On a recent twitter thread about intersex, I had someone working in healthcare tell me that hypospadias has nothing to do with intersex. They then posted a link to an NHS information page about hypospadias, which says:
Quote...We do not know what causes hypospadias - more research is needed to learn more about the causes. It is unlikely to have been caused by anything that happened during pregnancy...
I've read enough about hormones and prenatal development to know that hypospadias is a form of intersex, and is the result of there being insufficient androgens present during the critical period for genital development (weeks 7 to 12 after conception) for full male genital development to take place. I was puzzled as to why the NHS (and other medical bodies it seems) are telling the public that hypospadias is a "penile defect" of unknown cause, when the cause is known. I did some searching, and I found this excellent blog entry confirming that hypospadias is indeed a form of intersex, and explaining why we have a somewhat strange situation of doctors pretending it isn't:
http://intersexroadshow.blogspot.com/2013/02/hypospadias-intersexuality-and-gender.htmlOne interesting implication of this is that, through this diagnosis of hypospadias, doctors are effectively erasing large numbers of intersex people from existence. I found a recent paper looking at the incidence of hypospadias in Europe, and it occurs in about 1 in 230 live births (assuming 50:50 male:female ratio, that would be about 1 in 115 male-assigned births, similar to the figure quoted in that article for the US). Official figures for rates of intersex based on atypical genitals are about 1 in 1500, so straightaway we can see how the hypospadias diagnosis is making intersex look a lot less common than it actually is.
