The United Nations Special Rapporteur on Torture (SRT) just released a statement condemning the medical profession’s nonconsensual treatment of intersexuality. Although intersexuality—which surfaces as “ambiguous” external genitalia, sexual organs and/or as sex chromosomes that deviate from normative expectations—rarely poses a health threat, the medical profession continues to perform irreversible surgeries on babies and young children to “normalize” genitalia under the guise that these procedures will save one from enduring a life full of shame living in their “abnormal” body.
However, there is ample evidence from feminist scholars that these normalization surgeries harm more than they help individuals with intersex traits. Sociologist Sharon Preves made this explicitly clear a decade ago in her book Intersex and Identity: The Contested Self. More recently, anthropologist and bioethicist Katrina Karkazis has offered even more proof in her book Fixing Sex: Intersex, Medical Authority, and Lived Experience.
Given that the SRT is responsible for investigating and reporting to the UN on questions of human torture, it is telling that these medical practices are being recognized under such purview. The SRT’s powerful position throughout the world leaves us optimistic that these surgeries will get the public criticism they desperately need.
Committed to human rights, the SRT invited Advocates for Informed Choice (AIC), a leader in the fight for intersex rights, to testify on the medical treatment of intersex. The hearings resulted in the SRT’s formal stance against irreversible, involuntary and nonconsensual medical interventions. To quote the SRT’s report, “These [genital-normalizing surgeries] are rarely medically necessary, can cause scarring, loss of sexual sensation, pain, incontinence and lifelong depression and have also been criticized as being unscientific, potentially harmful and contributing to stigma.” AIC’s Executive Director, Anne Tamar-Mattis, described this recognition as “a very significant development.”
While this is progress for the intersex community, there are still some serious roadblocks to overcome for social change to occur.
One of the reasons why these irreversible surgical interventions continue is because the “diagnosis” is presented as a medical “emergency” to the parents of babies and young children with intersex traits. By constructing intersex traits as medical emergencies, medical providers create an urgent problem that only they can solve. The process begins with a wild goose chase for medical markers of one’s “true” sex, despite the difficulties of such a task given that there are few, if any, clear markers of sex. After the medical providers have crafted their best guess of one’s “true” sex, irreversible treatments are recommended to parents. In response, parents usually offer their consent to the suggested medical interventions because, like most of us, they defer to medical expertise.
Another reason these medically unnecessary surgeries continue is that parents rarely, if ever, are told that these irreversible interventions are almost always cosmetic and can result in loss of sexual pleasure, feelings of abnormality and even emotional harm. We doubt parents would consent to such elective procedures if they knew these dangerous outcomes. This is hardly informed consent.
Until the medical profession acknowledges that intersex traits are not abnormalities that need to be fixed, but rather a naturally occurring variation, surgeries will continue. We aren’t suggesting medical providers are evil people. Their intentions may be in the right place, but their surgical responses are not. The medical profession must recognize that genitals are not one-size-fits-all. Vaginas vary in appearance. So do penises. Intersex traits are not abnormalities but part of the larger picture of sex variance.
As feminist scholars have suggested before, we need to radically reorient the discussion around the socially constructed nature of gender and sex and foster a politics of belonging, where such variations are valued rather than surgically erased.
Intersexuality is hardly ever a medical concern. If we want to improve the lives of those born with intersex traits, we should begin by acknowledging how diverse all bodies, genitals included, actually are. We suspect such a project would be liberating for all of us regardless of our genital appearance.
This post was coauthored by Erin Murphy.