Georgina Somerset, British Intersex History, and the I in LGBTQI

ABSTRACT There are currently debates inside and outside intersex communities about whether to include the I in LGBTQI+. Intersex has historically been critical in arguments about the boundaries between significant ontological and epistemological categories, particularly: female and male; homosexuality and heterosexuality; and sex, gender and sexuality. There is also a long history of conflation and confusion of categories of sex, gender and sexuality. It is clear that intersex is in some way inseparable from LGBT politics. This article will present the historical case study of Georgina Somerset, a British intersex woman, focusing on 1960–1970. Somerset’s story illustrates both that intersex is different and separate from issues of gender and sexuality, and that intersex is always intimately connected to LGBT issues, whether historically or in contemporary politics. I identify four contemporary tensions that can be illuminated by this history of the entanglements and tensions of LGBT and I: the difficult boundary work between intersex and trans; the association of both intersex and trans with homosexuality; the issues of distraction and instrumentalization; and the affordances and limitations of identity politics. As the “I” was there all along, the politics of recognition might help us generate different discussions of LGBTQI+ politics and responsibilities.


Introduction
Intersex scholarship has always recognized and debated links between LGBT and I histories and politics. 1There is a long history of the existence of variations of sex characteristics complicating conceptions of both homosexuality and heterosexuality (Dreger, 1998;Mak, 2013;Preves, 2003).The existence of intersex variations has historically "been critical in defining the exclusive boundaries between male and female" (Reis, 2009, p. ix).Not only this, but concerns about homosexuality have structured responses to intersex throughout history, whether conceptualized as a "monstrous birth," or as a social and medical "emergency" to be "fixed" and "normalised" through surgical, hormonal, and psychological technologies.Furthermore, Suzanne Kessler has convincingly argued that normative gender and sexuality have been used as measures of "success" for these surgeries (Kessler, 1990).
The history of intersex activism shows an overlap, but also tension with, LGBT activism.Maayan Sudai draws attention to the tensions within intersex movements around questions of fellowship with LGBT activism, but also emphasizes the historical continuities between some forms of intersex activism and AIDS activism (Sudai, 2018 see also Holmes, 2002Holmes, , 2008Holmes, , 2016)).Activists and advocates have been trying for decades to improve healthcare for individuals born with sex characteristics that do not neatly fit social norms of simply male or female.This includes offering parents viable non-surgical options and improving psychosocial care.Activist tactics have included the goal of reframing intersex (or variations of sex characteristics) as a social rather than medical concern.Indeed, in the early days of the Intersex Society of North America, an attempt was made to reframe intersex as "primarily a problem of stigma and trauma, not gender" (Isna.org, 2008).In recent years, the framing of intersex as a human rights issue (and concomitantly infant genital surgeries as human rights abuses) has begun to be acknowledged or adopted by various international bodies.There seems to be a growing consensus among these supranational bodies that intersex is best understood as a human rights issue (see for examples: Amnesty International, 2017; Council of Europe Commissioner for Human Rights, 2015;European Parliament, 2018;Mendez, 2013;United Nations, 2015).
In the turn to considering intersex surgeries and medical interventions as a human rights issue, LGBTQI+ groups have often been integral to intersex activists and advocates gaining visibility and resources.Global intersex activists have a range of perspectives on the connections between intersex and LGBT activism and politics.Some activists argue for closer links between the intersex and LGBT communities, while others are more cautious.The concern is that intersex will be misrecognized or misrepresented as an issue of gender and/or sexuality, distracting focus from differences in sex characteristics and medical mismanagement of these variations.
Intersex is clearly separate from, but also entangled with, global LGBT histories and politics.I begin this paper by focusing on the history of Georgina Somerset, a British intersex woman, in the 1960s.Somerset was possibly the first out intersex woman in the UK and was certainly the first intersex person to speak publicly on her own behalf in the media in Britain, if not the world.Intersex history is not always easy to reconstruct.Terminology changes over time, both in medical and public discourse.Not only this, but the history of intersex is a history of silencing, stigmatizing, and invisibilising.This historical account draws on medical texts, newspaper articles and television show recordings, as well as Georgina's own writing in her autobiography, letters and articles.I draw together multiple sources, from multiple and varied archives, indebted to Jennifer Terry's notion of a "deviant historiography," the tracing of the complex discursive and textual ways in which historical subjects (particularly non-normative ones) emerge and become legible.This case study, then, can illuminate how subjects become legible through different frameworks, and the recognition and misrecognition that can occur within these.
I present this history to inform and provide resources for current global debates.More than this, these historical resources can help reframe debates beyond current impasses that exist.As I will describe, it is problematic that intersex/variations of sex characteristics only become legible through competing dominant frameworks of biomedicine or identity.The 1960s in Britain were a key time where legal, medical, and public opinion about sex, gender and sexuality were being defined, legislated, and debated.The history of homosexuality in Britain in this period has been explored (see, Cook et al., 2007;Lewis, 2013;Weeks, 2016), but in this article I connect it for the first time to a history of intersex in Britain.Previous decades had seen an increase in press stories about "sex change," and huge amounts of popular press attention had been paid to trans women like Roberta Cowell and Christine Jorgensen.The 1960s were also a key time for biomedical knowledge of sex, gender and sexuality.Karyotypes beyond XX and XY were described in the late 1950s and early 1960s, playing part of what Susan Lindee has described as human medical genetics being transformed from a "from a medical backwater to an appealing medical research frontier between 1955 and 1975' (Lindee, 2005, p. 1).In 1969, Professor Jack Dewhurst published The Intersexual Disorders, a key publication in the medical "management" of intersex in Britain.The First International Conference on Gender Identity was held in London in July 1969.This event was attended by Dewhurst, as well as influential global experts such as John Money and Richard Green.This conference has been described as central to the development of US-style gender clinics in Britain (Playdon, 2021).The conference is considered a key part of the early history of the Harry Benjamin International Gender Dysphoria Association, and the World Professional Association for Transgender Health (WPATH).This same year, April Ashley would also go to court in a case that would have lasting global significance for legal understandings of sex and gender.This case would conceptualise legal sex as defined at birth by genitals, chromosomes and gonads (with genitals predominating if there is incongruence between the three).Despite much reform since this case, legal gender recognition in Britain and further afield continues to be haunted by what legal scholar Alex Sharpe calls the "spectre" of Corbett v Corbett (Sharpe, 2000;Sharpe, 2002).
In this paper, I argue that a historical focus on Britain in the 1960s, and specifically on Georgina Somerset, can illuminate contemporary global debates about the relationship between intersex and LGBT politics.Specifically, I focus on Georgina Somerset's history in the 1960s and her appearances in print media, on television, and in court in this decade, and I identify four historical and contemporary tensions: difficult boundary work between intersex and trans; the association of both intersex and trans with homosexuality; the issues of distraction and instrumentalization; and the affordances and limitations of identity politics.
I will conclude that while it is often framed as such, it is not about adding the "I" to LGBT+, but rather recognizing the fact that the "I" has been there all along.Recognition is key.In his 2005 analysis of Anne Fausto-Sterling and Suzanne Kessler's early 80s-90s work on intersex, Iain Morland argued that "Surgery for intersex marks a failure of recognition, both of intersexed bodies and of intersexuality's social significance."(Morland, 2005, p. 70).For Morland, surgery is a double failure of recognition, as the surgeon fails to recognize the body as not needing surgery, as well as not recognizing their role as one of the social construction of sex and gender, enacted upon the often infant body that cannot consent.For Morland, in the face of this, any kind of recognition of intersex would be what he calls a "gesture towards social justice, because it is a recognition that the sexual is political" (Morland, 2005, p. 72).I end this paper with a discussion of the politics of recognition.In particular, I draw on Paddy McQueen's (2015) development of Charles Taylor's (1994) work on the politics of recognition, connecting this with work in gender studies by scholars such as Judith Butler.I draw on this work and connect it with recent scholarship in intersex studies, to consider the importance of recognition and misrecognition of intersex.I conclude that these theoretical and historical resources can suggest different ways of thinking about LGBTQI + representation, politics and demands.

Georgina Somerset
Georgina Somerset was born on March 3 rd , 1923.In her autobiography she recounts that the registration of her birth was delayed "for reasons embarrassedly evaded" by her parents (Somerset, 1992, p. 19).Her birth certificate registered her as male, with an incorrect birth date of March 23 rd .Somerset went to Croydon High School for Boys and Reigate Grammar School for Boys, passing pre-medical exams in 1940 and then training in dentistry at King's College Hospital.In 1944, Somerset joined the Royal Navy as a dentist.There is a history of surgical treatment of intersex bodies in the first half of the twentieth century in Britain.Lennox Ross Broster, surgeon at Charing Cross Hospital in London, published in 1938 that he had seen hundreds of patients, describing them as mainly "women with virilism" or women with "adrenogenital syndrome" (Broster et al., 1938).By the 1950s, intersex was increasingly associated with children rather than adults, although medical professionals reported increasing numbers of requests from adults for medical interventions related to sex characteristics (Griffiths, 2018a;Haire, 1950).
Somerset states that she sought medical help in 1955 after trying to live as a man, and even taking male hormones (Somerset, 1992, p. 33).She saw some of the leading experts at the time.The physician AP Cawadias (1943), who had published Hermaphroditos the Human Intersex, examined her and, according to her autobiography, found testicular and ovarian tissue and "albeit cautiously" recommended a "change of sexual role" (Somerset, 1992, p. 34).The surgeon and philosopher Kenneth Walker, who would go on to write the foreword for her 1963 textbook Over the Sex Border, appealed to the leading plastic surgeon Sir Harold Gillies.Gillies had worked with Michael Dillon, the first trans man to undergo a recorded phalloplasty, and Roberta Cowell, the first woman known to undergo "sex reassignment surgery" in Britain (Griffiths, 2018a).Gillies, however, refused to treat Somerset; her account is that he thought she could not pass as a woman, and the General Medical Council was getting increasingly worried about these kinds of operations in the 1950s.In 1957 she had a "small operation" by Harley Street surgeon Patrick Clarkson, which she described forcefully as "not the so-called 'sexchange operation' of common knowledge today" (Somerset, 1992, p. 35).It took until 1960, and the submission of statements from Walker, Cawadias, Clarkson and her father, for her to successfully reregister as a woman and receive a corrected birth certificate.

Somerset in the news (1960)
Somerset first gained media attention in 1960 from local and national newspapers.On the 15 th July 1960, The Brighton Evening Argus ran the headline: "After 37 Years as a Man-Ex-Naval Officer is Now a Woman" (p.[16][17].The article employed the language of "sex change," declaring that for 37 years, Somerset (Turtle at the time) "was a man."Somerset's account here is one of never feeling like a boy or a man: "The same feeling has followed me throughout my life.I never developed in a masculine way.But now at last I am happy" (p.16).She also spoke of her plastic surgery operation in 1957 as being "very successful as I always had certain male deficiencies" (p.16).The same day, the Evening Standard ran with the headline "Former Navy Dentist Now a Woman."The short article outlines the fact that she had an operation in 1957 and had legally registered as a woman.The article ends by affirming Somerset's status as a heterosexual woman, and indeed affirms that the surgery and registration supports her heterosexual status: "I always knew that I would never marry.But now?I think I'd be quite happy to do so."The implication is that prior to 1960 she could not fit into heterosexual society, and she frames the surgery and reregistration as vital to the happy heterosexual closure of her narrative.
The story was carried by a number of national newspapers including the Daily Mail which ran the story under the headline "Ex-Navy man is now a woman" on the 16 th July 1960.In this article, Somerset states "I suppose it is correct to say that my sex was indeterminate when I was born, but I became more and more feminine as I grew up."In her autobiography she describes herself as "asexual" and "of ambiguous sex both physically and psychologically" as a child.Somerset's account in the Daily Mail is somewhat ambiguous.It is unclear what physical characteristics she is referring to.She is, however, critical of the language of sex change: "People call it a sex-change operation, but that's not really true.I was already a woman before the operation."She would remain critical of this phrase as long as she was in the public eye.In the previous decade in the 1950s, there had been much press attention in Britain to the trans woman Roberta Cowell (Griffiths, 2018a). 2 There was much interest in so-called "sex change" stories in the popular press at this time.Richard Ekins and Dave King argue that developments in trans healthcare in the 1950s (in particular the work of Harry Benjamin) combined with the global press coverage of trans woman Christine Jorgensen to produce a recognizable trans narrative which was about certain normative types of gender performance (Ekins & King, 2006: p. xiii).Somerset reported that when the Jorgensen case broke: "it immensely distressed me as I felt no one would then believe that my own case had not been influenced by hers and that I might be different" (Somerset, 1992, p. 33).The recognizable narrative that was emerging around Jorgensen at this time allowed a level of visibility, but was not entirely comfortable for Somerset.
The News of the World was the newspaper that paid the most attention to Somerset's story.Over the course of three weeks, in the 17 th , 24 th and 31 st July 1960, Somerset seemingly told her own story in the newspaper.In this series she used the phrase "sex change" but it is unclear to what extent the series was truly in her exact words.Throughout she stressed that a mistake was made when registering her sex at birth and that she always felt more like a woman than a man.As regards her sexuality: I must stress that I have had no sex life in the normal sense.I occasionally took out a girl, just because it was the accepted thing.But believe me, I did not know what to say or do.Even holding hands seemed unnatural -and that was about as far as I ever got.(17 th July 1960) And the following week she stressed: Among the many letters I received after my article in the News of the World last week were several proposals of marriage.One eager suitor even made a personal call to propose.Let me say at once that marriage is included in my plans for the future -if Mr. Right comes along.But there will be no romance resulting from a pen friendship.(24 th July 1960) In these articles, Somerset legitimized the correction of her birth certificate through the deployment of a narrative of normative gender and sexuality.In a sense, Somerset was both empowered and constrained by the "transsexual story" that Ekins and King associate with Christine Jorgensen (Ekins & King, 2006, p. xiii).She assured the reader that she had no sexual activity with women when she was living as a man, and projected a heterosexual marriage with a man into the future.This heteronormative narrative in which heterosexuality makes a real woman also functions to confirm that she is living in her "true" sex (see, Griffiths & Hubbard, 2022).
These newspaper articles demonstrate a performance of a particular kind of respectable femininity.Recognizable and coherent gender performances here work to disavow any homosexuality and reinforce the "correct" nature of the stated "true" sex. 3 The article is accompanied by photographs that support this.The front page of the News of the World on the 17 th July announcing the 3-part series is accompanied by a photograph of Somerset by the sea in a swimsuit being observed by two young men in shorts with the title: "Who's this girl on the prom?."The other accompanying photos show Somerset in a traditional feminine role: applying makeup at a dressing table and selecting a dress from a wardrobe.Heterosexuality here confirms Somerset's gender, as well as the mistake on registration at birth and the appropriateness of correcting that mistake and reregistering as a woman.
As scholars have noted, newspaper accounts of "sex change" increased in the interwar period but were often surprisingly sympathetic to the individuals they portrayed (Griffiths, 2018a;Heggie, 2010;Oram, 2011).The articles from 1960 about Somerset certainly seem to continue this tradition.They presented Somerset in a sympathetic light, and appeared not to contradict her story.Socalled sex change seemed to be a story of interest, but not entirely scandalous.In Somerset's case, this was achieved in part by the suggestion that actually there was no sex change, and that Somerset had been a woman all along, mistakenly registered male.Integral to this was the emphasis on Somerset's heterosexuality (in her lack of sexual experience while living as a man and her plan to marry as a woman).The scandalous potential of sex change was thus somewhat contained by the policing of the boundary between Somerset and trans experience, and Somerset and homosexuality.To be acceptable in this context, intersex had to clearly be not-trans and not-homosexual, even though gender and sexuality haunt all these articles.

Somerset on TV (1966)
In 1966, Somerset appeared on the BBC's Horizon episode: Sex Change.This was the first time that an openly intersex person had spoken on television about intersex/variations of sex characteristics.In fact, Ekins and King claim that this programme was the first appearance of "sex changes and transsexualism" on British television (Ekins & King, 2006, pp. 57-8).These topics were previously considered worthy of the popular press, but not of serious investigation on a television documentary.During the 1960s, however, it was seen as increasingly legitimate for these subjects to be "covered by the more serious press with a corresponding increase in the display of expert terminology and opinion" (Ekins & King, 2006, p. 57).This display of a particularly classed form of expertise is noticeable on Sex Change.Somerset appears alongside an impressive roster of medical experts: Dr D Innes Williams, urological registrar at Great Ormond Street Hospital once described as the "father of paediatric urology" in the UK (Woodhouse, 2015); "pioneering" psychiatrist Dr Sydney Brandon (Rollin, 2002); Dr Gerald Swyer, whose "hitherto undescribed" variation of sex characteristics in 1955 would go on to be known as "Swyer syndrome" (Swyer, 1955); and Professor Paul Polani, a geneticist and pediatrician who, in his work with Turner Syndrome, published one of the first articles to suggest that karyotypes beyond XX and XY might exist in humans (Griffiths, 2018b;Polani et al., 1956).Somerset's own interview was edited for the show, taking up just over three minutes.
The documentary begins with Williams stating that it is important to make an "absolutely clear distinction between the intersex group where there is an anatomical or physiological abnormality [. ..] that the individual has been born with, and the purely psychological disorder which we call transsexualism."Throughout the documentary, however, this distinction does not hold.While this was the first time an openly intersex person was speaking on television about being intersex, the show unhelpfully describes Somerset as a "transsexualist."This is not just an error about Somerset; indeed, the documentary discusses diagnosis-specific terms such as "testicular feminization" as being "another form of transsexualism."The narrator frames the documentary by arguing that biological and psychological sex variance (the documentary does not use the term "gender") had previously provoked "amazement rather than sympathy" and "speculation rather than understanding."This is perhaps something of a projection.As scholars have argued, the popular press in the early to mid-twentieth century, while often replete with amazement and speculation, could often show a surprising level of sympathy and understanding.
The section focused on Somerset begins with the narrator introducing and describing Somerset as: A qualified dentist, a Mason, and for the first 37 years of his [sic] life, a man, served as a surgeon lieutenant in the Royal Navy, and is one of the few transsexualists with the medical training and the emotional balance to be able to give both a personal and professional account of the transsexualist experience.
The narrator describes how Somerset changed her birth certificate and married, showing photographs of Somerset and her wedding day.In her autobiography, Somerset states that she recorded a forty-minute filmed interview, but only three minutes were used.In the interview she appears in a studio, wearing a dress and jewelry, between a desk with a bouquet of flowers and a television screen.She states that she does not want to "justify" herself as she is past the stage of persuading people to "help" her.She is asked how she managed this initially, and she responds: Well, it is just that one presses . . . it is very difficult to say.You just go from place to place.And eventually I was able to receive the necessary surgery to enable me to take what I feel is my correct role in life.And I think if there is any real proof wanted of my correctness in my change now, I think it's here today!Somerset tells the interviewer that after the surgery she began taking hormones, and that she feels "very much better" on hormones.The section ends with Somerset stating: There is no question that anybody can actually change sex.You can assist them to change their role if their psychological state is such that it necessitates it.If in fact they can't live in any other way except, say, if a male can't live any other way than as a woman, then of course I think that rather than they just sort of hide away and eventually commit suicide, I think that the medical profession are right to help them.
Somerset here employs "they" and "them," in an attempt to maintain a boundary between her experience and the general experience of what the documentary calls "transsexualists."She is articulating this category of "transsexualists" clearly, so as to define herself against it.Similar to the newspaper interviews from 1960, Somerset also attempts to legitimize her status as a woman through a particular performance of respectable femininity.
Despite the fact that the documentary begins with the call for an "absolutely clear distinction" between intersex and "transsexualism," this boundary is illdefined, and the categories are conflated throughout.Also, despite the framing of the show as about medical expertise and legitimate enquiry, Somerset in her autobiography argues that the media billed the show as a "shock" programme, and quotes a review in the Daily Telegraph: "Last week, in the programme on BBC-2 on sex-changes, one participant in particular said far more than the BBC were prepared to broadcast and it was accordingly deleted by the producer" (Somerset, 1992, p. 68).This is supported by written correspondence between Controller of Programming Huw Weldon and BBC Editor Robert Reid before transmission (Weldon, 1966).This was the first of numerous television appearances throughout Somerset's life in which she presented herself as a figure of respectable heterosexual femininity, distinct from her descriptions of many trans people.She also went on to write correspondence to many medical journals including the BMJ (British Medical Journal).Her appearances and letters were often concerned with policing a very careful boundary, not only between intersex and trans issues, but often between those trans people who deserve treatment and those who do not.That is, between "true transsexuals" who "deserve our pity and confidential time-consuming help" and the "large numbers of homosexuals, anti-socials, exhibitionists and perverts have for some time been jumping onto the transsexual bandwagon" (Somerset, 1990, p. 416).

Somerset in court (1969)
On January 11, 1969, the medical journal Pulse published an article titled "'Sex change': facts and folklore."The article was written by Clifford Allen, consultant psychiatrist at Charing Cross, who had worked for decades with Lennox Ross Broster.The article was written in response to previous reader's letter about so-called "sex change" surgeries.Allen was introduced as an "authority on psychosexual questions" who "feels that too many practitioners still accept uncritically the folklore of 'sex change.'"Indeed, in the article, Allen described such a change as "impossible."He admitted that at the time, there was legally "no definition of what is a man and what is a woman" (see, Griffiths & Hubbard, 2022) and discussed a number of intersex variations that might complicate a straightforward medical definition of sex.Despite this, he insisted on a binary "correct sex" which is immutable.Halfway through the article he introduced the cases of Christine Jorgensen, Roberta Cowell and Georgina Somerset.Allen grouped these three women together, speculating that they shared histories and treatments.He described them as cases "where surgeons claimed that sex had been changed by operation," outlining certain plastic operations and hormonal prescriptions.He went even further: The Danish surgeons who operated on Christine Jorgensen stated that they received letters from 455 people who wished to have a change of sex.[. ..]Hamberger, who led the team found that "the homosexual libido plays a considerable, if not a predominant, role" in the wish to change sex.
Allen claimed that sex cannot be changed; that Jorgensen, Cowell and Somerset's "correct sex" is male; that they had had surgical and hormonal interventions to "mutilate them into a simulacrum of the opposite sex"; and that they were actually homosexual men.
Somerset's reaction upon reading this was to instigate libel proceedings against Pulse and Allen.Somerset was successful and received an apology and the payment of her fees from the defendants.At Somerset's request, the court documents were destroyed.For this reason, the most detailed account of the court case is the one in Somerset's own autobiography, although the case was reported in mainstream print media such as the Telegraph (Man who becomes a woman sues doctor for libel, 1970).Somerset makes it clear in her autobiography that she had four main concerns about the article: the association with the well-known trans woman, Christine Jorgenson; the description of her as homosexual; the questioning of the legal status of her marriage; and the description of her appearance as being a consequence of medical and/or cosmetic intervention (Somerset, 1992, p. 44).Somerset's counsel was Leon Brittan, who would go on to hold one of the most senior roles in the government of the United Kingdom, as Home Secretary.In Somerset's account, she had to provide every medical report she had ever had, as well as submitting to more medical tests.During the two years of the preliminaries of libel action, Somerset discovered her mosaic XO/XY chromosome status for the first time, which appears to have been important to the defendants accepting Somerset's account and issuing their apology.
It is worth noting that homosexuality had been legalized in England and Wales two years before the article was printed (at least for two men over the age of twenty-one in private).Despite this, however, negative attitudes toward homosexuality remained common, as did pathologisation and criminalization.Scholar of the history of nursing, Tommy Dickinson, emphasizes that: the 1967 Sexual Offences Act 1967 and the new legal climate it supposedly opened up did not appear to have a radical effect on reducing the numbers of patients being referred for treatment of their sexual deviations.One rationale for this is because the recorded incidence of indecency between men in public actually doubled between 1967 and 1977.(Dickinson, 2015, p. 203) In fact, Dickinson draws on a Gay Times opinion poll from 1975 on decriminalization stating that "most participants supported the 1967 legislations.However, 45% believed that there should be curbs on gay men working in teaching and medicine, and the notion of gay men being a danger to young people persisted" (p.205).Somerset, then, had a particularly strong reason for seeing the accusation of homosexuality as a potentially damaging slur, as she was at the time working in medicine as a practising dentist.

LGBT . . . I? Four tensions
Georgina Somerset attempted, through the 1960s and beyond, to control how she was recognized.In the print press, on television and in court, she tried to navigate and negotiate competing framings of her body and identity.While she sometimes succeeded, often through a performance of a specific kind of respectable heterosexual femininity, her negation of a trans or homosexual narrative was not always successful.This was due to these terms being contested, and the differences between them being confused.In this section I explore competing perspectives on the inclusion of I in LGBTQI+ politics and activism from an intersex perspective.I identify four themes that can be illuminated by an understanding of the historical case of Somerset outlined in the previous section.These themes are: the confusion between and conflation of intersex and trans; the association of intersex with homosexuality or nonnormative sexualities; issues of resources and the question of whether LGBT issues distract from intersex issues; and the question of whether the kinds of identity politics that ground some LGBT activism is at odds with the demands of intersex communities and movements.

Intersex/trans confusion
The history of Georgina Somerset, and in particular the 1960s representations of her in the newspapers, on television and in court, illuminate a long history of the confusion and conflation of intersex and trans issues.Reis has argued that the history of the term intersex also demonstrates this kind of slippage (Reis, 2009).In a sense, "intersex" has historically functioned as a signifier for multiple forms of non-normative embodiment, identity or behavior.
In biomedical research, intersex often only comes into focus within a framework of gender and/or sexuality.A clear example of this is a paper from 2010 which reviewed and classified 98 psychological studies on individuals with Congenital Adrenal Hypoplasia (CAH) from 1955 to 2009 (Stout et al., 2010).The paper cataloged the "psychological endpoints" that these studies investigated.CAH affects the production of hormones from the adrenal glands and can have various effects on physical sex characteristics.The majority of studies investigated psychosexual outcomes, including "gender role," "gender identity" and "sexual orientation."Far fewer studies were considered with issues such as "health-related quality of life."Here then is a continuing history of intersex/variations of sex characteristics being legible in psychological or biomedical research only when the true focus is on possible non-conformities of gender and/or sexuality.Similarly, intersex individuals and groups have criticized academics in the humanities (particularly gender or sexuality studies) for instrumentalising intersex people in order to make arguments about gender or sexuality, without due focus on the real issues facing intersex people (Koyama & Weasel, 2002).Koyama (2002) argues that "conflation almost always leads to erasure."This was certainly true for Somerset when she appeared on the BBC in 1966.The conflation of intersex and trans issues led to the erasure of specific intersex experiences.Somerset attempted to avoid conflation of intersex and trans by leaning heavily on a biomedical narrative.The biomedical narrative also potentially conflates or erases intersex experiences.This conflation and erasure could be seen as a kind of "epistemic violence."In 2006 the "consensus" statement was published, after a conference in Chicago the previous year.This meeting was attended by 50 experts, only two of whom were not medical professionals.The statement recommended (among other things) moving medical terminology away from "intersex" and earlier terms such as "hermaphroditism" to the newly coined DSD or "disorders of sex development."Merrick (2019) argues that this move (from social to medical understandings of bodily variation) represents a "biomedical epistemic injustice" (p.4434).Merrick explicitly compares this move to the historical medicalization and pathologisation of homosexuality and trans identities.Historically, there have been two dominant frameworks within which intersex has been made intelligible or recognizable: that of biomedicine, and that of gender and/or sexuality.Demanding that intersex be intelligible only through these frameworks can work as a kind of epistemic violence, whereby intersex demands, testimonies and politics are ignored in favor of more dominant narratives.This is obviously problematic, and other frameworks are emerging such as those that draw on lived experience.It is worth stressing, however, that these are not unproblematic, as dominant narratives can always exclude voices and experiences within very heterogenous communities.

Association with homosexuality
When Somerset took Clifford Allen to court for libel in 1969, the concern was not just around gender, but the association with homosexuality.This is still very much an issue.As with intersex often coming into focus for research only when the concern is with gender, the same can be said for sexuality.CAH, in particular, has a long history of being studied so as to find the so-called "cause" of homosexuality.A recent systemic review of 30 studies on CAH and sexual orientation, suggested that research into CAH can "indicate that sexual development, including sexual orientation, are programmed into our brain structures prenatally" (Daae et al. 2020).It is concerning that so much research into variations of sex characteristics is not for the benefit of people with these variations, but rather part of a long and sinister history of the search for the socalled "cause" of non-normative sexualities (Hegarty, 2017;Jordan-Young, 2010).
In 2015, the Council of Europe's (COE) Commissioner for Human Rights published an issue paper on human rights and intersex people.The following year, a small group of health professionals and patient advocates published a response in the journal of the European Association of Urology (Cools et al., 2016).The authors' first section questions "the authority of the Lesbian, Gay, Bisexual, and Trans (LGBT) movement to speak on behalf of this community and their families" (Cools et al., 2016, p. 407).This sets up an interesting distinction between LGBT issues and issues of concern for intersex people and families.The authors' concern is with the addition of "I" to LGBT without consulting clinical or parent groups and the allocation of funds to LGBT groups for intersex issues.Furthermore, the authors argue that: the adoption of intersex issues by LGBT under the umbrella of human rights, with the assumption that intersex is per se related to sexual orientation and gender dysphoria or confusion, has a detrimental effect on societal understanding of variances in sex development and undermines the efforts of many people working towards optimal outcomes.This argument is based on the understanding that LGBT groups are adding the "I" rather than recognizing its role in this history.As the history of Georgina Somerset demonstrates, intersex has always been part of debates about trans and homosexuality, and trans and homosexuality have historically often been the frameworks through which intersex became intelligible.It is also unclear as to why the association of I with LGBT would have such a detrimental and undermining effect on social understandings and improved outcomes.In fact, research on public understandings of intersex suggests that opinions about social and medical approaches to intersex are better predicted by sexuality than any other variable, with non-heterosexual individuals favoring social over medical explanations and approaches (Hegarty et al., 2021;Hegarty & Smith, 2022).
The history of Georgina Somerset in the 1960s illustrates complex boundary work to maintain a distinction between intersex and homosexuality, particularly during the 1969 court case.These tensions are only magnified when considering the use of the term "queer."Fae Garland and Mitchell Travis found in interviews with intersex people that some identified with queer as an identity or politics, and some were keen to draw a distinction between intersex and queer (Garland & Travis, 2021).Their findings suggest that on the one hand, framing intersex issues as queer can offer intersex people a voice to challenge medical authority.On the other hand, this framing threatens to unhelpfully and inaccurately portray all individuals with variations of sex characteristics as necessarily queer, and distract from intersex issues to more established issues of concern within queer politics (Garland & Travis, 2021; See also Griffiths, 2021).This echoes Morgan Carpenter's concerns about adding the I to LGBT, when it leads to a lack of resourcing for "affirmative peer and family support and systemic advocacy, substituted by representation by 'LGBT' organizations offering services for queer adult sexual health, HIV prevention, and gender affirmation" (Carpenter, 2018, p. 492).

Resources, distraction, instrumentalization
Carpenter has argued that the move from LGBT to LGBTI has not always included attention to the specific implications of this move, and that the "I" gets subsumed within a focus on gender identity issues such as pronouns or toilets, or sexual orientation issues such as sexual health: A framing of sexual orientation and gender identity is inadequate to address issues affecting intersex people but has dangerously been perceived as adequate.It is necessary to move beyond matters of identification, and to consider how bodies are treated."(Carpenter, 2021, p. 522) Some intersex activist groups take Carpenter's claim further.For example, the association StopIGM have argued that linking the "I" to LGBT is actually harming work done at UN level.Truffer (2017) argues that: These days my most pressing concern is how our pain and suffering is constantly used as a means to an end for LGBT and gender politics, and how such misrepresentations seem to increasingly gain traction also at the UN.
For Truffer, too close an association with LGBT groups can lead to misrecognition and misrepresentation, distracting attention from intersex-specific demands: This is a major setback for intersex human rights at the UN, fueled not only by the constant denial and pinkwashing of IGM [Intersex Genital Mutilation] by State parties, but also by often big-money LGBT NGOs and agencies [. ..] constantly misrepresenting intersex and IGM as "LGBT", "discrimination" and "health-care" issues, while conveniently failing to recognise that intersex and IGM first and foremost constitute genital mutilation, a harmful practice, cruel and inhuman treatment, and other serious violations of non-derogable human rights, and MUST be addressed accordingly.
Again, Koyama's (2002) claim is relevant.Conflation can lead to erasure and the potential epistemic violence of intersex being made legible only through frameworks of gender and sexuality.StopIGM take this further, arguing that this epistemic violence can also lead to the continuation of state-sanctioned physical violence on intersex people.
The history of Georgina Somerset demonstrates the difficulty in attempting to construct and control intersex representation, and the boundary work needed to control this narrative, while maintaining distinctions between intersex, trans and homosexuality.In the early newspaper reports, this seems to have been successful, as she performed the kind of respectable (hetero) femininity that confirmed her "true sex."However, the television appearance in 1966 demonstrates just how dangerously close the possibility is of losing control of the narrative and being co-opted and instrumentalised for more popular or recognizable narratives.Throughout the 1960s, Somerset was concerned with misrecognition, and the 1969 libel case represents Somerset seeking redress for the epistemic violence of her misrepresentation.

Identity politics
Somerset self-describes as "asexual" when speaking of her childhood, as a "sexchangeling" at other points of her autobiography, and as "intersexual," particularly when she is making a distinction between this and "transsexuality" (Somerset, 1992, p. 67).It seems that she is searching for identity terms, and particularly ones that will maintain the distinctions between intersex, trans and homosexuality.For Somerset at least, attempting to find identity categories unique to intersex, which are not misrecognized and misrepresented as "homosexuality," "sex change," "transsexuality" is an important, but a difficult task.
While "intersex" is a more legible category today, there remains a question as to whether an identity-based approach centered on this term will be successful in improving healthcare.Garland and Travis (2021) argue that from a legal perspective, identity-based approaches such as those traditionally favored by LGBT activism may not address the central matter at the heart of the intersex community: prohibiting non-therapeutic interventions.Their argument supports that of Carpenter (2016Carpenter ( , 2018) ) as they argue that these approaches do not protect intersex individuals or challenge the 'systemic inequalities that pervade different social insitutions' (Garland and Travis, 2020: p. 141, see also Garland and Travis 2018).Garland and Travis argue that identity-based approaches might leave the idea of a temporal gap between the intersex child and the intersex adult unchallenged, and not consider the rights of the individual in a temporal, embodied and processual way (see also, Roen, 2008).In 2021, Garland, Thomson, Travis and Warburton published the results of a Freedom of Information request sent in 2018 to National Health Service (NHS) Trusts in England.Following analysis of the data, they express concerns: regarding clinical record-keeping, geographical variation in MDTs [multi-disciplinary teams], use of clinical guidelines, the composition of MDTs and professional hierarchies within the health sector.(Garland et al., 2021, p. 132) Garland, Thomson, Travis and Warburton approach the issue of data not from the perspective of identity, but the perspective of medical care.This goes further than Somerset's attempts to find identity categories and terms, as it raises the question of the need for identity categories in this field at all.
As seen in Somerset's history, intersex was not a legible identity term in the 1960s.Indeed, she somewhat succeeded at performing (hetero)femininity, but was often misrecognized and misrepresented as trans and/or homosexual.Koyama argued in 2002 that: People with intersex conditions generally do not organize around the "identity" or "pride" of being intersex; "intersex" is a useful word to address political and human rights issues, but there is yet to be an intersex "community" or "culture" the way we can talk about LGBT communities (although this may change in the future).
More recent research has demonstrated a growth in intersex being used as an identity term, and indeed of intersex "communities" (Davis 2015;Karkazis, 2008).A number of intersex autobiographies have been published in recent years that attest to a growing intersex community, but also to the difficulties and tensions within this community, between this community and medical profession, and in the connections between LGBT and I (see, Viloria, 2017;Zieselman, 2020).
The historical tensions remain unresolved.There are intersex individuals, communities and organizations who are calling for the I to be included more within and alongside LGBT+ politics, for a variety of reasons.There are also many reasons to be cautious about including the I in LGBT+ acronyms.These include dedicated intersex activists who argue that this can lead to instrumentalization, distraction, and ultimately intersex being erased and ignored, in favor of more recognizable conversations, approaches, or concerns.

Conclusion: From addition to recognition
Intersex is separate from, but entangled with, LGBT histories.Intersex people have always been there, in the construction and policing of the boundaries within and around the LGBTQI+ acronym.Despite this fact, intersex has often only been made visible through frameworks of gender and sexuality, and only ever told through competing discourses, such as the popular press, the television documentary and the discourses of law and biomedical science.Somerset's history demonstrates the demands of recognition, but also the dangers of misrecognition and the epistemic (or potential physical) violence that this might entail.
In the context of British intersex history and government policy, it seems increasingly difficult to disentangle the "I" from LGBTQI+.The British government is only just getting data on intersex issues, and seemingly only because of its connection to LGBT.The government's national LGBT survey (launched in 2017) did not focus specifically on intersex issues, but intersex individuals were encouraged to complete the survey.2% of the survey respondents (1,980) identified as intersex (UK Government Equalities Office, 2018b, p. 24).The summary of the report stated: Key intersex themes from the optional free-text responses included medical records concerning medical interventions at a young age (e.g., "cosmetic" surgery to amend ambiguous genitalia) being withheld from intersex people and a lack of advice and information about what to do when you are diagnosed as having an intersex condition.(UK Government Equalities Office, 2018b, p. 24) The research report states that "cosmetic" (in inverted commas) surgery on infant genitals is something the government wants to learn more about in the future: The Government is nonetheless keen to learn more about the experiences of intersex people and issues, such as legal protections, the availability of psychosocial support upon diagnosis, and the prevalence of "cosmetic"' surgery when children are born with atypical genitalia.(UK Government Equalities Office, 2018a, p. 234) In 2019, the British government launched the "Variations of Sex Characteristics Call for Evidence."This call for evidence explicitly followed and built on the 2017 LGBT survey, and a 2018 consultation on the UK's Gender Recognition Act 2004.It focused on the following seven areas: terminology; healthcare and medical intervention; experiences in education; support services; workplace, benefits, sport and leisure services; sex assignment, birth registration and correcting birth certificates.At time of writing, the Call for Evidence has concluded and the data has been collected, but no analysis, conclusions or recommendations have been published.
Iain Morland (2005) has suggested that misrecognition is integral to intersex medical (mis)management.Shifting from questions of addition of the "I" to recognition of the "I" might therefore be a significant move.One of the differences between addition and recognition is visibility.While addition may lead to the kinds of erasure that Carpenter talks about (focus shifting from medical mistreatment to issues of pronouns, passport markers, sexual health), recognition might demand that LGBT+ communities can use their power and resources to increase recognition and visibility of specifically intersex issues (see also Ayoub, 2016).
Recent scholarship has suggested that not just the surgical moment, but the moment of diagnosis is one that is fraught with the challenges of recognition.Natalie Delimata (2019) argues that within the current model of pathologizing bodily difference under the umbrella term of "DSD," diagnosis is a moment of misrecognition, and one that she describes as a moment of disinterpellation, and a "crisis," where the scientific knowledge of bodily variation intersects with the social ideal of neatly binary bodies.
Recognition at the point of diagnosis and at the point of medical intervention are significant, but there are also significant questions around the recognition of intersex within LGBTQI+ politics.If the recognition of intersex gestures toward social justice as Morland has suggested, then this might suggest that LGBT groups can "add" the "I" as a commitment to social justice.This is obviously insufficient, and there are still tensions between intersex and LGBT politics.While some intersex activists and scholars argue for the importance of adding the "I," and some argue against, what they have in common is an awareness of these tensions.
In scholarship on the politics of recognition, it has been suggested that tensions and contrasts can open up to new horizons.Charles Taylor (1994), for example, argues that recognition demands a working through of tensions, a thinking toward what he calls "the fusion of horizons": The 'fusion of horizons' operates through our developing new vocabularies of comparison, by means of which we can articulate these contrasts [. ..] real judgments [. ..] suppose a fused horizon of standards [. ..] they suppose that we have been transformed by the study of the other, so that we are not simply judging by our original familiar standards."(pp. 67-70) There are two key points here.One is the need for new vocabularies, and one is the fact that a true politics of recognition is necessarily transformative.In terms of LGBTQI+ politics, the danger is adding the I, but not developing new vocabularies, or being transformed in any real way.McQueen (2015) has argued that recognition might not always be positive, and that recognition can function as a regulatory social practice.Drawing on Judith Butler, he suggests that recognition can often "undo" the individual.Indeed, so-called "normalizing" surgeries that activists seek to challenge are an attempt to make intersex bodies recognizable within particular cultural and social constraints, following the disinterpellating effects of diagnosis described by Delimata.
McQueen's ambivalent account of recognition might be useful when thinking about competing epistemic frameworks (biomedical or LGBT) within which intersex has been recognizable.Key to Taylor and McQueen's argument is that being recognized and being made recognizable are not the same.Being made recognizable is to be asked to speak in the vocabulary of gender identity or sexual health.Whereas a politics of recognition commits to the necessity of LGBT organizations transforming and developing new vocabularies as they build toward new inclusive horizons.
Merrick's reading of "epistemic injustice" suggests that the lack of attention to intersex testimony is itself an injustice and part of epistemic violence.A politics of recognition must be open to intersex testimony, and wary of misrecognition and misrepresentation.LGBT associations adding the "I" need to be aware of intersex histories, politics and demands, and to provide the resources and platforms for intersex testimonies to be heard and recognized.At the same time, and as Georgina Somerset's history tells us, it would be simplistic to think of "LGBT" as something stable itself.The history of LGBTQI+ scholarship, politics and activism is one of long and ongoing debates and dilemmas.
Intersex is always already part of the "contested terrain" of LGBTQI+ histories, politics and activisms.The question "should we add the 'I'" therefore distracts from a more important question: "how do we reckon with the fact that the I has always already been part of the LGBTQ terrain, but that neither LGBT identity politics nor Q theories or politics have done the 'I' justice?" Might a politics of recognition open up a new horizon of space in which intersex testimonies and politics are not made recognizable through either biomedical discourses or frameworks of gender and/or sexuality?It seems that it is not possible to police that boundary between the I and the rest of the LGBT+ acronym, if the "I" has been intrinsically linked all along.Instead, the responsibility becomes to recognize the separate but entangled nature of these histories, politics and demands.

Notes
1. Terminology in this field is contested.Medical professionals tend to group diagnoses under the umbrella term of Disorders of Sex Development (DSD).Many, including those named by this term, critique or refuse this term as it is seen to be pathologizing.Instead, many use a variety of terms including "intersex", "intersex variations", "variations of sex characteristics".This paper uses this as preferred terminology, noting that terms shift over time, and were applied differently and inconsistently to sex, gender and sexuality in the past.For more on intersex/DSD, see (Davis, 2011;Lundberg et al., 2018;Reis, 2007).2. It is not unproblematic to describe Cowell as a "trans woman".In her autobiography and interviews she deployed an intersex narrative, attempting to use this to secure a moral legitimacy she did not associate with contemporary discourses of "transsexuality".For discussion of this see, Griffiths (2018a).3. It is interesting to note the connections between Georgina Somerset's history and the more well-known history of the US trans woman Agnes, who became known through the work of the sociologist Harold Garfinkel in the 1950s.Garfinkel's work would play an important part in critical theories of sex, gender and sexuality, particularly through the work of Kessler and McKenna (1978), and Butler (1990).For more on Agnes and the history of gender and sexuality, see, Schilt (2016).