a framework for intersex justice
Intersex justice is medical justice. Intersex surgeries hurt everyone.
These medical violations bring immediate harm to the child who is subjected to them.
Parents who consent to medically unnecessary surgeries participate in a culture of shame, silence and stigma, perpetuated by doctors, that allows these surgeries to continue. Parents are often left to fend for themselves as they navigate shame and guilt. The issue of parents consenting to these surgeries is especially complex when societies believe that children don’t have individual rights and that parents are always acting in their best interest.
Medical practitioners such as pediatricians, obstetricians, urologists, social workers, and endocrinologists all play a role in upholding an institution that continues to harm children with intersex variations. The practitioners, in turn, are protected by hospitals and state laws that grant them immunity.
This is why intersex justice is important.
Although the framework is evolving, the following is a definition of intersex justice co-created with Dr. Mel Michelle Lewis (they>she), an Associate Professor of Gender/Sexuality in Studio and Humanistic Studies at Maryland Institute College of Art:
These medical violations bring immediate harm to the child who is subjected to them.
Parents who consent to medically unnecessary surgeries participate in a culture of shame, silence and stigma, perpetuated by doctors, that allows these surgeries to continue. Parents are often left to fend for themselves as they navigate shame and guilt. The issue of parents consenting to these surgeries is especially complex when societies believe that children don’t have individual rights and that parents are always acting in their best interest.
Medical practitioners such as pediatricians, obstetricians, urologists, social workers, and endocrinologists all play a role in upholding an institution that continues to harm children with intersex variations. The practitioners, in turn, are protected by hospitals and state laws that grant them immunity.
This is why intersex justice is important.
Although the framework is evolving, the following is a definition of intersex justice co-created with Dr. Mel Michelle Lewis (they>she), an Associate Professor of Gender/Sexuality in Studio and Humanistic Studies at Maryland Institute College of Art:
Intersex justice is a decolonizing framework that affirms the labor of intersex people of color fighting for change across social justice movements. By definition, intersex justice affirms bodily integrity and bodily autonomy as the practice of liberation. Intersex justice is intrinsically tied to justice movements that center race, ability, gender identity & expression, migrant status, and access to sexual & reproductive healthcare. Intersex justice articulates a commitment to these movements as central to its intersectional analysis and praxis. Intersex justice acknowledges the trauma caused by medically unnecessary and nonconsensual cosmetic genital surgeries and addresses the culture of shame, silence and stigma surrounding intersex variations that perpetuate further harm.
The marginalization of intersex people is rooted in colonization and white supremacy. Colonization created a taxonomy of human bodies that privileged typical white male and female bodies, prescribing a gender binary that would ultimately harm atypical black and indigenous bodies. As part of a liberation movement, intersex activists challenge not only the medical establishment, which is often the initial site of harm, but also governments, institutions, legal structures, and sociocultural norms that exclude intersex people. Intersex people should be allowed complete and uninhibited access to obtaining identity documents, exercising their birth and adoption rights, receiving unbiased healthcare, and securing education and employment opportunities that are free from harm and harassment.
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This framework serves a radical vision where intersex children are protected and survivors of genital cutting are cared for and respected. We owe that to intersex people and we owe that to ourselves.
The implementation of an intersex justice framework should include the following components: |
Poster art by Saifa and Micah Bazant
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Parents often consent to surgeries because of their trust in medical professionals. More often than not, doctors are not forthcoming about the long-term effects of intersex surgeries that include scarring and loss of sensation for genital procedures, and the permanent reliance on hormone replacement therapy. By creating a model of consent based on survivor accounts and current patient experiences, parents and children would be made aware of every possible risk in order to make informed decisions about hormones and surgery.
Governments have the capacity to address harm through financial compensation. Reparations for intersex people would look like gender-affirming care in the gender that they choose, paid for by the federal government through Medicaid/Medicare or provisions in private health insurance (in the United States). If medical harms have caused a physical, mental, or emotional disability, financial compensation should be awarded to account for the trauma caused.
Except for a senate resolution in California (SCR-110) that urged medical professionals to reconsider surgeries on intersex infants, there are no protections for intersex children in the United States. Even though the resolution was a step in the right direction, surgeries are still continuing in California and the rest of the United States.
Protections for intersex children should start from birth. Most of the surgeries done on intersex children are purely cosmetic and medically unnecessary. Surgery should be delayed until a child has the right to consent to procedures that feel good for them. How is it that we continually deny surgeries for transgender kids, but force sex reassignment surgeries on intersex children? In countries where intersex people are denied human rights based on intersex status, laws should be created to explicitly protect intersex people and allow them full inclusion in society.
Protections for intersex children should start from birth. Most of the surgeries done on intersex children are purely cosmetic and medically unnecessary. Surgery should be delayed until a child has the right to consent to procedures that feel good for them. How is it that we continually deny surgeries for transgender kids, but force sex reassignment surgeries on intersex children? In countries where intersex people are denied human rights based on intersex status, laws should be created to explicitly protect intersex people and allow them full inclusion in society.
The doctors who continue to do these surgeries have faced no consequences from their colleagues or medical/research institutions. The implementation of intersex justice means that doctors would have to prove that medical intervention is necessary and physician bias would automatically be interrogated. Doctors continuing to provide these procedures in states where intersex surgery is illegal, would not be allowed to practice medicine and subsequently have their licenses revoked.
Change medical terminology from disorder and reclassify intersex variations: Intersex justice is both reclaiming and removing intersex identities from the purview of the medical establishment. Historically, the medical establishment has referred to intersex people as “hermaphrodites” or “pseudohermaphrodites.” This terminology existed in medical texts until 2006, where intersex people were classified as having “disorders of sexual development.”
Intersex people are not disorders. Intersex is not a pathology. Intersex bodies are not meant to be fixed. The category of intersex should be removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and references to disorder should be replaced with terms such as “intersex variations” or “variations in sex characteristics.”
Intersex people are not disorders. Intersex is not a pathology. Intersex bodies are not meant to be fixed. The category of intersex should be removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and references to disorder should be replaced with terms such as “intersex variations” or “variations in sex characteristics.”
The fight for intersex justice is rooted in consent and recognizes that a child has rights. Practitioners and organizations such as the CARES Foundation frame this as a parents' rights issue, but children should have dominion over their bodies. Unless a child is at risk of dying should surgery should be done, but genital and/or gonadal surgery should be avoided at all costs until the child is old enough to make that decision for themselves.
Intersex variations require individual and specialized attention. Some people who come out as intersex later discover that they were diagnosed with one variation and had something completely different. Misdiagnosis is particularly devastating to intersex people who eventually transition from one gender to another. So often these people have survived genital cutting and years of misinformation about their bodies. A restorative model of healthcare for intersex people would respect a person’s choice around gender identity, explore reproductive options, and offer hormonal support that allows intersex people to be in their full humanity.