In the past few years, most of us have noted with surprise, maybe even shock, that whenever we are required to fill a form that requires us to state our gender type, the answer is no more binary. That is, it is no more just male or female. Nowadays, we have phrases like ‘non-conforming’, ‘gender neutral’ or just simply ‘others’ on the drop-down menu. It is easy to just dismiss these words as mere western propaganda, a collaborative effort by the west to shove their immoral and unrealistic ideas down our throats. But have we ever really thought about it? These people who are born with both male and female parts and confused about their identity, have we ever contemplated how hard life must be for them?
In my line of work, I have met a fair share of people who have presented this way. Some have had surgery and gone on to live normal lives, while some who cannot afford these procedures or are simply not interested, continue to live their lives as queer people or harbour secrets they take with them to their graves. Of all the people I have met, there are two people whose stories resonate with me. Sit back while I give you an insight into what it means to be intersex in Nigeria.
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But first of all, what is intersex?
“Intersex” is the term that a person may use when they have both male and female sex characteristics. These characteristics include genitalia, hormones, chromosomes, and reproductive organs. It is an umbrella term that describes differences in sex characteristics that do not fit the typical binary idea of male or female. There are many ways that a person can be intersex. Medically, there at least 40 different intersex variations. Some intersex traits may be visible at birth, while others may not appear until the person reaches puberty. In some cases, a person may never know that they are intersex. Like the woman who came in for an appendectomy and we incidentally found testes in her abdomen! According to some estimates, up to 1.7 per cent of the population has intersex traits.
Let me begin with the story of Amina*, whom I met many years ago. She was a nineteen-year-old undergraduate who was worried because she was yet to start her menses. All her friends and two of her younger sisters had started menstruating. She spoke with a husky, deep voice and as I listened to her, noticed a few facial hairs. She was tall and had stern facial features. Amina narrated that she often pretended to be on her period while in secondary school just to fit in with her mates. Her mother had told her repeatedly not to worry, as it was just delayed, but Amina knew in her heart that she was not normal. When I asked her to remove her hijab, she was hesitant at first but relaxed after I cracked a few jokes. The first thing I noticed was her short hair, which is not uncommon in this part of the world. She appeared to have a small bust size until I noticed that she wore a heavily padded bra to cover up for her lack of bust. By this time, I knew something was deeply wrong. When I asked to examine her genitalia, I noticed tears clouding her eyes as she surrendered to fate. Amina had what I now know to be a small rudimentary penis. There was no vaginal opening and the hair distribution was that of a male.
Several investigations later, Amina was diagnosed with Klinefelter’s syndrome (XXY). She was definitely not a woman as an ultrasound revealed no womb or ovaries, but neither was she fully male. Her mother narrated that when Amina was born, she noticed that she had rather large female genitalia and confessed that she was not quite sure from where she passed urine. The mother was just a girl herself, as Amina was her first child and she just assumed she would grow out of it. By the time Amina hit puberty, her genitalia began to assume the shape of what she saw on baby boys. Scared, she hid her secret from her family and friends, but later found the courage to visit the hospital after she started university and her new friends made rude comments about her height and voice.
I still remember the meeting we had with Amina and her parents. What now? They asked. I told them the choice was Amina to make and to give her time to think about it. Did she want to continue masquerading as a girl to the world, but then what about the bullying? Marriage? Or did she want to be a male (which would be easier for us medically) and start life afresh in a different environment? There was also another issue to be addressed- her sexuality. Who was she attracted to- men or women?
Amina called a few weeks later, after counselling sessions with a psychiatrist that she had decided to become male. She admitted to being attracted to females, but she was afraid of the transitioning process. All her life, she had been brought up as a girl in northern Nigeria- to sit a certain way, to speak softly and to cover up her body. How could she possibly take off her headscarf all of a sudden?
Baby steps. We started with baby steps. I say ‘we’ because I was as apprehensive as she was. Amina started with having a haircut and learning to be comfortable with that for a few months. She would come to the hospital covered up and practice walking about the hospital premises where she was not known, with only a shirt and trousers. Many a time she cried. She felt naked and returned to me in fear. Could this work? What if someone recognised her and told everybody she was a freak? Meanwhile, the psychiatrist continued his psychotherapy and monitoring her mental health. The final transition to a man with testosterone injections would be the last step, in case she decided to change her mind. Her parents had made arrangements to send her to a distant relative in Calabar, where she could start life over as a man. Perhaps she could go to school there or learn a trade.
Months later, Amina* adopted her father’s name and simply became ‘Isa’*. He enrolled in a college of education in Calabar and worked as a taxi driver over the weekends. He was on anti-anxiety meds as he still had moments of doubt and confusion. Isa still stayed at home and did not join his male friends at clubs or joints. He talked with female mannerisms- waving his hands and rolling his eyes. He missed his mother terribly and often cried to her on the phone. His depression and anxiety spiralled out of control when he stopped taking his medication and resorted instead to alcohol. He became known in his circle as an effeminate man, the man who moved like a woman, talked like a woman and who knew how to expertly tie a headscarf.
He stopped calling me last year and after a few attempts to reach him failed, I stopped trying. His heartbroken mother later told me that he had stopped calling them too. That he did not want to be reminded of his old life. He still drove his taxi but had dropped out of school.
If you ever think your life is hard, then just remember that there is an effeminate, depressed man out there who belongs to the 1.7 per cent of individuals born intersex. And Allah knows best.
The second story continues next week.
*Names changed for ethical purposes.
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