The intersex condition affects not just people within the United States, but affects people from all over the world. Below includes a list of countries known to give special treatment to those born with a form of the intersex condition. Each of these locations and cultures have different methods of handling intersex cases, as well as has different cultural traditions on how to include or exclude intersexuals.

Intersex Treatment in the United States

Dana Zzym, an intersex individual who prefers to go by “they” (see Rejection of Assigned Gender for more infomation on Zzyym) faced discrimination just last year (2016) when trying to obtain a valid passport that best represented them. Zzyym wished to have their passport be gender-neutral, which would include both the male and female sex options be checked, rather than just one of them. However, the U.S. State Department denied Zzyym this option, forcing Zzyym to sue the State Department. The Department's reasoning for not issuing this gender‐neutral passport was because: This would compromise the Department's efforts to prevent identity theft and passport fraud by upending the Department's long‐established system for validating the identity and citizenship of passport applicants. Even with Zzyym's “unknown” birth certificate and many doctor records from Veterans Affairs that proved Zzyym's intersex condition, it is unclear whether or not Zzyym actually received their passport. This denial of a gender‐neutral passport is quite unfair and takes away Zzyym's rights to the free expression transgender individuals have— transgender people are permitted to change their sex options on passports provided that they are switching from one gender on the binary to the other.

Another instance which shows the inequality that intersex individuals face from society ironically comes to light through the celebration of the first intersex birth certificate, which was issued to Sara Keenan by the New York City Department of Health in December of 2016. Just last year, after 55 years living as a female, Keenan became the first official intersex individual to be labeled not as “male” or “female”, but as “intersex”. While this may seem like a great achievement for intersex rights, it just goes to show how far the intersex community has to go before their condition will become accepted by the larger society. The certificate was granted not on a national level to all intersex individuals, but by one city's health department. This was the first certificate, and it was only handed out at the end of last year. Those factors, combined with the invasive evidence Keenan had to provide in order to prove the severity of her condition (just as Zzyym had to do when trying to obtain their passport), demonstrates the need for intersex education and advocacy within the U.S. to create awareness and help others achieve this same triumph.

Similar to the intersex birth certificate, the Oregon Transportation Commission announced in June of 2017 that, beginning the following month, they will begin issuing driver's licenses and official ID cards with a new sex option: “X”, or “non‐binary”. This decision was the result of an Oregon judge's ruling to allow an individual to legally identify themselves as non‐binary in June of 2016, supposedly the first case of its kind to rule in favor of the non‐binary individual. Once implemented, this will be a great achievement for the intersex and LGBTQ community, as it will allow those who do not wish to be identified as Male (M) or Female (F) to choose the sex that best fits their needs. However, like the intersex birth certificate given to Sara Keenan, this is only being offered by a single location and has little national support. Thus, it must be looked at as the very beginning of the U.S.'s journey towards creating safe environments and feelings of inclusion for intersex and other non‐binary individuals.

While the dominant United States culture still averts its eyes from the reality of intersexuals' existence, this is not the case for all minorities within the U.S. like some Native American tribes, nor is it the same in various countries like Colombia, the Dominican Republic, Australia, Nepal, New Zealand, and Papua New Guinea.

While the United States is still on the fence regarding the issue of gender‐neutral or third‐gender passports, there are countries such as Australia, Nepal, and New Zealand which permit individuals to identify outside of the gender binary on their passports.

Many Native American cultures from the Plains, Great Lakes, and Southwest were known to give intersexuals, feminine males, and masculine females great respect, instead of being forced to conform to one gender expectation or another. These individuals were known as the “two‐spirits”, or those with the spirits of both males and females. The Natives believed these beings were powerful, with great spiritual gifts, and thus were treated as such. “Two‐spirits”, instead of being stigmatized and ostrasized from society, are given cherished positions as religious leaders within the community. They were also looked up to due to their usefulness in performing both male and female‐designated work. In some cultures, the two‐spirits would be allowed to marry whatever sex best complemented their gender; for example, a masculine female would marry a more feminine female.

Overall, Native societies before major colonialism and spread of European beliefs favored the inclusion and positive treatment of intersexuals and those who did not conform to the gender binary, creating spiritual meaning for their existence and placing them in positions of nobility, to some extent.

In some small communities within the Dominican Republic and Papua New Guinea, there is a large percentage of villagers born with an intersex hereditary condition known as 5‐Alpha Reductase Deficiency. It is commonly found within the males of the community, causing the males to be born with small or unrecognizable penises. As a child with this condition grows and reaches puberty, the penis will grow as well. These people are willingly accepted as females until they have reached this stage in their development, from which they are promptly accepted as males. Unlike the U.S., these cultures accept these individuals and allow them to grow up without the intervention of harmful, unncessary surgery.

As mentioned on the Effects page, Jennifer Cagandahan of the Philippines was born with congenital adrenal hyperplasia, which is an intersex condition that resulted in Cagandahan having small ovaries and male secondary characteristics during puberty. Before Cagadahan's court case, the Supreme Court of the Philipines had argued that it was not legal to change one's sex on their birth certificate, however in this case the court allowed Cagandahan to do so because they were matured, and because their transition was due to a natural medical condition.

The country of Colombia has especially made significant progress on accepting intersex individuals, as the Constitutional Court of Columbia ruled in Sentencia 377/99 that corrective surgery on a child over the age of five would NOT be performed without the informed consent of that child. This was because of a previous case, Sentencia T‐477/95, in which a child was accidentally castrated and subjected to reassignment surgery as an infant. When the child grew older, they discovered their true identity and sued both the doctors and the hospital that performed the surgery, leading to the court finding that the sex of a child could not be changed unless that child had given doctors informed consent. The court also argued that parental consent for the surgery could not replace the consent of that child, especially in cases in which the child was older and could determine which sex was right for them for themselves. While parental consent was important, the court argued that the surgery could not be performed unless both child and parents willingly and knowingly consented.

Informed consent is such an important factor for the U.S. to consider in order to protect intersex individuals' rights. In the U.S. currently, parental consent is the dominating factor that controls a child's health. No American has successfully sued the medical field for corrective surgery performed on them prior to them maturing and being able to give informed consent.There has been little headway in creating acceptance of intersexuals, as there is more focus on surgery to correct the condition than a focus on the child themselves. As Anne Fausto‐Sterling states in her article “The Five Sexes, Revisited”, intersexuality should be defined as normal, and should be treated with therapy, not surgery to make American society more accepting of this binary‐breaking condition.