Between The Sexes

In 1993 Debbie Hartman was sure she was hearing things in her hospital room. She had just undergone a caesarean section, and the doctors were saying the baby was healthy but they weren't sure whether it was a boy or a girl. "I thought the drugs were making me hallucinate," she recalls. In fact, she was hearing just fine. But nothing about her child's biology--from the chromosomes to the reproductive tissue--conformed to the standard demarcations we have come to expect between the male and female sexes. In the language of developmental biologists, the baby was "intersexual."

Careful examination showed that the infant had one testis, what looked like a small penis and no uterus or vagina. Genetic tests did not make things any clearer: some of the child's cells contained the XX chromosome pairing typically seen in girls, others contained the XY pattern seen in boys, and some had but a single X chromosome, commonly seen in girls with a condition called Turner syndrome.

Technically speaking, the Hartman baby was a true hermaphrodite. Scientists don't know how this happens, but one possible explanation is that two eggs are fertilized in the womb--one XX and the other XY--but rather than developing separately into twins, the zygotes merge to become one embryo. At any rate, "hermaphrodite" is not one of the options available on a birth certificate, so the Hartmans' doctors struggled to figure out which sex was more appropriate for the child. Meanwhile, Debbie's sister and mother told relatives and friends not to send anything pink or blue. "They said yellow or green," Hartman recalls. "Or better yet, just send a card."

After two weeks, the doctors decided the baby was a boy. Debbie and her husband--they have since divorced--named their son Kyle and took him home. Debbie quickly dubbed her little guy Mr. Man and Slugger. When Kyle was 11 weeks old, however, he developed a hernia that required surgery. Midway through the operation, four doctors came to the waiting room, and one of them told Kyle's parents that "your child is in fact a girl." The surgical team had found rudimentary ovarian and Fallopian-tube tissue in Kyle's body.

In some ways, this latest turn of events was even more upsetting and confusing than the birth. But the physician's recommendation was clear: the vestigial ovarian and Fallopian-tube tissue and the testis should be removed at once, while the child was still under anesthesia. Otherwise the tissue could become cancerous. "All I could hear was cancer, cancer, cancer," Debbie says. So she and her husband consented to the operation. (The phallus, which doctors eventually renamed a clitoris, was surgically reduced two years later.) The next day the Hartmans took home their recovering infant, whom they quickly renamed Kelli. The family held a second baby shower, and boyish clothing was replaced with lacy pink dresses and other feminine attire.

Kelli went on to have three more surgeries to construct female-looking genitalia. But the matter wasn't settled. At the age of 4, she started asking, "Mommy, am I a boy or a girl?" When she was 6, she questioned her mother about all her surgical scars, and when Kelli was 8, her mother told her the whole story.