The way we think about biological sex is wrong

Did you know that almost 150 million people worldwide are born intersex -- with biology that doesn't fit the standard definition of male or female? (That's as many as the population of Russia.) At age 10, Emily Quinn found out she was intersex, and in this wise, funny talk, she shares eye-opening lessons from a life spent navigating society's thoughtless expectations, doctors who demanded she get unnecessary surgery -- and advocating for herself and for the incredible variety that humans come in. (Contains mature language)

[This talk contains mature content]

I have a vagina.

(Laughter)

Just thought you should know.

That might not come
as a surprise to some of you.

I look like a woman.

I'm dressed like one, I guess.

The thing is, I also have balls.

And it does take a lot of nerve

to come up here and talk to you
about my genitalia.

Just a little.

But I'm not talking
about bravery or courage.

I mean literally -- I have balls.

Right here,

right where a lot of you have ovaries.

I'm not male or female.

I'm intersex.

Most people assume that you're
biologically either a man or a woman,

but it's actually a lot more
complex than that.

There are so many ways
somebody could be intersex.

In my case, it means
I was born with XY chromosomes,

which you probably know
as male chromosomes.

And I was born with a vagina
and balls inside my body.

I don't respond to testosterone,

so during puberty, I grew breasts,

but I never got acne
or body hair, body oil.

You can be jealous of that.

(Laughter)

But even though I don't
actually have a uterus --

I was born without one,

so I don't menstruate,
I can't have biological children.

We put people in boxes
based on their genitalia.

Before a baby's even born,
we ask whether it's a boy or a girl,

as if it actually matters;

as if you're going to be less excited
about having a baby

if it doesn't have
the genitals you wanted;

as if what's between somebody's legs
tells you anything about that person.

Are they kind, generous, funny?

Smart?

Who do they want to be when they grow up?

Genitals don't actually tell you anything.

Yet, we define ourselves by them.

In this society, we love
putting people into boxes

and labeling each other.

It kind of gives us a sense of belonging

and teaches us how to interact
with one another.

But there's one really big problem:

biological sex is not black or white.

It's on a spectrum.

Besides your genitalia,
you also have your chromosomes,

your gonads, like ovaries or testicles.

You have your internal sex organs,

your hormone production,
your hormone response

and your secondary sex characteristics,
like breast development, body hair, etc.

Those seven areas of biological sex
all have so much variation,

yet we only get two options:

male or female.

Which is kind of absurd to me,

because I can't think
of a single other human trait

that there's only two options for:

skin color, hair, height, eyes.

You can either have nose A or nose B,
that's it, no other options.

If there are infinite ways
for our bodies to look,

our minds to think,

personalities to act,

wouldn't it make sense
that there's that much variety

in biological sex, too?

Did you know that besides
XX or XY chromosomes,

you could have XX and XY chromosomes?

Or you could have an extra X -- XXY.

Or two extra -- XXXY.

Goes on from there.

And for those "normal"
people with XX or XY,

what does that mean?

I have XY chromosomes.

If my DNA is found
at the scene of a crime --

not saying it will,
but, you know, we'll see.

(Laughter)

If my skeleton is discovered
thousands of years from now,

I'll be labeled male.

Is that the truth?

My balls would say so.

But what about the rest of me?

And what if a woman has ovarian cancer
and has to have her ovaries removed?

Does she still qualify as a woman?

What about other intersex people
who are born without balls or ovaries

or with just one
or a combination of the two?

Where do they go?

Do you have to have a uterus
to be a woman?

There's a lot of us
who are born without one.

And everyone's favorite part, genitalia:

you either have one or the other, right?

You either have a six-inch-long penis
that's exactly this thick,

jutting straight out of the body
at a 90-degree angle,

or you have a vagina
that's this wide internally

and a clitoris that's half an inch
above the vaginal opening

and labia that look exactly
like they're supposed to look like,

according to that one porn video
you watched that one time.

You know the one.

If you've been with more than one
sexual partner in your lifetime,

and you line them up, one by one,

I guarantee you can identify them
just by their genitalia.

(Laughter)

Think about it.

Go on.

(Laughter)

I see you.

No judging.

Just notice.

All different, right?

The sex and gender binary
are both so ingrained in our society,

that we never stop to think about it.

We just automatically place each other
into one box or the other,

as if it actually matters.

Until somebody comes along
to make you question it.

And if you're thinking that
I'm the exception, an anomaly, an outlier:

intersex people represent
around two percent of the population.

That's the same percentage
as genetic redheads.

It's about 150 million people, roughly,

which is more than
the entire population of Russia.

So there's a lot of us, needless to say.

We're not new or rare.

We're just invisible.

We've existed throughout
every culture in history.

Yet, we never talk about it.

In fact, a lot of people might not know
that they're intersex.

Have you had a karyotype test
to determine your chromosomes?

What about a full blood panel
for all of your hormone levels?

A friend of mine found out
last year, in his 50s.

The executive director of interACT,

which is the leading organization
for intersex human rights here in the US,

she found out she was intersex at age 41.

Her doctors found out when she was 15,

but they didn't tell her.

They lied and said that she had cancer,

because that seemed like an easier option

than finding out
she wasn't "fully" a woman.

This kind of thing happens a lot,

where intersex people are lied to
or kept in the dark about our bodies,

which comes as a surprise
to a lot of people.

But we live in a society that doesn't talk
about sex or bodies at all,

unless it's to mock or shame each other.

I found out I was intersex at age 10,

and for the most part,
I was fine with that information.

It didn't really faze me;

I was still developing
my understanding of the world.

It wasn't until I got older

and realized I didn't fit
society's expectations of me,

that I didn't belong, that I was abnormal.

And that's when the shame started.

How many times have you seen kids
play with the "wrong" toys

for their gender?

Or try on the "wrong" clothes?

All the time, right?

Kids don't have these ideas
about gender norm,

they don't have shame
about who they're supposed to be

or what they're supposed to like or love.

They don't care about any of this stuff.

They don't have shame
until we put it on them.

I also had doctors lie to me.

At age 10, they told me
that I would also get cancer

unless I removed my balls.

Then they proceeded
to tell me that every year.

Until today, there are still doctors
who want me to remove them.

But there's literally no reason.

If a typical XY male,
like yourself, has testicles,

and one is undescended,

there's a high chance of it
becoming cancerous --

or a higher chance
of it becoming cancerous.

They need to thermoregulated.

So they drop down
away from the body to cool off,

or they shrink back up to get warm.

Mine don't need to do that.

They're not responding to testosterone,
they're not producing sperm.

They're fine right here inside my body.

Yet, because there's such a lack
of information about intersex people,

my doctors never understood
the difference.

They never really understood my body.

As I got older,

I had another doctor tell me that
I needed to have surgery on my vagina.

She said that until I had an operation,
until she operated,

I would not be able to have
"normal sex" with my husband one day.

Her words.

I didn't end up going through
with the operation,

and I'm incredibly grateful for that.

I'm not here to talk about my sex life.

(Laughter)

But let's just say it's fine.

(Laughter)

I'm fine, my body is fine.

You actually wouldn’t be able
to tell the difference

between me and another person
unless I told you;

you wouldn't be able to tell
that I was intersex unless I told you.

But again, because of the lack
of understanding about bodies,

my doctor didn't understand
the difference.

And for the most part,
my sex life is fine.

The only issue that really comes up

is that sometimes, sexual situations
bring up memories of doctors touching me,

over and over again since I was 10.

I've been really lucky to escape --

I didn't think I would get emotional --

I've been really lucky to escape
the physical harm

that comes from these
unnecessary surgeries.

But no intersex person is free
from the emotional harm

that comes from living in a society
that tries to cover up your existence.

Most of my intersex friends
have had operations like these.

Oftentimes, they will remove
testes like mine,

even though my risk of testicular cancer
is lower than the risk of breast cancer

in a typical woman with
no predisposition, no family history.

But we don't tell her
to remove her breasts, do we?

It's rare to meet an intersex person
that hasn't been operated on.

Oftentimes, these surgeries are done
to improve intersex kids' lives,

but they usually end up
doing the opposite,

causing more harm and complications,

both physical and emotional.

I'm not saying that
doctors are bad or evil.

It's just that we live in a society
that causes some doctors to "fix"

those of us who don't fit
their definition of normal.

We're not problems that need to be fixed.

We just live in a society
that needs to be enlightened.

One of the ways I'm doing that

is by creating a genderless
puberty guidebook

that can teach kids
about their bodies as they grow up.

Not their girl bodies
or their boy bodies --

just their bodies.

We often place unrealistic expectations
on the things that our bodies do

that are outside of our control.

I mean, if one man can grow
a full, luxurious, hipster beard,

and the other can only grow
a few mustache hairs,

what does that mean
about who they are as men?

Nothing.

It literally, most likely, just means

that their hair follicles
respond to testosterone in different ways.

Yet, how many times have you heard
a man ashamed about something like this?

Imagine a world where
we could live in a society

that teaches us not to have shame

about the things
that our bodies do or do not do.

I want to change the way that we think
about biological sex in this society --

which is a lot to ask for.

You could say it's ballsy, I guess.

(Laughter)

But eventually we accepted
the world as round, right?

We no longer diagnose gay people
with mental disorders

or women with hysteria.

We don't think epilepsy is caused
by the devil anymore, so that's cool.

(Laughter)

We constantly change and evolve,
the more we understand as a society.

And biological sex is on a spectrum.

It's not black or white.

Not only could that knowledge
save intersex kids

from physical and emotional harm,

I think it would help everyone else, too.

Who here has ever felt
inadequate or ashamed

because you weren't girly enough,
you were too girly,

you weren't manly enough, or too manly?

We constantly shame people
for not fitting into a box,

but the reality is,

I think we shame others
because it prevents them from seeing

that we don't fit
inside our boxes, either.

And the truth is that
nobody actually fits in a box,

because they don't exist.

This binary, this false male-female facade
is something we constructed,

we built ourselves.

But it doesn't have to exist.

We can break it down.

And that's what I want to do.

Will you join me?

Thanks.

(Applause)