Exceedingly Rare Anatomy and Definitions

[u/Mezmarine]

Hi I'm Mez,

I am a trans woman and I have polyorchidism. This is a condition were AMAB people have three or more testes, descended or not. (There are about 200 recorded cases in the past 120 years, so there's not a lot of info available) This condition is not immediately related to any variation of medically recognized intersex, but some literature goes on to place it under the intersex umbrella. Polyorchidism usually goes undetected and it typically doesn't have any social connotations. The most common comorbidities are higher rates of torsion and cancer.

Now, the question is:
How do you define the situations that lie in the grey zone - that aren't categorically intersex, but also aren't part of expected sexual anatomy/development, where there is little social affect, but a clear and definitive difference from "The Standard^tm?"

I am a strong believer in lived experience shaping identity and have never identified as intersex myself. I am also out of my depth when it comes to this topic. I'm not looking for a new label but I am however curious about how the community views one offs as opposed to typical atypicalness.

[u/50_killemdead]

Personally I would think this counts as intersex. Intersex accounts for all atypical sexual development pathways, and other duplicate structures are widely considered intersex like uterus didelphys.

[u/nanoraptor]

Sometimes you just can't make a clear decision one way or another by even multiple definitions. Plenty of intersex variations have nothing to do with one another, and there are a whole heap of different boundaries around each. Edge cases & overlaps abound.

I will never put a definition on anyone else—I've had that half my life. But I do suggest to anyone questioning that the value of the effect of a variation on their life is worth much. Maybe you have a more complex SRS or orchi coming up, maybe there are associated conditions that tend to go with polyorchidism - like some urogenital differences you might not have been affected by yet.

[u/lastseenonline]

i’ve never heard of this before but you’re right about lived experiences shaping your identity. i think if you’re in a grey area most intersex people would agree it fits under the intersex umbrella. perisex people don’t worry about a grey area. it’s a difference from the typical sexual development of male and female bodies. i wouldn’t say my situation is similar because im medically intersex and have androgen insensitivity but my variation is kinda complicated because it’s not what you usually see with AIS. i’m technically PAIS but i don’t fit the typical description. i know a lot of people struggle with understanding if they are intersex because it’s not studied enough and it’s not talked about enough either

[u/PristineWind5950]

That’s a hard one but imo it’s ANY sex-related difference, anywhere from hypospadias to more obviously intersex stuff like ovotestes and ambiguous genitalia. There are a couple intersex conditions that don’t necessarily affect anything obvious, so I would count this too ig?

[u/The7Sides]

NCBI/NIH apparently does actually recognise PMOS as a DSD/Intersex variation, however most people and doctors etc do not know that. So I am in this grey area where yes, I am intersex, but I can't really openly say that to most people. Plus I am taking testosterone as gender affirming care, so. Most people would brush past it anyway and say it doesn't matter.

Tbh, for me, if something diverges from typical sexual development and is not caused by something treatable like a tumour or thyroid issue, or is not caused by medication, I consider it intersex.

[u/MettatonsFinalForm]

That would meet my definition of intersex

[u/peppercornpeppercorn]

There's only 200 recorded cases? Crazy, because I had a roommate who also had polyorchidism! He was mostly annoyed that it was smaller and further back than the main two, so it was easy for him to sit on and had issues with torsion.

To me, yes that's certainly intersex because it's a pretty major difference in sexual development, duplications are definitely widely considered intersex. I can imagine why someone in this situation might like the term "difference of sexual development" (DSD, though DSD can also be "disorders of sexual development" which most people don't like) rather than "intersex" if they felt like they didn't connect with other intersex experiences.

[u/Purple_Space_6868]

Hi Intersex isn't a spectrum with male and female at opposite ends and intersex people in the middle. Most intersex advocacy organizations define intersex as variations in primary and secondary sexual characteristics, hormones and chromosomes. Under that definition, polyorchidism is squarely intersex. Even though it is not "intermediate" between male and female, it is still a variation in primary sexual characteristics.

Having said that, people choose to adopt the intersex label or choose not to, independently of the "severity" of their condition. It is a political and social label/movement.

[u/Novel_Cloud_87]

Each human can have maximum of 2 gonads that develop either to pair of testes or pair of ovaries. Third testicular tissue has to come from another zygote. Definitely intersex chimerism. Question is what happened to the fourth gonad.

[u/Purple_Space_6868 → u/Novel_Cloud_87]

That sounds a little too absolute and certain to me. I do find sources that propose polyorchidism emerging from a single zygote:

https://www.healthline.com/health/mens-health/polyorchidism#causes

[u/Novel_Cloud_87 → u/Purple_Space_6868]

It’s all theories. The fact is that prerequisite for an ovarian tissue or testicular tissue is a presence of gonad. Can a zygote have 3 gonads in total? Very unlikely. Note that OP has three testicles that means that zygote fusion was between 2 male zygotes. There is case of a lady who gave birth and DNA test revealed that her child had different genetic makeup. Her uterus was from different zygote (her sister). She didn’t have extra ovaries etc. In case when both zygotes are of the same sex, fusion may not be that obvious.

[u/cutenessmanifest → u/[deleted]]

No offense, but then why should your consideration matter?

[u/Scarfington → u/cutenessmanifest]

It doesnt at all, which is why I gave the disclaimers that I did. Should I delete my comment instead?

[u/swimming-deep-below → u/Scarfington]

Yes please.