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This resource unpacks the qualities and features of healthy relationships and ways in which people can make their relationships work best for them. It is designed for people with an innate variation of sex characteristics / people with an intersex variation (IVSC) but can also be used by partners, friends and family who do not have a variation.
This resource also contains information about power dynamics and making decisions in relationships. You may wish to use this resource to better understand and improve your relationships with those around you. This may be particularly useful if you are experiencing uncertainty or challenges in a relationship or if you are looking to build new ways of being in a relationship where you feel safe and respected.
As a person with an IVSC, you should feel supported by your partner when making health decisions for your body, making sexual, reproductive or parenting decisions and setting the terms for how you would like to engage with intimacy, sex and romance.
Healthy relationships come in all shapes and sizes, as each relationship looks different. While some people use the word relationship to talk specifically about intimate and romantic relationships, there are many other relationships we have with people in our lives such as those with our family, friends, co-workers and acquaintances. This resource will focus specifically on close, romantic and sexual relationships.
This category of relationships can be quite varied, including casual sexual and/or romantic relationships, longer-term established and committed romantic relationships such as a boyfriend/girlfriend/partner, de facto or engaged couple, as well as formalised relationships such as marriage and civil unions. These relationships can be very new, well established and long-term in nature.
Relationships are typically understood to exist between two people, though may involve more than two people in some cases such as in ethical non-monogamy and polyamory. How everyone relates to one another in these situations will vary between those involved, and different dynamics can be healthy without being the same for all involved parties. However this might work, effective communication and ethical consent-based decision making is best.
At the heart of a healthy relationship is safety, trust and respect. In a healthy relationship all emotions and feelings are okay, and it does not mean that there will not be issues or conflict that arises from time to time. Conflict and disagreements are a healthy and normal part of every relationship, however it is how these situations are handled and communicated that determine how safe and healthy a relationship is.
While it is up to the people involved who get to decide what is important to them and for their relationship, healthy relationships share some common attributes. Some of these may include kindness, friendship, teamwork, fun, taking responsibility, independence, balance, support, shared interests, common goals, modes of communication and much more.
The most common features of a healthy relationship are:
These are often interconnected and dependent on one another and will be explored below:
Safety is a primary concern in any relationship, and is necessary for a relationship to be and remain healthy. There are a few aspects to safety and all are important to establishing and maintaining healthy relationships. The main types of safety in healthy relationships include physical safety, material safety, and mental and emotional safety.
Physical safety is the most prominent of these and what most people think about when considering safety in relationships. This concerns whether or not you are experiencing or are at risk of exposure to physical and/or sexual violence, coercion, intimidation, stalking, harassment and other forms of abuse. This is sometimes called domestic violence or intimate partner violence. Other threats to your physical safety that are less commonly discussed include risks to your health. This may include non-consensual or uninformed sexual risk taking, cheating, tampering with or withholding medications or interfering with health or healthcare decisions. In a healthy relationship everyone should feel physically safe with their partner and their body, boundaries and health.
Material safety is often interwoven with physical safety. At its most basic, it can include everyday life pressures and stressors such as housing security, financial considerations and the ability to meet you and your partner’s needs. It can however also include security around the respect and care of your belongings, risks of damage or destruction to your property, or controlling access to finances and assets.
Mental and emotional safety are significant factors in healthy relationships. These concern our ability to be heard and understood as well as feeling safe by having our boundaries respected and upheld. Having enough space to feel and sit with our emotions and having a safe environment to express our thoughts and feelings with a partner without blame, hostility or judgment is important to be able to communicate our wants, hopes and needs.
Having mental and emotional safety does not mean that hurt feelings, jealousy, sadness or frustration won’t occur, but it does mean that you are able to express these feelings in a reasonable way to your partner without fear of their anger or rejection. Having mental and emotional safety in a relationship allows you to work through these challenges and foster stable and secure relationships. This is sometimes easier said than done, and for most people it will be a process that they constantly work with over their lifetime and relationships.
Mental and emotional safety also concerns the respect and care for a person’s health and wellbeing, so that the relationship does not become or feel like a constant sense of stress, anxiety, sadness, fear or anguish. Healthy relationships are strengthening, supportive and uplifting, even when experiencing and working through challenging circumstances and situations.
Mental and emotional safety, as well as aspects around material safety such as everyday life pressures, can and do fluctuate over time. Imbalances and stressors in these areas do not mean that a relationship is automatically unhealthy. The health of a relationship is largely down to a mindset/commitment to collaborative betterment, problem solving and team work when facing challenges.
Other aspects of safety such as physical safety, and the material safety of your possessions and property, are more concrete and this type of safety should remain constant in a healthy relationship. It is never okay to use violence, intimidation, manipulation, control, harassment or abuse in a relationship, and in many cases such behavior is unlawful.
As a person with an IVSC it can be hard to recognise when we are feeling unsafe or when we are exposed to harm, particularly if we have experienced harm and trauma at a young age, or when we have not had our physical, mental or emotional boundaries respected. It can be a good idea to check in regularly about our intimate relationships and how we feel we are treated by our partners. Early signs of unhealthy dynamics can be easy to miss. It is important to remember that we all have the right and deserve to feel safe and secure within our relationships.
Trust is another key feature of a healthy relationship and extends to all areas of the relationship, underpinning both safety and respect. Trust involves an ongoing commitment and choice to do what you can, within your ability, to maintain the safety and wellbeing of your partner, and for them to do so in return.
Having each other’s best interests at heart, being open and honest about your intentions and feelings, making decisions together and communicating openly are all important to establishing and maintaining trust in a relationship.
In a healthy relationship, partners can trust that they are each acting in ways that uphold any prior agreements or arrangements and maintain and respect one another’s boundaries. This may look like decisions around what behaviours are okay within and beyond the relationship, such as expectations around monogamy or non-monogamy, sexual health decisions and maintaining privacy or confidentiality when disclosing personal information.
For someone with an IVSC this may include information about how their body is described, disclosure of their diagnosis or what is said about their variation to whom. It is up to you to decide what information is shared about your body and with whom this information is shared.
Trust and support also extends to trusting a partner’s decision-making around their health and their body. If you are a person with an IVSC you should feel confident that your partner and loved ones trust that you know yourself best, and that you are best placed to make health decisions about your body, even if it isn’t a decision that they would make for themself..
Trust in healthy relationships extends to communication. There is often a need for trust in an individual’s ability to communicate their own needs, feelings and boundaries, especially when emotional safety has been established in the relationship. This can sometimes be taken for granted or overlooked which can be a cause for resentment. Even in an intimate relationship, we cannot know or understand what another person is thinking or feeling. Keeping secrets from your partner runs the risk of hurting them in the long run.
A key part of emotional safety is trusting that when your feelings and needs are communicated, they will be taken seriously, and respected, rather than ridiculed, judged or used against you, and that you can be honest when expressing them.
Honesty is an important part of respect too, and allows us to provide our loved ones, and be provided with, all the information needed to make decisions together.
For people with experiences of trauma, or who have had their personal boundaries crossed or broken down, trust can be difficult and take time to foster, especially in new relationships. If you struggle with establishing, maintaining or repairing trust in your intimate relationships you may wish to seek help and support from a trained therapist, psychologist or counsellor to work on your ability to self-regulate strong feelings and build trust that the world can be a safe place.
Respect is another foundational principle for a healthy relationship and is one that is intrinsically linked to all other facets of a healthy relationship.
When you have an IVSC respect may involve our partners understanding and respecting our identity, body, medical history, mental health, traumatic experiences and health decisions we have made or may wish to make. It may require someone who has the capacity to either sit with you when you are going through a tough time or give you the space you need without making you feel guilty.
Respect is showing appreciation and positive regard for one another. Being respectful acknowledges that another person has their own unique experience. Respect is necessary when creating and maintaining both safety and trust, and is instrumental in driving open honest communication.
Respect should be shared and equal within a relationship and extends to respecting a partner’s boundaries, beliefs, values and opinions, even if you do not share these.
Respect may look like listening without judgement, supporting decisions, engaging in each other’s interests and having conversations without forcing your view and beliefs or attempting to change the other person to match your convictions.
In any relationship various factors will influence who holds power, at what time and in what ways. Intimate relationships should in most cases be built on an equal, fair and balanced power dynamic, where all individuals share responsibility and control over the relationship equitably.
This does not mean that each person will have the exact same roles and responsibilities in the relationship, or that they will contribute in the same ways to the relationship. What is important is that both parties feel a shared sense of effort and contribution to the relationship and have an agreement about how the relationship looks, functions and works for them.
In some cases power dynamics may exist in a relationship where one party earns more money, works a more demanding job, owns more assets or is otherwise advantaged or privileged over their partner. This may also exist where there are additional responsibilities such as caring responsibilities for either the other party or other dependents. It may also exist where one party is more vulnerable due to past trauma and experiences.
For some people with an IVSC caring roles may be assumed by an intimate partner, either temporarily while accessing medical care or ongoing where there may be a need for this support. Employment, earning capacity, health issues and other factors may also in some cases mean that we are more dependent on support and care from our intimate partners, creating power imbalances where we can be disadvantaged in a relationship.
Another consideration for people with an IVSC is that experiences of shame, stigma and medical intervention, even in childhood, can have lasting impacts on our sense of self, self-esteem and self-worth.
Low self-esteem can predispose people to tolerate and stay in unhealthy relationships due to a fear of abandonment, worry about being alone and thinking that a better relationship or finding another partner is not possible. These thoughts can lead to excusing unhealthy, unsafe or disrespectful behaviour, minimising our own experiences or disregarding our own emotions and responses. It is important to have confidence in our internal perception of events and behaviours and to trust our “gut feelings” especially when this is backed up with evidence.
Power differences in and of themselves are okay in a relationship, however it is important to be mindful of the ways in which this can expose the person with less power to harm, abuse, and mistreatment. For more information on these harms and how they can manifest in relationships visit (link to abuse resource).
Making health decisions is an important part of any person’s life, however for those of us with an IVSC, making healthcare decisions can occur more frequently, have greater implications and be harder to make when there is less precedent or medical advice available for how to best manage your health. When making healthcare decisions it is important to remember that you do not need to change your body for your partner or for the sake of the relationship.
It is also important to note that scheduling and attending medical appointments or making healthcare decisions can be triggering for people with an IVSC. It is reasonable and can be quite helpful to ask your partner for extra support, care and sensitivity around this. How this looks will depend on your relationship, but it may include helping to book appointments, a date or fun activity scheduled before or after an appointment or spending quality time with one another.
Health decisions are an important area in which our individually expressed wishes, preferences, and sense of self hold weight alongside clinical information and medical advice. You should always be supported to make healthcare decisions that work for you and reflect what is important to you as a person.
In the context of a relationship, your healthcare decisions and choices about what happens to your body should always be respected by your partner, even if they do not agree with or support a particular decision. These decisions should also be self-directed and made for you, rather than for the benefit or preferences of a partner unless you both feel comfortable and agree on the decision.
Any healthcare decisions that involve or concern your partner should be able to be discussed in a considerate manner and you should not feel overly worried about your partner’s reaction to any health information you may wish to share. Being frightened, worried or overly concerned about how your partner may react to your health information, choices or decisions should be addressed through clear communication or with the help of an individual or couples counsellor.
If this doesn’t resolve matters, it may indicate that there is an unhealthy relationship dynamic or unhealthy behavioural patterns developing in your relationship. You should feel supported to raise these with your partner if they arise, and unpack why they may be feeling uncomfortable about a healthcare choice or decision you have made.
Your partner should also allow you to share or disclose your health information on your own terms, by being mindful to not put you in a position where you need to disclose information when you don’t want or are not ready to.
Hormone Replacement Therapy (HRT) is a medical decision that you may need to make in relation to your IVSC. Which hormone replacement options are available to you will largely be determined by your IVSC, your personal preferences and your other health factors.
HRT can be important if your IVSC impacts the amount or type of sex hormones your body produces, or if you have had a medical intervention that has removed sex hormone producing tissue from your body.
Typical sex hormones involved with HRT include estrogen, progesterone and testosterone. All bodies require a balance of sex hormones and will produce these to varying amounts. Healthy levels of sex hormones are important for general health and wellbeing, bone density, heart and brain health, energy and mood, so HRT is very commonly prescribed for people with an IVSC.
The choice of HRT should be one you feel supported to make, depending on your wishes and preferences. In most bodies particular sex hormones drive feminising or masculinising changes that may or may not align with your gender identity or wishes. However, for some people with an IVSC, sex hormones will not produce these changes. For example, someone who has CAIS can use testosterone as HRT, and will not develop any masculine features. Testosterone is in many cases preferred for its effects on mood, energy and sex drive, though these may be less desirable or not agree with someone else.
For some people with an intersex variation, HRT can be used to initiate or direct puberty development or affirm a gender identity through the physical changes it may cause.
Any decisions around HRT should be made by you and should be supported by your partner. Choices around HRT may also impact your fertility or family planning options. This may influence the health decisions you choose to make for yourself. You can find information on HRT, fertility and family planning options specific to your variation in our individual resources here:
Dilation is often a prescribed therapy to deepen or widen the vagina for some people with an IVSC or as post-operative care from a medical intervention related to an IVSC if penetrative sex is desired. The purpose of vaginal dilation is mainly to help people who wish to receive penetrative vaginal intercourse where this may otherwise be uncomfortable, painful, or limited. Vaginal dilation can also be useful if you have a urogenital sinus and urinate from the vaginal opening. If you think vaginal dilation may be useful or important to you, you may wish to discuss this with a trusted healthcare provider.
Dilation may be something that you choose to do before becoming sexual with a partner or alternatively, something you may want to involve your partner in. It is therefore important to feel that you are old enough, ready for and wanting to engage in dilation as a personal choice. Typically dilation is recommended as a clinical and therapeutic practice using medical-grade dilators. This approach can be a confronting and distressing experience for some people, though this does not need to be the case. Dilators are available in different materials like glass, silicone and plastic. Silicone is softer, gives a more natural feel and tends to mold to the shape of your vagina. Try different types to find the most comfortable fit for you.
Dilation can be as clinical or as relaxed as you wish. Some people choose to dilate as part of their own self-exploration, masturbation or sexual practices using various sex toys such as dildos and vibrators, with or without the help of a partner. Some people may also choose to practice or assist dilation through sexual intercourse and other sexual behaviours with their partner.
Dilation in this way can be an empowering and pleasurable experience when it happens on your own terms. More information about dilation is available here.
Fertility and family planning can be complex and sensitive topics in any relationship, but can be especially so if one or both people in the relationship has an IVSC. Different intersex variations and individual factors have varied impacts on fertility, alongside the implications of any prior medical interventions such as surgeries.
A partner should not make you feel bad about your body or the options available to you both because of your IVSC and/or any related medical interventions you’ve undergone. Processing complex feelings around infertility by yourself or with a counselor will put you in a better position to deal with it in a partnership with someone else.
Your fertility and family planning options will largely depend on what anatomy you have and how your body responds to any fertility treatment options.
You and/or your partner may need to make decisions around fertility preservation and/or family planning options such as assisted reproductive technologies if you wish to have children that are genetically related to one or both of you, or other healthcare decisions and options that may impact your future choices and options.
If fertility is not an option there are many ways of expressing your nurturing side as an aunt, uncle, pet parent, your role in the community and many more. You may also wish to consider other options such as fostering or adopting children and how this will impact you and your relationship.
These decisions should be discussed openly and respectfully within a relationship. Both parties should ultimately show care and respect to one another, in these discussions. When making these decisions you should never feel pressured into making a decision or doing something that you are not comfortable with. You may wish to discuss the decision and the process of making it with a trusted person or with a couples counsellor for external support,
If a partner pressures you into making a particular decision around your fertility or family planning this may be a form of abuse called reproductive coercion.
Certain decisions around fertility and family planning can also affect your sexual health. You should never feel pressured to engage in sexual behaviours with which you are not comfortable. For example, if you are engaging in sexual behaviours that could lead to a pregnancy, but your IVSC means that you are infertile, a partner should not use this to pressure you into having sex without a condom, or other barrier, against your wishes. Healthy relationships are sexually responsible relationships in which sexual health and risks are discussed, and responsibility is shared.
Sexual intimacy is a feature of many, but not all intimate and romantic relationships. Many asexual and aromantic people have healthy, intimate and caring relationships that do not involve sexual intimacy, though sexual intimacy can also exist in these relationships.
Sexual intimacy goes beyond sexual behaviours and instead concerns the dynamic of the sexual relationship and the sense of safety, security and communication involved.
Sexual intimacy with a partner means that you are able to openly and respectfully discuss all elements of your sexual relationship, sexual decision making, boundaries, likes and dislikes and the things you are uncomfortable with or nervous about. Sexual intimacy also involves health choices and decisions around sexual behaviors such as taking equal responsibility for any contraceptive needs or family planning measures and your sexual health.
Sexual behaviours you and your partner engage in should be consensual and involve fully informed consent from all parties. This includes disclosing any relevant knowledge upfront such as your sexual health status, or any other intimate sexual and/or romantic relationships you have had recently. It may also include information such as when you last had sexual health screening and any important boundaries or hard limits you have.
You may also wish to discuss any previous traumatic physical or emotional experiences that might influence your ability to engage in sex, or any of your likes and dislikes. What you choose to discuss is up to you and your partner and should be something you mutually agree upon. You should not feel pressured to disclose anything you are uncomfortable with, or do not wish to talk about that relates to your sexual history or your intersex variation. It is only important to discuss aspects of your sexual history where the information is relevant to the health of your partner, such as any current or ongoing sexually transmitted infections, or if you have other sexual/romantic/intimate partners.
For people with an IVSC these conversations may include additional information about your diagnosis or medical history that could be relevant, such as what feels pleasurable or painful, what things may be off limits or anything you wish to share about your body that you feel is important for your partner to know.
Sexual behaviours and sexuality in a relationship should be based around mutual enjoyment. You should never feel any pressure to engage in anything you do not want to or that you find uncomfortable or painful for the pleasure or benefit of your partner. Your partner should not make you feel bad for not engaging in these behaviours with them. If it is not mutually enjoyable, you should ask yourself whether you are repeatedly ignoring your needs to please the other person.
Sex is an expansive term that can include a large range of activities and behaviours. What sex looks like for you in the context of the relationship, is up to you and your partner/s. You may wish to try something new or express interest in experimentation or a certain behavior with your partner and this should be something that you should feel confident to discuss with your partner. In a healthy relationship you would ideally feel supported and encouraged when discussing what you want, though it is most important that you feel safe and respected.
Fear, judgment, disparaging comments or ridicule may be signs that your relationship is not healthy and is lacking in sexual intimacy. More detailed information on sexual relationships for people with an IVSC is available here.
Understanding our own boundaries, likes and dislikes can be easier when we have a good understanding of ourselves. Self-exploration and experimentation can be an important part of developing this understanding by figuring out what works for your body and what you find pleasurable before involving another person.
For people who have discomfort and trauma with their body or genitals, neutral, safe and gradual self-exploration can help build comfortability and confidence and even introduce elements of pleasure, desire and sensuality that may have otherwise been difficult to access.
Experimenting with different kinds of touch and sensory input can be an act of self-care and help to reconnect you with yourself and your body. It may also help you to connect with a partner by being able to describe and communicate what it is that you enjoy sexually or to show your partner how you like to be touched and what feels good for you.
Self-exploration may involve sensual touch, masturbation, trying out new sexual behaviours or sex toys. It may involve reading and researching different things that may interest you that you wish to try out alone or with a trusted partner. It may also involve seeking professional help from someone like a somatic or sexological bodyworker.
You should not feel bad or guilty for prioritising your needs, pleasure and enjoyment by making time for sexual self-exploration. A confident partner who knows their body and needs is in a much better position to offer healthy boundaries and consent when it comes to mutual pleasure.
Boundary setting is an important but often challenging aspect of relationships. Our boundaries are the limits of what we are comfortable with and help to keep us safe. If we are not familiar with establishing, communicating and maintaining our boundaries doing so can feel confronting, and may even feel rude or inconsiderate. This is especially true when we have past experiences where our boundaries have not been upheld or respected and we may have become accustomed to compromising our needs in favour of someone else’s.
Setting boundaries is about what you feel safe and comfortable with and making choices around your own actions and behaviour. Boundary setting is not about attempting to control or change your partner’s behaviour, however may dictate how you choose to respond to these.
Boundary setting also requires a degree of self-confidence and assertiveness to maintain. This means when a boundary is challenged, you can push back on this and maintain a firm healthy boundary.
Setting boundaries is an act of self-care and is important for a healthy and respectful relationship. Sometimes if our boundaries are crossed we may notice that we become angry or resentful toward the person who crossed them. Boundaries allow you to avoid assumptions about one another and what is important in your relationship. Self-care fills your cup so that you are not trying to continue to give from an empty cup.
This is an area in which communication, trust, and respect are crucial. Setting boundaries can be a process that exposes any challenges or weaknesses in the health of your relationship. This is a great opportunity to address, discuss and strengthen your relationships.
Setting boundaries should be a positive change in your relationship and not something marked by fear, anxiety or distress. If you notice these responses when setting boundaries in a relationship you may wish to discuss this with a therapist or counsellor who can offer you insight, support and strategies to work with and manage your feelings.
Disagreement is a natural and healthy part of relationships as it is a common result of open and direct communication. Our opinions, views and values are integral facets of our personality and identity. How we choose to hold and express these is also important to how we relate to people in our lives. For some people with an IVSC their variation is an important part of who they are, while for others it is not something that they consider to be of much importance. The way you understand, relate to and discuss your variation may influence decision-making, discussion and conflicts in your relationship, particularly if this is not well understood or respected by your partner. Differences in these areas help introduce us to new ideas, perspectives and ways of thinking about the world. These disagreements can also form the basis of many useful and productive conversations.
In relationships it is generally important for most people that their morals, values and goals align with their partner, though this may not always be the case. It is important however that a healthy dialogue can exist where all parties feel able to share and express their thoughts, beliefs and what is important to them, without feeling like the other person is trying to change, influence or pressure them.
Disagreeing respectfully and peacefully resolving conflict in a relationship is an important skill that may need to be developed and practiced. Often this comes down to taking responsibility for your behaviour, emotional self-regulation, introspection and non-violent communication skills.
This means that to have respectful disagreement and resolve conflict in relationships we must first understand ourselves and be able to reflect on how we think, feel and communicate. For people with an IVSC your acceptance, self esteem and self-awareness around your variation can affect your capacity to engage in conflict resolution. For example, poor self esteem or having a negative view of yourself because of your IVSC can make it difficult to assert healthy boundaries and stand up for yourself in conflicts. This means you may be more likely to be influenced by or agree with a partner, going against your own feelings about the situation. To have these conversations all parties should have equal opportunity to speak and be listened to with respect and integrity. Compromise may or may not form an important part of conflict resolution within relationships.
It is important to decide what is important to you, your partner and the relationship, and to know what areas you have control over and input into. Some small disagreements may not impact the relationship but larger or more significant ones might, especially where core values and beliefs are challenged.
How greatly disagreement impacts your relationship is largely determined by the value you place on the topic of disagreement. For example, disagreeing over your favourite food is likely to have less impact than a disagreement about where you want to live or choices about the relationship such as marriage or having children.
Sometimes a conflict or disagreement within a relationship is too significant and can contribute to or even bring about the end of the relationship. In some cases this may be the safest or healthiest choice, if the disagreement or your partner’s position requires you to disregard your own thoughts and feelings, crosses your boundaries or compromises your health, safety or wellbeing.
Having happy, healthy relationships as someone with an intersex variation is not only possible but achievable. Individuals engaging in healthy relationships will have disagreements. Safe and healthy conflict can be an opportunity for couples to embrace them as opportunities for growth and deeper connection.
It’s essential to approach disagreements with respect, empathy, and an open mind. Communicate your thoughts and feelings clearly, and be willing to listen to your partner’s perspective without judgment. Prioritise creating a safe space where both parties feel valued and heard. Trust is built when each individual feels secure in expressing their true selves without fear of reproach.
Remember, the goal is not to “win” the argument but to understand each other better and find a resolution that respects both parties’ needs and boundaries. By engaging in healthy disagreements, individuals in relationships can build trust, foster mutual respect, and create a stronger, more resilient bond.
Ultimately, fostering healthy relationships is about ensuring that everyone feels safe, respected, and valued.
InterLink acknowledges the Traditional Owners of the lands on which we work and pay our respects to Elders past, present, and emerging. We recognise that soverignty was never ceded and honour the continuation of Aboriginal and Torres Strait Islander connection to land, waters, and culture. We celebrate the rich diversity within our communities, extending our respect to all First Nations peoples.