On Intersex Infants, Including Clitoral Reductions and Vaginoplasties | Advocates for Intersex Youth
Children born with intersex traits—variations that cause their bodies to transcend typical notions of male and female—continue to suffer brutalizing and traumatic surgeries performed without their consent, often before they are even old enough to speak. Today, May 12th, 2017, marks the opening of the annual conference of the Society for Pediatric Urology in Boston, Massachusetts. Some pediatric urologists across the United States continue to perform operations that have no medical indication on vulnerable intersex infants, including irreversible surgical sex assignment, clitoral reduction, sterilization, and vaginoplasty—surgery that can safely be delayed until the individual is able to participate in the decision-making process. These surgeries, which both are medically and legally controversial, carry risks of unnecessary anesthesia on the developing brain, the subject of a recent FDA warning, and have well-known complications including incorrect sex assignment, loss of sexual function and sensation, incontinence, and high levels of psychological distress.
Despite recognition by a group of international experts of the “plea by social scientists and support groups to avoid irreversible surgery at an early age when the concerned individual has no voice, and must rely on a surrogate (parent) to decide,” SPU has failed to recommend implementing simple measures that would protect vulnerable intersex children and their families who rely on pediatric urologists to provide safe, evidence-based care. Building on recommendations from such international human rights bodies as the United Nations, Amnesty International, and the World Health Organization, as well as US-based medical associations such as GLMA: Health Professionals Advancing LGBT Equality, interACT joins the chorus of voices urging SPU to support the human rights of children to bodily autonomy by issuing clear, unequivocal guidance calling for a delay of all medically unnecessary interventions until the intersex individual can participate in decisions. Additionally, working with the intersex community and allies, pediatric urologists could develop a process of immediate support and education for families that begins at the moment of diagnosis. A process deferring irreversible interventions encourages healthy parenting of children with unusual genitals. Urologists who care for, and about, these patients must develop skills and training to facilitate high-quality outcomes in individuals who do desire cosmetic alteration. Like all patients, intersex people deserve to be free from medically unnecessary interventions, to make their own medical decisions, and to enjoy psychological and peer support.
“We know that many doctors are opposed to early surgery that has no clear benefit and can be safely delayed, and there are individual doctors out there doing the right thing,” says Kimberly Zieselman, interACT’s Executive Director. “But it is high time that SPU, and other US-based medical associations tasked with caring for our children, make clear that they do not condone their members continuing to perform these surgeries in infancy, and that they support educational programs supporting families and maintaining children’s human rights. We invite SPU to join us on the right side of history.”
interACT: Advocates for Intersex Youth is an intersex-led nonprofit dedicated to advancing the legal and human rights of children born with intersex traits. Founded in 2006, interACT oversees the largest youth-led intersex advocacy group in the United States, is at the forefront of intersex litigation, and regularly advises public and private entities on how best to support the needs of intersex youth, while working to bring an end to unnecessary and unwanted childhood surgeries. For more information, please visit www.interactadvocates.org