The mystery of ambiguous genitalia

18 May, 2019 - 00:05 0 Views
The mystery of ambiguous genitalia Dr Solwayo Ngwenya

The Chronicle

Andile Tshuma

IMAGINE being born with two sexual organs. It can’t be easy, particularly during the childhood days when curious age mates start wondering if you are a boy or girl. 

The girls won’t want you, and probably the boys could reject you. It is not what it should be, but unfortunately children can be like that. 

Ambiguous genitalia is a rare condition in which an infant’s external genitals don’t appear to be clearly either male or female at birth.

The condition affects a number of people as an estimated one in 2 000 babies is born with the condition.

While some gender activists are calling for hermaphrodites to be left alone, some people in society are for the idea of corrective surgery during the early years of life to avoid cases of people growing up with acute identity crises.

Last year, Whinsely Masara, a journalist wrote a series of stories about a Tsholotsho child who had ambiguous genitalia and was appealing for financial assistance to undergo surgery. 

The child got help and has been through a number of surgeries, after tests proved that she was a girl but had also developed male organs. However, she will have to take hormonal medication for the rest of her life so that her body organs can fully function, as a woman. 

Hermaphrodites, also referred to as Intersex people, tend to suffer a lot of social prejudices as communities may not understand them due to failure to classify them as either male or female. 

The school going days must be the worst as children can be evil sometimes. Imagine school bullies or a whole class laughing at one of their own because he or she is neither a girl nor a boy, when they discover that the classmate has two sets of private parts. It can make a child hate school completely. 

Sometimes even insensitive teachers can make the situation worse, especially if they are made to make a decision on the toilet that the child is going to use, the boys or girls’ loo. Teachers can make a bad and painful joke that could haunt a child for life.

Intersex people are born with a mixture of male and female sex characteristics. To determine the sex of an intersex child doctors try to work out what happened during the baby’s development. 

They check the body’s DNA containers, the chromosomes, to see whether the child is genetically female or male. They see if the baby has ovaries or testes, and whether they have a womb or not. 

They also test the hormones the body is producing and try to determine how the baby’s genitals may develop. 

Test results can be on a scale between male or female and after the results, a series of corrective procedures may begin to help the person identify with a particular sex. According to the United Nations, the condition affects up to 1,7 percent of the world’s population.

Mpilo Central Hospital has to be commended for the initiative to register all people with ambiguous genitalia. An effort to help intersex people when they are still young is very much welcome as they are also often mistaken for being gay, lesbian, bisexual or transgender or queer when they are older, which also brings about its own set of stigma and challenges. 

In many African communities, being born intersex may be considered to be a curse to a family or a whole clan. Some people do not understand the medical and biological side of things that like other conditions and deformities, someone can be born with two sexual organs. 

Growing up intersex must make for a confusing, isolating and sometimes dangerous childhood, being brought up in a conservative society such as Zimbabwe. 

It must also be difficult to make and sustain friendships as people may not understand what and why that person is like he or she is. Human beings are curious by nature, children are even worse, and once they get the hint that one of them is different from the rest, all hell can break loose. 

Some intersex children are reportedly permanently hidden at home, with some being killed at birth, as families feel that their conditions would bring bad luck to a whole clan as they are considered to be a sign of bad omen. 

Mpilo Central Hospital has initiated a register for people with ambiguous genitalia in a bid to help them deal with the issue and avoid future psycho-social problems they may encounter regarding sexuality.

In a baby with ambiguous genitalia, the genitals may be incompletely developed or the baby may have characteristics of both sexes.

Speaking to journalists on Tuesday, Mpilo Central Hospital clinical director Dr Solwayo Ngwenya said it was saddening to see parents parading their children before prophetic healers instead of seeking medical care.

He said the issue was prevalent in most parts of Matabeleland due to historic factors though most of the affected prefer to suffer in silence due to stigma.

“We decided to help our communities deal with ambiguous genitalia after noting many resort to faith healers to solve the medical problem. 


“We have started a register which will help us ascertain the prevalence and we will be able to help everyone who will approach our public relations department for help,” said Dr Ngwenya.

“We launched this register on Monday and already we have people from as far as Plumtree registering their new born babies for help. Ideally, we should be able to help affected children soon after birth but because of other factors we tell mothers to come back for surgery after some months and they just disappear,” he said.

According to Dr Ngwenya, prolonged delays in determining the sex of a person may expose them to diseases like cancer.

“We have also attended to a few cases of older people who present with cancer only for us to discover they had been living with unsolved ambiguous genitalia. We have a lot of girls who are being raised as boys and upon reaching puberty, they can start menstruating which can cause cancer problems in the long run,” he said.

Dr Ngwenya said Mpilo Central Hospital has the capacity to screen and determine the dominant hormones in a person and conduct necessary surgeries if there be need.

“For under-fives as per Government policy we will not charge anything just like for adults aged over 65. 

“However if anyone feels they cannot afford the services we will do our best to get them donors and still conduct the procedure so that they get help,” said Dr Ngwenya.

He added that people with ambiguous genitalia cannot be classified under the lesbian, gay, bisexual, transgender and intersex community as that belief tends to fuel stigma.

“This is a medical problem that must be solved medically to avoid future health problems for those affected. We therefore urge members of the public to come in their numbers and register,” said Dr Ngwenya.

 In many hospital maternity wards, babies with ambiguous genitalia are born to freaked-out parents who’ve never even heard of such a condition, mothers in a highly emotional state who are not always offered counselling and advise on how best to help their children and their situations. 

Mpilo Central Hospital has started a good cause and hopefully other stakeholders in the health sector will be roped in so that more children and older people with the condition can get all the assistance that they need. 

Hopefully, this move will create better awareness of the condition so more people will understand that it is a genetically occurring condition and has nothing to do with witchcraft and curses. 

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