Among all the current discussions centered around gender identity as a spectrum, whether or not people believe it is different from the sex binary male-female, there is often the misconception that biological sex can be divided in as rigid, distinct categories as it sounds. However biological sex is found on a spectrum as well – even more than a spectrum, no person’s biological characteristics are exactly the same to the next person’s.
Intersex people are the people who are born with sex characteristics (that is biology, not the gender they identify with) that don’t fall under the male-female categories in the way that the medical community and thus society defines them. More specifically, and according to the definition of OII Europe: “Intersex individuals are persons who do not match medical and societal norms of so called female and male bodies with regard to their chromosomal, gonadal, endocrine or anatomical sex.” This means that the chromosomes, hormones, genitalia, secondary sex characteristics (muscle growth, menstruation, hair growth and essentially everything that happens in puberty) in Intersex people may vary in ways different than expected in what the medical community categorizes as either female or male.
That does not mean that Intersex people are in any way abnormal or in need of a “cure”. Most Intersex people’s health is not when they are born and will not be negatively affected during their lifetime because of their Intersex variation. Of course that is not always the case, but more often than not Intersex people can live full, healthy lives, without any intervention the sole purpose of which is to make a person’s sex conform to what we’ve been taught to have in mind about what it means to be assigned “male” or “female” at birth. Some Intersex variations are not visible at birth. Some Intersex people learn at some point in their life by chance, after having reproduction-related tests, or never learn at all. Today (the number varies depending on different studies) we know that about 1 in 200 people is born Intersex.
The oppressive history of unnecessary medicalization of Intersex people is the reason Intersex activists inform allies that we should avoid pathologizing language that has often been used in derogatory ways, such as “hermaphrodites”, “Disorders of Sex Development (DSD)” “Intersex conditions” or medical terms describing Intersex variations. Instead, terms such as “Intersex people” or “Intersex variations” are suggested.
Although most Intersex people don’t need surgeries (or at least as many as are performed) for health reasons, even in what we call “developed countries”, nonconsensual surgical interventions which, most of the time, can be described no differently than genital mutilation still take place today. These are normalizing procedures aiming to make a baby or child’s body look more typically male or female – they are often cosmetic surgeries, with no proven positive health value. Doctors often decide rather arbitrarily the gender a child will socially be brought up in, and convince the worried panicking parents to consent, often without providing sufficient information and based solely on the power of scientific expertise.
There are many reasons for which these non-consensual medical interventions (including clitoral reductions, vaginoplasties, gonadectomies and others) need to stop immediately. These surgeries are performed on children who cannot give consent, often starting from infancy. These children most of the times grow up without knowing they are Intersex, being told lies about their health and the frequent visits to the hospital for follow-up surgeries and hormone treatments. These children often have to fight as adolescents or adults to learn the truth about their medical history, since the families of Intersex children are usually encouraged by doctors to bring up their children in secrecy, which enhances shame and stigma, and makes it particularly hard for particularly valuable communities of Intersex communities to be formed and gain visibility.
As Intersex activist Morgan Carpenter says: “Genital mutilations don’t take place because infants have a particular identity. They take place because the kids are considered to be disordered – and this is wrong. The only disorder in most cases is that our bodies don’t fit medical and social expectations of what it means to look male or female.”
In addition, many of these surgeries may actually be have an impact on people’s health that is more harmful than positive, trapping them in a circle of constant experiments with hormones and additional operations that can negatively affect the health of the individual, compared to what would be the case if the person’s body was left with its initial organs and produced hormones naturally.
People who have undergone genital surgeries in childhood (usually just in order to be able to have heterosexual sex later in life, despite whether or not this will actually be their choice) will most likely have trouble enjoying sex at all. Parents of children who have a vaginoplasty, as explained by Gina Wilson of OII Australia, “[…] will have to insert a dilator into their baby’s vagina at first on a daily basis and then on a weekly basis until their child is old enough to do it itself. This is the therapeutic sexual penetration of one’s own child. Consider the psychological effects of that.” Intersex people are often used in inhumane medical processes, such as being inspected and presented for purely academic reasons by one doctor after the other without their consent. It has even been recorded that doctors have subjected infants to sexual stimulation to see if their newly constructed clitoris reacts as expected. Such procedures may have irreversible psychological effects on Intersex children.
There are also very few long-term studies that confirm the efficacy of these surgeries, especially surgeries of people over thirty, or including people with several specific variations that are the cause of many Intersex Genital Mutilation operations. To add to that, we do have a study that shows that unconsented genital surgeries conducted in infancy and childhood leave adults dissatisfied and harmed by the results. These results may include pain, loss of sexual sensation and pleasure, involuntary sterilization, and the need to be on long-term hormonal treatment with many risks for the person’s wellbeing.
Moreover, the gender that the doctors decide to assign to a child will not necessarily be the one the individual will identify with. As we mentioned already, an Intersex person may have any gender identity – cis or trans, binary or non-binary – as well as any sexual orientation (straight, gay, bi, asexual, and so on), just like a dyadic (= non-Intersex) person. These surgeries are irreversible, so if the individual decides to transition to their correct gender later in life – which is often the case – things become very difficult.
An Intersex activist explains that, following corrective surgery on her genitalia, she then had to start taking hormones of the type used by menopausal women in childhood, ending up suffering from osteoporosis at a very young age. Such outcomes greatly affect the physical and mental heath of Intersex people who may often suffer from discrimination, stigma, and even feel suicidal.
As a result, several UN treaty bodies such as the High Commissioner of Human Rights and the Committee Against Torture have characterized Intersex Genital Mutilation as a harmful practice and numerous human rights organizations call for its end. The UK was condemned for human rights violations, tortures and crimes against the child, based on a review of the United Nations Committee on the Rights of the Child (UNCRC) using the data of the human rights organisation IntersexUK.
So, what is there to be done for Intersex Genital Mutilation to come to an end?
Parents need to be given true and full information concerning what is vital and what not for their child’s health, and for which reasons. Parents need to give fully informed consent concerning their child when the issue is a pressing health matter, and not for cosmetic reasons.
The bodily autonomy, physical and psychological health of Intersex children need to be prioritized over our fixation with bringing them up in a binary world, and force-fitting bodies that may be perfectly healthy in fixed boxes, risking severe threats to the wellbeing of the individuals as children, teenagers and adults.
Medical practitioners need to be trained to treat Intersex children in a way that will not impair them in their lives as adults – and the dialogue with adult activists who have undergone or not surgeries in childhood is vital.
As allies of Intersex people we need to raise awareness on the issue and support the voices that advocate for change. We shouldn’t speak over Intersex voices for their needs, but we need to give them the space to phrase them and support their cause. Intersex groups and organizations need funding – we can speak up for that, donate and encourage those who support Intersex initiatives. But what’s even more important: we need to educate ourselves, and we shouldn’t expect Intersex people to do that for us.
If you are not familiar with the issues Intersex people face, there are many resources on the web, as well as movies, books and stories by and for Intersex people. Here is the resource page of ILGA (International Lesbian and Gay Association) on Intersex issues. Here you can find the publications of OII (Organization Intersex International).