I'm I a boy or a girl? My secret dilemma

Mary Waithera was born 25 years ago. And being the first born, her arrival was supposed to be met with celebration. She was supposed to bring joy to her parents.

When she was born, everyone wanted to know if the new child was a boy or a girl, including her father. "Is it a boy or a girl," he asked, as soon as he got home from work that day. But Waithera's mother was hesitant, not knowing what to say. The baby was neither boy nor girl. Waithera had what is known as a disorder of sex development (DSD). She was intersex.

'Intersex' is a complex biological condition where children are born with either two sex organs (male and female), or one visible organ while the other is either hidden, malformed or deformed but present.

Waithera's condition marked the beginning of the end of the couple's brief marriage. "My father said I was a curse. He accused my mother of having brought a curse into his house." That is what her mother told her when she was old enough to understand.

Eventually, Waithera's father left never to return. But her mother has stood by her since day one, raising her as a girl despite her condition.  But because the community did not understand what being intersex meant, Waithera suffered a lot of stigma and discrimination as a child.

Just like Waithera, thousands of intersex Kenyans suffer in silence. The Child Rights International Network estimates that Kenya has approximately 20,000 intersex people.

After Form Four in 2010, Mary Waithera decided to live as a man. She changed her name to James Karanja. "My community was used to seeing me as a girl, and when I decided to live as a man, things got even worse.  Karanja's mother, unable to stand the way her child was being shunned, became mentally ill. She was admitted to Mathari Hospital and has never left the facility.

Susan Njoroge, a psychologist and family counsellor, says it is unfortunate the way that many communities treat intersex children as if there were lesser human beings. "Families with intersex children find it hard to cope with the challenge so they opt to hide them. The condition has caused strained relationships, blame games, separation, and violence," she says.

The children, Njoroge explains, as they continue to grow and attend school begin to realise that they are different from others and start isolating themselves.

"Most students will drop out from school. They suffer an acute identity crisis when they reach adolescence, are stigmatized, suffer low self-esteem and feel rejected. Some of them commit suicide."

Karanja recounts some of his tribulations at school: "I attended Kambala Girls High Boarding in Molo. I had to have a bath when all the other students had gone to asleep. At one point, the girls became curious and demanded to see my genitalia.

 It was a real challenge. Completing high school wasn't easy. l owe it to God." For Karanja and others who grew up as girls with birth certificates bearing female names, it has become difficult to change their male names. "My school certificates bear the name Mary Waithera. I have asked the Kenya National Examinations Council to change my official name to James Karanja but so far I have been unsuccessful," Karanja says.

This struggle to change names recently saw Rayan Muiruri arrested and detained at the Kenya Commercial Bank in Limuru for suspected impersonation. Muiruri, 25, grew up as girl and her ID reads Ruth Wangui.

"Two weeks ago, I had gone to withdraw some money. The bank employees arrested and detained me because l was not the Ruth Wangui on my ID," Muiruri says. It took the intervention of Nominated Member of Parliament Hon. Isaac Mwaura, who is also the chair of the Special Persons group in Parliament to explain his situation so that he could be released.

Muiruri who deserted his rural home in Kiambu due to stigma and discrimination, says: "Before l left home, I had tried to commit suicide five times."

He has nothing but praise and gratitude for his mother who has been there for him during hard times.

Muiruri cannot use his ID because it has his old name on it. He was forced to abandon school when he couldn't cope with discrimination and stigma from fellow students.

Mrs. Gathoni Muchomba, founder of the Gamafrica Foundation, which rescues children who have been stigmatized for their intersex condition, says it is not easy being intersex - not for the children and not for their families.

"In Baringo, an intersex child who was being raised as a boy and thought he was one, had a menstruation leak in class. He knew was a boy and menstruation was the last thing he expected. Because of shame and ridicule from colleagues, he threw himself into a river on the way home and died," she says.

Kenya National Commission on Human Rights (KNCHR) CEO Patricia Nyaundi reiterates that the trials and tribulations of the intersex community amount to a violation of human rights.

"Why is the intersex community not legally recognised when Article 5 of the Universal Declaration on Human Rights states that everyone has a right to recognition as person before the law?" she poses.

According to the Persons Deprived of Liberty Act (2014) an intersex person is defined as a person certified by a competent medical practitioner to have both female and male reproductive organs. This is a local Act that has made the first attempts to protect the rights of the intersex community.

Gamafrica Foundation, KNCHR, The National Gender Equality Commission and Hon. Isaac Mwaura have presented a petition to government seeking to have the intersex community recognized within the policy framework of the Constitution.

"The first time l introduced it to Parliament, members had no idea what l was talking about. I am calling for political support, to push for legislation that will recognize the intersex community in Kenya, and have their needs addressed," says Hon. Mwaura.

Part of the petition demands legal reform to amend the Registration of Births and Deaths Act, Registration of Persons Act, National Hospital Insurance Fund Act, Kenya National Examination Council Act, Statistics Act, Basic Education Act, and Children Act among other laws to recognize intersex persons.

Last month, Kenya marked the International Intersex Awareness Day at the inaugural commemoration of the day locally, and members of the intersex community and their families participated.

Under the 'Let Me Be Me' campaign banner they sought support from all Kenyans to understand that they had no choice in the matter - they were born intersex - and to allow them to choose if they wanted to live as males or females.

Surgery is not always the answer

Genetically, women will usually carry the XX chromosome and men the XY chromosome. "However, something can go wrong during the mixing of genetics and you end up with something like XXY. This will result in conditions such as intersex," says Dr. Bernard Gatinu, a consultant paediatrician.

He explains that intersex people who were raised as girls but later on in life decided to live as men, were assigned the wrong gender by the parents at birth.

He says: "The major confusion is during childhood and how they are brought up. A person may grow up knowing he's female, probably dressed in female clothes, but when he becomes adult, decides to live as a man because it is their true identity and vice versa."

He says that although the intersex condition can be corrected through surgery, that invasive option depends on how bad the condition is. Some cases are simple and corrective surgery can be done. However, in some cases surgery is impossible.

But before treatment/surgery commences, primary investigations involving ultra sounds, X-Rays, genotyping (investigating genetic constitution), counselling and karyotyping (detection of chromosomal abnormalities) are done. Some of these tests must be done abroad.

In situations where surgery is impossible, individuals are counselled to accept their condition. Some of those who undergo successful surgery can marry, give birth and live normally.

Is it possible to choose your gender and acquire the characteristics of that gender? "As an adult, irrespective of how you look externally, if your internal organs are female, you will produce female hormones; if your internal organs are male, you will produce male hormones," the doctor says.

Corrective surgery will cost you between Sh300,000-400,000 in public hospitals - and even more in private facilities. This is a major challenge because it is too expensive for most Kenyans. Dr. Gatinu cites a challenge for children born at home.

"If more children were born in hospitals, and experts discovered early that they were intersex, they would have time to consider their options rather than wait until it is too late," he says.