Held upright by her parents, Emma shows off her church finery. She is a little more than a year old, and the surgery to make her look like a girl has healed.
When Emma McDonald was born on September 15, 1998, doctors whisked her away so quickly her family barely had a chance to look at her. For hours, they waited anxiously for news. Then Emma's grandmother, Anita Jones, overheard a doctor speaking to a group of medical students. Alarmed, she hurried back to her daughter. "Vicki," she said, "that doctor called Emma a hermaphrodite."
Months later, Emma played happily in her mother’s lap. “Hey, punkadoodle,” cooed Vicki McDonald. For 18 years, Vicki, now 43, pursued infertility treatments. Finally, she and her husband Charles turned to adoption, and now they have Emma: a solemn child with a gaze that locks in like a searchlight. She was also neither male nor female. The medical term is intersexual.
In the kitchen of the family’s Gainesville, Florida, home, Vicki changed Emma’s diaper, revealing ambiguous genitals. The child’s phallus was larger than a clitoris, but it lacked many of the structures of a penis and was bound down by foreskin. Emma had one testicle, no vaginal opening, and an enlarged urethral hole located where a vagina would have been. The structures looked lumpy and unfamiliar, but not startling. Within Emma’s abdomen are a rudimentary uterus, one fallopian horn, and an undeveloped gonad. Her chromosomes, Vicki explained, are “mosaic,” a pattern called XY/XO.
Emma’s particular condition is rare. But intersexuality, in a variety of forms, occurs in about one of every 2,000 births—about the same proportion as cystic fibrosis. Sex, in reality, is more than the simple blueprint learned in high-school biology—XX for female, XY for male. All embryos are identical for the first eight weeks of gestation, and then several factors nudge the infant toward male or female development.
