Over the last two decades, through the voices of groups including non-governmental organizations, persons bearing sex differentiation disorders have begun to question when and how one should decide in favor of or against surgical intervention following diagnosis.

Semi-structured interviews were held with seven adult patients who showed sex differentiation disorders at birth: Two with 5-alpha-reductase type-2 deficiency and five with congenital adrenal hyperplasia.

To investigate both how sexual identity is structured and the relationship between sexual identity, choice of sex object and sexual difference.

There is no ideal moment to perform surgical reassignment interventions on intersex patients, since the depth of the trauma can be neither predicted nor avoided. Traumatic events and their numerous occurrences are overdetermined, and depend on how parents, medical teams and subjects themselves cope with them throughout life. This fact is closely related to the question of how and when to operate, and who makes any decision to operate in order to “normalize” “abnormal” sex organs. The subject should never be left out of this decision.

This most complex discussion involves many variegated factors, including X and Y chromosomes, testosterone levels, hormone receptor sensitivities, sexual practices, the gender of partners, mannerisms, clothing, accessories, dream content and sexual fantasies, and none of them determine individuals’ identification nor their preferences for this or that sexual object.

Sex is trauma. Neither male nor female nor any other gender identification implies the choice of sex object, genders of partners or sexual practices.