The Human Rights Watch and interACT note in a 185-page report they released on Tuesday that intersex people in the U.S. “are subjected to medical practices that can inflict irreversible physical and psychological harm on them starting in infancy.”
The report summary indicates intersex children have undergone surgeries that “reduce the size of the clitoris for cosmetic reasons” and remove gonads that force them to receive hormone replacement therapy for the rest of their lives.
“Many of these procedures are done with the stated aim of making it easier for children to grow up ‘normal’ and integrate more easily into society by helping them conform to a particular sex assignment,” it reads. “The results are often catastrophic, the supposed benefits are largely unproven, and there are generally no urgent health considerations at stake.”
“Procedures that could be delayed until intersex children are old enough to decide whether they want them are instead performed on infants who then have to live with the consequences for a lifetime,” adds the report.
Researchers interviewed 30 intersex adults, two intersex children, 17 parents of intersex children and 21 healthcare providers who work with intersex people. The report includes testimony from those who underwent so-called “normalization” surgery as children.
Dierdre, a 55-year-old intersex woman, told researchers she has had at least six surgeries between 1970-1978.
“I basically recall pain and hurt . . . down there . . . in the genital area,” said Dierdre.
An intersex woman in California discussed the impact of having doctors examine her body when she was a child.
“All of these exams on my body as a kid sent a strong message that I was freakish, and that I had something wrong with me that had to do with my sex,” she said.
Surgeries ‘assault on our bodies’
The report notes 1.7 percent of babies are born intersex. It also indicates one out of every 2,000 of them are “different enough that doctors may recommend surgical intervention.”
Surgeries to “normalize” the sex of intersex children emerged in the U.S. in the 1960s.
InterACT Executive Director Kimberly Zieselman on Tuesday told reporters and advocates who attended a Chicago press conference that medical providers have committed “assault on our bodies.”
Zieselman and others who spoke noted some medical providers have begun to refuse to conduct these surgeries on intersex children. Zieselman stressed it is “not enough.”
“It’s time for these surgeries to stop,” said Zieselman. “These surgeries tell us we need to be erased before we can tell them who we are.”
The State Department last October issued a statement on Intersex Awareness Day that stated intersex people “routinely face forced medical surgeries that are conducted at a young age without free or informed consent.”
“These interventions jeopardize their physical integrity and ability to live free,” it read.
Former U.S. Surgeons General Joycelyn Elders, David Satcher and Richard Carmona last month expressed their opposition to “normalization” surgeries for intersex children that are not medically necessary. Zieselman on Tuesday noted the U.S. Department of Health and Human Services last year added intersex people to those who fall under the provision of the Affordable Care Act that bans discrimination in health care based on sex.
“Of course now we have a new administration,” she told the Washington Blade.
The U.N. Special Rapporteur on Torture in 2013 issued a report that notes intersex children who undergo “involuntary genital normalizing surgery” face a series of complications that include “irreversible infertility.” The World Health Organization is among the international bodies that have also taken a position against the practice.
The Associated Press on Tuesday reported the American Medical Association is considering a proposal that would discourage “normalization” surgery on intersex children. The news wire said other U.S. medical associations are also reviewing the issue.
“The U.S. government and medical bodies should put an end to all surgical procedures that seek to alter the gonads, genitals or internal sex organs with atypical sex characteristics too young to participate in the decision,” said Human Rights Watch and interACT in a press release that announced their report.
A law that took effect in Malta in 2015 bans doctors from performing “surgical intervention on the sex characteristics of a minor” until he or she can provide “informed consent.”
The Chilean government in 2016 released guidelines that urge doctors to no longer perform “normalization” surgeries on intersex children. Germany since 2013 has allowed parents to designate the gender on their children’s birth certificates as “indeterminate.”