You may be reading this thinking, “I don’t treat Intersex patients in my practice. I’ve never even met anyone who is Intersex. What’s the point of learning about Intersex variations?” However, statistically speaking, you most likely have met someone who is Intersex, and you might even have a few patients right now who are Intersex (but you just don’t know it)!

In fact, 1.7% of the population is Intersex. This is about the same percentage of folks who are redheads. So, if you’ve ever seen someone walking down the street or treated someone in your clinic as a patient who has red hair, you’ve probably also seen and treated someone who was Intersex.

Someone who is Intersex may have variations in their hormones, chromosomes, internal reproductive anatomy, and/or external/genital anatomy. Intersex variations can be found in utero during pregnancy, at birth, during adolescence if someone has not undergone puberty by the typical age, during examinations in adulthood while screening for other health issues, and during adulthood if someone is struggling with conception. Some folks even go their entire lives without knowing they are Intersex, and it’s actually found on a post-mortem exam!

Have you ever wanted to show LGBTQIA+ patients your allyship and that your health care facility is an inclusive and welcoming environment, but have never been sure how? You're not alone! Many healthcare professionals feel uncertain about how best to support LGBTQIA+ individuals, especially given the diverse and evolving nature of these communities. Below are 3 simple yet impactful ways to make your office a more inclusive space for LGBTQIA+ and Intersex patients.

As healthcare professionals, we have the responsibility to create environments where every patient feels safe, seen, and understood. While it may seem like a lot to consider, small adjustments can have a lasting impact on the experiences of LGBTQIA+ patients. To dive deeper into building an inclusive practice, including how to be an ally to LGBTQIA+ folx, join the upcoming session on Intersex Patients: Rehab & Inclusive Care with Dr. Molly O’Brien-Horn on August 23, 2025!

Inclusive Documentation and Forms
When it comes to making a space truly inclusive, one of the first areas to look at is documentation. While many healthcare facilities have begun to add spaces for patients to share their pronouns or gender identity on intake forms, there’s always more that can be done to reflect the diversity of your patients.

• Gender Identity: Include options beyond just "Male" or "Female." Consider adding options like “Non-binary,” “Genderqueer,” “Prefer not to answer,” or a free text field where patients can write in their gender identity.
• Sexual Orientation: Instead of only asking for heterosexual or homosexual orientations, provide a range of options, including "Bisexual," "Pansexual," "Asexual," and “Queer.” Also, give patients the space to self-identify if their sexual orientation doesn’t fall within these options.
• Intersex and Variations in Sex Characteristics: Patients may have unique needs based on intersex traits or variations in sex characteristics. Including a question about whether a patient identifies as intersex or has a variation in sex characteristics can provide vital context for care. This helps in creating an affirming space and avoids erasure of intersex experiences.

Why This Matters: By offering these inclusive options, you make it clear that your office recognizes the unique experiences and identities of all patients. This not only fosters trust but also improves healthcare outcomes by tailoring care to the individual’s specific needs.

Inclusive Signs, Flags, and Pins
Visually demonstrating your commitment to inclusivity can be incredibly powerful, but it’s important to go beyond just a rainbow pride flag.

“The times they are a-changin,” Bob Dylan once sang.(1) Dylan’s song may have been from 1964, but the lyrics can be applied to the present day. Very recently, the world, and the United States in particular, has seen rapid changes in political landscapes.

For instance, America has seen an increase in anti-transgender legislation over the last several years, but also in the past few weeks and months. Many of these laws seek to ban gender-affirming care for transgender, gender non-conforming, and non-binary people, youth in particular., Another bill was introduced just 1 week prior to this post that would make it illegal to identify as transgender on legal documents in Texas, calling it “gender identity fraud,” and carrying with it potential felony charges and jail-time.(2)

What many don’t know is that in addition to charges like the one above, many of these bills also contain exceptions that allow for non-consensual surgeries to be performed on intersex infants and children. The Human Rights Watch states that these procedures on intersex children “are justified by decision-makers on the grounds that they will reduce stigma and prevent gender dysphoria, but they often have the opposite effect and also carry risks of scarring, loss of sensation, lifelong sexual dysfunction, urinary incontinence, psychological trauma, and permanent sterilization.”(3)

When we consider the intersectionality of sexual orientation and gender identity within the realm of intersex and LGBTQIA+ identities, we must recognize the multifaceted nature of individuals' experiences. For some intersex individuals, navigating aspects of identity may be complex, as their biological sex characteristics may not align with societal expectations of gender. Intersex individuals face a range of challenges in navigating their identities, including medical interventions without their consent, stigmatization, and lack of awareness and understanding from healthcare providers. These challenges highlight the need for clinicians to educate themselves on intersex experiences and provide inclusive and affirming care.

Resources for Clinicians to Support Intersex Patients
While you may be reading this thinking, ‘I don’t know anyone who is intersex,’ or ‘I don’t work with Intersex patients,’ you might be surprised to learn that you probably do! Intersex variations are as common as having red hair. The United Nations Free & Equal Initiative Intersex Fact Sheet states that “According to experts, somewhere between 0.05 percent and 1.7 percent of the global population is born with intersex traits. The upper estimate is bigger than the population of Mexico.” So, if you know, or have ever seen someone with red hair, you probably know or have seen someone who is intersex too.

Clinicians who are looking to better support their intersex patients can benefit from accessing resources specifically tailored to understanding and addressing the unique needs of this community. Two great Intersex-led organizations to help educate you and provide support to intersex patients and their caregivers are InterACT Advocates for Intersex Youth and InterConnect.

While you may be reading this thinking, ‘I don’t know anyone who is Intersex,’ or ‘I’ve never treated a patient who is Intersex’ you might be surprised to find that 1.7% to 4% of people are Intersex, according to Zeeman and Aranda (2020) in their 2020 article A Systematic Review of the Health and Healthcare Inequalities for People with Intersex Variance.

According to Haghighat, et. al (2023) in their article Intersex people's perspectives on affirming healthcare practices: A qualitative study, “Intersex people have variations in their sex characteristics that do not exclusively fall within binary definitions of male and female.” These variations can be chromosomal, hormonal, gonadal, or anatomical (Cochetti, Monro, Vecchietti, & Yeadon-Lee [2020] and Haghighat, et. al [2023]).

Intersex folx are often seen by multiple healthcare providers throughout their lifetime, including pelvic rehab practitioners. However, one thing that most don’t know, is that historically; Intersex folx have been very mistreated and pathologized by healthcare workers. Many Intersex folx have been given non-medically necessary and non-consensual surgical procedures and hormone treatments over the years; and unfortunately, some of these practices are still occurring around the world even today. Intersex folx have also been treated by providers with inaccurate education and inadequate training needed to provide care to Intersex populations, leaving many patients who are Intersex being the ones who educate their own medical providers about their variations and healthcare needs. Tiffany Jones (2018) also mentions in her article Intersex Studies: A Systematic Review of International Health Literature that even language in the medical literature is inaccurate and inadequate when describing Intersex populations (Jones, 2018).