If the coronavirus hits hardest at the margins, among the most marginalised are those born intersex, neither clearly male nor female at birth and often struggling as adults with the fallout. The impact on intersex people can be economic, medical or emotional, health experts say, and can worsen with isolation, as the pandemic limits access to healthcare and support.

Advocates worry about a prolonged lockdown for these already-isolated people, many traumatised by childhood operations that were not needed and carried out without consent to make their genitalia more masculine or feminine.

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The United Nations estimates 1.7% of people are intersex, born with atypical chromosomes or sex characteristics.

Alex David lives alone in Brisbane, Australia, and has post-traumatic stress disorder. David, who uses the pronouns they and them - feeling neither male nor female - had genital feminisation surgery at birth, and then again several years later, but was not told until aged 17.

"Because of my situation I'm a bit worried about going to the hospital for any health issues," said the 36-year-old, who has other underlying health conditions. My specialist told me if I caught COVID-19, it would be potentially deadly. So I'm just having to sit tight."