Androgen Insensitivity Syndrome (AIS) is one of a number of biological intersex conditions. Intersex results from a variation in the embryological development of the reproductive tract, often determined by a known genetic mutation.
Index to this Page
What is Intersex?
The usual pattern of human foetal development results in a 3-part alignment, as follows
1) sex chromosomes = XY, leading to
2) gonads = testes, leading to
3) external genitalia = male
1) sex chromosomes = XX, leading to
2) gonads = ovaries, leading to
3) external genitalia = female
So what happens in intersex?
… is a type of intersex condition in which the person actually has a male/female mix at the genetic (free porn chromosome) level and at the gonadal level (the ‘1’ and ‘2’ above). This is extremely rare and only one or two members of our group are in this situation. The old term used in medicine for this situation is a hermaphrodite. Note, however, that a hermaphrodite, in the sense understood by most of society, is a purely mythical creature from ancient literature, one that supposedly has a complete working set of both male and female internal and external organs (such that the individual can, in theory, impregnate itself). This is not humanly possible. Unfortunately medicine took over this literary term in the days before genetics was understood and used it as a medical term, to refer to these individuals who have both ovarian and testicular tissue internally (an ovo-testis) and who, as a result, can have ambiguous external genitalia.
Not quite so rare…
… is the type of intersex condition in which the sex chromosomes are either XY or XX (i.e. not a mixture) and the gonads are either testes or ovaries (i.e. not a mixture) – as in the majority of the population – but there is a mismatch or distortion in the usual alignment of these two elements (the ‘1’ and ‘2’ above) with the external genitalia (the ‘3’ above).
This means that you can, for example, have an XY individual with testes but with an external appearance that is essentially female (i.e. an XY female: either completely female in appearance as in Complete AIS, or partly female in appearence as in Partial AIS) or an XX individual with ovaries but with some degree of male genital appearance (e.g. a woman with congenital adrenal hyperplasia or CAH).
Note that the term ‘intersex’ relates to the elements of this entire axis or alignment (the sex chromosomes, the gonads and the genitalia), and not just to the appearance of the external genitalia. A patient with the complete form of AIS (CAIS), or with Swyers Syndrome (XY gonadal dysgenesis), will always appear female externally (no ambiguity) but she is still intersexed, because she has XY chromosomes and internal testes (testicular streak gonads in the case of Swyers) that are considered at odds with her external femaleness.
Terminology (and Media Confusion)
Before we get into a basic introduction to what AIS is, in medical terms, a brief but important diversion to the subject of bad/confusing terminology and how the media can make things worse.
First off, please note that it is nonsense to talk, in relation to sport for example, of ‘gender testing’ because gender is to a large extent a social construct, describing the way people present themselves to the world and so cannot usefully be subjected to ‘verification’. Rather, it is the notion of sex that Olympic committees and the like are seeking to police.
Intersexuality is not the same as a transsexuality (gender dysphoria) and is not a transgender state. Neither of the latter terms is one that we recognise as belonging in any general discussion of intersex. We are not happy with the recent tendency of some trans groups/people to promote transgender as an umbrella term to encompass, for example, transsexuality, transvestitism and intersex. We object to other organisations/individuals putting us in categories without consulting us, especially categories that imply that interexed people, of necessity, have gender identity issues. See the paper by Mazur et al cited at foot of this page.
The problems this causes…
We are constantly trying to get away from the idea that intersex is necessarily to do with gender identity, a notion that others (including the press/media) like to impose on us. Moreover, the prefix trans- infers a “moving across”, and although a few people with intersex conditions may choose to change their gender role, the vast majority never “go” anywhere in terms of their sex or their gender, but are happy to stay in the status in which they grew up.