Editing Sex assignment (section)

{{Short description|Process of discerning sex at birth}}
{{pp-semi-indef|date=August 2024}}
{{About|sex assignment in humans|sex assignment in other animals|sexing}}{{Redirect|AGAB|the enzyme|AgaB}}
{{See also|Determination of sex}}
{{Use dmy dates|date=August 2022}}
{{Medical references|date=June 2023}}

'''Sex assignment''' (also known as '''gender assignment'''<ref>{{cite web |title=gender assignment |url=https://dictionary.apa.org/gender-assignment |access-date=2023-06-06 |website=APA Dictionary of Psychology |publisher=[[American Psychological Association]] |language=en |archive-date=6 June 2023 |archive-url=https://web.archive.org/web/20230606121209/https://dictionary.apa.org/gender-assignment |url-status=live }}</ref><ref name=":0">{{cite book |title=[[Diagnostic and Statistical Manual of Mental Disorders]] |date=2022 |publisher=American Psychiatric Association |isbn=978-0-89042-575-6 |editor-last=American Psychiatric Association |editor-link=American Psychiatric Association |edition=Fifth edition, text revision |location=Washington, DC |pages=511}}</ref>)<!-- NOTE: "Gender assignment" is here, per WP:Alternative title; read that Wikipedia policy. "Gender assignment" is the alternative name for this article and redirects here. Also, see what the rest of this article states.--> is the discernment of an infant's [[sex]], typically made at birth based on an examination of the baby's external [[genitalia]] by a healthcare provider such as a [[midwife]], [[nurse]], or [[physician]].<ref name="Rathus">{{cite book |vauthors=Rathus SA, Nevid JS, Rathus LF |title=Human Sexuality in a World of Diversity |isbn=978-0-205-78606-0 |publisher=[[Allyn & Bacon]] |year=2010 |page=168 |url=https://books.google.com/books?id=ZotYAAAAYAAJ |access-date=5 December 2019 |archive-date=6 June 2021 |archive-url=https://web.archive.org/web/20210606214653/https://books.google.com/books?id=ZotYAAAAYAAJ |url-status=live}}</ref> In the vast majority of cases (99.95%), sex is assigned unambiguously at birth. However, in about 1 in 2000 births, the baby's genitalia may not clearly indicate [[male]] or [[female]], necessitating additional diagnostic steps, and deferring sex assignment.<ref name="witchel">{{cite journal |author=Selma Feldman Witchel |date=2018 |title=Disorders of Sex Development |journal=Best Practice & Research. Clinical Obstetrics & Gynaecology |volume=48 |pages=90–102 |doi=10.1016/j.bpobgyn.2017.11.005 |pmc=5866176 |pmid=29503125 |issn=1521-6934}}</ref><ref>{{cite journal |author=Dhamankar Rupin |date=9 April 2020 |title=Fetal Sex Results of Noninvasive Prenatal Testing and Differences With Ultrasonography |journal=Obstet. Gynecol. |language=English |publication-date=9 April 2020 |volume=135 |issue=5 |pages=1198–1206 |doi=10.1097/AOG.0000000000003791 |pmc=7170435 |pmid=32282607 |s2cid=215758793}}</ref> 

In most countries the healthcare provider's determination, along with other details of the birth, is by law recorded on an official document and submitted to the government for later issuance of a [[birth certificate]] and for other legal purposes.<ref name="UNCRVS">{{cite web |title=Birth and Death Registration Completeness |url=https://unstats.un.org/unsd/demographic-social/crvs/ |website=Demographic and Social Statistics |publisher=United Nations |access-date=19 August 2024}}</ref>

The prevalence of [[intersex|intersex conditions]], where a baby's sex characteristics do not conform strictly to typical definitions of male or female, ranges between 0.018% and 1.7%.<ref>{{cite web |date=16 September 2019 |orig-date=28 September 2013 |title=Intersex population figures |url=https://ihra.org.au/16601/intersex-numbers/ |access-date=3 July 2023 |website=Intersex Human Rights Australia |archive-date=17 July 2018 |archive-url=https://web.archive.org/web/20180717183724/https://ihra.org.au/16601/intersex-numbers/ |url-status=live }}</ref><ref name="sax">{{cite journal |last1=Sax |first1=Leonard |date=2002 |title=How common is intersex? a response to Anne Fausto-Sterling |url=https://www.leonardsax.com/how-common-is-intersex-a-response-to-anne-fausto-sterling/ |journal=Journal of Sex Research |language=English |publisher=Scholarly Publications |volume=39 |issue=3 |pages=174–178 |doi=10.1080/00224490209552139 |pmid=12476264 |s2cid=33795209 |access-date=27 June 2020 |archive-date=28 February 2021 |archive-url=https://web.archive.org/web/20210228000512/https://www.leonardsax.com/how-common-is-intersex-a-response-to-anne-fausto-sterling/ |url-status=live |url-access=subscription }}</ref><ref>{{cite journal |last1=Blackless |first1=Melanie |last2=Charuvastra |first2=Anthony |last3=Derryck |first3=Amanda |last4=Fausto-Sterling |first4=Anne |author-link4=Anne Fausto-Sterling |last5=Lauzanne |first5=Karl |last6=Lee |first6=Ellen |date=2000 |title=How Sexually Dimorphic Are We? Review and Synthesis |department=Department of Molecular and Cell Biology and Biochemistry |journal=[[American Journal of Human Biology]] |language=English |volume=12 |issue=2 |pages=151–166 |doi=10.1002/(SICI)1520-6300(200003/04)12:2<151::AID-AJHB1>3.0.CO;2-F |pmid=11534012 |s2cid=453278}}</ref> While some intersex conditions result in [[Ambiguous genitalia|genital ambiguity]] (approximately 0.02% to 0.05% of births<ref name="witchel" />), others present genitalia that are distinctly male or female, which may delay the recognition of an intersex condition until later in life.<ref name="Mieszczak2009">{{cite journal |last1=Mieszczak |first1=J |last2=Houk |first2=CP |last3=Lee |first3=PA |title=Assignment of the sex of rearing in the neonate with a disorder of sex development |journal=Curr Opin Pediatr |date=Aug 2009 |volume=21 |issue=4 |pages=541–7 |pmid=19444113 |doi=10.1097/mop.0b013e32832c6d2c |pmc=4104182}}</ref><ref>{{Cite web |date=2006 |title=Answers to Your Questions About Individuals With Intersex Conditions |url=https://www.apa.org/topics/lgbtq/intersex.pdf |access-date=2023-06-07 |website=www.apa.org |publisher=[[American Psychological Association]] |archive-date=24 May 2023 |archive-url=https://web.archive.org/web/20230524103131/https://www.apa.org/topics/lgbtq/intersex.pdf |url-status=live }}</ref> 

Societally and medically, it is generally assumed that a person's gender identity will align with the sex assigned at birth, making them [[cisgender]]. However, for a minority, assigned sex and gender identity do not coincide, leading to [[transgender]] identity experiences. When assigning sex to intersex individuals, some healthcare providers may consider the gender identity that most people with a similar intersex condition develop, although such assignments may be revised as the individual matures.<ref name=":0" /><ref name="HardackerDucheny20182">{{cite book |url=https://books.google.com/books?id=SfhyDwAAQBAJ&pg=PA3 |title=Transgender and Gender Nonconforming Health and Aging |publisher=Springer |year=2019 |isbn=978-3-319-95031-0 |editor-last=Hardacker |editor-first=Cecilia |location=Cham |page=3 |language=en |doi=10.1007/978-3-319-95031-0 |s2cid=52986156 |editor-last2=Ducheny |editor-first2=Kelly |editor-last3=Houlberg |editor-first3=Magda |access-date=23 May 2020 |archive-date=3 August 2024 |archive-url=https://web.archive.org/web/20240803145441/https://books.google.com/books?id=SfhyDwAAQBAJ&pg=PA3#v=onepage&q&f=false |url-status=live }}</ref>

The use of surgical or hormonal interventions to reinforce sex assignments in intersex individuals without informed consent is considered a violation of human rights, according to the Office of the [[United Nations High Commissioner for Human Rights]].<ref name="witchel2">{{cite journal |last1=Witchel |first1=Selma Feldman |date=2018 |title=Disorders of Sex Development |journal=Best Practice & Research. Clinical Obstetrics & Gynaecology |volume=48 |pages=90–102 |doi=10.1016/j.bpobgyn.2017.11.005 |issn=1521-6934 |pmc=5866176 |pmid=29503125}}</ref><ref name=":0" /><ref name="un2016">{{cite press release |last1=UN Committee against Torture |title=Intersex Awareness Day – Wednesday 26 October. End violence and harmful medical practices on intersex children and adults, UN and regional experts urge |date=24 October 2016 |url=http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E |work=[[Office of the High Commissioner for Human Rights]] |archive-url=https://web.archive.org/web/20161121185256/http://ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E |url-status=live |archive-date=21 November 2016 |last2=UN Committee on the Rights of the Child |last3=UN Committee on the Rights of People with Disabilities |last4=UN Subcommittee on Prevention of Torture and other Cruel Inhuman or Degrading Treatment or Punishment |last5=Juan Méndez, Special Rapporteur on torture and other cruel inhuman or degrading treatment or punishment |last6=Dainius Pῡras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health |last7=Dubravka Šimonoviæ, Special Rapporteur on violence against women its causes and consequences |last8=Marta Santos Pais, Special Representative of the UN Secretary-General on Violence against Children |last9=African Commission on Human and Peoples' Rights |author1-link=United Nations Convention against Torture#Committee against Torture |author2-link=Committee on the Rights of the Child |author3-link=Committee on the Rights of Persons with Disabilities |author5-link=Juan E. Méndez |author9-link=African Commission on Human and Peoples' Rights |last10=Council of Europe Commissioner for Human Rights |author10-link=Commissioner for Human Rights |last11=Inter-American Commission on Human Rights |author11-link=Inter-American Commission on Human Rights}}</ref><ref name="who2015">{{Cite book |last=World Health Organization |title=Sexual health, human rights and the law |date=2015 |publisher=World Health Organization |isbn=978-92-4-156498-4 |location=Geneva |author-link=World Health Organization}}</ref>