Measuring Laypeople’s Notions of Intersex: Construction and Validation of the Intersex Knowledge and Attitudes Scale (IKAS) in the Netherlands and Flanders

Abstract Introduction Intersex people can face serious stigmatization and discrimination, which may be reinforced by a lack of information and knowledge in the general society. The first objective of this study was to develop and validate a scale for measuring both knowledge of the term intersex and attitudes toward intersex people in the general population. A second aim was to establish a baseline measurement in a representative sample in the Netherlands and Flanders. Methods A scale was developed after a carefully documented stepped process of literature review, expert consultations, and pretesting. A representative sample of 2003 respondents took part in the baseline measurement in 2020. Results Two-thirds of the sample had no (correct) knowledge of the term intersex. Even among the intersex respondents, only one person was aware of the term intersex. The average attitude was moderately positive to neutral. Having a female gender or sex assigned at birth, an advanced level of education, lower importance of religion, belonging to a minority group, more tolerant gender beliefs, and preexisting knowledge on the topic all resulted in more positive attitudes. After validity analyses and based on the baseline measurement, the “Intersex Knowledge and Attitudes Scale” (IKAS) was finalized. Conclusions The results of the baseline measurement indicate that in both countries, there is room for improvement in terms of knowledge and attitudes toward intersex people. To increase acceptance of intersex people in society, knowledge about intersex in the general population should be expanded, and acceptance of people who do not fit into the binary should be promoted. Policy Implications It is vital to include intersex in monitoring studies of population attitudes, to be able to genuinely incorporate the “I” in LGBTI + in emancipation policies. The IKAS can inform and support policy, and can also increase exposure to information about intersex in the general population.