CN: Gender dysphoria, coercive assignment, genital talk, puberty.
Additional quick note for my transfem sisters & siblings: This might make you dysphoric as fuck, and it might feel like I wrote a list of what a jammy cunt I am for lacking lots of dysphoria-inducing aspects. You don’t have to read it. You can call me a jammy cunt if you like.
So ‘Intersex Awareness Day’ exists: https://intersexday.org/en/ This is good. Everyone should definitely be more aware of intersex people. And this is relevant to me because… yeah, erm… I’m pretty damn sure I’m intersex, and I have been since my teens. As a trans woman, this has had a relatively positive effect, or at least blunted the worst. It’s political now in a way that really matters to trans folk and everyone affected by the TERF Wars. Gender isn’t binary and sex isn’t either. I’m here today to explain why you’re wrong and/or lying about my body, you phobic fuck. (Not you, dear reader. You’re fine.)
Caveat 1: ‘Intersex’ is often used to refer only to people with conditions which affect the appearance and/or functioning of their genitals, whether during sex assignment at birth or during puberty or prospective parenthood. I am not in this group, and nothing here should imply that I claim such a thing. The abusive, coercive treatment many intersex people experience in medical, social and legal settings is horribly real and we should listen to the people who have endured it.
Caveat 2: Much of my reporting is historical. I began medical gender transition with oestrogen & T-blockers in 2017 and had GRS in 2021. Most of this writing refers to the way my body was before that, and while my particular physiology has determined the way I am now, the specifics here are only really relevant to my life before I started HRT. There are few practical implications to my body as it exists in 2023, but the question is still hassling me and still has wider significance. I don’t know if I was fully fertile, I never wanted kids so it never, y’know, came up.
Caveat 3: I’m certain I have an intersex condition which, while bloody obvious is difficult to prove and can’t be tested for on the NHS. I still feel I have to caveat everything with ‘probably’ and ‘pretty sure’ because I don’t have medical paperwork to say, in empirical fact, that I am intersex. I’ve been trying to find a way to get tested in the UK and am not getting far. My evidence is not medical diagnosis. It’s everything which follows.
Caveat 4: This is from lots of poking the internet to tell me I’m right and is subject to my own dearth of research skills, attention span and confirmation bias. I wish I had the time and access to cite all my sources.
Caveat 5: Gregor Samsa. Everything here is based on my subjective experience of living in my own body and how I have observed it functioning and developing over decades, compared to my experience of the same in other people. It is entirely possible that my self-perception is utterly false, and that what I see and feel is different to the reality the rest of y’all experience. I dread that eventually the illusion will break and that I too will awake one morning to find myself transformed into a hideous bug.
Right, caveats done? Let’s get on with the fun stuff.
I’m as certain as I can be that I have an androgen insensitivity condition. Androgen insensitivity has three broad categories: Complete; Partial and Mild Androgen Insensitivity Syndrome (CAIS, PAIS, MAIS) representing the degrees of effect on appearance and development. The NHS site lists CAIS and PAIS, which you can read if you want, but not MAIS. I believe this is primarily because the mild form doesn’t affect fertility or assignment at birth, but that’s a whole other kettle of worms outside the scope of this piece. TL;DR it means testosterone doesn’t affect the development of cells in the usual way, meaning that the body does not ‘masculinise’ the way most assigned-male bodies do. My body did not do that thing. I’m glad of it, but that’s not the point right now. You can read more on wikipedia, but it’s very genital-y in a way that isn’t totally helpful: https://en.wikipedia.org/wiki/Mild_androgen_insensitivity_syndrome
So here’s a little story about figuring something out:
One morning in 2002, a year before the end of section 28 and at least 21 years before trans people stopped being a punchline, an obnoxious little shite got home, horribly hungover, and crawled into bed at about 9am, having crashed at a mate’s house and having made a bloody nuisance of themself. They over-microwaved some chilli and while eating scorched bean, watched some telly their dad had kindly taped the night before (for which they were very grateful). It was The League of Gentlemen, season 3, episode 2: ‘The One-Armed Man is King.’ [I may have had to look that up. Shh.] In that episode, a horrible bloke loses his arm in a road accident and gets an ill-considered transplant. It’s <gasp> a woman’s arm! A few scenes in, a friend remarks, “You have a lady’s arm! It is all girlish and fair!”
They were 18 years old, and while 18 is pretty damn new to the world, it’s definitely not a kid anymore. They looked at the ‘girlish and fair’ arm absurdly juxtaposed to the caricature of a man, their own waifish arms, back to the screen and… something broke.
Can I drop the third-person act now? Ok. That was the first time I twigged that my body was not doing a lot of the things AMAB bodies do, and the start of a question which has haunted me since.
What follows is a top-down scan of all the aspects which have led me to conclude that testosterone had a diminished effect on my body. It is partly informed by characteristics associated with Klinefelter syndrome (though I definitely do not have it) and AIS broadly, and partly from seeing, being around and getting in bed with AMAB folk who had the regular stuff. For each individual aspect, keep in mind that while there may be other explanations or it might be just the way I am, it isn’t that one thing, it’s everything, everywhere, all at once.
From the top:
Youthful appearance: I regularly get mistaken for 5-10 years younger, and my whole life I’ve had people tell me I don’t look as old as I am. If you don’t know already, go on, guess. If you get it first time, I’ll buy you a pint. Only kidding, I already told you if you were paying attention.
Skin: T makes skin thicker and more opaque, with distinctive raised veins and a more firm and oily texture. My skin is pale, thin, translucent. Look at all those pretty blue veins under that ghostly tone. Very easy to bruise, hilarious leopard pattern after moshpits.
Eyebrows: T-influenced brows tend to be denser and bushier. I got “Do you pluck them?” since always.
Cheeks & lips: Skin changes from T make the lips narrower and less curved, and cheek recesses more pronounced. Mine are unusually full and rosy. Aw.
Facial hair: I had stubble but it didn’t start growing particularly thick until my late 20s, and there was never enough for a beard. The photo linked below is the closest I ever came to being a beardy metalhead, aged 27, when I used dysphoria to incentivise myself to complete work for uni deadlines. I fucking hated growing facial hair, and still do. But it could be worse.
https://keirajamesart.com/wp-content/uploads/2023/10/384616_10151031254450640_76000884_n.jpg
Shoulders: My lack of default-muscle makes my shoulders quite pointy. The bones are long and end-to-end they’re pretty broad but the lack of muscle kept them narrower than usual.
Arms: Girlish and fair as fuck. Limited muscle, hair and no raised veins make them the most obvious display of how un-T-affected my body is. I had trouble finding anything to fit my wrists cos they were s damn skinny everything slid off. I can still wrap my thumb round to the little finger’s first knuckle.
Hands: My hands are narrow, thin and delicate to an extent I very rarely see in AMAB folk. They’re distinctly unsuited to heaving big bits of metal for fun.
Chest: The fancy medical term for what my chest looked like in the old days is ‘gynaecomastia’. My term was ‘Boybs’. My enlarged fatty deposits were quite distinctive and I wasn’t shy about showing them off. They got a major upgrade with oestrogen post-2017 but I can’t get them out in public now.
Core temperature: Ok, I never had my body temp taken as an adult until I got my surgery, but I heard “Jesus, [Keira], you’re freezing!” often enough, consistently enough, to know I didn’t run hot.
Tum: I’m gonna skip over this one cos it gets nasty. Apologies for subjecting others to my internalised bullshit over the years.
Alcohol tolerance: <Giggle> liightweeight…
Hips: My hips are big, broad and bony. They’re deadly sharp and cruel. They’re bigger and spikier than usual and my most metal feature. Hell yeah.
Coquette: She was small, soft and delicate, and it was over for her when I started calling her that.
Legs: Like my arms, they’re narrow and pointy with little muscle that wasn’t caused by growing up poor in Sheffield. I still have to overwrap my boots because size 9’s are not made for ankles & calves as skinny as mine.
Now, I did/do not look entirely ‘feminine’. I had plenty of ‘masculine’ characteristics which I’d prefer to downplay or, y’know, have surgically altered beyond recognition, but the fact I read characteristics of intersex conditions and just see a checklist description of my body (except that bit, that bit and those two bits right there) feels pretty convincing, especially since I didn’t start HRT until age 33, far past the time I would expect my skin & hair to be thicker and unprompted muscle to develop.
The biggest convincer, though, is having a direct point of comparison. My nesting partner has been taking testosterone for several years and has physically changed far more in those few years than ever happened to me in as many decades. My skin didn’t change in the same way, I didn’t grow hair as thick or in as many places, I never grew the amount of muscle they put on recently, ever. The difference is startling. I can say for certain that if my body had reacted to testosterone in that way, it would look and feel very different indeed.
That’s why I’m so certain I’m intersex. If testosterone had worked on me, I would look and feel like someone else, on the outside and inside.
Keira James Art 
