The Missing Vagina Monologue--part of the Our Bodies Ourselves website--approaches the transgender/intersexed question from a different angle: What if you were a woman, such as author Esther Morris, born without a vagina? For too many people, their concerns focus around whether this woman can be penetrated, not whether she cares. Questions about gender identity may fill her mind, and she may experience terrible cramping, but none of that seems to matter as long as she can have so-called "normal" sexual relations. (Never mind decades of sex research indicating that "normal" isn't quite as straight-forward as the missionary position with the lights off.)
In one sense, this disorder--Mayer-Rokitansky-Kuster-Hauser Syndrome, or MRKH--has parallels with transsexuality, in that women with gender issues are seeking surgery to "correct" their genitalia. In another sense, women with MRKH are 180 degress from transsexual women; while transsexuals often know from an early age that their gender differs from their body, MRKH women are usually unaware of any incongruity until puberty. In some ways, women with MRKH have similarities closer to being intersexed, whether via chromosonal, gonadal, or hormonal means. Any changes in their gender perception come later, when puberty goes differently than expected. Psychological changes follow the physical. In contrast, for transsexuals, physical changes follow the mental. In both cases, however, we find ourselves wrestling with society's expectations of sex, gender, and sexuality.
It's promising that Our Bodies Ourselves now includes a chapter on gender identity and sexuality, but thanks to the imposition of gender based on a crude check of a baby's crotch at birth, it often feels more like damage control instead of progress.