Anti-trans legislation makes it legal to conduct unnecessary surgery on intersex children.
On March 30, 2022, SB AZ 1138, one of the many legislation preventing trans children from accessing healthcare, was signed into law by Arizona Governor Doug Ducey. While this law, makes it illegal for minors to have gender reassignment surgery, there is an exception made for those who have a “sex development disorder including an individual with external biological sex characteristics that are irresolvably ambiguous.” A more preferred term over “sex development disorder” is intersex. Rather than operating out of a medical necessity, this legislation in Arizona and other legislation in several states, allows medical providers to operate on intersex children for the sole purpose of fitting them into the sex binary by assigning them male or female. It has been proved that sex is non-binary and that this surgery is harmful on both a physical and emotional level.
“Intersex is an umbrella term for differences in sex traits or reproductive anatomy” defined by InterACT, an intersex youth advocate organization. “There are many possible differences in genitalia, hormones, internal anatomy, or chromosomes, compared to the usual two ways that human bodies develop.” Intersex people are the “I” in LGBTQIA.
It is difficult to know exactly how many people are intersex but it is more common than many believe. “Around 1.7% of the population is born with intersex traits,” according to an Amnesty International article debunking intersex myths.
Intersex people were historically called hermaphrodites but this term is now considered a slur. “Sex development disorder” is also frowned upon because the word “disorder” implies that there is something wrong.
“Intersex is an umbrella term for differences in sex traits or reproductive anatomy”
InterACT, Intersex youth advocate organization
The non-profit organization, Freedom for All Americans, tracks anti-LGBTQ+ bills across the United States. There are anti-trans healthcare bills being considered in Alabama, Kentucky, Missouri, Idaho, and Louisiana that have a direct effect on intersex people. “What many don’t realize is that in the rush to control transgender minors’ bodies, many of these bills also include specific exemptions allowing ‘corrective’ procedures on intersex traits,” according to an article on InterACT about how this legislation affects intersex children.
“SB 1138 is harmful because it denies young people their autonomy and discriminatorily limits their ability to make intensely personal decisions about what is right for their own bodies and lives,” said Sylvan Fraser, the Senior Staff Attorney at InterACT.
Since these bills prohibit “gender reassignment surgery” and they do not consider intersex surgery also known as “gender normalizing surgery” to be “gender reassignment surgery,” “gender normalizing surgeries” and “treatments” are permitted.
Even though intersex activists disagree, These bills like IDHO675 do not consider intersex surgeries to be mutilation.
Some of these bills are also known under names that imply they “protect children” like, “Missouri Save Adolescents from Experimentation (SAFE) Act” and “Alabama Vulnerable Child Compassion and Protection Act (V-CAP).”
According to InterACT, intersex surgeries are “non-life saving” and occur without the child’s consent. These surgeries usually occur when the child is an infant. Doctors pressure parents of intersex children to have the surgeries done.
“Intersex surgeries include ‘reducing’ or ‘repositioning’ a clitoris (sometimes called clitoroplasty, or clitoral reduction or recession), creating or altering a vagina (vaginoplasty) moving a urethra that already works (hypospadias repair), and removing the organs that would make sex hormones (gonadectomy),” according to InterACT’s FAQ page.
Hypospadias can create a lot of scar tissue in the urinary tract which can lead to these children to develop constant UTIs, according to physician and intersex person Dr. Michael Kreuzer.
These surgeries can also result in intersex people experiencing pain and loss of sexual pleasure.
Intersex surgeries are “non-life saving” and occur without the child’s consent.
“One of the myths about the Hermaphrodite is that these people are sterile, which is not true,” Kreuzer said. “When you remove sex organs that produce sex hormones from children you do two things: you make them dependent on sex hormones for the rest of their lives and you sterilize them.”
“Interventions imposed on intersex children are driven by risky assumptions about what a child may experience or desire later rather than giving the individual the opportunity to articulate their experiences and needs for themselves,” Fraser said. “As such, preemptive surgery may make other people more comfortable with the child’s body, but often leaves the individual feeling more alienated from their own body due to the inherent violation of autonomy and self-determination.”
It is very common for intersex people to not realize they are intersex until later in life.
Though Ruth always questioned why she had so many surgeries as a child, she did not know she was intersex until she stole her medical records after having another surgery due to hemorrhaging during sexual activity, according to a report about intersex people on Human Rights Watch.
“The core rationale of unnecessary surgeries on intersex children is to make their bodies conform to typical notions of ‘male’ or ‘female’ — essentially, to try to make them match stereotypes about what a boy or girl’s body is ‘supposed’ to look like, and how boys or girls are (or aren’t) ‘supposed’ to behave,” Fraser said
The sex binary includes the belief that there are only two possible sets of chromosomes XX and XY. This is false because there are a variety of combinations our chromosomes can have like XXY also known as Klinefelter Syndrome, according to InterACT’s FAQ page.
However, someone can have XY chromosomes and still fall outside the sex binary. “Someone with Androgen Insensitivity Syndrome, has XY chromosomes, internal testes, no uterus, and no ovaries,” Kreuzer said
These surgeries reinforce gender roles and heteronormativity. Many intersex children are assigned female and “corrected” as female because it is easier to “construct a hole than a pole, according to Kreuzer. They rather “turn” the child into a girl and cut off the penis than have a penis that is too small for heterosexual sex and is not “manly enough.”
“The core rationale of unnecessary surgeries on intersex children is to make their bodies conform to typical notions of ‘male’ or ‘female’ — essentially, to try to make them match stereotypes about what a boy or girl’s body is ‘supposed’ to look like, and how boys or girls are (or aren’t) ‘supposed’ to behave,”
SYLVAN Fraser, Senior Staff Attorney InterACT
Thus, because there is such an emphasis on assuming these children will grow up to be heterosexual, their bodies have to be constructed to prepare them for heterosexual sex. These surgeries have no consideration for a child who might grow up to be non-heterosexual and/or have non-heterosexual sexual experiences, according to Fraser.
“Attempting to force intersex children to live cisgender, heterosexual lives through non-consensual surgery is essentially another form of conversion therapy,” Fraser said.
The reason why our society is so obsessed with the sex binary is because it would invalidate our ideas about sexual orientation and gender norms.
“How can you be a hetero or homo intersex person if you are not a man or woman? How can you be gender conforming if you are an intersex person? What would your gender identity be? Are you cis, intersex, trans?” Kreuzer said. “It doesn’t work it, it all falls apart the moment intersex comes in the mix as a group of people who are neither men or women technically speaking.”
However some parents fight back by not letting doctors operate on their children. Kreuzer did not have the surgery because their father is Navajo and in the Navajo tradition the sex binary. does not exist. Rosie Lohman was born intersex, with Congenital Adrenal Hyperplasia (CAH) and her parents Stephani and Eric Lohman did not let Rosie get operated on even though they were pressured from their daughter’s doctor and the CAH organization CARES Foundation, according to their book Raising Rosie: Our Story of Parenting an Intersex Child. The book was written to help other parents of intersex children learn about the other options they have and to give them information that was hidden from them.
Consent is key for intersex activists. The surgeries should be available for those who want it but are the age when they can choose what they want, according to Kreuzer.
“How can you be a hetero or homo intersex person if you are not a man or woman? How can you be gender conforming if you are an intersex person? What would your gender identity be? Are you cis, intersex, trans?”
Dr. Michael Kreuzer, Intersex Person and Activist
To intersex activists it is important for intersex people and trans people to fight against this kind of legislation together. “Intersex people deserve to have autonomy over their own bodies, just like transgender people deserve, and these bills make a point of taking that away from both communities at once,” Fraser said.
“What InterACT hopes to accomplish is to help build a world where intersex people are valued rather than stigmatized for their natural differences, and where bodily autonomy is safeguarded,” Fraser said. “So that intersex people can be in charge of the decisions that will have permanent effects on their physical, psychological, sexual, and reproductive health.”