Document Type



Doctor of Philosophy


Education, Counseling

Date of Defense


Graduate Advisor

R. Rocco Cottone, Ph.D.


M. Lee Nelson, Ph.D.

Mark Pope, Ed.D.

Ruxandra Ritter, Ph.D.



Intersex people are born with sex development differences; for example, atypical genitals. The intersex community is the only sexual minority population subjected to medical treatments in infancy designed to make their bodies conform to cultural expectations for male and female bodies. Intersex activism to stop the medicalized treatments began in the late 1990s. No other qualitative study has focused on the experiences of intersex activists. Four leading activists were interviewed in depth regarding their personal, activist, and counseling experiences. Data were collected through semistructured interviews and analyzed using interpretative phenomenological analysis. A 3-stage intersex identity development model was formulated to explain the psychological growth involved in moving beyond society's pathologizing notion of intersex variations. The model stands in contrast with other identity models as it emphasizes three social frameworks (i.e., contexts) at its highest level and places the individuals' processes or states of being at a lower level. The intersex identity development model's 3 social contexts are Stage 1. Binary-only framework: intersex as a disorder, Stage 2. Breaking the binary-only framework, and Stage 3. Beyond the binary-only framework: intersex as a natural bodily variation. An identity development model developed specifically for intersex people will help counselors appreciate the unique psychological challenges of an underserved population. The counseling profession is directly implicated in optional intersex infant sex-related surgeries through the 2006 Consensus Statement on Management of Intersex Disorders, which includes professional counseling as a part of multidisciplinary teams that offer irreversible surgical treatments. Findings from this study may help to better inform counseling professionals so they can distinguish themselves from mental health professionals who cooperate with medical professionals who deny infants their right of self-determination. In recognition that the mental health and medical communities have often acted on behalf of intersex people against their wishes, this study was reviewed by all four activist participants.