Communicating in the family

International literature emphasizes the importance of open, sincere communication in the family as from the early stages of the intersex person's development, to establish a trusting relationship that will help them build a positive self-image.

Parents might have trouble accepting their child’s Variation of Sex Characteristics (VSC)/Difference of Sex Development (DSD) and in some cases may experience emotions such as fear, anger, shame, sadness. They might worry that their child has an illness or will suffer discrimination for being “different.” It is therefore crucial for parents to find a suitable environment where they may express and process their experience. If they are overwhelmed, seeking professional psychological support could help. It is also important to speak with other family members, especially the intersex child. Parents must be supported in creating a communication channel through which the child can feel free to ask questions and express themselves.

In some cases, intersex children are unaware of their condition. Previously, people would not discuss VSC/DSD with their children, but now it is essential to help parents be open and honest with them, but still using age-appropriate language.

Children’s awareness of belonging to a specific gender, based on certain physical characteristics (mostly genitalia), usually emerges as early as preschool age, when they become curious about their bodies. At this developmental stage, it is desirable to stimulate their curiosity by conveying the message that one can talk freely about one's body. In such a context, it will be easier later on to discuss the fact that some people are born with atypical characteristics. As children with VSC/DSD may be very inquisitive about their bodies and bodily functions throughout childhood, the family must have the tools to calmly respond. If the family feels the need, they can ask for professional help. Again, open and honest communication will help children understand the peculiarity of their characteristics, for they may ask for explanations as to why they need to go to the doctor’s more often than siblings or friends do.

Typically, puberty is a sensitive time in a person’s development, and can be even more so in the case of young intersex people. Again, it is important to talk openly about what will happen to their body and their specific VSC/DSD, so that the young person knows what to expect. If they feel that talking to parents about these topics is awkward or too complicated, seeking professional help would be an option: they might find it easier to express themselves in a more neutral psychological environment.

Another influential issue is that of to share, one's VSC/DSD condition with others, starting with other family members. There is no rule nor right way to do so. While parents might worry about their child speaking freely about their condition outside the family, forbidding it will confound the adolescent, especially if it is not clear why. In these cases, it is better to support the adolescent in their choices, and help them reflect on any information they may want to share and whom to share it with.

Families can also benefit from contacting pertinent organizations where they can learn from other parents’ experience, or help a child with intersex traits to connect with peers.

We should bear in mind that communication within the family and with others is a process that does not end with a diagnosis or a set of medical data; it is rather a life-long endeavor and a valuable way to learn, understand, and grow together.

Bibliography
Coleman E et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal Transgender Health. 2022 Sep 6;23(Suppl 1):S1-S259
Danon LM, Krämer A. Between Concealing and Revealing Intersexed Bodies: Parental Strategies. [Abstract]. Qualitative health research. 2017 Aug;27(10):1562-1574