Intersex is a term that refers to a range of medical conditions whereby the genetic makeup of an individual is different from their sex organs. For example, a person who is genetically female may have testes instead of ovaries or a genetic male may not have a penis. These medical conditions affect around 1.7% of the world’s population, an almost equal amount of people across the world as there are redheads, and yet it is a fairly hidden condition, unknown to most.
Intersex Surgery on Children
In 2017 Belgian model, Hanne Gaby Odiele, made headlines with a public announcement that she was intersex. In the video, she called for an end to “traumatising” surgeries which are performed on young children and infants in order to conform them to the binary conception of gender. She describes the traumatic process of countless surgeries that she underwent as a child in an attempt to “normalise” her, resulting in recurring physical ailments as well as psychological distress. Since the mid-60s doctors across the world have been routinely performing such “normalising” surgeries on children, long before they are capable of deciding for themselves whether they want these procedures.
The idea behind these surgeries is based on the work of Dr. John Money, an American doctor who specialised in gender identity and advocated that gender was a socially malleable construct. He was made famous by the tragic case of David Reimer. David Reimer underwent a botched circumcision as a child, destroying his penis. Dr. Money advised that the child undergo surgery to change his genitalia from male to female, his name be changed to Brenda, and he be raised as female. Brenda had many mental health issues as a child and was eventually told of her gender reassignment at 14. She transitioned back to her original gender and became known as David, once again. David continued to suffer from mental illnesses and eventually took his own life at age 38. Despite this tragic outcome, the surgery was hailed by Dr. Money as proof that gender could be socially constructed, a sort-of nurture triumphs nature viewpoint.
In May 2018, California became the first US state to condemn unnecessary surgery on intersex children. The state recognised that while certain surgeries on intersex children can sometimes be necessary from a medical point of view, cosmetic surgery can be “unnecessary, irreversible, often traumatising and carries a risk of lifelong harm” according to Human Rights Watch. Such surgeries have been condemned by the WHO, Physicians for Human Rights, Amnesty International, the UN, the FRA and the Council of Europe, Malta, Australia and many other countries and organisations. The practice is often likened to Female Genital Mutilation and there is a growing body of medical research which shows that such early, unnecessary surgeries can lead to physical and psychological harm or trauma for intersex people, including the risk of assigning the wrong sex. There also exists insufficient evidence demonstrating that a failure to have such surgeries leads to the individual struggling in society.
In Ireland, births and sex must be registered within three months. In exceptional cases, consent may be obtained by the Registrar for a period up to a year. Ireland is one of 21 European countries where “normalising” surgeries continue to be performed, although their frequency is decreasing. Consent is required once the individual is of a certain age with adequate cognitive abilities and the ability to decide, usually around 15, but this does not apply in the case of young children. There lacks any formal medical protocol when dealing with intersex children in Ireland.
What needs to change?
The Council of Europe and the Fundamental Rights Agency, alongside several other NGOs and lobby groups, have called for an end to “normalising” surgeries without the informed consent of the intersex individual. They also call for the establishment of international medical protocols for surgeons and medical staff when dealing with intersex patients. From a legal perspective, rights groups have called for the prohibition of such surgeries and, in Ireland, are currently lobbying for legal recognition of a third, non-binary gender under the Gender Recognition Act 2015.
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