There are two main ways of determining the sex of a fetus prior to birth. One is, basically, looking: an ultrasound at 20 weeks of pregnancy gives you (well, professionals) a pretty good look at fetal anatomy, and that includes the genital region.
The other, which has only become mainstream in the past 10 years, is through genetic testing earlier. A pregnant person can have their blood drawn around 12 weeks of pregnancy and that blood can be tested for the fetus’ genetic material, including whether said fetus is XX , XY, or another combination.
And that also leads to intersex: not all people are born with either XX or XY sex chromosomes, nor are all people born with what you might think of as the “standard” set of reproductive organs and systems. “Intersex” is a broad term that encompasses a range of individual conditions and body types that fall under that umbrella, outside of the binary. (This is different from someone having a non-binary gender identity, as sex and gender are not interchangeable.)
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