Basic differences between intersex and trans

Here are some of the general differences between the experience of trans and intersex individuals in Australia.

Intersex is not a part of the trans umbrella (such as transgender or transsexual) or gender diversity because intersex is not about gender, or transition. Intersex is about congenital physical differences in sex characteristics.

Intersex, trans, and same sex attraction are distinct concepts and issues, and people with intersex variations face distinct health and human rights issues. The medical model for the treatment of people with intersex variations means that the intersex movement also has much in common with the disability movement. Intersex people, and intersex-led organisations, must be centred in work on intersex issues.

We recognise that some people with intersex variations change sex classification, and that some identify with the trans community – including members and directors of OII Australia. This is no more or less remarkable than when intersex or trans people are lesbian or gay. A particular difficulty faced by many intersex people who transition is that we may have had involuntary and irreversible medical treatment to make our bodies appear more like our incorrect assigned sex, thus, much of the right hand column applies.

Trans/gender diverse


  • No ambiguities in innate biological sex.
  • Self-identified gender does not match apparent biological birth sex.
  • A full and functional reproductive system, at least prior to any chosen transition process.
  • As with same sex attracted people, physical differences may be apparent in a correlation with ‘brain sex’ differences.
  • A chosen experience of transition, whether surgical and/or hormonal, permanent or temporary.
  • An identical twin of a trans person may or may not be trans.

  • Natural variation in biological sex does not match social expectations of normality.
  • Physical differences affect the whole of the body including genetic, chromosomal and hormonal differences, and especially sex anatomy.
  • Other than in specific diagnoses such as CAH, may rarely be able to reproduce because of physical differences in reproductive parts.
  • Intersex differences may be accompanied by other physical differences, or (in some cases) cognitive differences.
  • An identical twin of an intersex person will also be intersex, except in rare recorded cases of mosaicism that stretch the definition of ‘identical’.

  • Basic public understanding about transition between genders.
  • Some human rights protection.
  • Can change cardinal documents, but still often requires irreversible surgeries usually involving sterilisation; applicants must not be married.
  • The right to marry someone of the opposite legal gender, unless gender is non-binary.

  • Public confusion about the nature of intersex, often conflating intersex with non-binary gender identities.
  • New human rights protections.
  • If desired, can change cardinal documents in New South Wales, Victoria and Queensland on evidence of intersex status, due to error on birth certificate.
  • No right to marriage as intersex. The right to marry someone of the opposite legal gender.

  • Surgical and/or hormonal intervention is prohibited at least until a person is old enough to consent
  • Medicalised as Gender Dysphoria, formerly Gender Identity Disorder.
  • Transsexual people have effective medical protocols that produce effective outcomes with long-term studies and follow-ups.
  • Good medication readily available through the PBS (Pharmaceutical Benefits Scheme) that is both effective and adequate.
  • The right to choose the time of surgery with extensive peer support.
  • The ability to participate fully and in an informed manner in their surgical and hormonal options.
  • No prenatal testing; no selective termination on grounds of trans gender identity.

  • Early surgical and/or hormonal intervention is considered therapeutic (but contested), prior to a person’s ability to personally consent.
  • Medicalised and pathologised as Disorders of Sex Development (DSD).
  • Many diagnosis-specific medical protocols exist, with sixty years of medical research, predominantly focusing on genitalia and “normalising” treatments; no long-term follow-up, and no firm evidence of good outcomes.
  • Insistence on inappropriate and harmful medication when individuals do not conform with diagnosis or gender identity expectations; limited access to well-studied and appropriate medications.
  • Only some medication available through PBS.
  • Often surgery is conducted without consent; often surgery is coerced with no peer support.
  • Prenatal testing available for many intersex traits, with selective termination possible on grounds of intersex status.
  • Administration of harmful drugs to pregnant women in an effort to prevent intersex births with a possible outcome of brain damage to the foetus.

  • May be required to undergo irreversible surgeries to compete in sport in self-identified gender; able to compete as originally assigned sex.
  • Many effective and extensive organizations worldwide, with some NGOs attracting government funding (e.g. NSW Gender Centre).

  • May be required to undergo irreversible gonadectomies and clitorial surgeries to compete in sport in either legal birth sex or a self-identified gender.
  • Very few intersex organizations worldwide, with none receiving any government funding.

More information

More reading on this issue:

This page is not intended as an introduction to intersex. Introductory information, and reading on related issues:

This article was originally written for the Camp Betty Intersex 101 workshop, and has since been updated including to reflect legislative and regulatory changes.