Priscilla Nakafeero, now 20, once felt trapped in a body that defied her expectations. What started as a quiet anxiety over never menstruating evolved into a life-altering discovery: she is intersex, born with both male and female genital characteristics.
After going through surgery in vain, experiencing emotional setbacks, depression, and eventual counselling, Nakafeero has transformed her pain into empowerment, emerging resilient and unapologetic. Her troubles started during her school years when she was 18.
Unlike her peers, she never experienced menstruation, despite reaching puberty. Nakafeero says after a long time of thinking and questioning herself, she decided to share her ordeal with her mother. Concerned, her mother took her to the hospital in search of medical intervention.
She says doctors discovered her vaginal canal was completely enclosed -a condition that required a surgical intervention ‘I was told a surgical procedure had to be done to create a canal, which was successful, but later failed during my recovery process,’ she says.
She reveals that the canal closed again. Desperate for solutions, she turned to herbalists, but she says this was not helpful either.
‘I enclosed back, something that traumatised me; this was the worst experience in my life,’ she adds. Undeterred, Nakafeero returned to Mulago National Referral Hospital for advanced testing. She says specialists were baffled by the recurring closure until internal examinations revealed the truth: she had dual genital structures -external female parts and internal male ones. Her male hormones dominated, overriding female development and causing the canal to seal repeatedly, according to scientists.
Dr Nasser Kakembo, a paediatrician at Mulago Hospital, says her condition is known as a Disorder of Sexual Development (DSD) where abnormalities occur during the separation of the developing baby to either be a male or female, depending on hormones. He says in her case, a surgery can be performed on the patient and leave her with a more active part, depending on the male and female chromosomes she has.
However, Kakembo revealed that the most common condition is known as fused labia, where a baby girl is born with a normal anus, but her urethra and productive canal are covered by skin folds.
‘The vaginal folds, which include, labia minora and majora or the vulva, can come together and join each other, causing a seal on the vaginal opening,’ he elaborates.
‘When a child has this condition, all the genital structures are present only but the canal is sealed.’
‘The doctor separates the canal by tearing her apart, especially if she is still a baby, unless the whole area is fused, then surgery might be necessary,” he adds.
The expert also reveals that such conditions are caused by hormonal imbalances. According to the Office of the United Nations High Commissioner for Human Rights (OHCHR), an estimated 1.7 percent of newborn babies across the world can be classified as intersex.
Dr Kakembo says it is hard for parents to determine such abnormalities, not until those who are kin observe their kids urinating like boys, since the vaginal opening is closed.
‘People should be taught about this issue as many are not aware that the urinating canal is different from the reproductive canal, something that can lead to women going into marriages without the main reason for it, hence awareness is needed,’ he adds.