS, Rathus LF (2010). Human Sexuality in a World of Diversity. Allyn & Bacon. p. 168. ISBN 978-0-205-78606-0. Archived from the original on 6 June 2021. Retrieved 5 December 2019.
- ^ a b Selma Feldman Witchel (2018). "Disorders of Sex Development". Best Practice & Research. Clinical Obstetrics & Gynaecology. 48: 90–102. doi:10.1016/j.bpobgyn.2017.11.005. ISSN 1521-6934. PMC 5866176. PMID 29503125.
- ^ Dhamankar Rupin (9 April 2020). "Fetal Sex Results of Noninvasive Prenatal Testing and Differences With Ultrasonography". Obstet. Gynecol. 135 (5): 1198–1206. doi:10.1097/AOG.0000000000003791. PMC 7170435. PMID 32282607. S2CID 215758793.
- ^ "Birth and Death Registration Completeness". Demographic and Social Statistics. United Nations. Retrieved 19 August 2024.
- ^ "Intersex population figures". Intersex Human Rights Australia. 16 September 2019 [28 September 2013]. Archived from the original on 17 July 2018. Retrieved 3 July 2023.
- ^ Sax, Leonard (2002). "How common is intersex? a response to Anne Fausto-Sterling". Journal of Sex Research. 39 (3). Scholarly Publications: 174–178. doi:10.1080/00224490209552139. PMID 12476264. S2CID 33795209. Archived from the original on 28 February 2021. Retrieved 27 June 2020.
- ^ Blackless, Melanie; Charuvastra, Anthony; Derryck, Amanda; Fausto-Sterling, Anne; Lauzanne, Karl; Lee, Ellen (2000). "How Sexually Dimorphic Are We? Review and Synthesis". Department of Molecular and Cell Biology and Biochemistry. American Journal of Human Biology. 12 (2): 151–166. doi:10.1002/(SICI)1520-6300(200003/04)12:2<151::AID-AJHB1>3.0.CO;2-F. PMID 11534012. S2CID 453278.
- ^ Mieszczak, J; Houk, CP; Lee, PA (August 2009). "Assignment of the sex of rearing in the neonate with a disorder of sex development". Curr Opin Pediatr. 21 (4): 541–7. doi:10.1097/mop.0b013e32832c6d2c. PMC 4104182. PMID 19444113.
- ^ "Answers to Your Questions About Individuals With Intersex Conditions" (PDF). www.apa.org. American Psychological Association. 2006. Archived (PDF) from the original on 24 May 2023. Retrieved 7 June 2023.
- ^ Hardacker, Cecilia; Ducheny, Kelly; Houlberg, Magda, eds. (2019). Transgender and Gender Nonconforming Health and Aging. Cham: Springer. p. 3. doi:10.1007/978-3-319-95031-0. ISBN 978-3-319-95031-0. S2CID 52986156. Archived from the original on 3 August 2024. Retrieved 23 May 2020.
- ^ Witchel, Selma Feldman (2018). "Disorders of Sex Development". Best Practice & Research. Clinical Obstetrics & Gynaecology. 48: 90–102. doi:10.1016/j.bpobgyn.2017.11.005. ISSN 1521-6934. PMC 5866176. PMID 29503125.
- ^ UN Committee against Torture; UN Committee on the Rights of the Child; UN Committee on the Rights of People with Disabilities; UN Subcommittee on Prevention of Torture and other Cruel Inhuman or Degrading Treatment or Punishment; Juan Méndez, Special Rapporteur on torture and other cruel inhuman or degrading treatment or punishment; Dainius Pῡras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health; Dubravka Šimonoviæ, Special Rapporteur on violence against women its causes and consequences; Marta Santos Pais, Special Representative of the UN Secretary-General on Violence against Children; African Commission on Human and Peoples' Rights; Council of Europe Commissioner for Human Rights; Inter-American Commission on Human Rights (24 October 2016). "Intersex Awareness Day – Wednesday 26 October. End violence and harmful medical practices on intersex children and adults, UN and regional experts urge". Office of the High Commissioner for Human Rights (Press release). Archived from the original on 21 November 2016.
- ^ World Health Organization (2015). Sexual health, human rights and the law. Geneva: World Health Organization. ISBN 978-92-4-156498-4.
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