Neither boy nor girl

Josephine Chinele has seen and heard many strange things during her time as a resident of the earth, but when she met a boy with male and female sex organs she had to ask again and again to be sure that her ears were not playing games on her. She asked again and heard: this ‘boy’ has both female and male sex organs. Now fully recovered from the shock, she shares the pick of her travels.

“Your child is neither a boy nor a girl. Amenewa ndi malodza [This is a bad omen]. We need to eliminate the baby before the whole village knows about it,” said the traditional birth attendant (TBA).

The TBA said should the boy live, he will portend misfortunes for the family. But Chilaza—whose real identity we have withheld—held firm in his determination to keep his son.

“I am a devoted Christian and decided that the child deserved to live. God gave me such a child for a purpose,” he said.

This is how nine-year-old Fortune (real name withheld) was saved. Fortune was born with both male and female genitals, but uses the female genital to urinate.

“The penis is on top and the vagina is below. Since birth, his penis looks like he was circumcised,” said the boy’s father.

Chilaza said he took Fortune to the College of Medicine (COM) in Blantyre for examination and treatment. He said doctors debated whether to remove one genital but ended up not operating on him.

“According to some tests done on him, Fortune has neither a uterus nor fully-fledged male organs to impregnate a woman,” he said.

According to Chilaza, Fortune is an intelligent boy who has always been the best pupil in his class.

But Fortune, a Standard Three pupil, said the problems he faces when he wants to pass urine is affecting his education.

“Every time I want to urinate, I struggle to concentrate in class because I can’t urinate in the toilets at the school. My fear is that my peers would be surprised with my genitals, so either I rush into the nearby bushes or go home to pass urine,” he said.

Fortune said most of the time teachers punish him for coming to class late when he goes home to pass urine.

To avoid problems with teachers, after going home to pass urine sometimes he does not go back to school.

“The school toilets don’t have doors, so people would be curious to see me take off my underwear to urinate like a woman when everyone knows me as a boy,” he said.

Fortune, the fourth born in a family of six children, said he wants to become a surgeon when he finishes school. He said he wants to repair injured internal organs to save lives.

According to Chilaza, Fortune used to wear dresses until he turned four when he asked to begin wearing male clothes because he felt he was a boy.

He said the boy likes playing football but sometimes behaves like a woman.

Chilaza said the family has informed teachers and some church members about his condition.

“Teachers told him to use the staff toilet when he wants to relieve himself, a facility he uses once in a while,” said the father.

He said the family is secretive about Fortune’s condition to protect the boy.

“We are aware that the issue of his condition is all over the place, but in the form of speculation. At some point, his friends ridiculed him that he is a girl when he played the role of a groom at the play ground,” he said.

According to Chilaza, the taunts hurt Fortune so much that he spent the day indoors, crying.

Clinical psychologist at COM Professor Chiwoza Bandawe said children such as Fortune need a lot of support and counseling to help them know and understand themselves.

“It’s very difficult for them if they are not told what they are. This is a major problem everywhere in the world. Children need to be handled carefully because others tend to tease them and this has an effect on their well-being,” said Bandawe.

Chilaza appealed to communities not to associate such conditions with witchcraft, saying God created everyone in his own image.

“Sometimes I sense discrimination and hear rumours that my son is a wizard or our family is unlucky as a result of witchcraft, but I am proud of Fortune. He is very intelligent, considerate and compassionate,” said Chilaza.

He said illiteracy in communities is the reason people want to kill babies born with conditions such as Fortune’s.

“If they asked me to kill my child, how many children have been killed before or are being killed now because of such conditions? My son may look strange perhaps because many children who had his condition are not there since they are killed,” said Chilaza.

He said he is not interested in having one genital removed because it is God’s plan and he fears that an operation may kill Fortune.

A gynaecologist at the Queen Elizabeth Central Hospital (QECH) in Blantyre Dr Ennet Chipungu said the phenomenon of having both male and female sex organs is a result of insufficient exposure to the male hormone androgen in the uterus.

“The baby was meant to be male, but inadequate exposure to male hormones in the uterus may lead to one becoming intersex,” said Chipungu.

According to the gynaecologist, it is difficult for parents to detect if a child is intersex while the mother is expectant through a normal 2D scan which most people use.

Chipungu said for a doctor, it is hard to relay news of the condition because parents expect to be told “it’s a boy!’  or ‘girl!’

“It is also frustrating because most of the initial investigation can’t be done because we do not have the capacity,” she said, adding that intersex people usually have fertility problems.

Traditional Authority (T/A) Kachere of Dedza said he was touched by Fortune’s story. He said before meeting Fortune, he only heard that such people exist.

“If it happened to this family, it can happen to anybody. It is high time people accepted that there are such people in society,” he said.

Kachere said most communities view such children as an abomination and a product of witchcraft.

“This, therefore, calls for enhanced advocacy in communities. Medical personnel should also learn such conditions in medical school so that they are familiar with them because their reaction to such babies could discourage the parents,” he said.

The traditional leader said nurses need to prepare expectant women for such eventualities during the antenatal clinic.

Fortune’s family said they need support to take Fortune to good hospitals to be treated for complications.

“I wish we had money to take him to good hospitals since he has developed a new problem. Sometimes he passes blood mixed with urine,” said Chilazi.

He said when they took the boy to hospital, medical personnel told them that the condition is not menstruation or bilhazia.

“I normally feel abdominal pains for four days and when I urinate, I produce urine mixed with blood. This also lasts for four days,” said Fortune.

Spokesperson for the Ministry of Health Henry Chimbali said the ministry does not have a policy for intersex people because medical doctors make their own assessment when they encounter the condition.

“At the moment, the ministry doesn’t have statistics of such people but maybe at the facility level,” he said.

Programmes manager for the Centre for Human Rights and Rehabilitation (CHRR) Michael Kaiyatsa said Fortune’s life is at risk because his condition is widely associated with witchcraft.

“Since the community does not understand the condition, parents are not free to admit that they have such a child despite the rumours,” he said.

Kaiyatsa said Fortune needs a lot of help in terms of education, counseling and medical attention.

He said the boy also needs encouragement that he has rights just like everybody.